TY - JOUR
T1 - Sarcopenia and health-related quality of life in older adults after transcatheter aortic valve replacement
AU - Damluji, Abdulla A.
AU - Rodriguez, Gregory
AU - Noel, Thomas
AU - Davis, Lakerria
AU - Dahya, Vishal
AU - Tehrani, Behnam
AU - Epps, Kelly
AU - Sherwood, Matthew
AU - Sarin, Eric
AU - Walston, Jeremy
AU - Bandeen-Roche, Karen
AU - Resar, Jon R.
AU - Brown, Todd T.
AU - Gerstenblith, Gary
AU - O'Connor, Christopher M.
AU - Batchelor, Wayne
N1 - Funding Information:
Presentations: This work is part of a PhD for Dr Damluji at Johns Hopkins University’ GTPCI program. It was presented at the National Claude D. Pepper Older Americans Independence Centers funded by the National Institute on Aging, National Institutes of Health, and the 2019 Society of Cardiovascular Angiography and Intervention 2019 Scientific Sessions in Las Vegas, NV.
Funding Information:
Funding and financial disclosures: Dr Damluji receives research funding from the Pepper Scholars Program of the Johns Hopkins University Claude D. Pepper Older Americans Independence Center funded by the National Institute on Aging P30-AG021334 . Dr Brown is supported in part by K24AI120834 .
Funding Information:
Funding and financial disclosures: Dr Damluji receives research funding from the Pepper Scholars Program of the Johns Hopkins University Claude D. Pepper Older Americans Independence Center funded by the National Institute on Aging P30-AG021334. Dr Brown is supported in part by K24AI120834.
Publisher Copyright:
© 2020 Elsevier Inc.
PY - 2020/6
Y1 - 2020/6
N2 - Background: Skeletal muscle wasting, or sarcopenia, affects a significant proportion of patients undergoing transcatheter aortic valve replacement (TAVR). However, its influence on post-TAVR recovery and 1-year health-related quality of life (HR-QOL) remains unknown. We examined the relationship between skeletal muscle index (SMI), post-TAVR length of hospital stay (LOS), and 1-year QOL. Methods: The study sample consisted of 300 consecutive patients undergoing TAVR from 2012 to 2018 who had pre-TAVR computed tomographic scans suitable for analysis of body composition. Skeletal muscle mass was quantified as cm2 of skeletal mass per m2 of body surface area from the cross-sectional computed tomographic image at the third lumbar vertebra. Sarcopenia was defined using established sex-specific cutoffs (women: SMI < 39 cm2/m2; men: < 55 cm2/m2). Multivariable linear regression analysis was used to determine the relationship between SMI, LOS, and HR-QOL using the Kansas City Cardiomyopathy Questionnaire. Results: Sarcopenia was present in most (59%) patients and associated with older age (82 vs 76 years; P <.001) and lower body mass index (27 vs 33 kg/m2; P <.001). There were no other differences in baseline clinical or echocardiographic characteristics among the 4 quartiles of SMI. SMI was positively correlated with LOS and 1-year QOL. After adjusting for age, gender, race, and body mass index, SMI remained a significant predictor of both LOS (P =.01) and 1-year QOL (P =.012). For every 10 cm2/m2 higher SMI, there was an 8-point increase in Kansas City Cardiomyopathy Questionnaire score, a difference that is clinically meaningful. Conclusions: Sarcopenia is prevalent in TAVR patients. Higher SMI is associated with shorter LOS and better 1-year HR-QOL. To achieve optimal TAVR benefits, further study into how body composition influences post-TAVR recovery and durable improvement in QOL is warranted.
AB - Background: Skeletal muscle wasting, or sarcopenia, affects a significant proportion of patients undergoing transcatheter aortic valve replacement (TAVR). However, its influence on post-TAVR recovery and 1-year health-related quality of life (HR-QOL) remains unknown. We examined the relationship between skeletal muscle index (SMI), post-TAVR length of hospital stay (LOS), and 1-year QOL. Methods: The study sample consisted of 300 consecutive patients undergoing TAVR from 2012 to 2018 who had pre-TAVR computed tomographic scans suitable for analysis of body composition. Skeletal muscle mass was quantified as cm2 of skeletal mass per m2 of body surface area from the cross-sectional computed tomographic image at the third lumbar vertebra. Sarcopenia was defined using established sex-specific cutoffs (women: SMI < 39 cm2/m2; men: < 55 cm2/m2). Multivariable linear regression analysis was used to determine the relationship between SMI, LOS, and HR-QOL using the Kansas City Cardiomyopathy Questionnaire. Results: Sarcopenia was present in most (59%) patients and associated with older age (82 vs 76 years; P <.001) and lower body mass index (27 vs 33 kg/m2; P <.001). There were no other differences in baseline clinical or echocardiographic characteristics among the 4 quartiles of SMI. SMI was positively correlated with LOS and 1-year QOL. After adjusting for age, gender, race, and body mass index, SMI remained a significant predictor of both LOS (P =.01) and 1-year QOL (P =.012). For every 10 cm2/m2 higher SMI, there was an 8-point increase in Kansas City Cardiomyopathy Questionnaire score, a difference that is clinically meaningful. Conclusions: Sarcopenia is prevalent in TAVR patients. Higher SMI is associated with shorter LOS and better 1-year HR-QOL. To achieve optimal TAVR benefits, further study into how body composition influences post-TAVR recovery and durable improvement in QOL is warranted.
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U2 - 10.1016/j.ahj.2020.03.021
DO - 10.1016/j.ahj.2020.03.021
M3 - Article
C2 - 32416332
AN - SCOPUS:85084520501
VL - 224
SP - 171
EP - 181
JO - American Heart Journal
JF - American Heart Journal
SN - 0002-8703
ER -