Relationship between nutrition status and muscle mass and its impact on 1-year mortality in patients with aortic stenosis undergoing transcatheter aortic valve implantation

TL;DR

Combining nutritional status and muscle mass assessments improves predicting 1-year mortality in patients undergoing heart valve implantation.

Contribution

This study introduces a combined nutritional and muscle mass assessment to better predict mortality after TAVI.

Findings

Patients with low nutritional status and low muscle mass had higher 1-year mortality.

Combined assessment outperformed individual markers in predicting mortality.

The low-risk group showed significantly better survival than others.

Abstract

We aimed to evaluate whether dual assessment of nutritional status and muscle mass could enhance the prediction of 1-year mortality in patients undergoing transcatheter aortic valve implantation (TAVI).

This retrospective study included 312 consecutive patients who underwent TAVI for aortic stenosis. Nutritional status was determined by calculating the geriatric nutritional risk index (GNRI), with a cutoff of 98. Muscle mass was calculated from the psoas muscle volume index (PMVI). Patients were stratified into three groups based on GNRI and PMVI: Low, middle, and high groups (GNRI: < 98, < 98, and > 98; and below, or below, and above the sex-specific median PMVI, respectively). The primary endpoint was all-cause mortality within 1-year.

After exclusion, 259 patients were included in the analysis, and 22 died within 1-year. Kaplan-Meier survival curves showed a significant difference in all-cause mortality within 1-year among the three groups. Multivariate analysis of the Cox proportional hazards model for factors related to all-cause mortality within 1-year showed no significant association in the middle group when the high group was used as a reference, and the low group was independently associated.

The combined assessment of nutritional status and muscle mass improves the identification of high-risk patients undergoing transcatheter aortic valve implantation and enhances the prognostic accuracy beyond individual markers. This approach may aid in refining the risk stratification and tailoring the perioperative management of patients undergoing TAVI.

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