Smaller psoas muscle area was associated with a significantly higher 1-year incidence of heart failure hospitalization or all-cause death compared to larger area (46.5% vs 26.6%, P=0.003).
Cohort (n=214)
No
Does a smaller psoas muscle area predict adverse clinical outcomes in patients undergoing mitral transcatheter edge-to-edge repair?
Decreased psoas muscle area on preprocedural CT is associated with higher 1-year rates of heart failure hospitalization or death in patients undergoing M-TEER.
Absolute Event Rate: 46.5% vs 26.6%
p-value: p=0.003
Abstract Background Sarcopenia has been reported to be associated with poor prognostic outcomes in patients with heart failure. Recent studies have demonstrated the poor prognostic value of the decreased psoas muscle area (PMA) in various clinical settings as the assessment of sarcopenia. However, the clinical significance of PMA as a marker of sarcopenia for predicting skeletal muscle mass in patients undergoing mitral transcatheter edge-to-edge repair (M-TEER) remains uncertain. Purpose The aim of this study is to investigate the clinical significance of PMA utilizing preprocedural computed tomography (CT) in patients receiving M-TEER. Methods We retrospectively enrolled 214 patients who received M-TEER with MitraClip system in our facility between January 2019 and July 2023. PMA was measured by cross-sectional area of bilateral psoas muscle at the level of inferior border of L4 vertebra utilizing preoperative CT, and PMA index was obtained as follows: PMA (mm2)/body surface area (m2)]. To account for the gender differences, patients with the lowest tertile of PMA index in each sex was defined as smaller PMA (N = 71), and the remainder was classified as larger PMA (N = 143) (Figure 1). Outcome measures were composite outcome (heart failure hospitalization or all-cause death), heart failure hospitalization and all-cause death within one year after the procedure. Results The 1-year incidence of composite outcome and heart failure hospitalization was significantly higher in smaller PMA group compared to larger PMA group (composite outcome: 46.5% versus 26.6%, Log-rank P = 0.003; heart failure hospitalization: 35.1% versus 17.3%, Log-rank P = 0.006) (Figures 2A and 2B). The 1-year incidence of all-cause death was not significantly different between the groups (25.4% versus 16.1%, Log-rank P = 0.10) (Figure 1C). Conclusions Decreased PMA measured by preprocedural CT in patients undergoing M-TEER was associated with adverse clinical outcomes. PMA can be a potential poor prognostic indicator in patients undergoing M-TEER.
Shigeno et al. (Sat,) conducted a cohort in Patients undergoing mitral transcatheter edge-to-edge repair (M-TEER) (n=214). Smaller psoas muscle area (PMA) vs. Larger psoas muscle area (PMA) was evaluated on Composite outcome (heart failure hospitalization or all-cause death) (p=0.003). Smaller psoas muscle area was associated with a significantly higher 1-year incidence of heart failure hospitalization or all-cause death compared to larger area (46.5% vs 26.6%, P=0.003).