Computed tomography-based fat and muscle characteristics are associated with mortality after transcatheter aortic valve replacement.
Computed tomography-based fat and muscle characteristics are associated with mortality after transcatheter aortic valve replacement.
复制标题
DOI：
10.1016/j.jcct.2018.03.007
复制
发表时间：
2018-05
影响因子：
5.4
通讯作者：
Shah R
中科院分区：
文献类型：
--
作者：
Foldyna B;Troschel FM;Addison D;Fintelmann FJ;Elmariah S;Furman D;Eslami P;Ghoshhajra B;Lu MT;Murthy VL;Hoffmann U;Shah R
基于计算机断层扫描（CT）的脂肪和肌肉测量与大量人群的结果相关。我们测试了肌肉和脂肪特征是否与TAVR术后的长期结局相关。我们纳入了2008年至2016年期间在我中心进行TAVR之前进行的403项临床CT，测量腰大肌（PM）、皮下脂肪（SAT）和内脏脂肪组织（VAT）的面积（cm 2）和密度（Hounsfield单位，HU）。面积测量指数的高度，对数转换和面积和密度进行标准化分析。我们评估了每项指标与全因死亡率的相关性（调整了年龄、性别、体重指数（BMI）和胸外科医师协会（STS）风险评分）。在403例受试者（83 ± 8岁; 52%为女性）中，167例（41.4%）在458天的中位随访期间死亡（四分位距IQR 297-840）。脂肪措施是可行的和快速的。242例（60%）患者的脂肪区域可用，视野充足。具有最低PM面积、SAT面积或VAT面积的个体表现出最高的死亡风险。此外，较高的SAT密度与较高的死亡率风险相关（密度每标准差增加的校正HR = 1.35，95%CI 1.10-1.67，P = 0.005）。基于CT的快速组织定征在转诊接受TAVR的患者中是可行的。PM面积减少和SAT密度增加与TAVR后的长期死亡率相关，即使考虑了年龄、性别、BMI和STS评分。有必要进一步研究CT组织指标和死亡率之间的性别特异性关系，以及CT指标是否增加了完善的虚弱指标。
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. 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. 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). 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.
登录
查看更多内容
DOI：
10.1016/j.numecd.2015.12.002
发表时间：
2016-02-01
影响因子：
3.9
作者：
Shah, Ravi V.;Allison, M. A.;Murthy, V. L.
通讯作者：
Murthy, V. L.
DOI：
10.1016/j.jtcvs.2015.11.022
发表时间：
2016-03-01
影响因子：
6
作者：
Paknikar, Raghavendra;Friedman, Jeffrey;Patel, Himanshu J.
通讯作者：
Patel, Himanshu J.
影响因子：
168.9
作者：
Mack, Michael J.;Leon, Martin B.;Svensson, Lars G.
通讯作者：
Svensson, Lars G.
影响因子：
2.8
作者：
Garg, Lohit;Agrawal, Sahil;Hanson, Ivan D.
通讯作者：
Hanson, Ivan D.
影响因子：
37.8
作者：
Shimura, Tetsuro;Yamamoto, Masanori;Hayashida, Kentaro
通讯作者：
Hayashida, Kentaro