Clinical significance of left atrial volume in clinical outcomes of heart transplant recipients

Saad Ahmad, Pradeep Gujja, Tehmina Naz, Jun Ying, Stephanie Hope Dunlap, Yukitaka Shizukuda

Research output: Contribution to journalArticle

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.

Original languageEnglish (US)
Article number96
JournalJournal of Cardiothoracic Surgery
Volume10
Issue number1
DOIs
StatePublished - Jul 11 2015

Fingerprint

Hospitalization
Transplants
Transplant Recipients
Body Surface Area
Cardiomegaly
Heart Atria
Atrial Fibrillation
Echocardiography
Cardiovascular Diseases
Retrospective Studies
Exercise
Mortality

Keywords

  • Clinical outcomes
  • Echocardiography
  • Heart transplant
  • Left atrial volume
  • Retrospective study

ASJC Scopus subject areas

  • Surgery
  • Pulmonary and Respiratory Medicine
  • Cardiology and Cardiovascular Medicine

Cite this

Clinical significance of left atrial volume in clinical outcomes of heart transplant recipients. / Ahmad, Saad; Gujja, Pradeep; Naz, Tehmina; Ying, Jun; Dunlap, Stephanie Hope; Shizukuda, Yukitaka.

In: Journal of Cardiothoracic Surgery, Vol. 10, No. 1, 96, 11.07.2015.

Research output: Contribution to journalArticle

Ahmad, Saad ; Gujja, Pradeep ; Naz, Tehmina ; Ying, Jun ; Dunlap, Stephanie Hope ; Shizukuda, Yukitaka. / Clinical significance of left atrial volume in clinical outcomes of heart transplant recipients. In: Journal of Cardiothoracic Surgery. 2015 ; Vol. 10, No. 1.
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AB - 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.

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