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Assessment of transabdominal fat volumes as a predictor of prognosis in patients undergoing transcatheter aortic valve replacement

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Abstract

Transcatheter aortic valve replacement (TAVR) has emerged as a well-established treatment option for eligible patients with severe aortic stenosis. This study aimed to investigate the correlation between abdominal fat tissue volumes, measured using computed tomography (CT), and all-cause mortality in patients undergoing TAVR. The study included 258 consecutive patients who underwent TAVR at a single center between September 2017 and November 2020. During the preoperative preparation, CT scans were used to perform a semi-quantitative measurement of abdominal fat components. Body mass index (BMI) for each participant was calculated. The relationship between fat parameters and overall survival was determined using multivariable Cox proportional hazards models. Participants had a mean age of 76.8 ± 7.8 years, of whom 32.9% were male. The median follow-up period was 12 months, during which 38 patients (14.7%) died. Both the survivor and non-survivor groups showed comparable risk factors. Regarding transabdominal fat volume parameters, deceased individuals exhibited significantly lower values. However, no significant differences were observed in BMI and transabdominal area measurements. Among transabdominal fat parameters, only subcutaneous fat volume [adjusted Hazard Ratio (aHR) = 0.83, p = 0.045] and total fat volume (TFV) [aHR = 0.82, p = 0.007] were identified as significant predictors of reduced all-cause mortality. Furthermore, TFV demonstrated the highest discriminative performance with a threshold of ≤ 9.1 L (AUC = 0.751, p < 0.001, sensitivity 71.1%, specificity 70.9%). Preoperative CT-based abdominal fat volume parameters, particularly TFV, can serve as potential predictors of survival in patients undergoing TAVR.

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Funding

No funding was received for this research. The authors declare that no funds, grants, or other support were received during the preparation of this manuscript.

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Authors and Affiliations

  1. Department of Cardiology, Basaksehir Cam & Sakura City Hospital, Istanbul, Turkey

    Ahmet Guler, Omer Genc & Aslan Erdogan

  2. Department of Cardiology, Adana City Training & Research Hospital, University of Health Sciences, Adana, Turkey

    Abdullah Yildirim, Bozkurt Gulek & Ibrahim Halil Kurt

  3. Department of Cardiology, Adana Cukurova State Hospital, Adana, Turkey

    Orsan Deniz Urgun

  4. Department of Radiology, Adana City Training & Research Hospital, University of Health Sciences, Adana, Turkey

    Okan Dilek

  5. Department of Cardiology, Adana Medical Park Hospital, Adana, Turkey

    Omer Sen

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  1. Ahmet Guler
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Contributions

Genc O., Yildirim A., Dilek O., Urgun O.D., Gulek B., Kurt I.H. and Guler A. carried out the study, participated in collecting data and drafted the manuscript. Genc O., Guler A., and Sen O. performed the statistical analysis and participated in its design. Guler A., Genc O., Yildirim A., Urgun O.D., Gulek B., and Kurt I.H. participated in the acquisition, analysis, or interpretation of data and draft of the manuscript. All authors have read and approved to the published version of the manuscript.

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Correspondence to Ahmet Guler.

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Guler, A., Genc, O., Yildirim, A. et al. Assessment of transabdominal fat volumes as a predictor of prognosis in patients undergoing transcatheter aortic valve replacement. Int J Cardiovasc Imaging (2024). https://doi.org/10.1007/s10554-024-03079-x

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