Prognostic Value of Fat Mass and Skeletal Muscle Mass Determined by Computed Tomography in Patients Who Underwent Transcatheter Aortic Valve Implantation

Risk stratification using lean body mass in patients undergoing transcatheter aortic valve replacement

“…On the contrary, the amount of skeletal muscle mass is associated with mortality in an elderly population . A recent study demonstrated that loss of skeletal muscle mass was associated with poor outcomes after TAVR .…”

Albumin Is Predictive of 1-Year Mortality After Transcatheter Aortic Valve Replacement

“…However, this study had a small sample size (n ¼ 159) with limited clinical events, resulting in wide confidence intervals for areas under the curve. Furthermore, they used low body mass index as an indicator of frailty, a substitution repeatedly proven to be an inadequate assessment of frailty [8,19]. Finally, the patients in their study were part of the original Placement of Aortic Transcatheter A serum albumin of less than 3.4 g/dL has been commonly used as an indication of frailty in prior TAVR reports [4,20].…”

“…Before TAVR, frailty is traditionally evaluated by a composite of four metrics: gait speed, dominant hand grip strength, serum albumin, and the Katz activities of daily living (ADL) survey [1,7]. These metrics largely rely on subjective physical performance tests and fail to account for changes in body mass composition associated with frailty, defined as sarcopenia [8]. Approximation of sarcopenia by psoas muscle area (PMA) measured on computed tomography (CT) has been validated as a predictor of death and adverse events after a variety of operations, including those routinely performed in vascular, colorectal, and cardiac surgery [9][10][11][12].…”

Transcatheter Aortic Valve Replacement in the Care of Older Persons with Aortic Stenosis

“…Frailty has consistently been associated with a two‐to‐threefold greater risk of death 1–2 years after TAVR. It also has variably been associated with short‐term risk of death and complications, with some studies reporting a positive association and others failing to demonstrate it in a statistically significant fashion . When major complications did arise, these were more likely to be fatal in frail patients .…”

“…It also has variably been associated with short-term risk of death and complications, with some studies reporting a positive association 20,[28][29][30] and others failing to demonstrate it in a statistically significant fashion. 11,[31][32][33][34][35] When major complications did arise, these were more likely to be fatal in frail patients. 29 Furthermore, frailty has been associated with lengthier hospital stays, a lower likelihood of being discharged home, 20,29,32 and a greater risk of functional decline 6-12 months after TAVR.…”