Key result
Lower pre-procedural CT-derived muscle area independently predicted cardiac mortality in men after TAVI (adjusted OR 0.935, P=0.016), while reduced fat area predicted conduction defects in women.
Why the study?
Post-procedural complications remain a significant clinical challenge after TAVI, and growing evidence suggests that sarcopenia may adversely affect morbidity and mortality in this population.
Does pre-procedural CTA-derived body composition assessment predict all-cause mortality, cardiac mortality, and conduction disturbances in adults with symptomatic severe aortic stenosis undergoing elective TAVI?
Cohort (n=171)
Single-blind
No
Does pre-procedural CTA-derived body composition assessment predict all-cause mortality, cardiac mortality, and conduction disturbances in adults with symptomatic severe aortic stenosis undergoing elective TAVI?
Routine pre-procedural CTA-derived body composition parameters offer sex-specific prognostic value in TAVI patients without additional cost or radiation, linking lower muscle mass to cardiac mortality in men and lower adipose tissue to conduction disturbances in women.
Answers are grounded in this paper and cite their sources.
Sex-specific CT body composition metrics may refine TAVI prognostication; leaves open whether targeted interventions improve outcomes.
Background: Transcatheter aortic valve implantation (TAVI) is increasingly performed for severe aortic stenosis with improving procedural success rates; however, post-procedural complications remain a significant clinical challenge. Growing evidence suggests that sarcopenia may adversely affect morbidity and mortality in this patient population. Methods: This retrospective, single-center cohort study included 171 patients undergoing elective TAVI (January 2018-February 2024). Muscle area (MA), visceral, subcutaneous (SATA), and total adipose tissue area (TATA) were measured at the L3 vertebral level from pre-procedural computed tomography angiography (CTA). Primary endpoints were all-cause and cardiac mortality; secondary endpoints were permanent cardiac conduction defect, permanent pacemaker implantation (PPI), and hospital stay. Results: The cohort comprised 95 women (55.5%) and 76 men (44.5%), median age 78.9 years, society of thoracic surgeons score 6.30 (IQR = 4.37-9.33). Over 21.8 ± 17.9 months, 43 patients (25.1%) died, including 12 cardiac deaths (7.0%). Lower MA and MA/body mass index (BMI) ratio were independently associated with cardiac mortality in men (adjusted odds ratio [OR] = 0.935, P = .016 and OR = 0.983, P = .042). Permanent cardiac conduction defect occurred in 44 patients (27.7%); lower SATA and TATA were independent predictors in women (OR = 0.990, P = .031 and OR = 0.994, P = .024). Permanent pacemaker implantation was required in 30 patients (18.6%); adipose tissue parameters were associated with PPI in women on univariate analysis but did not retain significance after multiple adjustment. Conclusion: Pre-procedural CTA-derived body composition assessment may contribute to the prediction of mortality and morbidity in TAVI patients without additional cost or radiation exposure. The association of lower MA with cardiac mortality in men, and of reduced adipose tissue with conduction disturbances in women, suggests that sex-specific body composition parameters may provide prognostic value beyond conventional risk scores.
No takes yet. Share an insight, caveat, or question.
Ersoysal et al. (2026) conducted a cohort in Symptomatic severe aortic stenosis undergoing transcatheter aortic valve implantation (TAVI) (n=171). CT-derived L3 skeletal muscle area (MA) vs. Higher muscle area / continuous per cm2 increase in muscle area was evaluated on Cardiac mortality in male patients (co-primary with all-cause mortality) (OR 0.935, 95% CI 0.886-0.987, p=0.016). Lower pre-procedural CT-derived muscle area independently predicted cardiac mortality in men after TAVI (adjusted OR 0.935, P=0.016), while reduced fat area predicted conduction defects in women.
Synapse has enriched 10 related papers. Consider them for comparative context: