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Walpot J, van Herck P, Collas V, Van de Heyning CM, Vandendriessche T, Heidbuchel H, Rodrigus I, Bosmans J. Tumour necrosis factor-alpha serum level is an independent predictor of medium-term all-cause mortality after transcatheter aortic valve replacement. Acta Cardiol 2024; 79:114-122. [PMID: 38375765 DOI: 10.1080/00015385.2023.2223012] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/19/2022] [Accepted: 05/31/2023] [Indexed: 02/21/2024]
Abstract
BACKGROUND Transcatheter aortic valve implantation (TAVI) is a suitable treatment for patients with severe aortic stenosis and severely increased operative risk. There is need for a better preoperative risk assessment for TAVI candidates. AIM To determine whether Tumour necrosis factor-alfa (TNFα) is an independent predictor of survival 500 days after TAVI. METHODS Sixty patients undergoing TAVI were enrolled in the study. TNFα was determined. The CT measured low-density muscle fraction (LDM%) of the psoas muscle was determined. Operative risk assessment by Logistic EuroSCORE, EuroSCORE II, and STS score was performed. Frailty scores (FRAIL scale and Barthel index) were determined. RESULTS Mean age was 81.01 ± 7.54 years. Twenty-six (43.3%) of the patients were males. In the univariable analyses, FRAIL scale and Barthel index were no predictors of survival after TAVI. In the multivariable analysis, including EuroSCORE II, LDM% and TNFα serum concentration, TNFα serum level was an independent predictor of survival 500 days after TAVI (HR: 3.167; 95%: 1.279-7.842; p = 0.013). The multivariable analysis, including TNFα as a categorical variable, showed that compared to patients in the conjugated first and second TNFα serum level tertile, patients in the third tertile had a hazard ratio (HR) of 10.606 (95%CI: 1.203 - 93.467) (p = 0.033). CONCLUSION TNFα is an incremental independent predictor of long-term survival after TAVI.
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Affiliation(s)
- Jeroen Walpot
- Department of Cardiology, University Hospital Antwerp, Antwerp, Belgium
- Department of Cardiology, ZorgSaam Hospital, Terneuzen, The Netherlands
| | - Paul van Herck
- Department of Cardiology, University Hospital Antwerp, Antwerp, Belgium
| | - Valerie Collas
- Faculty of Health Sciences and Medicine, University of Antwerp, Wilrijk, Belgium
| | - Caroline M Van de Heyning
- Department of Cardiology, University Hospital Antwerp, Antwerp, Belgium
- Faculty of Health Sciences and Medicine, University of Antwerp, Wilrijk, Belgium
| | | | - Hein Heidbuchel
- Department of Cardiology, University Hospital Antwerp, Antwerp, Belgium
- Faculty of Health Sciences and Medicine, University of Antwerp, Wilrijk, Belgium
| | - Inez Rodrigus
- Department of Cardiac Surgery, University Hospital Antwerp, Antwerp, Belgium
| | - Johan Bosmans
- Department of Cardiology, University Hospital Antwerp, Antwerp, Belgium
- Faculty of Biomedical Sciences, University of Antwerp, Wilrijk, Belgium
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Niebauer J, Bäck C, Bischoff-Ferrari HA, Dehbi HM, Szekely A, Völler H, Sündermann SH. Preinterventional frailty assessment in patients scheduled for cardiac surgery or transcatheter aortic valve implantation: a consensus statement of the European Association for Cardio-Thoracic Surgery (EACTS) and the European Association of Preventive Cardiology (EAPC) of the European Society of Cardiology (ESC). Eur J Prev Cardiol 2024; 31:146-181. [PMID: 37804173 DOI: 10.1093/eurjpc/zwad304] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/10/2022] [Revised: 03/22/2023] [Indexed: 10/09/2023]
Affiliation(s)
- Josef Niebauer
- Paracelsus Medical University Salzburg, Institute of Sports Medicine, Prevention and Rehabilitation, Salzburg, Austria
