Association of body mass index and visceral fat with aortic valve calcification and mortality after transcatheter aortic valve replacement: the obesity paradox in severe aortic stenosis

被引:20
|
作者
Mancio, Jennifer [1 ,2 ]
Fonseca, Paulo [2 ]
Figueiredo, Bruno [1 ]
Ferreira, Wilson [2 ]
Carvalho, Monica [2 ]
Ferreira, Nuno [2 ]
Braga, Pedro [2 ]
Rodrigues, Alberto [2 ]
Barros, Antonio [1 ]
Falcao-Pires, Ines [1 ]
Leite-Moreira, Adelino [1 ,3 ]
Ribeiro, Vasco Gama [2 ]
Bettencourt, Nuno [1 ]
机构
[1] Univ Porto, Fac Med, Dept Cardiothorac Surg & Physiol, Alameda Prof Hernani Monteiro, P-4200319 Oporto, Portugal
[2] Ctr Hosp Vila Nova Gaia & Espinho, Dept Cardiol, Vila Nova De Gaia, Portugal
[3] Ctr Hosp Sao Joao, Dept Cardiothorac Surg, Oporto, Portugal
关键词
Severe aortic stenosis; Aortic valve calcification; Transcatheter aortic valve implantation; Obesity; Body mass index; Visceral abdominal fat; Mortality; Cardiac computed tomography; CHRONIC HEART-FAILURE; METABOLIC SYNDROME; PROGRESSION; WEIGHT; IMPLANTATION; IMPAIRMENT; SURVIVAL; INSIGHTS; INSULIN; DISEASE;
D O I
10.1186/s13098-017-0285-2
中图分类号
R5 [内科学];
学科分类号
1002 ; 100201 ;
摘要
Background: Previous studies showed that metabolic syndrome is associated with aortic valve calcification (AVC) and poor outcomes in aortic stenosis (AS). However, if these associations change and how body fat impacts the prognosis of patients in late stage of the disease have been not yet explored. Aims: To determine the association of body mass index (BMI) and visceral fat with AVC and mortality after transcatheter aortic valve replacement (TAVR). Methods: This was a prospective cohort of 170 severe AS patients referred to TAVR. We quantified AVC mass score and fat depots including epicardial adipose tissue, intrathoracic fat, and abdominal visceral (VAF) and subcutaneous fats by computed tomography. Fat depots were indexed to body surface area. All-cause and cardiovascular-related deaths after TAVR were recorded over a median follow-up of 1.2 years. Results: Higher AVC mass was independently associated with low BMI and low VAF. All-cause mortality risk increased with the decrease of BMI and increment of VAF. A stratified analysis by obesity showed that in non-obese, VAF was inversely associated with mortality, whereas in obese, high VAF was associated with higher mortality (p value for interaction < 0.05). At long-term, hazard ratio [HR] with non-obese/low VAF was 2.3 (95% confidence interval [CI] 1.1-4.9; p = 0.021) and HR with obese/high VAF was 2.5 (95% CI 1.1-5.8; p = 0.031) compared with obese/ low VAF patients. Conclusions: In AS patients submitted to TAVR, BMI and VAF were inversely associated with AVC. Pre-intervention assessment of VAF by computed tomography may provide a better discrimination of mortality than BMI alone.
引用
收藏
页数:10
相关论文
共 50 条
  • [31] Transcatheter aortic valve replacement valve in transcatheter aortic valve replacement valve for severe periprosthetic regurgitation
    Nandy, Sneha
    Wan, Siu-Hin
    Klarich, Kyle
    HEART VIEWS, 2020, 21 (01): : 49 - 51
  • [32] Sex Differences in the Impact of Aortic Valve Calcium Score on Mortality After Transcatheter Aortic Valve Replacement
    Patel, Parth P.
    El Sabbagh, Abdallah
    Johnson, Patrick W.
    Suliman, Rayan
    Salwa, Najiyah
    Morales-Lara, Andrea Carolina
    Pollak, Peter
    Yamani, Mohamad
    Parikh, Pragnesh
    Sonavane, Sushilkumar K.
    Landolfo, Carolyn
    Alkhouli, Mohamad Adnan
    Eleid, Mackram F.
    Guerrero, Mayra
    Fortuin, F. David
    Sweeney, John
    Noseworthy, Peter A.
    Carter, Rickey E.
