Prognostic Impact of Computed Tomography-Derived Abdominal Fat Area on Transcatheter Aortic Valve Implantation
Background: Obesity has previously been identified as an indicator of good prognosis in patients undergoing transcatheter aortic valve implantation (TAVI), an association known as the “obesity paradox”. We investigated whether abdominal total fat area (TFA), visceral fat area (VFA), or subcutaneous...
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| Veröffentlicht in: | Circulation Journal 2018/11/24, Vol.82(12), pp.3082-3089 |
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| creator | Okuno, Taishi Koseki, Keita Nakanishi, Toru Ninomiya, Kai Tomii, Daijiro Tanaka, Tetsu Sato, Yu Osanai, Akira Sato, Kei Koike, Hideki Yahagi, Kazuyuki Kishi, Satoru Komiyama, Kota Aoki, Jiro Yokozuka, Motoi Miura, Sumio Tanabe, Kengo |
| description | Background: Obesity has previously been identified as an indicator of good prognosis in patients undergoing transcatheter aortic valve implantation (TAVI), an association known as the “obesity paradox”. We investigated whether abdominal total fat area (TFA), visceral fat area (VFA), or subcutaneous fat area (SFA) are prognostic indicators of long-term clinical outcome in patients undergoing TAVI. Methods and Results: We retrospectively analyzed 100 consecutive patients who underwent TAVI between December 2013 and April 2017. TFA, VFA, and SFA were measured from routine pre-procedural computed tomography (CT). Patients were divided into 2 groups according to median TFA, VFA, or SFA, and we investigated the association of abdominal fat area with adverse clinical events, including all-cause death and re-hospitalization due to worsening heart failure. At a median follow-up of 665 days, patients with higher SFA had significantly lower incidence of the composite outcome and all-cause death compared with patients with lower SFA (15.0% vs. 37.7%, P=0.025; and 8.9% vs. 23.7%, P=0.047, respectively). In contrast, patients with higher TFA or VFA did not show significant reduction in the incidences of the composite outcome or all-cause mortality. Conclusions: CT-derived SFA had prognostic value in patients undergoing TAVI. |
| doi_str_mv | 10.1253/circj.CJ-18-0709 |
| format | Article |
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We investigated whether abdominal total fat area (TFA), visceral fat area (VFA), or subcutaneous fat area (SFA) are prognostic indicators of long-term clinical outcome in patients undergoing TAVI. Methods and Results: We retrospectively analyzed 100 consecutive patients who underwent TAVI between December 2013 and April 2017. TFA, VFA, and SFA were measured from routine pre-procedural computed tomography (CT). Patients were divided into 2 groups according to median TFA, VFA, or SFA, and we investigated the association of abdominal fat area with adverse clinical events, including all-cause death and re-hospitalization due to worsening heart failure. At a median follow-up of 665 days, patients with higher SFA had significantly lower incidence of the composite outcome and all-cause death compared with patients with lower SFA (15.0% vs. 37.7%, P=0.025; and 8.9% vs. 23.7%, P=0.047, respectively). In contrast, patients with higher TFA or VFA did not show significant reduction in the incidences of the composite outcome or all-cause mortality. Conclusions: CT-derived SFA had prognostic value in patients undergoing TAVI.