Gait Speed Assessment in Transcatheter Aortic Valve Replacement

Afilalo, Jonathan; Forman, Daniel E.

doi:10.1161/circinterventions.117.005746

Cited by 4 publications

(2 citation statements)

References 13 publications

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“…First, an important ancillary question in this study is whether these CT-based measures meet the standard of a contemporary biomarker of mortality in TAVR patients by providing incremental prognostic information (e.g., discrimination, reclassification) beyond known frailty metrics (e.g., 5-m walk time, grip strength) prognostic in TAVR. 6,12,27 Assessment of incremental value will require large, multi-center studies with careful prospective, comprehensive phenotyping of modern frailty indices (e.g., Fried index) alongside CT imaging to provide a definitive answer. Second, the role of interventions that combat obesity and sarcopenia (e.g., fitness training post-TAVR convalescence) is relevant, and the use of CT-based imaging markers that directly quantitate tissue phenotypes may be important alongside clinical metrics (frailty, exercise capacity, survival) to understand mechanisms of benefit for these interventions.…”

Section: Discussionmentioning

confidence: 99%

Computed tomography-based fat and muscle characteristics are associated with mortality after transcatheter aortic valve replacement

Foldyna

Troschel

Fintelmann

et al. 2018

Journal of Cardiovascular Computed Tomography

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Rapid CT-based tissue characterization is feasible in patients referred for TAVR. Decreased PM area and increased SAT density are associated with long-term mortality after TAVR, even after accounting for age, sex, BMI, and STS score. Further studies are necessary to interrogate sex-specific relationships between CT tissue metrics and mortality and whether CT measures are incremental to well-established frailty metrics.

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Section: Discussionmentioning

confidence: 99%

Computed tomography-based fat and muscle characteristics are associated with mortality after transcatheter aortic valve replacement

Foldyna

Troschel

Fintelmann

et al. 2018

Journal of Cardiovascular Computed Tomography

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“…1,2 For many health conditions, clinical assessments of physical performance are conducted to ascertain health status, to evaluate effectiveness of interventions, and/or to determine readiness for certain types of interventions, such as surgery. 3 How a person functions when tested clinically and when they are in their natural environment can be quite different. This difference can affect how the result of a functional test is interpreted, which is important not only for clinical care but also in research when functional outcomes provide evidentiary support for new interventions.…”

Section: Cme/cne Informationmentioning

confidence: 99%

Clinically Assessed Walking Capacity Versus Real-World Walking Performance in People with Multiple Sclerosis

