466 ConfirmRx Device Movement and R-Wave Amplitudes at 30 Days Post Implant

Abstract

Background: Frailty in TAVI patients correlates with poorer clinical outcomes. Sarcopenia as assessed on routine pre-TAVI CT imaging may provide a surrogate measure of frailty.Methods: Retrospective analysis of patients who underwent pre-TAVI CT imaging at a major tertiary hospital between 2009-2019. Skeletal muscle area was calculated on CT by 2 measures: overall cross-sectional skeletal muscle mass standardised for height (SMI) and psoas muscle area standardised for body surface (PMA) at L3 level. Sarcopenia cutoff on SMI was defined as ,52.4 cm 2 /m 2 in males and ,38.5 cm 2 /m 2 in females. We evaluated outcomes of mortality and composite endpoint of serious post-procedural complications being vascular complications, stroke, pulmonary embolus, new arrhythmia and acute kidney injury. Stepwise logistic regression was used to determine association between CT skeletal muscles measures and outcomes.Outcomes: In 258 patients who underwent TAVI, 191(74%) had assessable SMI and 221(80%) had assessable PMA. Mean SMI was 43.7 cm 2 /m 2 for males and 37.7 cm 2 / m 2 for females, with 138/191(72%) being sarcopenic. Sarcopenic patients were more likely to be male (p,0.001), nonobese (p,0.001), smokers (p=0.045), have CKD (p=0.01) and pulmonary hypertension (p=0.04). Sarcopenia defined by SMI independently predicted risk of post-procedural complications (OR 3.38, p=0.04) however did not predict mortality. PMA was inversely associated with all-cause mortality (OR 0.83, p=0.04) and risk of serious post-procedural complications (OR 0.79, p,0.001).Conclusion: Pre-procedural CT-defined measures of skeletal muscle indicative of sarcopenia predicts both serious post-procedural complications and all-cause mortality in patients undergoing TAVI. Further studies are warranted to compare clinical frailty markers with CT-defined measures of sarcopenia.