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Review
. 2025 May 26;17(5):107320.
doi: 10.4330/wjc.v17.i5.107320.

Osteosarcopenia in older adults undergoing transcatheter aortic valve replacement: A narrative review of mortality and frailty implications

Peng Li  1 , Hui-Ping Zhang  2
Affiliations
Review

Osteosarcopenia in older adults undergoing transcatheter aortic valve replacement: A narrative review of mortality and frailty implications

Peng Li et al. World J Cardiol. .

Abstract

This narrative review examines osteosarcopenia, characterized by the concurrent loss of muscle mass and bone density, as a pivotal marker of frailty in older adults. Its implications for patients undergoing transcatheter aortic valve replacement (TAVR) for severe aortic stenosis remain underexplored. This review examines the association between osteosarcopenia and adverse clinical outcomes in older adults undergoing TAVR, with an emphasis on mortality. It also evaluates the integration of osteosarcopenia into pre-procedural risk assessments. Contemporary studies were reviewed, focusing on older adults undergoing TAVR. Key parameters included pre-procedural assessments of muscle mass (psoas cross-sectional area) and bone density (lumbar trabecular attenuation) using computed tomography. Clinical correlations with frailty indices, nutritional deficiencies, functional disability and mortality were analyzed. Studies including the FRAILTY-AVR cohort indicate that osteosarcopenia affects 15%-20% of TAVR patients and independently predicts 1-year mortality. Combined deficits in muscle and bone health are associated with elevated risks of post-TAVR complications, prolonged hospitalizations, and worsening disability compared to isolated sarcopenia or osteoporosis (P < 0.05). Incorporating osteosarcopenia into risk stratification models could enhance predictive accuracy for adverse outcomes. Osteosarcopenia serves as a critical biomarker for frailty and should be routinely assessed in pre-TAVR evaluations. Targeted interventions, such as resistance training and nutritional optimization, may mitigate its impact and improve clinical outcomes. Early identification facilitates personalized management strategies, enhancing survival and quality of life in this high-risk cohort.

Keywords: Frailty; Mortality; Nutrition; Osteosarcopenia; Resistance training; Transcatheter aortic valve replacement.

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Conflict of interest statement

Conflict-of-interest statement: All the authors report no relevant conflicts of interest for this article.

Figures

Figure 1
Figure 1
Mechanism of osteosarcopenia and aortic valve disease.
See this image and copyright information in PMC

References

    1. Osnabrugge RL, Mylotte D, Head SJ, Van Mieghem NM, Nkomo VT, LeReun CM, Bogers AJ, Piazza N, Kappetein AP. Aortic stenosis in the elderly: disease prevalence and number of candidates for transcatheter aortic valve replacement: a meta-analysis and modeling study. J Am Coll Cardiol. 2013;62:1002–1012. - PubMed
    1. Coisne A, Montaigne D, Aghezzaf S, Ridon H, Mouton S, Richardson M, Polge AS, Lancellotti P, Bauters C VALVENOR Investigators. Association of Mortality With Aortic Stenosis Severity in Outpatients: Results From the VALVENOR Study. JAMA Cardiol. 2021;6:1424–1431. - PMC - PubMed
    1. Ya’qoub L, Arnautovic J, Faza NN, Elgendy IY. Sex Differences in Transcatheter Structural Heart Disease Interventions: How Much Do We Know? CVIA. 2023;8
    1. Afilalo J, Lauck S, Kim DH, Lefèvre T, Piazza N, Lachapelle K, Martucci G, Lamy A, Labinaz M, Peterson MD, Arora RC, Noiseux N, Rassi A, Palacios IF, Généreux P, Lindman BR, Asgar AW, Kim CA, Trnkus A, Morais JA, Langlois Y, Rudski LG, Morin JF, Popma JJ, Webb JG, Perrault LP. Frailty in Older Adults Undergoing Aortic Valve Replacement: The FRAILTY-AVR Study. J Am Coll Cardiol. 2017;70:689–700. - PubMed
    1. Binkley N, Buehring B. Beyond FRAX: it's time to consider "sarco-osteopenia". J Clin Densitom. 2009;12:413–416. - PubMed

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