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Impaired left atrial function in clinically well heart transplant patients

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Abstract

Left atrial (LA) enlargement is present in the majority of adult heart transplant (HT) recipients. We used speckle-tracking echocardiography to investigate whether LA phasic function in HT patients is altered and explored its relationship to HT-related clinical variables. This study evaluated LA function in 112 clinically well HT patients and 40 healthy controls. Clinical data included recipient age at HT, donor age, ischemia time, left ventricular function, and biochemical indicators. Atrial deformation and volume indices were measured with two-dimensional and three-dimensional speckle-tracking echocardiography, respectively. Components of phasic atrial function were calculated and correlations to clinical variables were explored. Compared with controls, HT patients had worse LA reservoir, conduit, and pump function. LA reservoir function of the bicaval group was better than the biatrial group, but differences did not persist after adjustment for potential confounders. Among patients with HT, those with lower LAS-peak had an older recipient age, larger LA volume, as well as worse left ventricular systolic function than those patients with higher LAS-peak. However, E/e′, biochemical indicators and donor-related information were similar across the quartiles of LA function. In HT cohort, we observed impairment in all phases of LA function, and LA reservoir function was decreased independent of surgical technique. LAS-peak was associated with worse left ventricular systolic function, which suggested that LA function may play an important role in HT patients.

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Data availability

The datasets used and/or analyzed during the current study are available from the corresponding author on reasonable request.

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References

  1. Arora S, Aukrust P, Andreassen A et al (2009) The prognostic importance of modifiable risk factors after heart transplantation. Am Heart J 158:431–436

    Article  Google Scholar 

  2. Dipchand AI, Rossano JW, Edwards LB et al (2015) The registry of the international society for heart and lung transplantation: eighteenth official pediatric heart transplantation report-2015; focus theme: early graft failure. J Heart Lung Transpl 34:1255–1263

    Article  Google Scholar 

  3. Clemmensen TS, Løgstrup BB, Eiskjær H et al (2015) Changes in longitudinal myocardial deformation during acute cardiac rejection: the clinical role of two-dimensional speckle-tracking echocardiography. J Am Soc Echocardiogr 28:330–339

    Article  Google Scholar 

  4. Mingo-Santos S, Moñivas-Palomero V, Garcia-Lunar I et al (2015) Usefulness of two-dimensional strain parameters to diagnose acute rejection after heart transplantation. J Am Soc Echocardiogr 28:1149–1156

    Article  Google Scholar 

  5. Saleh HK, Villarraga HR, Kane GC et al (2011) Normal left ventricular mechanical function and synchrony values by speckle-tracking echocardiography in the transplanted heart with normal ejection fraction. J Heart Lung Transpl 30:652–658

    Article  Google Scholar 

  6. White BR, Katcoff H, Faerber JA et al (2019) Echocardiographic assessment of right ventricular function in clinically well pediatric heart transplantation patients and comparison with normal control subjects. J Am Soc Echocardiogr 32(537–44):e3

    Google Scholar 

  7. Bech-Hanssen O, Pergola V, Al-Admawi M et al (2016) Atrial function in heart transplant recipients operated with the bicaval technique. Scand Cardiovasc J 50:42–51

    Article  Google Scholar 

  8. Lang RM, Badano LP, Mor-Avi V et al (2015) Recommendations for cardiac chamber quantification by echocardiography in adults: an update from the American Society of Echocardiography and the European Association of Cardiovascular Imaging. Eur Heart J Cardiovasc Imaging 16:233–271

    Article  Google Scholar 

  9. Loar RW, Pignatelli RH, Morris SA et al (2020) Left atrial strain correlates with elevated filling pressures in pediatric deart transplantation recipients. J Am Soc Echocardiogr 33:504–511

    Article  Google Scholar 

  10. Yeh J, Aiyagari R, Gajarski RJ, Zamberlan MC, Lu JC (2015) Left atrial deformation predicts pulmonary capillary wedge pressure in pediatric heart transplant recipients. Echocardiography 32:535–540

    Article  Google Scholar 

  11. Davies RR, Russo MJ, Morgan JA et al (2010) Standard versus bicaval techniques for orthotopic heart transplantation: an analysis of the United Network for organ sharing database. J Thorac Cardiovasc Surg 140(700–8):e2