- Ludwig Boltzmann Institute for Digital Health and Prevention, Salzburg, Austria
- REHA-Zentrum Salzburg, University Hospital Salzburg, Austria
| | - Caroline Bäck
- Department of Cardiothoracic Surgery, RT, Rigshospitalet, Copenhagen University Hospital, Copenhagen, Denmark
| | - Heike A Bischoff-Ferrari
- Center on Ageing and Mobility, University Hospital and University of Zurich, Zurich, Switzerland
| | - Hakim-Moulay Dehbi
- University College London, Comprehensive Clinical Trials Unit, London, Great Britain
| | - Andrea Szekely
- Semmelweis University, Department of Anesthesiology and Intensive Therapy, Budapest, Hungary
| | - Heinz Völler
- Faculty of Health Sciences Brandenburg, University of Potsdam, Department of Rehabilitation Medicine, Potsdam, Germany
- Klinik am See, Rehabilitation Centre for Internal Medicine, Rüdersdorf, Germany
| | - Simon H Sündermann
- Deutsches Herzzentrum der Charité, Department of Cardiothoracic and Vascular Surgery, Berlin, Germany
- Charité- Universitätsmedizin Berlin, corporate member of Freie Universität Berlin and Humboldt Universität zu Berlin, Berlin, Germany
- DZHK (German Center of Cardiovascular Research), Partner Site Berlin, Berlin, Germany
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3
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Sündermann SH, Bäck C, Bischoff-Ferrari HA, Dehbi HM, Szekely A, Völler H, Niebauer J. Preinterventional frailty assessment in patients scheduled for cardiac surgery or transcatheter aortic valve implantation: a consensus statement of the European Association for Cardio-Thoracic Surgery (EACTS) and the European Association of Preventive Cardiology (EAPC) of the European Society of Cardiology (ESC). Eur J Cardiothorac Surg 2023; 64:ezad181. [PMID: 37804175 DOI: 10.1093/ejcts/ezad181] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/10/2022] [Revised: 03/22/2023] [Indexed: 10/09/2023] Open
Affiliation(s)
- Simon H Sündermann
- Deutsches Herzzentrum der Charité, Department of Cardiothoracic and Vascular Surgery, Berlin, Germany
- Charité- Universitätsmedizin Berlin, corporate member of Freie Universität Berlin and Humboldt Universität zu Berlin, Berlin, Germany
- DZHK (German Center of Cardiovascular Research), Partner Site Berlin, Berlin, Germany
| | - Caroline Bäck
- Department of Cardiothoracic Surgery, RT, Rigshospitalet, Copenhagen University Hospital, Copenhagen, Denmark
| | - Heike A Bischoff-Ferrari
- Center on Ageing and Mobility, University Hospital and University of Zurich, Zurich, Switzerland
| | - Hakim-Moulay Dehbi
- University College London, Comprehensive Clinical Trials Unit, London, Great Britain
| | - Andrea Szekely
- Semmelweis University, Department of Anesthesiology and Intensive Therapy, Budapest, Hungary
| | - Heinz Völler
- Faculty of Health Sciences Brandenburg, University of Potsdam, Department of Rehabilitation Medicine, Potsdam, Germany
- Klinik am See, Rehabilitation Centre for Internal Medicine, Rüdersdorf, Germany
| | - Josef Niebauer
- Paracelsus Medical University Salzburg, Institute of Sports Medicine, Prevention and Rehabilitation, Salzburg, Austria
- Ludwig Boltzmann Institute for Digital Health and Prevention, Salzburg, Austria
- REHA-Zentrum Salzburg, University Hospital Salzburg, Austria
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4
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Colombo G, Cameli M, Metra M, Inciardi RM. Cardiovascular imaging updates and future perspectives. J Cardiovasc Med (Hagerstown) 2023; 24:488-491. [PMID: 37409594 DOI: 10.2459/jcm.0000000000001492] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 07/07/2023]
Affiliation(s)
- Giada Colombo
- ASST Spedali Civili di Brescia, Department of Medical and Surgical Specialties, Radiological Sciences and Public Health, University of Brescia, Brescia
| | - Matteo Cameli
