Role of computed tomography‐based evaluation of skeletal muscle area in predicting cardiovascular outcomes in patients with chronic heart failure after cardiac resynchronization therapy

Aim This study aimed to determine possible associations between sarcopenia and poor cardiovascular outcomes in patients with chronic heart failure after cardiac resynchronization therapy. Methods This retrospective study evaluated 120 patients who underwent cardiac resynchronization therapy between March 2004 and June 2018. In total, 58 patients who underwent computed tomography within 30 days of cardiac resynchronization therapy implantation were eligible for inclusion, and their data were analyzed (25 women; 33 men; mean age 71.6 ± 8.7 years). Skeletal muscle area was measured at the third lumbar vertebra, and skeletal muscle index was calculated. Major adverse cardiovascular events included cardiovascular death, hospitalization due to heart failure, cerebral infarction, acute myocardial infarction and cardiac arrest. Results During the follow‐up period (mean 868 ± 617 days), major adverse cardiovascular events occurred in 22 of 58 patients (38%). The patients were allocated to two groups according to sex‐based tertiles of skeletal muscle index. The lowest tertile was defined as the low skeletal muscle index group. Kaplan–Meier survival analysis showed that the low skeletal muscle index group had a higher incidence of major adverse cardiovascular events (log‐rank 4.38; P = 0.036). Cox proportional hazards regression analysis also showed that low skeletal muscle index values were significantly associated with major adverse cardiovascular events (hazard ratio 3.08; 95% confidence interval 1.26–7.66, P = 0.014). Conclusions Decreases in skeletal mass index on computed tomography might predict the occurrence of major adverse cardiovascular events in patients with chronic heart failure who underwent cardiac resynchronization therapy. Geriatr Gerontol Int 2022; 22: 1013–1018. This study aimed to explore the associations between sarcopenia and major adverse cardiovascular events in patients with chronic heart failure after cardiac resynchronization therapy. We calculated skeletal muscle index with skeletal muscle area measured at the third lumber vertebra. The low skeletal muscle index was significantly associated with the incidence of major adverse cardiovascular events and could be a predictor of poor cardiovascular outcomes in patients with cardiac resynchronization therapy.