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Volume 14
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This is an early access version, the complete PDF, HTML, and XML versions will be available soon.
Article

Impact of Computed Tomography-Defined Osteopenia on Outcomes of Transcatheter Aortic Valve Implantation: A Single-Center Retrospective Study

by
Hiroshi Kurazumi
1,
Ryo Suzuki
1,*,
Takato Nakashima
1,
Ryosuke Nawata
1,
Toshiki Yokoyama
1,
Kazumasa Matsunaga
1,
Yosuke Miyazaki
2,
Atsuo Yamashita
3,
Takayuki Okamura
2,
Akihito Mikamo
1,
Motoaki Sano
2 and
Kimikazu Hamano
1
1
Division of Cardiac Surgery, Department of Surgery and Clinical Science, Yamaguchi University Graduate School of Medicine, Ube 755-8505, Yamaguchi, Japan
2
Division of Cardiology, Department of Medicine and Clinical Science, Yamaguchi University Graduate School of Medicine, Ube 755-8505, Yamaguchi, Japan
3
Department of Anesthesiology-Resuscitology, Yamaguchi University School of Medicine, Ube 755-8505, Yamaguchi, Japan
*
Author to whom correspondence should be addressed.
J. Clin. Med. 2025, 14(20), 7182; https://doi.org/10.3390/jcm14207182 (registering DOI)
Submission received: 13 September 2025 / Revised: 5 October 2025 / Accepted: 9 October 2025 / Published: 11 October 2025
(This article belongs to the Section Cardiology)
Versions Notes

Abstract

Background/Objectives: Transcatheter aortic valve implantation (TAVI) is a standard treatment for severe aortic stenosis, especially in older adults and high-risk patients. However, many TAVI candidates have osteopenia or osteoporosis, indicated by low bone mineral density (BMD), which is linked to frailty and adverse outcomes. Although prior research suggests an association with poor clinical outcomes, data remain limited. We investigated the impact of osteopenia on TAVI outcomes, hypothesizing that a lower BMD is associated with poor perioperative outcomes and decreased long-term survival. Methods: In this single-center retrospective study, we analyzed data from 411 patients who underwent TAVI at Yamaguchi University Hospital from 2014 to 2024. Clinical and survival data were collected, and Cox regression analysis was used to identify independent predictors of mortality. Preoperative BMD was measured using computed tomography, defining osteopenia as <135 Hounsfield units at L1. Patients were categorized as having mild, moderate, or severe osteopenia. Results: Early clinical outcomes and procedural success were similar; however, patients with osteopenia had longer intensive care unit stays (p = 0.04) and higher late cardiac mortality (p < 0.001). Six-year survival was 36.2% and 88.1% in patients with and without osteopenia, respectively (p < 0.0001). Cox regression analysis revealed osteopenia as a mortality risk factor (hazard ratio: 6.75, 95% confidence interval: 2.96–15.38, p < 0.0001). Severe osteopenia was associated with the poorest outcomes. Conclusions: Osteopenia is an independent predictor of poor long-term survival after TAVI. These findings underscore the importance of comprehensive risk assessment, suggesting that targeted interventions may improve outcomes.
Keywords: aortic stenosis; transcatheter aortic valve implantation; osteopenia; frail; Japan aortic stenosis; transcatheter aortic valve implantation; osteopenia; frail; Japan

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MDPI and ACS Style

Kurazumi, H.; Suzuki, R.; Nakashima, T.; Nawata, R.; Yokoyama, T.; Matsunaga, K.; Miyazaki, Y.; Yamashita, A.; Okamura, T.; Mikamo, A.; et al. Impact of Computed Tomography-Defined Osteopenia on Outcomes of Transcatheter Aortic Valve Implantation: A Single-Center Retrospective Study. J. Clin. Med. 2025, 14, 7182. https://doi.org/10.3390/jcm14207182

AMA Style

Kurazumi H, Suzuki R, Nakashima T, Nawata R, Yokoyama T, Matsunaga K, Miyazaki Y, Yamashita A, Okamura T, Mikamo A, et al. Impact of Computed Tomography-Defined Osteopenia on Outcomes of Transcatheter Aortic Valve Implantation: A Single-Center Retrospective Study. Journal of Clinical Medicine. 2025; 14(20):7182. https://doi.org/10.3390/jcm14207182

Chicago/Turabian Style

Kurazumi, Hiroshi, Ryo Suzuki, Takato Nakashima, Ryosuke Nawata, Toshiki Yokoyama, Kazumasa Matsunaga, Yosuke Miyazaki, Atsuo Yamashita, Takayuki Okamura, Akihito Mikamo, and et al. 2025. "Impact of Computed Tomography-Defined Osteopenia on Outcomes of Transcatheter Aortic Valve Implantation: A Single-Center Retrospective Study" Journal of Clinical Medicine 14, no. 20: 7182. https://doi.org/10.3390/jcm14207182

APA Style

Kurazumi, H., Suzuki, R., Nakashima, T., Nawata, R., Yokoyama, T., Matsunaga, K., Miyazaki, Y., Yamashita, A., Okamura, T., Mikamo, A., Sano, M., & Hamano, K. (2025). Impact of Computed Tomography-Defined Osteopenia on Outcomes of Transcatheter Aortic Valve Implantation: A Single-Center Retrospective Study. Journal of Clinical Medicine, 14(20), 7182. https://doi.org/10.3390/jcm14207182

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