{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,17]],"date-time":"2026-08-17T14:48:33Z","timestamp":1786978113183,"version":"build-2736575974"},"reference-count":40,"publisher":"Wiley","issue":"1","license":[{"start":{"date-parts":[[2023,12,26]],"date-time":"2023-12-26T00:00:00Z","timestamp":1703548800000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["J cachexia sarcopenia muscle"],"published-print":{"date-parts":[[2024,2]]},"abstract":"Abstract<\/jats:title>\n \n Background<\/jats:title>\n Obesity is a known cardiovascular risk factor and associated with higher postoperative complication rates in patients undergoing cardiac surgery. In heart failure (HF), conflicting evidence in terms of survival has been reported, whereas sarcopenia is associated with poor prognosis. An increasing number of HF patients require left ventricular assist device (LVAD) implantations. The postoperative mortality has improved in recent years but is still relatively high. The impact of body composition on outcome in this population remains unclear. The aim of this investigation was to examine the preoperative computed tomography (CT) body composition as a predictor of the postoperative outcome in advanced HF patients, who receive LVAD implantations.<\/jats:p>\n <\/jats:sec>\n \n Methods<\/jats:title>\n Preoperative CT scans of 137 patients who received LVADs between 2015 and 2020 were retrospectively analysed using an artificial intelligence (AI)\u2010powered automated software tool based on a convolutional neural network, U\u2010net, developed for image segmentation (Visage Version 7.1, Visage Imaging GmbH, Berlin, Germany). Assessment of body composition included visceral and subcutaneous adipose tissue areas (VAT and SAT), psoas and total abdominal muscle areas and sarcopenia (defined by lumbar skeletal muscle indexes). The body composition parameters were correlated with postoperative major complication rates, survival and postoperative 6\u2010min walk distance (6MWD) and quality of life (QoL).<\/jats:p>\n <\/jats:sec>\n \n Results<\/jats:title>\n \n The mean age of patients was 58.21\u00a0\u00b1\u00a011.9\u00a0years; 122 (89.1%) were male. Most patients had severe HF requiring inotropes (Interagency Registry for Mechanically Assisted Circulatory Support [INTERMACS] profile I\u2013III, 71.9%) secondary to coronary artery diseases or dilated cardiomyopathy (96.4%). Forty\u2010four (32.1%) patients were obese (body mass index\u00a0\u2265\u00a030\u00a0kg\/m\n 2<\/jats:sup>\n ), 96 (70.1%) were sarcopene and 19 (13.9%) were sarcopene obese. Adipose tissue was associated with a significantly higher risk of postoperative infections (VAT 172.23\u00a0cm\n 2<\/jats:sup>\n [54.96, 288.32\u00a0cm\n 2<\/jats:sup>\n ] vs. 124.04\u00a0cm\n 2<\/jats:sup>\n [56.57, 186.25\u00a0cm\n 2<\/jats:sup>\n ],\n P<\/jats:italic>\n \u00a0=\u00a00.022) and in\u2010hospital mortality (VAT 168.11\u00a0cm\n 2<\/jats:sup>\n [134.19, 285.27 cm\n 2<\/jats:sup>\n ] vs. 135.42\u00a0cm\n 2<\/jats:sup>\n [49.44, 227.91\u00a0cm\n 2<\/jats:sup>\n ],\n P<\/jats:italic>\n \u00a0=\u00a00.033; SAT 227.28\u00a0cm\n 2<\/jats:sup>\n [139.38, 304.35\u00a0cm\n 2<\/jats:sup>\n ] vs. 173.81\u00a0cm\n 2<\/jats:sup>\n [97.65, 254.16\u00a0cm\n 2<\/jats:sup>\n ],\n P<\/jats:italic>\n \u00a0=\u00a00.009). Obese patients showed no improvement of 6MWD and QoL within 6\u00a0months postoperatively (obese: +0.94\u00a0\u00b1\u00a0161.44\u00a0months,\n P<\/jats:italic>\n \u00a0=\u00a00.982; non\u2010obese: +166.90\u00a0\u00b1\u00a0139.00\u00a0months,\n P<\/jats:italic>\n \u00a0<\u00a00.000; obese: +0.088\u00a0\u00b1\u00a00.421,\n P<\/jats:italic>\n \u00a0=\u00a00.376; non\u2010obese: +0.199\u00a0\u00b1\u00a00.324,\n P<\/jats:italic>\n \u00a0=\u00a00.002, respectively). Sarcopenia did not influence the postoperative outcome and survival within 1\u00a0year after LVAD implantation.\n <\/jats:p>\n <\/jats:sec>\n \n Conclusions<\/jats:title>\n Preoperative AI\u2010based CT body composition identifies patients with poor outcome after LVAD implantation. Greater adipose tissue areas are associated with an increased risk for postoperative infections, in\u2010hospital mortality and impaired 6MWD and QoL within 6\u00a0months postoperatively.<\/jats:p>\n <\/jats:sec>","DOI":"10.1002\/jcsm.13402","type":"journal-article","created":{"date-parts":[[2023,12,26]],"date-time":"2023-12-26T05:33:06Z","timestamp":1703568786000},"page":"270-280","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":7,"title":["Artificial intelligence\u2010based analysis of body composition predicts outcome in patients receiving long\u2010term mechanical circulatory support"],"prefix":"10.1002","volume":"15","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-1141-9387","authenticated-orcid":false,"given":"Isabell Anna","family":"Just","sequence":"first","affiliation":[{"name":"Department of Cardiothoracic and Vascular Surgery German Heart Center Berlin Berlin Germany"},{"name":"DZHK (German Centre for Cardiovascular Research), Partner Site Berlin Berlin Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Felix","family":"Schoenrath","sequence":"additional","affiliation":[{"name":"Department of Cardiothoracic and Vascular Surgery German Heart Center Berlin Berlin Germany"},{"name":"DZHK (German Centre for Cardiovascular Research), Partner Site Berlin Berlin Germany"},{"name":"Department of Cardiothoracic Surgery Charit\u00e9 \u2013 Universit\u00e4tsmedizin