title: Prognostic Value of Fat Mass and Skeletal Muscle Mass Determined by Computed Tomography in Patients Who Underwent Transcatheter Aortic Valve Implantation.
abstract: Body composition (fat mass [FM] and skeletal muscle mass [SMM]) predicts clinical outcomes. In particular, loss of SMM (sarcopenia) is associated with frailty and mortality. There are no data on the prevalence and impact of FM and SMM in patients undergoing transcatheter aortic valve implantation (TAVI). The objective of this study is to determine body composition from pre-TAVI computed tomography (CT) and evaluate its association with clinical outcomes in patients who underwent TAVI. A total of 460 patients (mean age 81 ± 8 years, men: 51%) were included. Pre-TAVI CTs of the aorto-ilio-femoral axis were analyzed for FM and SMM cross-sectional area at the level of the third lumbar vertebrae (L3). Regression equations correlating cross-sectional area at L3 to total body FM and SMM were used to determine prevalence of sarcopenia, obesity, and sarcopenic obesity in patients (64%, 65%, and 46%, respectively). Most TAVI procedures were performed through a transfemoral approach (59%) using a balloon-expandable valve (94%). The 30-day and mid-term (median 12 months [interquartile range 6 to 27]) mortality rates were 6.1% and 29.6%, respectively. FM had no association with clinical outcomes, but sarcopenia predicted cumulative mortality (hazard ratio 1.55, 95% confidence interval 1.02 to 2.36, p = 0.04). In conclusion, body composition analysis from pre-TAVI CT is feasible. Sarcopenia, obesity, and sarcopenic obesity are prevalent in the TAVI population, with sarcopenia predictive of cumulative mortality.
authors.affiliation: Quebec Heart and Lung Institute, Quebec City, Quebec, Canada.
authors.forename: Michael
authors.initials: M
authors.lastname: Mok
authors.affiliation: Quebec Heart and Lung Institute, Quebec City, Quebec, Canada.
authors.forename: Ricardo
authors.initials: R
authors.lastname: Allende
authors.affiliation: St. Paul's Hospital, Vancouver, British Columbia, Canada.
authors.forename: Jonathon
authors.initials: J
authors.lastname: Leipsic
authors.affiliation: Quebec Heart and Lung Institute, Quebec City, Quebec, Canada.
authors.forename: Omar Abdul-Jawad
authors.initials: OA
authors.lastname: Altisent
authors.affiliation: Quebec Heart and Lung Institute, Quebec City, Quebec, Canada.
authors.forename: Maria
authors.initials: M
authors.lastname: Del Trigo
authors.affiliation: Quebec Heart and Lung Institute, Quebec City, Quebec, Canada.
authors.forename: Francisco
authors.initials: F
authors.lastname: Campelo-Parada
authors.affiliation: Quebec Heart and Lung Institute, Quebec City, Quebec, Canada.
authors.forename: Robert
authors.initials: R
authors.lastname: DeLarochellière
authors.affiliation: Quebec Heart and Lung Institute, Quebec City, Quebec, Canada.
authors.forename: Eric
authors.initials: E
authors.lastname: Dumont
authors.affiliation: Quebec Heart and Lung Institute, Quebec City, Quebec, Canada.
authors.forename: Daniel
authors.initials: D
authors.lastname: Doyle
authors.affiliation: Quebec Heart and Lung Institute, Quebec City, Quebec, Canada.
authors.forename: Mélanie
authors.initials: M
authors.lastname: Côté
authors.affiliation: St. Paul's Hospital, Vancouver, British Columbia, Canada.
authors.forename: Melanie
authors.initials: M
authors.lastname: Freeman
authors.affiliation: St. Paul's Hospital, Vancouver, British Columbia, Canada.
authors.forename: John
authors.initials: J
authors.lastname: Webb
authors.affiliation: Quebec Heart and Lung Institute, Quebec City, Quebec, Canada. Electronic address: josep.rodes@criucpq.ulaval.ca.
authors.forename: Josep
authors.initials: J
authors.lastname: Rodés-Cabau
mesh_terms: D000273:Adipose Tissue / Q000000981:diagnostic imaging*; D000369:Aged, 80 and over; D001021:Aortic Valve / Q000601:surgery*; D001024:Aortic Valve Stenosis / Q000150:complications / Q000000981:diagnostic imaging / Q000601:surgery*; D001823:Body Composition; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008297:Male; D018482:Muscle, Skeletal / Q000000981:diagnostic imaging*; D011379:Prognosis; D012189:Retrospective Studies; D012307:Risk Factors; D055948:Sarcopenia / Q000150:complications / Q000000981:diagnostic imaging*; D014057:Tomography, X-Ray Computed / Q000379:methods*; D065467:Transcatheter Aortic Valve Replacement; D016896:Treatment Outcome