Evaluation of the Prognostic Value of Preoperative Quadriceps and Respiratory Muscle Thickness by Ultrasound Measurement in Cardiac and Thoracic Surgery Patients (MUSCA)

Evaluation of the Prognostic Value of Preoperative Quadriceps and Respiratory Muscle Thickness by Ultrasound Measurement in Cardiac and Thoracic Surgery Patients: a Prospective Observational Study

Cardiac and thoracic surgery are major procedures. In order to estimate the operative risk, many scores have been developed, including the Euroscore 2 in cardiac surgery. However, the Euroscore has limitations since it does not assess all the parameters that may influence postoperative complications, such as the patient's general condition or the status of his or her functional reserves.

However, it has been shown that the preoperative functional reserves have a significant impact on the patient's risk of developing postoperative complications following major surgery. In addition, there is a strong association between cardiac failure and a well-described decrease in peripheral muscle lean mass (sarcopenia) in patients older than 65 years.

Usually, a nutritional assessment is performed during the pre-anesthesia consultation. This assessment is based on clinical and biological criteria that are not totally predictive of the patient's functional reserve status.

Lean body mass (muscle) is a well-validated marker for the assessment of patients' functional reserves. However, the techniques used to date are complex and require radiation.

This study aims to use ultrasound of muscle groups (respiratory muscles - Quadriceps muscle - Diaphragm) to study the relationship between preoperative muscle mass and postoperative complications in patients over 65 years of age undergoing cardiac or thoracic surgery.

This is a prospective observational study to be conducted at the Dijon University Hospital by the cardiovascular anesthesia-intensive care department. A total of 300 patients will participate in this study, and we have planned to complete the project over a 2-year period. The participating patients (if they do not present any exclusion criteria and are not opposed to inclusion) will be included and undergo a muscle ultrasound in the cardiovascular surgery department or the thoracic and pulmonary surgery department the day before their intervention.

Study Overview

• Status: Completed
• Conditions: Thoracic Surgery; Cardiac Surgery With Extracorporeal Circulation
• Intervention / Treatment: Other: Ultrasound of the abdominal wall muscles; Other: Ultrasound quadricipital; Other: Ultrasound of the diaphragm; Other: Ultrasound of the inter-costal muscles; Other: Ultrasound of the inter-costal muscles

• Study Type: Observational
• Enrollment (Actual): 301

Contacts and Locations

Study Locations

• France
  • Dijon, France, 21000
    • Chu Dijon Bourgogne

Participation Criteria

Eligibility Criteria

• Ages Eligible for Study: 65 years and older (Older Adult)
• Accepts Healthy Volunteers: Yes

• Sampling Method: Non-Probability Sample

Study Population

Patient requiring cardiac or thoracic surgery

Description

Inclusion Criteria:

• Patient 65 years or older
• Patients who have not objected to their inclusion in the study
• Any patient requiring elective cardiac surgery, with extracorporeal circulation extracorporeal circulation OR
• Any patient requiring lung surgery with resection of at least one lobe

Exclusion Criteria:

• pneumectomy
• Person who is not affiliated to national health insurance
• Person subject to a measure of legal protection (curatorship, guardianship)
• Pregnant, parturient or breastfeeding women
• Major unable to express consent
• Persons with amputations of the proximal segment of a lower limb
• Persons suffering from a pre-existing neuromuscular pathology, tetra or paraplegia
• Person who must undergo emergency surgery

Study Plan

How is the study designed?

Number of groups / cohorts

2

Cohorts and Interventions

Group / Cohort	Intervention / Treatment
Cardiology patient; Patient requiring cardiac surgery with bypass	Other: Ultrasound of the abdominal wall muscles; the measurements will be performed during inspiration and expiration to take into account variability during the respiratory cycle. The examination is performed bilaterally and comparatively and lasts between 3 and 5 minutes.; Other: Ultrasound quadricipital; The examination is performed bilaterally and comparatively and takes between 3 and 5 minutes.; Other: Ultrasound of the diaphragm; The examination is performed bilaterally and comparatively and takes between 5 and 10 minutes.; Other: Ultrasound of the inter-costal muscles; measurements performed bilaterally on a patient in a half-sitting position at 45° and in spontaneous ventilation; Other: Ultrasound of the inter-costal muscles; In spontaneous ventilation, lying down, arms by the side of the body, palms up, head down
Pneumology patient; Patient requiring lung surgery with resection of at least one lobe	Other: Ultrasound of the abdominal wall muscles; the measurements will be performed during inspiration and expiration to take into account variability during the respiratory cycle. The examination is performed bilaterally and comparatively and lasts between 3 and 5 minutes.; Other: Ultrasound quadricipital; The examination is performed bilaterally and comparatively and takes between 3 and 5 minutes.; Other: Ultrasound of the diaphragm; The examination is performed bilaterally and comparatively and takes between 5 and 10 minutes.; Other: Ultrasound of the inter-costal muscles; measurements performed bilaterally on a patient in a half-sitting position at 45° and in spontaneous ventilation; Other: Ultrasound of the inter-costal muscles; In spontaneous ventilation, lying down, arms by the side of the body, palms up, head down

What is the study measuring?

Primary Outcome Measures

Outcome Measure	Measure Description	Time Frame
Onset of acute renal failure		Within 30 days after surgery
Occurrence of a respiratory complication	Occurrence of acute respiratory failure in cardiac surgery and occurrence of a severe extra-respiratory complication according to the european perioperative clinical outcome definition in pulmonary surgery	Within 30 days after surgery
Occurrence of a cardiovascular complication		Within 30 days after surgery
Occurrence of an infectious complication		Within 30 days after surgery
Death		Within 30 days after surgery

Collaborators and Investigators

• Sponsor: Centre Hospitalier Universitaire Dijon

Publications and helpful links

General Publications

• Berthoud V, Nguyen M, Vinay J, Perrot J, Pages PB, Guinot PG, Bouhemad B. Increase in Diaphragm and Expiratory respiratory muscles thickness is not associated with postoperative pulmonary complications after thoracic surgery: a prospective ultrasound cohort study. Anaesth Crit Care Pain Med. 2025 Nov 12:101683. doi: 10.1016/j.accpm.2025.101683. Online ahead of print.

Study record dates

Study Major Dates

• Study Start (Actual): May 31, 2022
• Primary Completion (Actual): September 26, 2023
• Study Completion (Actual): September 26, 2023

Study Registration Dates

• First Submitted: June 7, 2022
• First Submitted That Met QC Criteria: June 7, 2022
• First Posted (Actual): June 9, 2022

Study Record Updates

• Last Update Posted (Actual): January 29, 2026
• Last Update Submitted That Met QC Criteria: January 28, 2026
• Last Verified: January 1, 2026

More Information

Terms related to this study

• Additional Relevant MeSH Terms: Cardiovascular Diseases; Vascular Diseases; Aneurysm; Aortic Diseases; Dissection, Blood Vessel; Acute Aortic Syndrome; Aortic Dissection
• Other Study ID Numbers: BERTHOUD 2021

Drug and device information, study documents

• Studies a U.S. FDA-regulated drug product: No
• Studies a U.S. FDA-regulated device product: No
• product manufactured in and exported from the U.S.: No