Usefulness of skeletal muscle area detected by computed tomography to predict mortality in patients undergoing transcatheter aortic valve replacement: a meta-analysis study

Mohamad Soud, Fares Alahdab, Gavin Ho, Kayode O. Kuku, Marco Cejudo-Tejeda, Alexandre Hideo-Kajita, Pedro de Araujo Gonçalves, Rui Campante Teles, Ron Waksman, Hector M. Garcia-Garcia

Research output: Contribution to journalReview article

6 Citations (Scopus)

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 2 ± 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.

Original languageEnglish
Pages (from-to)1141-1147
JournalInternational Journal of Cardiovascular Imaging
Volume35
Issue number6
DOIs
Publication statusPublished - Jun 2019

Keywords

  • Computed tomography
  • Frailty
  • Mortality
  • Skeletal muscle area
  • Transcatheter aortic valve replacement

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