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

Mourik, Martijn S. van; Janmaat, Yvonne C.; Kesteren, Floortje van; Vendrik, Jeroen; Planken, R. Nils; Henstra, Marieke; Velu, Juliëtte F.; Vlastra, Wieneke; Zwinderman, Aeilko H.; Koch, Karel T.; Winter, Robbert J. de; Wykrzykowska, Joanna J.; Piek, Jan J.; Henriques, José P.S.; Lanting, V. R.; Baan, Jan; Latour, Corine; Lindeboom, Robert; Vis, Marije M.

doi:10.1002/ccd.27823

Cited by 19 publications

(24 citation statements)

References 25 publications

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Section: Resultsmentioning

confidence: 99%

“…Psoas muscle area index (PMAi) was investigated in only n = 2 prospective studies [ 56 , 57 ] with conflicting evidence for short-term mortality. Kofler et al [ 56 ] found that higher PMAi values were predictive of a lower relative risk of mortality, whereas van Mourik et al [ 57 ] stated no association between PMAi and death rates. Long-term mortality was investigated in n = 5 prospective [ 25 , 56 , 57 , 58 , 60 ] (2172 patients) and n = 3 retrospective [ 44 , 45 , 59 ] (2515 patients) studies.…”

Section: Resultsmentioning

confidence: 99%

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The Pandora’s Box of Frailty Assessments: Which Is the Best for Clinical Purposes in TAVI Patients? A Critical Review

Baritello

Salzwedel

Sündermann

et al. 2021

JCM

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Frailty assessment is recommended before elective transcatheter aortic valve implantation (TAVI) to determine post-interventional prognosis. Several studies have investigated frailty in TAVI-patients using numerous assessments; however, it remains unclear which is the most appropriate tool for clinical practice. Therefore, we evaluate which frailty assessment is mainly used and meaningful for ≤30-day and ≥1-year prognosis in TAVI patients. Randomized controlled or observational studies (prospective/retrospective) investigating all-cause mortality in older (≥70 years) TAVI patients were identified (PubMed; May 2020). In total, 79 studies investigating frailty with 49 different assessments were included. As single markers of frailty, mostly gait speed (23 studies) and serum albumin (16 studies) were used. Higher risk of 1-year mortality was predicted by slower gait speed (highest Hazard Ratios (HR): 14.71; 95% confidence interval (CI) 6.50–33.30) and lower serum albumin level (highest HR: 3.12; 95% CI 1.80–5.42). Composite indices (five items; seven studies) were associated with 30-day (highest Odds Ratio (OR): 15.30; 95% CI 2.71–86.10) and 1-year mortality (highest OR: 2.75; 95% CI 1.55–4.87). In conclusion, single markers of frailty, in particular gait speed, were widely used to predict 1-year mortality. Composite indices were appropriate, as well as a comprehensive assessment of frailty.

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Section: Resultsmentioning

confidence: 99%

Section: Resultsmentioning

confidence: 99%

The Pandora’s Box of Frailty Assessments: Which Is the Best for Clinical Purposes in TAVI Patients? A Critical Review

Baritello

Salzwedel

Sündermann

et al. 2021

JCM

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“…Although several studies have now described the relationship between psoas sarcopenia and poor outcomes following TAVR, this association between psoas muscle and the outcome after TAVR is not straightforward [38][39][40]. Mamane et al identified a correlation between the psoas muscle area and 6-month mortality in female patients only [33] in a relatively small cohort, and another study by van Mourik et al showed similar findings [39]. e use of sarcopenia of the psoas muscles as a surrogate for overall frailty has also been well-described in other patient groups Figure 1: Cross-sectional psoas and vertebral body areas derived from an axial CT image at the level of L4, using a freehand region-ofinterest tool (green outlines).…”

Section: Discussionmentioning

confidence: 99%

The Utility of Psoas Muscle Assessment in Predicting Frailty in Patients Undergoing Transcatheter Aortic Valve Replacement

