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Computed tomography-based fat and muscle characteristics are associated with mortality after transcatheter aortic valve replacement
- Source :
- Journal of cardiovascular computed tomography. 12(3)
- Publication Year :
- 2017
-
Abstract
- Background Computed tomography (CT)-based fat and muscle measures are associated with outcome in large populations. We tested if muscle and fat characteristics are associated with long-term outcomes after TAVR. Methods We included 403 clinical CTs performed prior to TAVR at our center between 2008 and 2016, measuring area (cm2) and density (Hounsfield units, HU) of both psoas muscles (PM), subcutaneous adipose (SAT), and visceral adipose tissue (VAT). Area measures were indexed to height, log-transformed and both area and density were standardized for analysis. We assessed the association of each measure with all-cause mortality (adjusted for age, sex, body mass index (BMI), and the Society of Thoracic Surgeons (STS) risk score. Results Of the 403 individuals (83 ± 8 years; 52% female), 167 (41.4%) died during a median follow-up of 458 days (interquartile range IQR 297–840). Fat measures were feasible and rapid. Fat area was available in 242 (60%) patients with an adequate field of view. Individuals with the lowest PM area, SAT area or VAT area exhibited the highest hazard of mortality. In addition, greater SAT density was associated with a higher mortality hazard (adjusted HR per standard deviation increase in density = 1.35, 95%CI 1.10–1.67, P = 0.005). Conclusion Rapid CT-based tissue characterization is feasible in patients referred for TAVR. Decreased PM area and increased SAT density are associated with long-term mortality after TAVR, even after accounting for age, sex, BMI, and STS score. Further studies are necessary to interrogate sex-specific relationships between CT tissue metrics and mortality and whether CT measures are incremental to well-established frailty metrics.
- Subjects :
- Male
medicine.medical_specialty
Time Factors
Intra-Abdominal Fat
Health Status
Subcutaneous Fat
Adipose tissue
030204 cardiovascular system & hematology
Risk Assessment
Body Mass Index
Transcatheter Aortic Valve Replacement
03 medical and health sciences
0302 clinical medicine
Interquartile range
Predictive Value of Tests
Risk Factors
Hounsfield scale
Internal medicine
Multidetector Computed Tomography
medicine
Humans
Radiology, Nuclear Medicine and imaging
030212 general & internal medicine
Obesity
Adiposity
Aged
Psoas Muscles
Retrospective Studies
Aged, 80 and over
Framingham Risk Score
business.industry
Aortic Valve Stenosis
medicine.disease
Treatment Outcome
Predictive value of tests
Aortic valve stenosis
Cardiology
Female
Cardiology and Cardiovascular Medicine
business
Body mass index
Boston
Subjects
Details
- ISSN :
- 1876861X
- Volume :
- 12
- Issue :
- 3
- Database :
- OpenAIRE
- Journal :
- Journal of cardiovascular computed tomography
- Accession number :
- edsair.doi.dedup.....70541c23e1ce2ca753bd1e280916d6f3