Mate¹,

Mayo²

2020

International Journal of MS Care

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CME/CNE Information Activity Available Online: To access the article, post-test, and evaluation online, go to http://www.cmscscholar.org. Target Audience: The target audience for this activity is physicians, physician assistants, nursing professionals, and other health care providers involved in the management of patients with multiple sclerosis (MS). Learning Objectives: 1) Differentiate between measurement tools for clinical walking capacity and for real-world performance. 2) Describe discrepancies between performance on a walking capacity test and real-world performance, and how these discrepancies vary between patients with high versus low walking capacity. Accreditation Statement: In support of improving patient care, this activity has been planned and implemented by the Consortium of Multiple Sclerosis Centers (CMSC) and Delaware Media Group. The CMSC is jointly accredited by the Accreditation Council for Continuing Medical Education (ACCME), the Accreditation Council for Pharmacy Education (ACPE), and the American Nurses Credentialing Center (ANCC), to provide continuing education for the healthcare team. Physician Credit: The CMSC designates this journal-based activity for a maximum of 1.0 AMA PRA Category 1 Credit(s)™. Physicians should claim only the credit commensurate with the extent of their participation in the activity. Nurse Credit: The CMSC designates this enduring material for 1.0 contact hour (none in the area of pharmacology). Disclosures: Francois Bethoux, MD, Editor in Chief of the International Journal of MS Care (IJMSC), has served as Physician Planner for this activity. He has disclosed relationships with Springer Publishing (royalty), Qr8 (receipt of intellectual property rights/patent holder), Biogen (receipt of intellectual property rights/patent holder, speakers’ bureau), GW Pharma (consulting fee), BioRhythms (consulting fee, contracted research), and Adamas Pharmaceuticals (contracted research). Laurie Scudder, DNP, NP, has served as Reviewer for this activity. She has disclosed no relevant financial relationships. Kedar K.V. Mate, PhD, has disclosed no relevant financial relationships. Nancy E. Mayo, PhD, has disclosed no relevant financial relationships. One peer reviewer for IJMSC has disclosed a relationship with Biogen (advisory board consultant, fee paid to institution); the other peer reviewer has disclosed no relevant financial relationships. The staff at IJMSC, CMSC, and Delaware Media Group who are in a position to influence content have disclosed no relevant financial relationships. Note: Financial relationships may have changed in the interval between listing these disclosures and publication of the article. Method of Participation: Release Date: June 1, 2020 Valid for Credit Through: June 1, 2021 In order to receive CME/CNE credit, participants must: 1) Review the continuing education information, including learning objectives and author disclosures.2) Study the educational content.3) Complete the post-test and evaluation, which are available at http://www.cmscscholar.org Statements of Credit are awarded upon successful completion of the post-test with a passing score of >70% and the evaluation. There is no fee to participate in this activity. Disclosure of Unlabeled Use: This educational activity may contain discussion of published and/or investigational uses of agents that are not approved by the FDA. CMSC and Delaware Media Group do not recommend the use of any agent outside of the labeled indications. The opinions expressed in the educational activity are those of the faculty and do not necessarily represent the views of CMSC or Delaware Media Group. Disclaimer: Participants have an implied responsibility to use the newly acquired information to enhance patient outcomes and their own professional development. The information presented in this activity is not meant to serve as a guideline for patient management. Any medications, diagnostic procedures, or treatments discussed in this publication should not be used by clinicians or other health care professionals without first evaluating their patients’ conditions, considering possible contraindications or risks, reviewing any applicable manufacturer’s product information, and comparing any therapeutic approach with the recommendations of other authorities.

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Gait Speed and 1‐Year Mortality Following Cardiac Surgery: A Landmark Analysis From the Society of Thoracic Surgeons Adult Cardiac Surgery Database

Afilalo

Sharma

Zhang

et al. 2018

JAHA

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Background In older adults undergoing cardiac surgery, prediction of downstream risk is critical. Our objective was to determine the association of 5‐m gait speed with 1‐year mortality and repeat hospitalization following cardiac surgery. Methods and Results In this prospective cohort of patients undergoing cardiac surgery at centers participating in the Society of Thoracic Surgeons Database with gait speed recorded, we examined all‐cause mortality using a landmark analysis at 0 to 30, 30 to 365, and >365 days, as well as repeat hospitalization. The cohort consisted of 8287 patients (median age, 74 years; 32% females). At 1 year, survival was 90% in the slow (<0.83 m/s), 95% in the middle (0.83–1.00 m/s), and 97% in the fast (>1.00 m/s) gait speed tertiles, and risk of hospitalization was 45%, 33%, and 27%, respectively (both P <0.0001). After adjustment, gait speed remained predictive of mortality (hazard ratio, 2.16 per 0.1‐m/s decrease in gait speed; 95% confidence interval, 1.59–2.93) and rehospitalization (hazard ratio, 1.71 per 0.1‐m/s decrease in gait speed; 95% confidence interval, 1.45–2.0). In a landmark analysis, the effect of slow gait speed on mortality was most marked from 30 to 365 days after surgery, where each decline in 0.1 m/s of gait speed conferred a 2‐fold increased risk of mortality. Conclusions Gait speed is a simple tool to screen for frailty and identify older adults at risk for adverse events in the early and midterm postoperative periods.

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Gait Speed Assessment in Transcatheter Aortic Valve Replacement

Cited by 4 publications

References 13 publications

Computed tomography-based fat and muscle characteristics are associated with mortality after transcatheter aortic valve replacement

Computed tomography-based fat and muscle characteristics are associated with mortality after transcatheter aortic valve replacement

Clinically Assessed Walking Capacity Versus Real-World Walking Performance in People with Multiple Sclerosis

Gait Speed and 1‐Year Mortality Following Cardiac Surgery: A Landmark Analysis From the Society of Thoracic Surgeons Adult Cardiac Surgery Database

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