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Erschienen in: The International Journal of Cardiovascular Imaging 5/2020

10.02.2020 | Original Paper

Importance of combined assessment of skeletal muscle mass and density by computed tomography in predicting clinical outcomes after transcatheter aortic valve replacement

verfasst von: Takahiro Tokuda, Masanori Yamamoto, Ai Kagase, Yutaka Koyama, Toshiaki Otsuka, Norio Tada, Toru Naganuma, Motoharu Araki, Futoshi Yamanaka, Shinichi Shirai, Kazuki Mizutani, Minoru Tabata, Hiroshi Ueno, Kensuke Takagi, Akihiro Higashimori, Yusuke Watanabe, Kentaro Hayashida, the OCEAN-TAVI Investigators

Erschienen in: The International Journal of Cardiovascular Imaging | Ausgabe 5/2020

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Abstract

Skeletal muscle mass (SMM) as calculated by computed tomography (CT) is a predictor of all-cause mortality after transcatheter aortic valve replacement (TAVR), but it remains unclear whether using CT-determined density of skeletal muscle has additive prognostic value. We utilized the Japanese multicenter registry data of 1375 patients who underwent CT prior to TAVR. Sarcopenia status was defined by the CT-derived SMM index (threshold: men, 55.4 cm2/m2; women, 38.9 cm2/m2). The threshold for high and low CT density was based on the median value of the entire cohort (men: 33.4 HU; women: 29.5 HU). Sarcopenia was observed in 802 patients (58.3%) overall. Patients were categorized into non-sarcopenia and high-CT density (n = 298), non-sarcopenia and low-CT density (n = 275), sarcopenia and high-CT density (n = 399), and sarcopenia and low-CT density (n = 403) groups, and procedural outcomes and mortality compared. The cumulative 3-year mortality rates in these groups were 18%, 27%, 24%, and 32%, respectively. Cox-regression multivariate analysis revealed that low-CT density (compared with high-CT density) and sarcopenia and low-CT density (compared with non-sarcopenia and high-CT density as reference) increased mortality after TAVR (hazard ratios [HR]: 1.35 and 1.43, 95% confidence intervals [Cis]: 1.06–1.72 and 1.00–2.08, p = 0.01, and 0.049, respectively). However, sarcopenia alone was not related to an increased risk of mortality (HR 1.30, 95% CI 0.99–1.69, p = 0.52). In conclusion, CT density-based skeletal muscle quality assessment combined with the SMM index improves prediction of adverse outcomes after TAVR.
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Metadaten
Titel
Importance of combined assessment of skeletal muscle mass and density by computed tomography in predicting clinical outcomes after transcatheter aortic valve replacement
verfasst von
Takahiro Tokuda
Masanori Yamamoto
Ai Kagase
Yutaka Koyama
Toshiaki Otsuka
Norio Tada
Toru Naganuma
Motoharu Araki
Futoshi Yamanaka
Shinichi Shirai
Kazuki Mizutani
Minoru Tabata
Hiroshi Ueno
Kensuke Takagi
Akihiro Higashimori
Yusuke Watanabe
Kentaro Hayashida
the OCEAN-TAVI Investigators
Publikationsdatum
10.02.2020
Verlag
Springer Netherlands
Erschienen in
The International Journal of Cardiovascular Imaging / Ausgabe 5/2020
Print ISSN: 1569-5794
Elektronische ISSN: 1875-8312
DOI
https://doi.org/10.1007/s10554-020-01776-x

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