Dominic Bertschi, University Department of Geriatric Medicine FELIX PLATTER, Burgfelderstrasse 101, 4055 Basel, Switzerland,
J Nutr Health Aging. 2021;25(1):64-70. doi: 10.1007/s12603-020-1448-7.
In older patients, sarcopenia is a prevalent disease associated with negative outcomes. Sarcopenia has been investigated in patients undergoing transcatheter aortic valve implantation (TAVI), but the criteria for diagnosis of the disease are heterogeneous. This systematic review of the current literature aims to evaluate the prevalence of sarcopenia in patients undergoing TAVI and to analyse the impact of sarcopenia on clinical outcomes.
A comprehensive search of the literature has been performed in electronic databases from the date of initiation until March 2020. Using a pre-defined search strategy, we identified studies assessing skeletal muscle mass, muscle quality and muscle function as measures for sarcopenia in patients undergoing TAVI. We evaluated how sarcopenia affects the outcomes mortality at ≥1 year, prolonged length of hospital stay, and functional decline.
We identified 18 observational studies, enrolling a total number of 9'513 patients. For assessment of skeletal muscle mass, all included studies used data from computed tomography. Cut-off points for definition of low muscle mass were heterogeneous, and prevalence of sarcopenia varied between 21.0% and 70.2%. In uni- or multivariate regression analysis of different studies, low muscle mass was found to be a significant predictor of mortality, prolonged length of hospital stay, and functional decline. No interventional study was identified measuring the effect of nutritional or physiotherapy interventions on sarcopenia in TAVI patients.
Sarcopenia is highly prevalent among patients undergoing TAVI, and negatively affects important outcomes. Early diagnosis of this condition might allow a timely start of nutritional and physiotherapy interventions to prevent negative outcomes in TAVI patients.
在老年患者中，肌肉减少症是一种常见的疾病，与不良结局相关。肌肉减少症已经在接受经导管主动脉瓣置换术（TAVI）的患者中进行了研究，但是疾病的诊断标准存在异质性。本系统综述旨在评估 TAVI 患者中肌肉减少症的患病率，并分析肌肉减少症对临床结局的影响。
从开始日期到 2020 年 3 月，我们在电子数据库中进行了全面的文献检索。使用预先确定的搜索策略，我们确定了评估骨骼肌肉质量、肌肉质量和肌肉功能作为 TAVI 患者肌肉减少症测量指标的研究。我们评估了肌肉减少症如何影响 1 年以上死亡率、延长住院时间和功能下降等结局。
我们确定了 18 项观察性研究，共纳入了 9513 名患者。对于骨骼肌肉质量的评估，所有纳入的研究都使用了计算机断层扫描数据。低肌肉质量的定义切点存在异质性，肌肉减少症的患病率在 21.0%至 70.2%之间。在不同研究的单变量或多变量回归分析中，低肌肉质量被发现是死亡率、延长住院时间和功能下降的显著预测因素。我们没有发现评估营养或物理治疗干预对 TAVI 患者肌肉减少症影响的干预性研究。
肌肉减少症在接受 TAVI 的患者中非常普遍，并且对重要结局产生负面影响。早期诊断这种情况可能会及时开始营养和物理治疗干预，以防止 TAVI 患者的不良结局。
