MedStar Authors catalog › Details for: Usefulness of skeletal muscle area detected by computed tomography to predict mortality in patients undergoing transcatheter aortic valve replacement: a meta-analysis study. [Review]
Usefulness of skeletal muscle area detected by computed tomography to predict mortality in patients undergoing transcatheter aortic valve replacement: a meta-analysis study. [Review] Journal: The international journal of cardiovascular imaging. Published: ; 2019 ISSN: 1569-5794. UI/PMID: 30915667. Subject(s): Age Factors | Aged | Aged, 80 and over | Aortic Valve/dg [Diagnostic Imaging] | Aortic Valve/pp [Physiopathology] | *Aortic Valve/su [Surgery] | Aortic Valve Stenosis/dg [Diagnostic Imaging] | Aortic Valve Stenosis/mo [Mortality] | Aortic Valve Stenosis/pp [Physiopathology] | *Aortic Valve Stenosis/su [Surgery] | Female | *Geriatric Assessment/mt [Methods] | Humans | Male | *Muscle, Skeletal/dg [Diagnostic Imaging] | Predictive Value of Tests | Risk Assessment | Risk Factors | *Sarcopenia/dg [Diagnostic Imaging] | Sarcopenia/mo [Mortality] | Time Factors | *Tomography, X-Ray Computed | Transcatheter Aortic Valve Replacement/ae [Adverse Effects] | *Transcatheter Aortic Valve Replacement/mo [Mortality] | Treatment Outcome Institution(s): MedStar Heart & Vascular Institute Activity type: Journal Article. Medline article type(s): Journal Article | Review Digital Object Identifier: https://dx.doi.org/10.1007/s10554-019-01582-0 (Click here) Abbreviated citation: Int J Cardiovasc Imaging. 35(6):1141-1147, 2019 Jun.
Abstract: Measures of sarcopenia, such as low muscle mass measured from the readily available preoperative computed tomography (CT) images, have been recently suggested as a predictor of outcomes in patients undergoing transcatheter aortic valve replacement (TAVR). However, results of these studies are variable and, therefore, we performed a systematic review of current literature to evaluate sarcopenia as a predictor of outcome post TAVR. The search was carried out in electronic databases between 2008 and 2018. We identified studies that reported CT-derived skeletal muscle area (SMA) and survival outcomes post TAVR. Studies were evaluated for the incidence of early (<= 30 days) and late all-cause mortality (> 30 days) post TAVR. Eight studies with 1881 patients were included (mean age of 81.8 years +/- 12, 55.9% men). Mean body mass index was (28.2 kg/m<sup>2</sup> +/- 1.1), mean Society of Thoracic Surgeons risk score (7.0 +/- 0.6), and mean albumin level was (3.8 g/dL +/- 0.1). Higher SMA was associated with lower long-term mortality [odds ratio (OR) 0.49, 95% confidence interval (CI) 0.28-0.83, p = 0.049], compared with low SMA. Also, higher SMA was associated with lower early mortality but was not statistically significant (OR 0.72; 95% CI 0.44-1.18; p = 0.285). CT-derived SMA provides value in predicting post-TAVR long-term outcomes for patients undergoing TAVR. This is a simple risk assessment tool that may help in making treatment decisions and help identifying and targeting high-risk patients with interventions to improve muscle mass prior to and following the procedures.