Comprehensive assessment of sarcopenia in patients with severe aortic stenosis undergoing transcatheter valve implantation

Transcatheter aortic valve implantation (TAVI) is an effective treatment for aortic stenosis (AS), particularly in older, frail and sarcopenic patients. This study aimed to assess the prevalence of sarcopenia in patients undergoing TAVI and evaluate its imaging and functional markers.

This prospective single-center study included consecutive patients aged ≥ 75 years undergoing TAVI for symptomatic severe AS. Sarcopenia was assessed per the 2018 European Working Group on Sarcopenia in Older People 2 criteria, including muscle strength (hand grip, chair stand), muscle quantity (computed tomography, bioelectrical impedance, ultrasound), and physical performance (Short Physical Performance Battery, Timed Up and Go, 5-Meter and 6-Minute Walk).

Thirty patients (83.2 ± 16 years) with severe aortic stenosis (AVA 0.79 cm², SD 0.15), preserved left ventricular systolic function (ejection fraction (EF) = 60%, IQR: 50-62), and moderate procedural risk (Society of Thoracic Surgeons (STS) score 3.91%, IQR: 2.2–7.76) were included. Probable sarcopenia was identified in 83.33% (25) of patients. All had low physical performance, and 86.67% (26) exhibited low muscle quantity. Consequently, 73.3% met criteria for severe sarcopenia. Strong correlations were found between fat-free mass and total psoas muscle cross-sectional area at the L4 level (R = 0.791, P < 0.001), as well as total muscle cross-sectional area at the L3 level (R = 0.722, P < 0.001).

Sarcopenia is highly prevalent among patients undergoing TAVI. Body composition parameters derived from bioimpedance strongly correlate with computed tomography measurements. There is a need for a simplified diagnostic approach to sarcopenia in AS patients.