Department of Cardiology, University Hospital Antwerp, Edegem, Antwerp, Belgium.
Department of Cardiology, ZorgSaam Hospital, Terneuzen, The Netherlands.
Clin Cardiol. 2022 Oct;45(10):1060-1069. doi: 10.1002/clc.23892. Epub 2022 Aug 6.
Quantifiable biomarkers may be useful for a better risk and frailty assessment of patients referred for transcatheter aortic valve implantation (TAVI).
To determine if adiponectin serum concentration predicts all-cause mortality in patients undergoing TAVI.
77 consecutive patients, undergoing TAVI, were analyzed. The CT axial slices at the level of the fourth lumbar vertebra were used to measure the psoas muscle area, and its low-density muscle fraction (LDM (%)). To assess the operative risk, the STS (Society of Thoracic Surgeons Predicted Risk of Mortality) score, Log. Euroscore, and Euroscore II were determined. A clinical frailty assessment was performed. ELISA kits were used to measure adiponectin serum levels. We searched for a correlation between serum adiponectin concentration and all-cause mortality after TAVI.
The mean age was 80.8 ± 7.4 years. All-cause mortality occurred in 22 patients. The mean follow-up was 1779 days (range: 1572-1825 days). Compared with patients with the lowest adiponectin level, patients in the third tertile had a hazards ratio of all-cause mortality after TAVI of 4.155 (95% CI: 1.364-12.655) (p = .004). In the multivariable model, including STS score, vascular access of TAVI procedure, LDM (%), and adiponectin serum concentration, serum adiponectin level, and LDM(%) were independent predictors of all-cause mortality after TAVI (p = .178, .303, .042, and .017, respectively). Adiponectin level was a predictor of all-cause mortality in females and males (p = .012 and 0.024, respectively).
Adiponectin serum level is an independent and incremental predictor of all-cause mortality in patients undergoing TAVI.
量化生物标志物可能有助于更好地评估接受经导管主动脉瓣置换术（TAVI）的患者的风险和脆弱性。
确定脂联素血清浓度是否可预测接受 TAVI 的患者的全因死亡率。
分析了 77 例连续接受 TAVI 的患者。使用第四腰椎水平的 CT 轴位切片来测量腰大肌面积及其低密度肌肉分数（LDM（%））。为了评估手术风险，确定了 STS（胸外科医师协会预测死亡率）评分、Log.Euroscore 和 Euroscore II。进行了临床虚弱评估。使用 ELISA 试剂盒测量脂联素血清水平。我们研究了 TAVI 后血清脂联素浓度与全因死亡率之间的相关性。
平均年龄为 80.8±7.4 岁。共有 22 例患者发生全因死亡。平均随访时间为 1779 天（范围：1572-1825 天）。与血清脂联素水平最低的患者相比，第三三分位数患者的 TAVI 后全因死亡率的危险比为 4.155（95%CI：1.364-12.655）（p=0.004）。在包括 STS 评分、TAVI 手术的血管入路、LDM（%）和脂联素血清浓度在内的多变量模型中，血清脂联素水平和 LDM（%）是 TAVI 后全因死亡率的独立预测因子（p=0.178、0.303、0.042 和 0.017）。脂联素水平是女性和男性全因死亡率的预测因子（p=0.012 和 0.024）。
脂联素血清水平是接受 TAVI 的患者全因死亡率的独立且递增的预测因子。
