De grootste kennisbank van het HBO

Inspiratie op jouw vakgebied

Vrij toegankelijk

Terug naar zoekresultatenDeel deze publicatie

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

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

Samenvatting

Objectives: The aim of this study was to assess the predictive value of PMA measurement for mortality. Background: Current surgical risk stratification have limited predictive value in the transcatheter aortic valve implantation (TAVI) population. In TAVI workup, a CT scan is routinely performed but body composition is not analyzed. Psoas muscle area (PMA) reflects a patient's global muscle mass and accordingly PMA might serve as a quantifiable frailty measure. Methods: Multi-slice computed tomography scans (between 2010 and 2016) of 583 consecutive TAVI patients were reviewed. Patients were divided into equal sex-specific tertiles (low, mid, and high) according to an indexed PMA. Hazard ratios (HR) and their confidence intervals (CI) were determined for cardiac and all-cause mortality after TAVI. Results: Low iPMA was associated with cardiac and all-cause mortality in females. One-year adjusted cardiac mortality HR in females for mid-iPMA and high-iPMA were 0.14 [95%CI, 0.05–0.45] and 0.40 [95%CI, 0.15–0.97], respectively. Similar effects were observed for 30-day and 2-years cardiac and all-cause mortality. In females, adding iPMA to surgical risk scores improved the predictive value for 1-year mortality. C-statistics changed from 0.63 [CI = 0.54–0.73] to 0.67 [CI: 0.58–0.75] for EuroSCORE II and from 0.67 [CI: 0.59–0.77] to 0.72 [CI: 0.63–0.80] for STS-PROM. Conclusions: Particularly in females, low iPMA is independently associated with an higher all-cause and cardiac mortality. Prospective studies should confirm whether PMA or other body composition parameters should be extracted automatically from CT-scans to include in clinical decision making and outcome prediction for TAVI.

Toon meer
OrganisatieHogeschool van Amsterdam
AfdelingKenniscentrum ACHIEVE
Gepubliceerd inCatheterization and Cardiovascular Interventions Wiley-Liss Inc., Vol. 93, Uitgave: 4, Pagina's: E248-E254
Datum2019-03-01
TypeAndersoortig materiaal
ISSN1522-1946
DOI10.1002/ccd.27823
TaalEngels

Op de HBO Kennisbank vind je publicaties van 26 hogescholen

De grootste kennisbank van het HBO

Inspiratie op jouw vakgebied

Vrij toegankelijk