</description><identifier>ISSN: 1346-9843</identifier><identifier>ISSN: 1347-4820</identifier><identifier>EISSN: 1347-4820</identifier><identifier>DOI: 10.1253/circj.CJ-18-0709</identifier><identifier>PMID: 30298852</identifier><language>eng</language><publisher>Japan: The Japanese Circulation Society</publisher><subject>Abdominal Fat - diagnostic imaging ; Aged, 80 and over ; Aortic Valve - diagnostic imaging ; Aortic Valve - surgery ; Aortic Valve Stenosis - diagnostic imaging ; Aortic Valve Stenosis - mortality ; Aortic Valve Stenosis - surgery ; Computed tomography ; Disease-Free Survival ; Female ; Follow-Up Studies ; Heart Valve Prosthesis ; Humans ; Incidence ; Male ; Obesity paradox ; Retrospective Studies ; Subcutaneous fat area ; Survival Rate ; Tomography, X-Ray Computed ; Transcatheter aortic valve implantation ; Transcatheter Aortic Valve Replacement</subject><ispartof>Circulation Journal, 2018/11/24, Vol.82(12), pp.3082-3089</ispartof><rights>2018 THE JAPANESE CIRCULATION SOCIETY</rights><lds50>peer_reviewed</lds50><oa>free_for_read</oa><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c623t-1db6a19b887441189b343a61d20d3a330e7aaaa8948b72a8c06861c6e888f99c3</citedby><cites>FETCH-LOGICAL-c623t-1db6a19b887441189b343a61d20d3a330e7aaaa8948b72a8c06861c6e888f99c3</cites></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><link.rule.ids>314,776,780,1877,27901,27902</link.rule.ids><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/30298852$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Okuno, Taishi</creatorcontrib><creatorcontrib>Koseki, Keita</creatorcontrib><creatorcontrib>Nakanishi, Toru</creatorcontrib><creatorcontrib>Ninomiya, Kai</creatorcontrib><creatorcontrib>Tomii, Daijiro</creatorcontrib><creatorcontrib>Tanaka, Tetsu</creatorcontrib><creatorcontrib>Sato, Yu</creatorcontrib><creatorcontrib>Osanai, Akira</creatorcontrib><creatorcontrib>Sato, Kei</creatorcontrib><creatorcontrib>Koike, Hideki</creatorcontrib><creatorcontrib>Yahagi, Kazuyuki</creatorcontrib><creatorcontrib>Kishi, Satoru</creatorcontrib><creatorcontrib>Komiyama, Kota</creatorcontrib><creatorcontrib>Aoki, Jiro</creatorcontrib><creatorcontrib>Yokozuka, Motoi</creatorcontrib><creatorcontrib>Miura, Sumio</creatorcontrib><creatorcontrib>Tanabe, Kengo</creatorcontrib><title>Prognostic Impact of Computed Tomography-Derived Abdominal Fat Area on Transcatheter Aortic Valve Implantation</title><title>Circulation Journal</title><addtitle>Circ J</addtitle><description>Background: Obesity has previously been identified as an indicator of good prognosis in patients undergoing transcatheter aortic valve implantation (TAVI), an association known as the “obesity paradox”. We investigated whether abdominal total fat area (TFA), visceral fat area (VFA), or subcutaneous fat area (SFA) are prognostic indicators of long-term clinical outcome in patients undergoing TAVI. Methods and Results: We retrospectively analyzed 100 consecutive patients who underwent TAVI between December 2013 and April 2017. TFA, VFA, and SFA were measured from routine pre-procedural computed tomography (CT). Patients were divided into 2 groups according to median TFA, VFA, or SFA, and we investigated the association of abdominal fat area with adverse clinical events, including all-cause death and re-hospitalization due to worsening heart failure. At a median follow-up of 665 days, patients with higher SFA had significantly lower incidence of the composite outcome and all-cause death compared with patients with lower SFA (15.0% vs. 37.7%, P=0.025; and 8.9% vs. 23.7%, P=0.047, respectively). In contrast, patients with higher TFA or VFA did not show significant reduction in the incidences of the composite outcome or all-cause mortality. Conclusions: CT-derived SFA had prognostic value in patients undergoing TAVI.