Li Hongde, Li Weiya, Li Junli, Peng Shiqin, Feng Yuan, Peng Yong, Wei Jiafu, Zhao Zhengang, Xiong Tianyuan, Chen Fei, Chen Mao
Department of Cardiology, West China Hospital, Sichuan University, #37 Guoxue Alley, Chengdu, 610041, China; Laboratory of Cardiac Structure and Function, Institute of Cardiovascular Diseases, West China Hospital, Sichuan University, Chengdu, 610041, China.
Laboratory of Cardiac Structure and Function, Institute of Cardiovascular Diseases, West China Hospital, Sichuan University, Chengdu, 610041, China.
J Nutr Health Aging. 2025 Feb;29(2):100454. doi: 10.1016/j.jnha.2024.100454. Epub 2024 Dec 19.
Nutritional status, as one of the core characteristics of frailty, the impact of its changes on clinical outcomes in older patients following transcatheter aortic valve replacement (TAVR) remains unclear.
A retrospective cohort study.
This study included a total of 781 patients who underwent TAVR at West China Hospital between 2012 and 2022.
The average age of the patients was 72.6 years, with a mean follow-up period of 2.2 years. All patients were followed for at least one year, and their nutritional status was assessed using the Controlling Nutritional Status (CONUT) score both before TAVR and six months post-TAVR. Based on post-TAVR changes in nutritional status, patients with normal nutritional status pre-TAVR were categorized into Non-malnutrition and New malnutrition groups, while patients with malnutrition pre-TAVR were categorized into Malnutrition regression and Malnutrition persistence groups.
The New malnutrition group experienced higher cumulative incidences of all-cause mortality (20.5% vs. 2.4%, P = 0.002), MACE (25.5% vs. 23.7%, P = 0.001), and readmissions for heart failure (13.1% vs. 7.3%, P = 0.027) compared to the Non-malnutrition group. Conversely, the Malnutrition regression group showed a lower cumulative incidence of all-cause mortality (3.1% vs. 18.0%, P = 0.016) compared to the Malnutrition persistence group, although no statistically significant differences were observed in MACE (14.7% vs. 28.5%, P = 0.087) and readmissions for heart failure (7.0% vs. 8.3%, P = 0.551).
Our study indicates that deterioration in nutritional status after TAVR is associated with poorer clinical outcomes, whereas improvement is associated with better outcomes.
营养状况作为衰弱的核心特征之一，其变化对老年患者经导管主动脉瓣置换术（TAVR）后临床结局的影响尚不清楚。
一项回顾性队列研究。
本研究纳入了2012年至2022年期间在华西医院接受TAVR的781例患者。
患者的平均年龄为72.6岁，平均随访期为2.2年。所有患者均随访至少一年，在TAVR术前和术后6个月使用控制营养状况（CONUT）评分评估其营养状况。根据TAVR术后营养状况的变化，将TAVR术前营养状况正常的患者分为非营养不良组和新营养不良组，而TAVR术前营养不良的患者分为营养不良改善组和营养不良持续组。
与非营养不良组相比，新营养不良组的全因死亡率（20.5%对2.4%，P = 0.002）、主要不良心血管事件（MACE，25.5%对23.7%，P = 0.001）和因心力衰竭再次入院率（13.1%对7.3%，P = 0.027）的累积发生率更高。相反，与营养不良持续组相比，营养不良改善组的全因死亡率累积发生率较低（3.1%对18.0%，P = 0.016），尽管在MACE（14.7%对28.5%，P = 0.087）和因心力衰竭再次入院率（7.0%对8.3%，P = 0.551）方面未观察到统计学显著差异。
我们的研究表明，TAVR术后营养状况恶化与较差的临床结局相关，而改善则与较好的结局相关。
