Average Density Of The Psoas Muscle Detected By Multislice Computed Tomography As A Measure Of Fragility In Candidates For Transcatheter Aortic Valve Replacement

ROMINA E TROSSERO; MARIA FLORENCIA CASTRO; AGUSTINA SCIANCALEPORE; PAOLA KUSCHNIR; MARIA TERESA POLITI; MARIA PAZ RICAPITO; RICARDO RONDEROS

Barcelona

Congreso; 2019 Heart Valve Society Annual Scientific Meeting; 2019

Heart Valve Society

Objective: The purpose of this study was to evaluate theassociation between the average density of both psoas muscles(ADPM) and the degree of fragility in patients undergoingtranscatheter aortic valve implantation (TAVI)Methods: A cohort of 35 consecutive patients who were candidatesfor TAVI was studied retrospectively. All of them hada fragility test divided in 4 grades. The tomographic analysis ofthe psoas was performed in a section perpendicular to themajor axis of the muscle, at the level of the fourth lumbarvertebra. The parameters were: bilateral area, perimeter andmuscle density and then ADPM. All parameters were categorizedaccording to their 50th percentile value. Associations wereexplored using univariate logistic regression models.Results: The average age was 83 ± 2 years, being 64% male,and a median degree of frailty of 2. The tomographic study ofboth psoas muscles indicated an ADPM value of 37.3 ± 10.8Hounsfield units, an average area of 111.8 ± 17.1 mm2 and anaverage perimeter of 884.1 ± 266.3 cm. Patients remainedhospitalized for a median of 7 days post-TAVI. The relationshipbetween the tomographic characteristics of both psoasand the degree of fragility was evaluated. A statistically significantrelationship was found between fragility and thepresence of a low ADPM (lower than the 50th percentile)(OR = 2.22, p = 0.039, 95% CI 1.04 - 4.74). There was noassociation between fragility and area (OR = 1.35, p = 0.366,95% CI 0.71-2.57). A low ADPM (lower than the 50th percentile)showed a tendency to be associated with prolongedhospitalization (greater than the 75th percentile) (OR = 1.95,p = 0.386, 95% CI 0.43 - 8.83).Conclusions: The degree of frailty could be associated witha low ADPM, conditioning a longer post-TAVI hospitalization.Large-scale prospective studies are needed to confirm this.