- Division of Cardiology, Department of Medical Biotechnologies, University of Siena, Siena, Italy
| | - Marco Metra
- ASST Spedali Civili di Brescia, Department of Medical and Surgical Specialties, Radiological Sciences and Public Health, University of Brescia, Brescia
| | - Riccardo M Inciardi
- ASST Spedali Civili di Brescia, Department of Medical and Surgical Specialties, Radiological Sciences and Public Health, University of Brescia, Brescia
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5
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Damluji AA, Alfaraidhy M, AlHajri N, Rohant NN, Kumar M, Al Malouf C, Bahrainy S, Ji Kwak M, Batchelor WB, Forman DE, Rich MW, Kirkpatrick J, Krishnaswami A, Alexander KP, Gerstenblith G, Cawthon P, deFilippi CR, Goyal P. Sarcopenia and Cardiovascular Diseases. Circulation 2023; 147:1534-1553. [PMID: 37186680 PMCID: PMC10180053 DOI: 10.1161/circulationaha.123.064071] [Citation(s) in RCA: 83] [Impact Index Per Article: 83.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 05/17/2023]
Abstract
Sarcopenia is the loss of muscle strength, mass, and function, which is often exacerbated by chronic comorbidities including cardiovascular diseases, chronic kidney disease, and cancer. Sarcopenia is associated with faster progression of cardiovascular diseases and higher risk of mortality, falls, and reduced quality of life, particularly among older adults. Although the pathophysiologic mechanisms are complex, the broad underlying cause of sarcopenia includes an imbalance between anabolic and catabolic muscle homeostasis with or without neuronal degeneration. The intrinsic molecular mechanisms of aging, chronic illness, malnutrition, and immobility are associated with the development of sarcopenia. Screening and testing for sarcopenia may be particularly important among those with chronic disease states. Early recognition of sarcopenia is important because it can provide an opportunity for interventions to reverse or delay the progression of muscle disorder, which may ultimately impact cardiovascular outcomes. Relying on body mass index is not useful for screening because many patients will have sarcopenic obesity, a particularly important phenotype among older cardiac patients. In this review, we aimed to: (1) provide a definition of sarcopenia within the context of muscle wasting disorders; (2) summarize the associations between sarcopenia and different cardiovascular diseases; (3) highlight an approach for a diagnostic evaluation; (4) discuss management strategies for sarcopenia; and (5) outline key gaps in knowledge with implications for the future of the field.
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Affiliation(s)
- Abdulla A Damluji
- Inova Center of Outcomes Research, Inova Heart and Vascular Institute, Falls Church, VA (A.A.D., W.B.B., C.R.D.)
- Johns Hopkins University School of Medicine, Baltimore, MD (A.A.D., M.A., G.G.)
| | - Maha Alfaraidhy
- Johns Hopkins University School of Medicine, Baltimore, MD (A.A.D., M.A., G.G.)
| | - Noora AlHajri
- Cleveland Clinic, Abu Dhabi, United Arab Emirates (N.A.)
| | | | | | | | | | | | - Wayne B Batchelor
- Inova Center of Outcomes Research, Inova Heart and Vascular Institute, Falls Church, VA (A.A.D., W.B.B., C.R.D.)
| | - Daniel E Forman
- University of Pittsburgh and the Pittsburgh Geriatric Research Education and Clinical Center, PA (D.E.F.)
| | | | | | | | - Karen P Alexander
- Duke Clinical Research Institute, Duke University, Durham, NC (K.P.A.)
| | - Gary Gerstenblith
- Johns Hopkins University School of Medicine, Baltimore, MD (A.A.D., M.A., G.G.)
| | | | - Christopher R deFilippi
- Inova Center of Outcomes Research, Inova Heart and Vascular Institute, Falls Church, VA (A.A.D., W.B.B., C.R.D.)
| | - Parag Goyal
- University of Arizona, Tucson (N.N.R., P.G.)
