Changes in muscle strength and muscle mass after transcatheter aortic valve implantation (TAVI)

Autor: D Van Erck, C D Dolman, W J M Scholte Op Reimer, J P Henriques, P J M Weijs, J D Schoufour, R Delewi
Rok vydání: 2023
Předmět:
Zdroj: European Journal of Preventive Cardiology. 30
ISSN: 2047-4881
2047-4873
DOI: 10.1093/eurjpc/zwad125.031
Popis: Funding Acknowledgements Type of funding sources: Public hospital(s). Main funding source(s): Amsterdam UMC. Background Maintenance of muscle strength and muscle mass is important for long-term health. Periods of physical inactivity and poor dietary intake (e.g. waiting for a medical procedure) can provoke loss of muscle strength and muscle mass. Purpose We aim to determine the course of muscle strength and muscle mass in patients with severe aortic stenosis from before until six months after an elective transcatheter aortic valve implantation (TAVI). Moreover, we aim to explore baseline characteristics associated with change. Methods All patients undergoing an elective TAVI in our high-volume tertiary center were asked to participate. Included patients received three home visits (pre-procedural and 30 days and 6 months post-procedural). During these home visits, handgrip strength was measured with a handheld dynamometer. Muscle mass was determined as skeletal muscle index with a bioelectrical impedance (BIA) measurement. Multivariate mixed linear models were used to determine changes over time. A linear model adjusted for age and sex was performed to explore baseline characteristics associated with changes in muscle strength or muscle mass. Results In total 112 patients were included, mean age of the participants was 81 ± 5 years and 58% were male. The preprocedural measurement took place on a median of 48 [IQR: 19 – 79] days before the TAVI. Preprocedural handgrip strength was on average 36 kg for male and 24 kg for female patients and decreased after the TAVI (-0.12 [95% CI: -0.21, -0.02] kg/month, p=0.02). Living alone and lower hemoglobin level were predictive for a higher decrease in strength (β -2.20 [95% CI: -3.98, -0.42], p=0.02 and β 0.14 [95% CI: 0.02, 0.27] per mmol/l, p=0.03, respectively). Appendicular skeletal muscle index was 7.2 kg/m2 for males and 6.1 kg/m2 for females and did not change after TAVI (0.00 [95%CI: -0.01, 0.01] kg/m2/month, p=0.95). No baseline characteristics were associated with a change in muscle mass. Conclusion Muscle strength significantly declines and muscle mass remains the same from before until six months after the TAVI procedure. Patients living alone or patients with low hemoglobin levels are at increased risk to lose muscle strength. Future studies should focus on the prevention of strength loss, for instance with interventions focusing on nutrition and exercise around the TAVI procedure.
Databáze: OpenAIRE
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