    Adedinsewo, Demilade
    CIRCULATION-CARDIOVASCULAR IMAGING, 2022, 15 (08) : 592 - 602
  • [33] Bicuspid Aortic Valve Morphology and Outcomes After Transcatheter Aortic Valve Replacement
    Yoon, Sung-Han
    Kim, Won-Keun
    Dhoble, Abhijeet
    Pio, Stephan Milhorini
    Babaliaros, Vasilis
    Jilaihawi, Hasan
    Pilgrim, Thomas
    De Backer, Ole
    Bleiziffer, Sabine
    Vincent, Flavien
    Schmidit, Tobias
    Butter, Christian
    Kamioka, Norihiko
    Eschenbach, Lena
    Renker, Matthias
    Asami, Masahiko
    Lazkani, Mohamad
    Fujita, Buntaro
    Birs, Antoinette
    Barbanti, Marco
    Pershad, Ashish
    Landes, Uri
    Oldemeyer, Brad
    Kitamura, Mitusnobu
    Oakley, Luke
    Ochiai, Tomoki
    Chakravarty, Tarun
    Nakamura, Mamoo
    Ruile, Philip
    Deuschl, Florian
    Berman, Daniel
    Modine, Thomas
    Ensminger, Stephan
    Kornowski, Ran
    Lange, Rudiger
    McCabe, James M.
    Williams, Mathew R.
    Whisenant, Brian
    Delgado, Victoria
    Windecker, Stephan
    Van Belle, Eric
    Sondergaard, Lars
    Chevalier, Bernard
    Mack, Michael
    Bax, Jeroen J.
    Leon, Martin B.
    Makkar, Raj R.
    JOURNAL OF THE AMERICAN COLLEGE OF CARDIOLOGY, 2020, 76 (09) : 1018 - 1030
  • [34] Reversibility of Cardiac Function Predicts Outcome After Transcatheter Aortic Valve Replacement in Patients With Severe Aortic Stenosis
    Sato, Kimi
    Kumar, Arnav
    Jones, Brandon M.
    Mick, Stephanie L.
    Krishnaswamy, Amar
    Grimm, Richard A.
    Desai, Milind Y.
    Griffin, Brian P.
    Rodriguez, L. Leonardo
    Kapadia, Samir R.
    Obuchowski, Nancy A.
    Popovic, Zoran B.
    JOURNAL OF THE AMERICAN HEART ASSOCIATION, 2017, 6 (07):
  • [35] Does Body Mass Index Affect Outcomes for Aortic Valve Replacement Surgery for Aortic Stenosis?
    Smith, Robert L., II
    Herbert, Morley A.
    Dewey, Todd M.
    Brinkman, William T.
    Prince, Syma L.
    Ryan, William H.
    Mack, Michael J.
    ANNALS OF THORACIC SURGERY, 2012, 93 (03) : 742 - 747
  • [36] Outcomes of transcatheter aortic valve replacement in bicuspid aortic valve stenosis
    Bob-Manuel, Tamunoinemi
    Heckle, Mark R.
    Ifedili, Ikechukwu A.
    Wang, Jiajing
    Ibebuogu, Uzoma N.
    ANNALS OF TRANSLATIONAL MEDICINE, 2019, 7 (05)
  • [37] BMI and acute kidney injury post transcatheter aortic valve replacement: unveiling the obesity paradox
    De Marzo, Vincenzo
    Crimi, Gabriele
    Benenati, Stefano
    Buscaglia, Angelo
    Pescetelli, Fabio
    Vercellino, Matteo
    Della Bona, Roberta
    Sarocchi, Matteo
    Canepa, Marco
    Ameri, Pietro
    Balbi, Manrico
    Porto, Italo
    JOURNAL OF CARDIOVASCULAR MEDICINE, 2021, 22 (07) : 579 - 585
  • [38] Prosthetic Valve Function after Aortic Valve Replacement for Severe Aortic Stenosis by Transcatheter Procedure versus Surgery
    Saito, Shunsuke
    Sairenchi, Toshimi
    Hirota, Shotaro
    Niitsuma, Ken
    Yokoyama, Shohei
    Kanno, Yasuyuki
    Kanazawa, Yuta
    Tezuka, Masahiro
    Takei, Yusuke
    Tsuchiya, Go
    Konishi, Taisuke
    Shibasaki, Ikuko
    Ogata, Koji
    Monta, Osamu
    Tsutsumi, Yasushi
    Fukuda, Hirotsugu
    JOURNAL OF CARDIOVASCULAR DEVELOPMENT AND DISEASE, 2022, 9 (10)
  • [39] Transcatheter aortic valve implantation versus surgical aortic valve replacement for severe aortic stenosis: a meta analysis
    Wu Yi-cheng
    Zhang Jian-feng
    Shen Wei-feng
    Zhao Qiang
    CHINESE MEDICAL JOURNAL, 2013, 126 (06) : 1171 - 1177
  • [40] Is transcatheter aortic valve replacement a safe treatment for elderly patients with severe aortic valve stenosis?
    Mohammadi, Mina
    Hill, Catherine
    Chaney, Susan
    JOURNAL OF THE AMERICAN ASSOCIATION OF NURSE PRACTITIONERS, 2016, 28 (07) : 387 - 392