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6
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Spaccarotella CAM, Sorrentino S, Mongiardo A, Riverso V, Mancuso C, Giordano S, Esposito G, Indolfi C. Acute expansion of nitinol-based self-expandable device in patients undergoing transfemoral aortic valve implantation. J Cardiovasc Med (Hagerstown) 2023; 24:308-312. [PMID: 36957987 DOI: 10.2459/jcm.0000000000001459] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 03/25/2023]
Abstract
BACKGROUND The acute adaptation of the nitinol-based stent frame self expandable valve to the aortic root after deployment is poorly understood. Accordingly, this study aimed to assess the occurrence, degree and determinants of acute adaptation of the nitinol-based stent frame self-expandable valves after implantation. METHODS This is a single-site prospective registry including patients undergoing transcatheter aortic valve replacement (TAVR) with a widely used second-generation nitinol-based self-expandable device (Evolut R, Medtronic, Minneapolis, Minnesota, USA). We measured valve diameters at three different sections: distal (aortic) level, central (annulus) level and proximal (ventricular) level. Valve expansion was estimated by the difference between the diameters calculated immediately after valve deployment (A) and at the end of the procedure (B). The absolute and relative stent changes were defined as B-A and (B-A)/B∗100, respectively. A linear regression model was performed to test the association between the degree of valve extension at each segment with baseline and procedural characteristics. RESULTS A total of 58 consecutive TAVR patients were included in this analysis, with a mean age of 82.12 ± 5.28 years. Out of the total, 46% of the patients had chronic kidney disease, 32% had diabetes and 76% had dyslipidaemia. The mean procedural time was 28.11 ± 11.6 min, with 53.45% of predilation. Postdilation was performed only in 3.5% of patients. Final stent diameters were significantly higher than those achieved immediately after valve implantation - an observation that was consistent for all the segments: 0.50 ± 0.51 mm and 2.48 ± 2.57% (P < 0.01) in the proximal, 0.46 ± 0.57 mm and 2.39 ± 2.96% (P < 0.01) in the central, as well as 0.58 ± 0.59 mm and 2.14 ± 2.14% (P < 0.01) at the distal segments. Postdilation significantly affected the expansion of the central segment, and, albeit not significantly, the proximal one, while no changes were observed for the distal portion of the platform. CONCLUSION This is the first study to have documented a significant degree of the Evolut R self-expandable valve expansion after deployment. However, further studies are required to assess the short- and long-term time course of self-expandable valve enlargement and the clinical relevance of this finding.
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Affiliation(s)
- Carmen A M Spaccarotella
- Division of Cardiology, Department of Advanced Biomedical Sciences, University of Naples Federico II, Naples
| | - Sabato Sorrentino
- Division of Cardiology, Department of Medical and Surgical Sciences, Magna Graecia University, Catanzaro, Italy
| | - Annalisa Mongiardo
- Division of Cardiology, Department of Medical and Surgical Sciences, Magna Graecia University, Catanzaro, Italy
| | - Vincenzo Riverso
- Division of Cardiology, Department of Medical and Surgical Sciences, Magna Graecia University, Catanzaro, Italy
| | - Cinzia Mancuso
- Division of Cardiology, Department of Medical and Surgical Sciences, Magna Graecia University, Catanzaro, Italy
| | - Salvatore Giordano
- Division of Cardiology, Department of Medical and Surgical Sciences, Magna Graecia University, Catanzaro, Italy
| | - Giovanni Esposito
- Division of Cardiology, Department of Advanced Biomedical Sciences, University of Naples Federico II, Naples
| | - Ciro Indolfi
- Division of Cardiology, Department of Medical and Surgical Sciences, Magna Graecia University, Catanzaro, Italy
