Impacts of Sarcopenia, Osteopenia, and Osteosarcopenia on Patients Undergoing Transcatheter Aortic Valve Implantation　― A Single-Center Retrospective Cohort Study ―

Abstract

Background: The advent of transcatheter aortic valve implantation (TAVI) has increased the rate of aortic valve treatment in frail older adults. Factors contributing to frailty include sarcopenia (characterized by reduced muscle mass), osteopenia (characterized by decreased bone mineral density), and the newly termed osteosarcopenia, which is characterized by a simultaneous decline in muscle mass and bone mineral density. In this study, we aimed to investigate the impacts of sarcopenia, osteopenia, and osteosarcopenia on the clinical outcomes of TAVI.

Methods and Results: We retrospectively analyzed 490 patients who underwent TAVI for aortic stenosis at Yamaguchi University Hospital between April 2014 and March 2025. Osteopenia, sarcopenia, and osteosarcopenia were diagnosed by preprocedural computed tomography. Patients were classified into normal (N), sarcopenia alone (S), osteopenia alone (O), and osteosarcopenia (OS) groups. Early clinical outcomes and 1-year survival rates exhibited no significant differences among the groups. However, the 5-year survival rates were 94.1%, 77.6%, 60.4%, and 46.5% in the N, S, O, and OS groups, respectively (P<0.05). The Cox proportional hazards model revealed osteosarcopenia as a significant risk factor for late death (hazard ratio, 2.09; P=0.0002).

Conclusions: Preoperative evaluation of muscle mass and bone density aids in stratifying TAVI risk.