Department of Radiology, University of Texas Southwestern Medical Center, Dallas, TX, 75390, USA.
Department of Internal Medicine, University of Texas Southwestern Medical Center, Dallas, TX, 75390, USA.
Clin Radiol. 2020 Dec;75(12):921-926. doi: 10.1016/j.crad.2020.07.011. Epub 2020 Aug 8.
To determine if there is an association between area-based visceral abdominal adipose tissue (VAT), subcutaneous abdominal adipose tissue (SAT), and abdominal circumference measured on computed tomography (CT) angiography before trans-catheter aortic valve replacement (TAVR) and post-TAVR acute kidney injury (AKI).
In this retrospective cohort study of 106 TAVR patients, SAT and VAT areas and abdominal circumference was measured on a single CT section at L4 vertebral level. Univariate comparisons between patients who did and did not develop AKI were undertaken for radiological measurements. Multivariable logistic regression was used to assess association between CT measurements and the development of post-TAVR AKI.
Post-TAVR AKI occurred in 20 of 106 patients (19%). In univariate comparisons, body mass index (BMI) did not differ significantly between patients who did and did not develop AKI (p=0.14); however, VAT+SAT (443.2±163.7 versus 351±168.7 cm; p=0.03), VAT (213.9±110.6 versus 153.9±96.1 cm; p=0.03), and outer abdominal circumference (100.2±14.4 cm versus 91.8±13.3 cm; p=0.02) were significantly higher in the patients who did not develop post-TAVR AKI. These three measures on pre-TAVR CT angiogram remained significantly associated with reduced post-TAVR AKI with a lower incidence of post-TAVR AKI after multivariable adjustment for pre-TAVR estimated glomerular filtration rate and patient height (p<0.05).
This study found that increased abdominal obesity as assessed by measures on pre-TAVR CT angiogram is associated with a significantly lower incidence of AKI.
确定经导管主动脉瓣置换术（TAVR）前 CT 血管造影测量的基于区域的内脏腹部脂肪组织（VAT）、腹部皮下脂肪组织（SAT）和腹围与 TAVR 后急性肾损伤（AKI）之间是否存在关联。
在这项对 106 例 TAVR 患者的回顾性队列研究中，在 L4 椎体水平的单个 CT 切片上测量 SAT 和 VAT 区域和腹围。对发生和未发生 AKI 的患者进行了影像学测量的单变量比较。多变量逻辑回归用于评估 CT 测量与 TAVR 后 AKI 发生之间的关联。
106 例患者中有 20 例（19%）发生 TAVR 后 AKI。在单变量比较中，发生和未发生 AKI 的患者的体重指数（BMI）无显著差异（p=0.14）；然而，VAT+SAT（443.2±163.7 与 351±168.7 cm；p=0.03）、VAT（213.9±110.6 与 153.9±96.1 cm；p=0.03）和外腹围（100.2±14.4 cm 与 91.8±13.3 cm；p=0.02）在未发生 TAVR 后 AKI 的患者中显著更高。这三个术前 CT 血管造影测量值在多变量调整了术前估计肾小球滤过率和患者身高后仍与 TAVR 后 AKI 发生率降低显著相关（p<0.05）。
这项研究发现，术前 CT 血管造影评估的腹部肥胖增加与 AKI 发生率显著降低相关。