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7
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Massussi M, Adamo M, Rosato S, Seccareccia F, Barbanti M, Biancari F, Tarantini G, Immè S, Vignali L, Badoni G, Ussia GP, Costa G, Baiocchi M, Metra M, Baglio G, D'Errigo P. Functional and metabolic frailty predicts mortality in patients undergoing TAVI: Insights from the OBSERVANT II study. Eur J Intern Med 2022; 106:90-96. [PMID: 36202717 DOI: 10.1016/j.ejim.2022.09.022] [Citation(s) in RCA: 8] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/28/2022] [Revised: 09/23/2022] [Accepted: 09/26/2022] [Indexed: 11/03/2022]
Abstract
BACKGROUND/AIM Despite the prognostic role of frailty among elderly patients undergoing transcatheter aortic valve implantation (TAVI) is known, its assessment still represents a challenge due to the multitude of scales proposed in literature. The aim of this study was to define the prognostic impact of a simple combined frailty model including both functional and metabolic parameters in a large cohort of patients undergoing TAVI with new generation devices. METHODS AND RESULTS We examined 1-year survival of patients affected by aortic valve stenosis treated with new generation TAVI devices from the OBSERVANT II study. Frailty of patients undergoing TAVI was stratified in four groups according to a combination of functional (geriatric status scale - GSS) and metabolic (global nutritional risk index - GNRI) assessment. Among 1985 patients included in the analysis, 1008 (51%) had no significant frailty, 246 (12%) had only functional impairment, 522 (26%) had only metabolic impairment and 209 (11%) had both functional and metabolic impairment. The presence of combined functional and metabolic frailty was associated with a two-fold increased risk of 1-year all-cause mortality (HR 2.06 [95% CI 1.35-3.14]; p = 0.001). GNRI as a single parameter had a lower impact on mortality (HR 1.48 [95% CI 1.05 - 2.09]; p = 0.027), whereas GSS did not impact on mortality (HR 1.23 [95% CI 0.77-1.97]; p = 0.386). CONCLUSIONS In a large real-world cohort of patients undergoing TAVI with new generation devices, combined functional and metabolic frailty had a significant and incremental impact on 1-year mortality.
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Affiliation(s)
- Mauro Massussi
- Cardiac Catheterization Laboratory and Cardiology, ASST Spedali Civili di Brescia and Department of Medical and Surgical Specialties, Radiological Sciences, and Public Health, University of Brescia, Piazzale Spedali Civili, 1, Brescia 25123, Italy
| | - Marianna Adamo
- Cardiac Catheterization Laboratory and Cardiology, ASST Spedali Civili di Brescia and Department of Medical and Surgical Specialties, Radiological Sciences, and Public Health, University of Brescia, Piazzale Spedali Civili, 1, Brescia 25123, Italy.
| | - Stefano Rosato
- National Centre for Global Health, Istituto Superiore di Sanità, Rome, Italy
| | - Fulvia Seccareccia
- National Centre for Global Health, Istituto Superiore di Sanità, Rome, Italy
| | - Marco Barbanti
- Division of Cardiology, A.O.U. Policlinico "G. Rodolico - San Marco", University of Catania, Catania, Italy
| | - Fausto Biancari
- Clinica Montevergine, GVM Care & Research, Mercogliano, Italy; Heart and Lung Center, Helsinki University Hospital, University of Helsinki, Helsinki, Finland
| | - Giuseppe Tarantini
- Division of Cardiology, Department of Cardiac, Thoracic and Vascular Sciences, University of Padova, Padova, Italy
| | - Sebastiano Immè
- Division of Cardiology, Centro Cuore Morgagni, Catania, Italy
| | - Luigi Vignali
- Division of Cardiology, University of Parma, Parma, Italy
| | - Gabriella Badoni
- National Centre for Global Health, Istituto Superiore di Sanità, Rome, Italy
| | | | - Giuliano Costa
- Division of Cardiology, A.O.U. Policlinico "G. Rodolico - San Marco", University of Catania, Catania, Italy
| | - Massimo Baiocchi
- Anestesia e Rianimazione Dipartimento Cardiotoracovascolare, IRCSS Policlinico S.Orsola, Università degli Studi di Bologna, Bologna, Italy
