CT-derived adipose tissue characteristics and TAVI all-cause mortality and complications: a systematic review

Figures

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  Fig. 1. PRISMA flow diagram of study selection process Diagram illustrates the identification, screening, and inclusion of studies for the systematic review. Initially, 94 records were identified from database searches, with no additional records from registers. After removing 37 duplicate records, 57 records were screened. All 57 reports were sought for retrieval, but 31 were not retrieved. Of the 26 reports assessed for eligibility, 12 were excluded for reasons including: epicardial adipose tissue only (n = 5), pericoronal adipose tissue only (n = 1), muscle analysis only (n = 2), and no analysis of fat tissue (n = 3). Finally, 14 new studies were included in the review, with 14 reports of new included studies

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  Fig. 2. Conceptual model of adipose tissue parameters and TAVI outcomes Observed trends in relationships between different adipose tissue parameters and mortality risk following Transcatheter Aortic Valve Implantation (TAVI), synthesized from our systematic review findings. Important note: The curves represent conceptual relationships and observed trends across studies, not exact quantitative values. The left panels show subcutaneous adipose tissue (SAT) parameters, while right panels show visceral adipose tissue (VAT) parameters. For SAT area/volume, higher values were consistently associated with better survival across multiple studies. VAT area/volume showed obesity-dependent effects, with different relationships in obese vs. non-obese patients (Mancio et al.). Both SAT and VAT density demonstrated consistent associations between lower density values and better survival outcomes, potentially reflecting healthier adipocyte morphology and metabolic profiles. VAT:SAT ratio < 1 was associated with more favorable outcomes in the limited studies examining this parameter. These relationships highlight the complex interplay between adipose tissue distribution, quality, and TAVI outcomes