Abdulla A. Damluji, M.D., FSCAI
,
Johns Hopkins University, Falls Church, VA
Gregory Rodriguez, Pharm D
,
Florida State University College of Medicine, Tallahassee, FL
Lakerria Davis, R.M.A.
,
Southern Medical Group, Tallahassee, FL
Vishal Dahya
,
Florida State University College of Medicine, Tallahassee, FL
Thomas E. Noel, M.D.
,
none, Tallahassee, FL
Penny Burroughs, RN
,
Southern Medical Group, Tallahassee, FL
Julian Hurt, M.D.
,
Southern Medical Group, Tallahassee, FL
Christopher Davis, Defilippi
,
Inova Heart and Vascular Institute, Fairfax, VA
Behnam N. Tehrani, M.D., FSCAI
,
INOVA Heart and Vascular Institute, Oakton, VA
Kelly Epps, M.D.
,
Inova Fairfax Hospital, Washington, DC
Matthew W. Sherwood, M.D., FSCAI
,
Inova Fairfax Hospital/IHVI, McLean, VA
Wayne B. Batchelor, M.D., FSCAI
,
Southern Medical Group, Tallahassee, FL
Background:
The combination of low muscle and high fat mass (sarcopenic obesity) is associated with negative outcomes. We estimated the prevalence of sarcopenic obesity among TAVR patients and determined the relationship between skeletal muscle index (SMI) and 1 year quality of life (QOL) in obese and non-obese patients.
Methods:
Using previously validated methods, we measured SMI from pre-TAVR CT scans in 344 consecutive patients. Obesity was defined as BMI>30 kg/m
2and established sex-specific cut-offs were used to define sarcopenia (SMI< 39 cm
2/m
2for women and < 55 cm
2/m
2 for men). Baseline characteristics and 1 year QOL (KCCQ Score) were extracted.
Results:
The median [IQR] age was 80 [74, 85], 49% were women, and 88% were Caucasian. The prevalence of sarcopenic obesity was 14% (n=47). Sarcopenic obese patients were older, more likely to be men and have dyslipidemia; other comorbidities were similar. SMI was weakly associated with BMI and body surface area, but not in patients with sarcopenic obesity (Figure 1.A-B). After adjusting for age, gender and race, SMI correlated with 1-year QOL in non-obese patients (p=0.016), but not in obese patients (p=0.09). For every 10 cm2/m2 increase in SMI, there was a 10 point increase in KCCQ seen in non-obese patients.
Conclusions:
Although one in 7 TAVR patients have sarcopenic obesity, SMI exerts its greatest influence on QOL in non-obese patients. Further study into how skeletal muscle mass and adiposity predict post TAVR recovery and QOL is warranted to identify patients who might benefit from targeted nutritional and muscle strengthening interventions.
