CT determined psoas muscle area predicts mortality in women undergoing transcatheter aortic valve implantation.

Autor: van Mourik MS; Amsterdam UMC, University of Amsterdam, AMC Heartcenter, Amsterdam Cardiovascular Sciences, Amsterdam, The Netherlands., Janmaat YC; ACHIEVE - Centre of Applied Research, Amsterdam University of Applied Sciences, Amsterdam, The Netherlands., van Kesteren F; Amsterdam UMC, University of Amsterdam, AMC Heartcenter, Amsterdam Cardiovascular Sciences, Amsterdam, The Netherlands.; Amsterdam UMC, University of Amsterdam, Department of Radiology, Amsterdam, The Netherlands., Vendrik J; Amsterdam UMC, University of Amsterdam, AMC Heartcenter, Amsterdam Cardiovascular Sciences, Amsterdam, The Netherlands., Planken RN; Amsterdam UMC, University of Amsterdam, Department of Radiology, Amsterdam, The Netherlands., Henstra MJ; Amsterdam UMC, University of Amsterdam, Department of Geriatrics, Amsterdam, The Netherlands., Velu JF; Amsterdam UMC, University of Amsterdam, AMC Heartcenter, Amsterdam Cardiovascular Sciences, Amsterdam, The Netherlands., Vlastra W; Amsterdam UMC, University of Amsterdam, AMC Heartcenter, Amsterdam Cardiovascular Sciences, Amsterdam, The Netherlands., Zwinderman AH; Department of Clinical Epidemiology, Biostatistics and Bioinformatics, University of Amsterdam, Amsterdam, The Netherlands., Koch KT; Amsterdam UMC, University of Amsterdam, AMC Heartcenter, Amsterdam Cardiovascular Sciences, Amsterdam, The Netherlands., de Winter RJ; Amsterdam UMC, University of Amsterdam, AMC Heartcenter, Amsterdam Cardiovascular Sciences, Amsterdam, The Netherlands., Wykrzykowska JJ; Amsterdam UMC, University of Amsterdam, AMC Heartcenter, Amsterdam Cardiovascular Sciences, Amsterdam, The Netherlands., Piek JJ; Amsterdam UMC, University of Amsterdam, AMC Heartcenter, Amsterdam Cardiovascular Sciences, Amsterdam, The Netherlands., Henriques JPS; Amsterdam UMC, University of Amsterdam, AMC Heartcenter, Amsterdam Cardiovascular Sciences, Amsterdam, The Netherlands., Lanting VR; Amsterdam UMC, University of Amsterdam, AMC Heartcenter, Amsterdam Cardiovascular Sciences, Amsterdam, The Netherlands., Baan J Jr; Amsterdam UMC, University of Amsterdam, AMC Heartcenter, Amsterdam Cardiovascular Sciences, Amsterdam, The Netherlands., Latour C; ACHIEVE - Centre of Applied Research, Amsterdam University of Applied Sciences, Amsterdam, The Netherlands., Lindeboom R; Department of Clinical Epidemiology, Biostatistics and Bioinformatics, University of Amsterdam, Amsterdam, The Netherlands., Vis MM; Amsterdam UMC, University of Amsterdam, AMC Heartcenter, Amsterdam Cardiovascular Sciences, Amsterdam, The Netherlands.
Jazyk: angličtina
Zdroj: Catheterization and cardiovascular interventions : official journal of the Society for Cardiac Angiography & Interventions [Catheter Cardiovasc Interv] 2019 Mar 01; Vol. 93 (4), pp. E248-E254. Date of Electronic Publication: 2018 Sep 12.
DOI: 10.1002/ccd.27823
Abstrakt: Objectives: The aim of this study was to assess the predictive value of PMA measurement for mortality.
Background: Current surgical risk stratification have limited predictive value in the transcatheter aortic valve implantation (TAVI) population. In TAVI workup, a CT scan is routinely performed but body composition is not analyzed. Psoas muscle area (PMA) reflects a patient's global muscle mass and accordingly PMA might serve as a quantifiable frailty measure.
Methods: Multi-slice computed tomography scans (between 2010 and 2016) of 583 consecutive TAVI patients were reviewed. Patients were divided into equal sex-specific tertiles (low, mid, and high) according to an indexed PMA. Hazard ratios (HR) and their confidence intervals (CI) were determined for cardiac and all-cause mortality after TAVI.
Results: Low iPMA was associated with cardiac and all-cause mortality in females. One-year adjusted cardiac mortality HR in females for mid-iPMA and high-iPMA were 0.14 [95%CI, 0.05-0.45] and 0.40 [95%CI, 0.15-0.97], respectively. Similar effects were observed for 30-day and 2-years cardiac and all-cause mortality. In females, adding iPMA to surgical risk scores improved the predictive value for 1-year mortality. C-statistics changed from 0.63 [CI = 0.54-0.73] to 0.67 [CI: 0.58-0.75] for EuroSCORE II and from 0.67 [CI: 0.59-0.77] to 0.72 [CI: 0.63-0.80] for STS-PROM.
Conclusions: Particularly in females, low iPMA is independently associated with an higher all-cause and cardiac mortality. Prospective studies should confirm whether PMA or other body composition parameters should be extracted automatically from CT-scans to include in clinical decision making and outcome prediction for TAVI.
(© 2018 The Authors. Catheterization and Cardiovascular Interventions published by Wiley Periodicals, Inc.)
Databáze: MEDLINE
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