Koizia

Naik

Peck

et al. 2020

Current Gerontology and Geriatrics Research

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Background. The rise in an ageing population has resulted in an increase in the prevalence of aortic stenosis. With the advent and rapid expansion in the use of transcatheter aortic valve replacements (TAVRs), patients with severe aortic stenosis, traditionally thought too high risk for surgical intervention, are now being treated with generally favourable results. Frailty is an important factor in determining outcome after a TAVR, and an assessment of frailty is fundamental in the identification of appropriate patients to treat. Objective. The objective of the study was to identify if the psoas muscle area is associated with frailty in TAVR patients and outcome after intervention. Method. In this prospective study, we measured outcomes of 62 patients who underwent TAVR procedures against the psoas muscle area and the Reported Edmonton Frail Scale (REFS). Our aim was to assess if psoas muscle assessment can be used as a simple method to predict frailty in our population group. Results. A total of 60 patients met the study criteria. Mean psoas-lumbar vertebral index was 0.61, with a lower value in the frail group. There was not a statistically significant correlation between the psoas measures, REFS score (indicative of frailty), and mortality. However, there was a statistically significant relationship between the psoas size and REFS score (p=0.043). Conclusion. Psoas assessment can be useful in providing additional information when planning for patients to undergo a TAVR and can be used as a screening tool to help identify frail patients within this high-risk group.

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“…The cross-sectional areas of the PM and ESM were normalized to the BSA, which resulted in the PM index (PMI) and ESM index (ESMI) [2]. BSA was calculated using the Haycock formula:BSA (m 2 ) = weight (kg) 0.5378 × height (cm) 0.3964 × 0.024265…”

Section: Methodsmentioning

confidence: 99%

“…Sarcopenia is characterized by a decrease in the quality and quantity of skeletal muscle mass, which can lead to worsened quality of life and mortality. Low muscle mass has a considerable impact on disease severity and mortality in adults with cardiopulmonary diseases [2]. Moreover, malnutrition and sarcopenia are associated with worse outcomes in pediatric patients with severe chronic illness [3].…”

Section: Introductionmentioning

confidence: 99%

Low Muscle Mass as a Prognostic Factor for Early Postoperative Outcomes in Pediatric Patients Undergoing the Fontan Operation: A Retrospective Cohort Study

Shin

Jeong

et al. 2019

JCM

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The impact of low muscle mass on pediatric cardiac patients remains unclear. We investigated the impact of low muscle mass on early postoperative outcomes in patients undergoing the Fontan operation. The electronic medical records of 74 patients (aged <18 years) who underwent the Fontan operation were retrospectively reviewed. The cross-sectional areas of the erector spinae and pectoralis muscles were measured using preoperative chest computed tomography (CT), normalized to the body surface area, and combined to obtain the total skeletal muscle index (TSMI). Low muscle mass was defined as a TSMI value lower than the median TSMI for the second quintile. The incidence of major postoperative complications was higher in patients with low muscle mass than in those with high muscle mass (48% (15/31) versus 14% (6/43); P = 0.003). Multivariable analyses revealed that a higher TSMI was associated with a lower likelihood of an increased duration of intensive care unit (>5 days) and hospital stay (>14 days) (odds ratio (OR) 0.86; 95% confidence interval (CI) 0.77–0.96; P = 0.006 and OR 0.92; 95% CI 0.85–0.99; P = 0.035 per 1 cm2/m2 increase in TSMI) and incidence of major postoperative complications (OR 0.90; 95% CI 0.82–0.99; P = 0.039 per 1 cm2/m2 increase in TSMI). Preoperative low muscle mass was associated with poor early postoperative outcomes in pediatric patients undergoing the Fontan operation.

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

Cited by 19 publications

References 25 publications

The Pandora’s Box of Frailty Assessments: Which Is the Best for Clinical Purposes in TAVI Patients? A Critical Review

The Pandora’s Box of Frailty Assessments: Which Is the Best for Clinical Purposes in TAVI Patients? A Critical Review

The Utility of Psoas Muscle Assessment in Predicting Frailty in Patients Undergoing Transcatheter Aortic Valve Replacement

Low Muscle Mass as a Prognostic Factor for Early Postoperative Outcomes in Pediatric Patients Undergoing the Fontan Operation: A Retrospective Cohort Study

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