Abstract 11454: Sarcopenia Evaluated by Thoracic Computed Tomography is Associated With Higher Mortality in Patients Undergoing Transcatheter Aortic Valve Replacement

Abstract

Introduction: Sarcopenia is associated with worse outcomes in various clinical situations. Traditional markers of strength and frailty have been used for pre-operative risk stratification in transcatheter aortic valve replacement (TAVR). However, the availability of computed tomography (CT) scans provides an opportunity to obtain direct skeletal muscle measurements. Hypothesis: We hypothesized that sarcopenia would lead to worse outcomes in patients following TAVR. Methods: Patients undergoing TAVR between January to July 2018 with pre-procedural chest CT were included. Semi-automatic measurements of skeletal muscle area (SMA) were made at the twelfth thoracic vertebra. SMA was normalized by height to obtain skeletal muscle index (SMI, cm 2 /m 2 ). Sarcopenia was defined as the lowest sex-stratified SMI tertile. Strength and functional testing data had been collected as part of the routine pre-TAVR evaluation. The primary outcome of interest was all-cause mortality. Results: A total of 76 patients were included, 26 sarcopenic based on SMI. Table 1 shows comparisons between the groups. During a median follow-up of 1496 (1401-1562) days, 10 (38.5%) deaths occurred in the sarcopenic group and 9 (18.0%) in the non-sarcopenic group. Figure 1 demonstrates this significant difference by Log-Rank testing (p=0.042). The secondary outcomes of length of stay and 30-day readmission did not differ between the groups on unadjusted comparison. Conclusions: Sarcopenia was associated with increased mortality in patients who underwent TAVR. A larger study is underway to assess the potential of muscle measurements serving as an additional pre-operative risk stratification tool.