</description><subject>Abdominal Fat - diagnostic imaging</subject><subject>Aged, 80 and over</subject><subject>Aortic Valve - diagnostic imaging</subject><subject>Aortic Valve - surgery</subject><subject>Aortic Valve Stenosis - diagnostic imaging</subject><subject>Aortic Valve Stenosis - mortality</subject><subject>Aortic Valve Stenosis - surgery</subject><subject>Computed tomography</subject><subject>Disease-Free Survival</subject><subject>Female</subject><subject>Follow-Up Studies</subject><subject>Heart Valve Prosthesis</subject><subject>Humans</subject><subject>Incidence</subject><subject>Male</subject><subject>Obesity paradox</subject><subject>Retrospective Studies</subject><subject>Subcutaneous fat area</subject><subject>Survival Rate</subject><subject>Tomography, X-Ray Computed</subject><subject>Transcatheter aortic valve implantation</subject><subject>Transcatheter Aortic Valve Replacement</subject><issn>1346-9843</issn><issn>1347-4820</issn><issn>1347-4820</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2018</creationdate><recordtype>article</recordtype><sourceid>EIF</sourceid><recordid>eNpFkE1v2zAMhoViQ7_vOw067uJOH45NHQOv7VoU2A7ZrgItM4kD2_IkpUD__ewmbXWgCOLhA-Jl7IsUN1It9HfXBre7qR4zCZkohTlh51LnZZaDEp9e-yIzkOszdhHjTghlxMKcsjM9dQALdc6G38FvBh9T6_hDP6JL3K955ftxn6jhK9_7TcBx-5L9oNA-T6Nl3fi-HbDjd5j4MhByP_BVwCE6TFtKFPjSh1n4F7tnmrUdDglT64cr9nmNXaTr43_J_tzdrqqf2dOv-4dq-ZS5QumUyaYuUJoaoMxzKcHUOtdYyEaJRqPWgkqcHpgc6lIhOFFAIV1BALA2xulL9u3gHYP_t6eYbN9GR910CPl9tErKUhuZaz2h4oC64GMMtLZjaHsML1YKO6dsX1O21aOVYOeUp5WvR_u-7ql5X3iLdQLuD8AuJtzQO4BzLB0djaAm_1w_1B_EFoOlQf8HhAWTiA</recordid><startdate>20181124</startdate><enddate>20181124</enddate><creator>Okuno, Taishi</creator><creator>Koseki, Keita</creator><creator>Nakanishi, Toru</creator><creator>Ninomiya, Kai</creator><creator>Tomii, Daijiro</creator><creator>Tanaka, Tetsu</creator><creator>Sato, Yu</creator><creator>Osanai, Akira</creator><creator>Sato, Kei</creator><creator>Koike, Hideki</creator><creator>Yahagi, Kazuyuki</creator><creator>Kishi, Satoru</creator><creator>Komiyama, Kota</creator><creator>Aoki, Jiro</creator><creator>Yokozuka, Motoi</creator><creator>Miura, Sumio</creator><creator>Tanabe, Kengo</creator><general>The Japanese Circulation Society</general><scope>CGR</scope><scope>CUY</scope><scope>CVF</scope><scope>ECM</scope><scope>EIF</scope><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>7X8</scope></search><sort><creationdate>20181124</creationdate><title>Prognostic Impact of Computed Tomography-Derived Abdominal Fat Area on Transcatheter Aortic Valve Implantation</title><author>Okuno, Taishi ; Koseki, Keita ; Nakanishi, Toru ; Ninomiya, Kai ; Tomii, Daijiro ; Tanaka, Tetsu ; Sato, Yu ; Osanai, Akira ; Sato, Kei ; Koike, Hideki ; Yahagi, Kazuyuki ; Kishi, Satoru ; Komiyama, Kota ; Aoki, Jiro ; Yokozuka, Motoi ; Miura, Sumio ; Tanabe, Kengo</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c623t-1db6a19b887441189b343a61d20d3a330e7aaaa8948b72a8c06861c6e888f99c3</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2018</creationdate><topic>Abdominal Fat - diagnostic imaging</topic><topic>Aged, 80 and over</topic><topic>Aortic Valve - diagnostic imaging</topic><topic>Aortic Valve - surgery</topic><topic>Aortic Valve Stenosis - diagnostic imaging</topic><topic>Aortic Valve Stenosis - mortality</topic><topic>Aortic Valve Stenosis - surgery</topic><topic>Computed tomography</topic><topic>Disease-Free Survival</topic><topic>Female</topic><topic>Follow-Up Studies</topic><topic>Heart Valve Prosthesis</topic><topic>Humans</topic><topic>Incidence</topic><topic>Male</topic><topic>Obesity paradox</topic><topic>Retrospective Studies</topic><topic>Subcutaneous fat area</topic><topic>Survival Rate</topic><topic>Tomography, X-Ray Computed</topic><topic>Transcatheter aortic valve implantation</topic><topic>Transcatheter Aortic Valve