Berlin Berlin Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Luise","family":"Roehrich","sequence":"additional","affiliation":[{"name":"Department of Cardiothoracic and Vascular Surgery German Heart Center Berlin Berlin Germany"},{"name":"DZHK (German Centre for Cardiovascular Research), Partner Site Berlin Berlin Germany"},{"name":"German Heart Foundation Frankfurt am Main Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Emanuel","family":"Heil","sequence":"additional","affiliation":[{"name":"Department of Cardiology German Heart Center Berlin Berlin Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Julia","family":"Stein","sequence":"additional","affiliation":[{"name":"Department of Cardiothoracic and Vascular Surgery German Heart Center Berlin Berlin Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Timo Alexander","family":"Auer","sequence":"additional","affiliation":[{"name":"Department of Radiology Charit\u00e9 \u2013 Universit\u00e4tsmedizin Berlin, corporate member of Freie Universit\u00e4t Berlin, Humboldt\u2010Universit\u00e4t zu Berlin, and Berlin Institute of Health Berlin Germany"},{"name":"Berlin Institute of Health (BIH) Berlin Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Uli","family":"Fehrenbach","sequence":"additional","affiliation":[{"name":"Department of Radiology Charit\u00e9 \u2013 Universit\u00e4tsmedizin Berlin, corporate member of Freie Universit\u00e4t Berlin, Humboldt\u2010Universit\u00e4t zu Berlin, and Berlin Institute of Health Berlin Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Evgenij","family":"Potapov","sequence":"additional","affiliation":[{"name":"Department of Cardiothoracic and Vascular Surgery German Heart Center Berlin Berlin Germany"},{"name":"DZHK (German Centre for Cardiovascular Research), Partner Site Berlin Berlin Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Natalia","family":"Solowjowa","sequence":"additional","affiliation":[{"name":"Department of Cardiothoracic and Vascular Surgery German Heart Center Berlin Berlin Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Felix","family":"Balzer","sequence":"additional","affiliation":[{"name":"Institute of Medical Informatics Charit\u00e9 \u2013 Universit\u00e4tsmedizin Berlin, corporate member of Freie Universit\u00e4t Berlin, Humboldt\u2010Universit\u00e4t zu Berlin, and Berlin Institute of Health Berlin Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Dominik","family":"Geisel","sequence":"additional","affiliation":[{"name":"Department of Radiology Charit\u00e9 \u2013 Universit\u00e4tsmedizin Berlin, corporate member of Freie Universit\u00e4t Berlin, Humboldt\u2010Universit\u00e4t zu Berlin, and Berlin Institute of Health Berlin Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Juergen","family":"Braun","sequence":"additional","affiliation":[{"name":"Department of Radiology Charit\u00e9 \u2013 Universit\u00e4tsmedizin Berlin, corporate member of Freie Universit\u00e4t Berlin, Humboldt\u2010Universit\u00e4t zu Berlin, and Berlin Institute of Health Berlin Germany"},{"name":"Institute of Medical Informatics Charit\u00e9 \u2013 Universit\u00e4tsmedizin Berlin, corporate member of Freie Universit\u00e4t Berlin, Humboldt\u2010Universit\u00e4t zu Berlin, and Berlin Institute of Health Berlin Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Georg","family":"Boening","sequence":"additional","affiliation":[{"name":"DZHK (German Centre for Cardiovascular Research), Partner Site Berlin Berlin Germany"},{"name":"Department of Radiology Charit\u00e9 \u2013 Universit\u00e4tsmedizin Berlin, corporate member of Freie Universit\u00e4t Berlin, Humboldt\u2010Universit\u00e4t zu Berlin, and Berlin Institute of Health Berlin 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muscle area predicts mortality after left ventricular assist device implantation","volume":"11","author":"Wittmann F","year":"2021","journal-title":"Life (Basel)"},{"key":"e_1_2_7_20_1","doi-asserted-by":"publisher","DOI":"10.1002\/ehf2.13764"},{"key":"e_1_2_7_21_1","doi-asserted-by":"publisher","DOI":"10.1111\/jocs.16100"},{"key":"e_1_2_7_22_1","doi-asserted-by":"publisher","DOI":"10.1002\/ehf2.12429"},{"key":"e_1_2_7_23_1","first-page":"554","article-title":"Effects of artificial intelligence\u2010derived body composition on kidney graft and patient survival in the eurotransplant senior program","volume":"10","author":"Beetz 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of Cachexia, Sarcopenia and Muscle"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/pdf\/10.1002\/jcsm.13402","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2024,2,1]],"date-time":"2024-02-01T21:29:22Z","timestamp":1706822962000},"score":1,"resource":{"primary":{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/10.1002\/jcsm.13402"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2023,12,26]]},"references-count":40,"journal-issue":{"issue":"1","published-print":{"date-parts":[[2024,2]]}},"alternative-id":["10.1002\/jcsm.13402"],"URL":"https:\/\/doi.org\/10.1002\/jcsm.13402","archive":["Portico"],"relation":{},"ISSN":["2190-5991","2190-6009"],"issn-type":[{"value":"2190-5991","type":"print"},{"value":"2190-6009","type":"electronic"}],"subject":[],"published":{"date-parts":[[2023,12,26]]},"assertion":[{"value":"2022-12-05","order":0,"name":"received","label":"Received","group":{"name":"publication_history","label":"Publication 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