Preprint Article Version 1 Preserved in Portico This version is not peer-reviewed

Total Muscle Area and Visceral Adipose Tissue Measurements for Frailty Assessment in TAVR Patients

Caglayan Demirel
ORCID logo ,
Christoph Fritz Rothenbuehler
,
Markus Huber
ORCID logo ,
Michelle Schweizer
,
Inga Todorski
,
David Alexander Gloor
,
Stephan Windecker
,
Jonas Lanz
,
Stefan Stortecky
,
Thomas Pilgrim
,
Gabor Erdoes
* ORCID logo
Version 1 : Received: 15 January 2024 / Approved: 16 January 2024 / Online: 16 January 2024 (13:56:43 CET)

A peer-reviewed article of this Preprint also exists.

Demirel, C.; Rothenbühler, C.F.; Huber, M.; Schweizer, M.; Todorski, I.; Gloor, D.A.; Windecker, S.; Lanz, J.; Stortecky, S.; Pilgrim, T.; Erdoes, G. Total Muscle Area and Visceral Adipose Tissue Measurements for Frailty Assessment in TAVR Patients. J. Clin. Med. 2024, 13, 1322. Demirel, C.; Rothenbühler, C.F.; Huber, M.; Schweizer, M.; Todorski, I.; Gloor, D.A.; Windecker, S.; Lanz, J.; Stortecky, S.; Pilgrim, T.; Erdoes, G. Total Muscle Area and Visceral Adipose Tissue Measurements for Frailty Assessment in TAVR Patients. J. Clin. Med. 2024, 13, 1322.

Abstract

Background: A careful work-up before Transcatheter aortic valve replacement (TAVR) consists not only of measuring anatomical conditions but also assessment of frailty. Previous studies have evaluated body composition parameters, primarily fat and muscle mass. Few data are available on other frailty parameters, which, however, can be easily determined by pre-TAVR computed tomography (CT). Objectives: The primary objective was to investigate the impact of total muscle area (TMA) and visceral adipose tissue (VAT), as frailty parameters, on 5-year all-cause mortality in patients undergoing TAVR. Methods: Between 01/2017 and 12/2018, consecutive TAVR patients undergoing CT-angiography scan enabling TMA and VAT measurement were included. A single axial image was acquired at the level of the middle third lumbar vertebra to perform TMA and VAT measurements using dedicated slicing software (Sliceomatic, TomoVision). Results: A total of 500 patients qualified for TMA analysis. Age was not associated with a higher risk of 5-year mortality HR 1.02 (95% CI: 0.998 - 1.049; p=0.069). Body surface area normalized TMA (nTMA) was significantly associated with 5-year all-cause mortality (HR 0.927, 95% CI: 0.927-0.997; p= 0.033), while VAT had no effect (HR 1.002, 95% CI: 0.99-1.015; p= 0.7). The effect of nTMA on 5- year all-cause mortality was gender-dependent: the protective effect of higher nTMA was found in male patients (pinteraction: sex * nTMA = 0.007). The combination of normalized TMA and VAT was not associated with higher mortality rates. Conclusion: Normalized TMA derived from routine CT before TAVR complements frailty assessment in patients undergoing TAVR.

Keywords

aortic valve stenosis; body composition parameters; CT scan; sarcopenia; frailty

Subject

Medicine and Pharmacology, Cardiac and Cardiovascular Systems

Copyright: This is an open access article distributed under the Creative Commons Attribution License which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.

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