Replacement</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Okuno, Taishi</creatorcontrib><creatorcontrib>Koseki, Keita</creatorcontrib><creatorcontrib>Nakanishi, Toru</creatorcontrib><creatorcontrib>Ninomiya, Kai</creatorcontrib><creatorcontrib>Tomii, Daijiro</creatorcontrib><creatorcontrib>Tanaka, Tetsu</creatorcontrib><creatorcontrib>Sato, Yu</creatorcontrib><creatorcontrib>Osanai, Akira</creatorcontrib><creatorcontrib>Sato, Kei</creatorcontrib><creatorcontrib>Koike, Hideki</creatorcontrib><creatorcontrib>Yahagi, Kazuyuki</creatorcontrib><creatorcontrib>Kishi, Satoru</creatorcontrib><creatorcontrib>Komiyama, Kota</creatorcontrib><creatorcontrib>Aoki, Jiro</creatorcontrib><creatorcontrib>Yokozuka, Motoi</creatorcontrib><creatorcontrib>Miura, Sumio</creatorcontrib><creatorcontrib>Tanabe, Kengo</creatorcontrib><collection>Medline</collection><collection>MEDLINE</collection><collection>MEDLINE (Ovid)</collection><collection>MEDLINE</collection><collection>MEDLINE</collection><collection>PubMed</collection><collection>CrossRef</collection><collection>MEDLINE - Academic</collection><jtitle>Circulation Journal</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Okuno, Taishi</au><au>Koseki, Keita</au><au>Nakanishi, Toru</au><au>Ninomiya, Kai</au><au>Tomii, Daijiro</au><au>Tanaka, Tetsu</au><au>Sato, Yu</au><au>Osanai, Akira</au><au>Sato, Kei</au><au>Koike, Hideki</au><au>Yahagi, Kazuyuki</au><au>Kishi, Satoru</au><au>Komiyama, Kota</au><au>Aoki, Jiro</au><au>Yokozuka, Motoi</au><au>Miura, Sumio</au><au>Tanabe, Kengo</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Prognostic Impact of Computed Tomography-Derived Abdominal Fat Area on Transcatheter Aortic Valve Implantation</atitle><jtitle>Circulation Journal</jtitle><addtitle>Circ J</addtitle><date>2018-11-24</date><risdate>2018</risdate><volume>82</volume><issue>12</issue><spage>3082</spage><epage>3089</epage><pages>3082-3089</pages><issn>1346-9843</issn><issn>1347-4820</issn><eissn>1347-4820</eissn><abstract>Background: Obesity has previously been identified as an indicator of good prognosis in patients undergoing transcatheter aortic valve implantation (TAVI), an association known as the “obesity paradox”. We investigated whether abdominal total fat area (TFA), visceral fat area (VFA), or subcutaneous fat area (SFA) are prognostic indicators of long-term clinical outcome in patients undergoing TAVI. Methods and Results: We retrospectively analyzed 100 consecutive patients who underwent TAVI between December 2013 and April 2017. TFA, VFA, and SFA were measured from routine pre-procedural computed tomography (CT). Patients were divided into 2 groups according to median TFA, VFA, or SFA, and we investigated the association of abdominal fat area with adverse clinical events, including all-cause death and re-hospitalization due to worsening heart failure. At a median follow-up of 665 days, patients with higher SFA had significantly lower incidence of the composite outcome and all-cause death compared with patients with lower SFA (15.0% vs. 37.7%, P=0.025; and 8.9% vs. 23.7%, P=0.047, respectively). In contrast, patients with higher TFA or VFA did not show significant reduction in the incidences of the composite outcome or all-cause mortality. Conclusions: CT-derived SFA had prognostic value in patients undergoing TAVI.</abstract><cop>Japan</cop><pub>The Japanese Circulation Society</pub><pmid>30298852</pmid><doi>10.1253/circj.CJ-18-0709</doi><tpages>8</tpages><oa>free_for_read</oa></addata></record> |
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| subjects | Abdominal Fat - diagnostic imaging Aged, 80 and over Aortic Valve - diagnostic imaging Aortic Valve - surgery Aortic Valve Stenosis - diagnostic imaging Aortic Valve Stenosis - mortality Aortic Valve Stenosis - surgery Computed tomography Disease-Free Survival Female Follow-Up Studies Heart Valve Prosthesis Humans Incidence Male Obesity paradox Retrospective Studies Subcutaneous fat area Survival Rate Tomography, X-Ray Computed Transcatheter aortic valve implantation Transcatheter Aortic Valve Replacement |
| title | Prognostic Impact of Computed Tomography-Derived Abdominal Fat Area on Transcatheter Aortic Valve Implantation |
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