Clinical significance of left atrial volume in clinical outcomes of heart transplant recipients
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RESEARCH ARTICLE
Open Access
Clinical significance of left atrial volume in clinical outcomes of heart transplant recipients Saad Ahmad1, Pradeep Gujja1, Tehmina Naz1, Jun Ying2, Stephanie H. Dunlap1 and Yukitaka Shizukuda1,3*
Abstract Background: Left atrial volume (LAV) is surgically kept enlarged in heart transplant (HT) recipients. On the other hand, LAV has been known an independent predictor of various cardiovascular diseases and is associated with exercise capacity of HT recipients. Thus, we evaluated the hypothesis that LAV is still associated with clinical outcomes in HT recipients whose left atria are artificially enlarged. Methods: Clinical outcomes over 5 years after HT were retrospectively evaluated in 35 HT recipients who had a LAV measurement with echocardiography at 1 year after HT at the University of Cincinnati Medical Center. The LAV was derived from a stacked disc method using apical 4 and 2 chamber views. Results: The average LAV normalized to body surface area was 38.3 ± 9.9 ml/m2 (mean ± SD) at 1 year after HT. Two deaths and one drop-out occurred during 5-year follow up. A total of 552 cardiac symptom-related hospitalizations occurred in the recipients. The average time to first hospitalization was 166 ± 279 days and average number of hospitalizations of each recipient was 15 ± 16. The indexed LAV failed to correlate with the time to first hospitalization and number of hospitalizations of each recipient (Spearman’s p-value; 0.141 and 0.519 respectively). When the patients were divided to groups of large LAV (n = 17) and small LAV (n = 18) using the cut off value of the mean LAV, no significant difference was noted in mortality, hospitalization, and new onset of atrial fibrillation between the groups. Conclusions: Although our study is limited by a retrospective study design and relatively small number of patients, our results implicate that LAV is not significantly associated with clinical outcomes in HT recipients over 5 years after HT. Keywords: Left atrial volume, Heart transplant, Clinical outcomes, Echocardiography, Retrospective study
Background Left atrial volume (LAV) is enlarged in heart transplant (HT) recipients [1, 2]. Enlarged LAV seems negatively correlated with exercise capacity [1] and it may be detrimental to clinical outcomes in HT recipients since limited exercise capacity has known to be a poor prognostic factor in various cardiovascular diseases such as heart failure and atrial fibrillation [3–5]. In addition, it is unknown whether LAV can still correlate with clinical outcomes in the setting of artificially enlarged LAV because previous published studies
examining a predictive value of LAV in clinical outcomes only have been described in altered LAV naturally by disease processes [6–8]. Therefore, a clinical relevance of artificially dilated LAV to clinical outcomes is largely unknown. In this study, we tested whether artificially enlarged LAV by HT is still associated with clinical outcomes in this population to address the above concerns.
Methods * Correspondenc
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