基于CT评估的骨骼肌密度与皮下脂肪量对老年女性心力衰竭患者预后的预测价值OA

Objective To explore the value of skeletal muscle density(SMD)and subcutaneous adipose tissue(SAT)area based on routine chest CT scans in predicting all-cause mortality in elderly female patients with heart failure(HF),and evaluate the prognostic stratification ability of a combined model of the two parameters.Methods This retrospective cohort study consecutively enrolled 159 hospitalized elderly female HF patients treated in Department of Cardiology,Huadong Hospital Affiliated to Fudan University,from January 2020 to December 2023.Their baseline clinical data were collected,and SMD and SAT area were quantitatively analyzed on CT images at the level of the T12 vertebral body.Optimal cutoff values were determined based on receiver operator character(ROC)curve analysis.Cox regression and Kaplan-Meier survival analyses were employed to assess the relationship between SMD,SAT area,and the risk of all-cause mortality.Results During a median follow-up of 611 days,a total of 46 deaths(28.9%)were recorded.The SMD and SAT area in the deceased group were significantly lower than those in the survival group.The ROC analysis determined that the optimal cutoff values for SMD and SAT area were 21.37 HU and 84.72 cm2,respectively.The predictive performance of the combined model(SMD+SAT area)(area under the curve=0.74)was significantly better than that of either single parameter.Multivariate Cox regression analysis revealed that both low SMD and low SAT area were independent predictors of all-cause mortality.Survival analysis showed that patients with both low SMD and low SAT area had the highest risk of death.Conclusion Both SMD and SAT area are independent predictors of all-cause mortality in elderly female HF patients.The combined assessment of these two parameters can more effectively identify high-risk populations,and provide a basis for clinical precise risk stratification and individualized management.