title: Clinical significance of left atrial volume in clinical outcomes of heart transplant recipients.
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/m(2) (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.
authors.affiliation: Division of Cardiovascular Disease and Health, Department of Internal Medicine, University of Cincinnati, 231 Albert Sabin Way, ML0542, Cincinnati, OH, 45267, USA. ahamadsm@uc.edu.
authors.forename: Saad
authors.initials: S
authors.lastname: Ahmad
authors.affiliation: Division of Cardiovascular Disease and Health, Department of Internal Medicine, University of Cincinnati, 231 Albert Sabin Way, ML0542, Cincinnati, OH, 45267, USA. gujjapp@uc.edu.
authors.forename: Pradeep
authors.initials: P
authors.lastname: Gujja
authors.affiliation: Division of Cardiovascular Disease and Health, Department of Internal Medicine, University of Cincinnati, 231 Albert Sabin Way, ML0542, Cincinnati, OH, 45267, USA. nazt@uc.edu.
authors.forename: Tehmina
authors.initials: T
authors.lastname: Naz
authors.affiliation: Department of Public Health Sciences, University of Cincinnati, 160 Panzeca Way, Cincinnati, OH, 45267, USA. yingj@uc.edu.
authors.forename: Jun
authors.initials: J
authors.lastname: Ying
authors.affiliation: Division of Cardiovascular Disease and Health, Department of Internal Medicine, University of Cincinnati, 231 Albert Sabin Way, ML0542, Cincinnati, OH, 45267, USA. dunlapse@uc.edu.
authors.forename: Stephanie H
authors.initials: SH
authors.lastname: Dunlap
authors.affiliation: Division of Cardiovascular Disease and Health, Department of Internal Medicine, University of Cincinnati, 231 Albert Sabin Way, ML0542, Cincinnati, OH, 45267, USA. shizukya@uc.edu.|Division of Cardiology, Cincinnati VA Medical Center, 3200 Vine Street, Cincinnati, OH, 45220, USA. shizukya@uc.edu.
authors.forename: Yukitaka
authors.initials: Y
authors.lastname: Shizukuda
mesh_terms: D002306:Cardiac Volume; D004452:Echocardiography / Q000379:methods*; D005260:Female; D006325:Heart Atria / Q000000981:diagnostic imaging / Q000503:physiopathology*; D016027:Heart Transplantation; D006801:Humans; D008297:Male; D008875:Middle Aged; D012189:Retrospective Studies