| | - Marco Metra
- Cardiac Catheterization Laboratory and Cardiology, ASST Spedali Civili di Brescia and Department of Medical and Surgical Specialties, Radiological Sciences, and Public Health, University of Brescia, Piazzale Spedali Civili, 1, Brescia 25123, Italy
| | - Giovanni Baglio
- Italian National Agency for Regional Healthcare Services, Rome, Italy
| | - Paola D'Errigo
- National Centre for Global Health, Istituto Superiore di Sanità, Rome, Italy
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Minol JP, Dalyanoglu H, Yilmaz E, Dalyanoglu I, Immohr MB, Korbmacher B, Aissa J, Boeken U, Akhyari P, Lichtenberg A, Sugimura Y. Impact of psoas muscle evaluation on clinical outcomes in patients undergoing left ventricular assist device implantation. J Cardiovasc Med (Hagerstown) 2022; 23:608-614. [PMID: 35994709 DOI: 10.2459/jcm.0000000000001361] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/05/2022]
Abstract
AIMS The measurement of muscle mass reflects the physical components of frailty, which might affect postoperative outcomes in patients undergoing left ventricular assist device (LVAD) implantation. The aim of this study was to investigate the relationship between preoperative skeletal muscle evaluation and clinical outcomes in patients undergoing LVAD implantation. METHODS From January 2010 to December 2017, a total of 63 patients were enrolled in this single-centre study. A retrospective analysis of preoperative abdominal computed tomography (CT) for psoas muscle index (PSMI) and Hounsfield-Units of the Psoas Muscle (PSHU) at the level of the mid-L4 vertebra was performed. RESULTS Sixty-three patients (male; n = 49, 78%), with a mean age of 58.0 ± 11.8 years, were treated with LVAD due to dilated (32%) or ischemic cardiomyopathy (68%). Among them, 43 patients (68.3%) were categorized in the Interagency Registry for Mechanically Assisted Circulatory Support profile I. The survival rate was 73.0% at 30 days and 44.4% at 1 year. Receiver-operating characteristic (ROC) curve analyses revealed that PSMI was a significant numeric predictor of 1-year mortality (P = 0.04). In contrast, PSHU displayed a significant predictive potential for pericardial effusion (P = 0.03) and respiratory insufficiency (P = 0.01). In addition, comparative ROC curve analysis revealed no significant difference in the predictive potential of PSMI and PSHU. CONCLUSION Preoperative PSMI might be a predictor of 1-year mortality in patients undergoing LVAD implantation. In contrast, the PSHU seemed to potentially assume postoperative adverse events in this study. Thus, the evaluation of the preoperative psoas muscle using CT appears to be promising.
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Affiliation(s)
- Jan-Philipp Minol
- Department of Cardiac Surgery, Medical Faculty, Heinrich Heine University, Dusseldorf, Germany
| | - Hannan Dalyanoglu
- Department of Cardiac Surgery, Medical Faculty, Heinrich Heine University, Dusseldorf, Germany
| | - Esma Yilmaz
- Department of Cardiac Surgery, Medical Faculty, Heinrich Heine University, Dusseldorf, Germany
| | - Ismail Dalyanoglu
- cand. med. Medical Faculty of the Semmelweiss University, Budapest, Hungary
| | - Moritz Benjamin Immohr
- Department of Cardiac Surgery, Medical Faculty, Heinrich Heine University, Dusseldorf, Germany
| | - Bernhard Korbmacher
- Department of Cardiac Surgery, Medical Faculty, Heinrich Heine University, Dusseldorf, Germany
| | - Joel Aissa
- Institute of Diagnostic and Interventional Radiology, Medical Faculty, Heinrich Heine University, Düsseldorf, Germany
| | - Udo Boeken
- Department of Cardiac Surgery, Medical Faculty, Heinrich Heine University, Dusseldorf, Germany
| | - Payam Akhyari
- Department of Cardiac Surgery, Medical Faculty, Heinrich Heine University, Dusseldorf, Germany
| | - Artur Lichtenberg
- Department of Cardiac Surgery, Medical Faculty, Heinrich Heine University, Dusseldorf, Germany
| | - Yukiharu Sugimura
