Abstract 11809: Role of Computed Tomography-Based Evaluation of Skeletal Muscle Area in Predicting Cardiovascular Outcomes in Patients With Chronic Heart Failure Following Cardiac Resynchronization Therapy

Abstract

Introduction : Sarcopenia, defined as skeletal muscle depletion, has been associated with poor cardiovascular outcomes in patients with chronic heart failure (CHF). Hypothesis : This study aimed to determine possible associations between sarcopenia and poor cardiovascular outcomes in patients with CHF after cardiac resynchronization therapy (CRT). Methods: This retrospective study evaluated 120 patients who underwent CRT implantation between March 2004 and June 2018. Only 58 patients who underwent computed tomography (CT) within 30 days of CRT were eligible for inclusion, and their data were analyzed (25 women; 33 men; mean age, 71.6 ± 8.7 years). The skeletal muscle area was measured at the third lumbar vertebra, and the skeletal muscle index (SMI) was calculated (Figure 1). Major adverse cardiovascular events (MACE) included cardiovascular death, hospitalization due to heart failure, cerebral infarction, acute myocardial infarction, and cardiac arrest. Results: During the follow-up period (mean, 868 ± 617 days), MACE occurred in 22 of 58 patients (38%). The patients were allocated to two groups according to sex-based tertiles of SMI. The lowest tertile was defined as the low SMI group. Kaplan-Meier survival analysis demonstrated that the low SMI group had a greater incidence of MACE (log-rank 4.38; P = 0.036, Figure 2). Cox proportional hazards regression analysis also revealed that low SMI was significantly associated with MACE (hazard ratio 3.08; 95% CI: 1.26-7.66, P = 0.014). Conclusions: Decreases in SMI on CT imaging may predict the occurrence of MACE in patients with CHF who underwent CRT.