- Department of Cardiac Surgery, Medical Faculty, Heinrich Heine University, Dusseldorf, Germany
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9
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Walpot J, van Herck P, Collas V, Bossaerts L, Van de Heyning CM, Vandendriessche T, Heidbuchel H, Rodrigus I, De Block C, Small GR, Bosmans J. Adiponectin serum level is an independent and incremental predictor of all-cause mortality after transcatheter aortic valve replacement. Clin Cardiol 2022; 45:1060-1069. [PMID: 35932173 PMCID: PMC9574742 DOI: 10.1002/clc.23892] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/04/2022] [Revised: 06/20/2022] [Accepted: 07/12/2022] [Indexed: 11/22/2022] Open
Abstract
Background Quantifiable biomarkers may be useful for a better risk and frailty assessment of patients referred for transcatheter aortic valve implantation (TAVI). Hypothesis To determine if adiponectin serum concentration predicts all‐cause mortality in patients undergoing TAVI. Methods 77 consecutive patients, undergoing TAVI, were analyzed. The CT axial slices at the level of the fourth lumbar vertebra were used to measure the psoas muscle area, and its low‐density muscle fraction (LDM (%)). To assess the operative risk, the STS (Society of Thoracic Surgeons Predicted Risk of Mortality) score, Log. Euroscore, and Euroscore II were determined. A clinical frailty assessment was performed. ELISA kits were used to measure adiponectin serum levels. We searched for a correlation between serum adiponectin concentration and all‐cause mortality after TAVI. Results The mean age was 80.8 ± 7.4 years. All‐cause mortality occurred in 22 patients. The mean follow‐up was 1779 days (range: 1572–1825 days). Compared with patients with the lowest adiponectin level, patients in the third tertile had a hazards ratio of all‐cause mortality after TAVI of 4.155 (95% CI: 1.364–12.655) (p = .004). In the multivariable model, including STS score, vascular access of TAVI procedure, LDM (%), and adiponectin serum concentration, serum adiponectin level, and LDM(%) were independent predictors of all‐cause mortality after TAVI (p = .178, .303, .042, and .017, respectively). Adiponectin level was a predictor of all‐cause mortality in females and males (p = .012 and 0.024, respectively). Conclusion Adiponectin serum level is an independent and incremental predictor of all‐cause mortality in patients undergoing TAVI.
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Affiliation(s)
- Jeroen Walpot
- Department of Cardiology, University Hospital Antwerp, Edegem, Antwerp, Belgium.,Department of Cardiology, ZorgSaam Hospital, Terneuzen, The Netherlands
| | - Paul van Herck
- Department of Cardiology, University Hospital Antwerp, Edegem, Antwerp, Belgium
| | - Valerie Collas
- Faculty of Health Sciences and Medicine, University of Antwerp, Wilrijk, Belgium
| | - Liene Bossaerts
- Faculty of Biomedical Sciences, University of Antwerp, Wilrijk, Belgium
| | - Caroline M Van de Heyning
- Department of Cardiology, University Hospital Antwerp, Edegem, Antwerp, Belgium.,Faculty of Health Sciences and Medicine, University of Antwerp, Wilrijk, Belgium
| | - Tom Vandendriessche
- Department of Cardiology, University Hospital Antwerp, Edegem, Antwerp, Belgium
| | - Hein Heidbuchel
- Department of Cardiology, University Hospital Antwerp, Edegem, Antwerp, Belgium.,Faculty of Health Sciences and Medicine, University of Antwerp, Wilrijk, Belgium
| | - Inez Rodrigus
- Department of Cardiac Surgery, University Hospital Antwerp, Antwerp, Edegem, Belgium
| | - Christophe De Block
- Department of Endocrinology-Diabetology and Metabolism, Antwerp University Hospital, Edegem, Antwerp, Belgium
| | - Gary R Small
- Division of Cardiology, University of Ottawa Heart Institute, Ottawa, Ontario, Canada
| | - Johan Bosmans
- Department of Cardiology, University Hospital Antwerp, Edegem, Antwerp, Belgium.,Faculty of Biomedical Sciences, University of Antwerp, Wilrijk, Belgium
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