    Google Scholar 

  12. Badano LP, Miglioranza MH, Edvardsen T et al (2015) European Association of cardiovascular imaging/cardiovascular imaging department of the Brazilian Society of cardiology recommendations for the use of cardiac imaging to assess and follow patients after heart transplantation. Eur Heart J Cardiovasc Imaging 16:919–948

    Article  Google Scholar 

  13. Schnoor M, Schäfer T, Lühmann D et al (2007) Bicaval versus standard technique in orthotopic heart transplantation: a systematic review and meta-analysis. J Thorac Cardiovasc Surg 134(1322–31):e7

    Google Scholar 

  14. Morris DA, Takeuchi M, Krisper M et al (2015) Normal values and clinical relevance of left atrial myocardial function analysed by speckle-tracking echocardiography: multicentre study. Eur Heart J Cardiovasc Imaging 16:364–372

    Article  Google Scholar 

  15. Sugimoto T, Robinet S, Dulgheru R et al (2018) Echocardiographic reference ranges for normal left atrial function parameters: results from the EACVI NORRE study. Eur Heart J Cardiovasc Imaging 19:630–638

    Article  Google Scholar 

  16. Kraigher-Krainer E, Shah AM, Gupta DK et al (2014) Impaired systolic function by strain imaging in heart failure with preserved ejection fraction. J Am Coll Cardiol 63:447–456

    Article  Google Scholar 

  17. Linden K, Goldschmidt F, Laser KT et al (2019) Left atrial volumes and phasic function in healthy children: reference values using real-time three-dimensional echocardiography. J Am Soc Echocardiogr 32:1036–1045

    Article  Google Scholar 

  18. Kurt M, Wang J, Torre-Amione G et al (2009) Left atrial function in diastolic heart failure. Circ Cardiovasc Imaging 2:10–15

    Article  Google Scholar 

  19. Santos ABS, Roca GQ, Claggett B et al (2016) Prognostic relevance of left atrial dysfunction in heart failure with preserved ejection fraction. Circ Heart Fail 9:e002763

    Article  CAS  Google Scholar 

  20. Schuster A, Backhaus SJ, Stiermaier T et al (2019) Left atrial function with MRI enables prediction of cardiovascular events after myocardial infarction: insights from the AIDA STEMI and TATORT NSTEMI trials. Radiology 293:292–302

    Article  Google Scholar 

  21. Cameli M, Pastore MC, Righini FM et al (2019) Prognostic value of left atrial strain in patients with moderate asymptomatic mitral regurgitation. Int J Cardiovasc Imaging 35:1597–1604

    Article  Google Scholar 

  22. Boyd AC, Richards DAB, Marwick T et al (2011) Atrial strain rate is a sensitive measure of alterations in atrial phasic function in healthy ageing. Heart 97:1513–1519

    Article  Google Scholar 

  23. Cameli M, Caputo M, Mondillo S et al (2009) Feasibility and reference values of left atrial longitudinal strain imaging by two-dimensional speckle tracking. Cardiovasc Ultrasound 7:6

    Article  Google Scholar 

  24. Singh A, Addetia K, Maffessanti F et al (2017) LA strain for categorization of LV diastolic dysfunction. JACC: Cardiovasc Imaging 10:735–743

    Google Scholar 

  25. Morris DA, Belyavskiy E, Aravind-Kumar R et al (2018) Potential usefulness and clinical relevance of adding left atrial strain to left atrial volume index in the detection of left ventricular diastolic dysfunction. JACC Cardiovasc Imaging 11:1405–1415

    Article  Google Scholar 

  26. Santos ABS, Kraigher-Krainer E, Gupta DK et al (2014) Impaired left atrial function in heart failure with preserved ejection fraction. Eur J Heart Fail 16:1096–1103

    Article  CAS  Google Scholar 

  27. Ersbøll M, Andersen MJ, Valeur N et al (2013) The prognostic value of left atrial peak reservoir strain in acute myocardial infarction is dependent on left ventricular longitudinal function and left atrial size. Circ Cardiovasc Imaging 6:26–33

    Article  Google Scholar 

  28. Russo C, Jin Z, Homma S et al (2012) Left atrial minimum volume and reservoir function as correlates of left ventricular diastolic function: impact of left ventricular systolic function. Heart 98:813–820

    Article  Google Scholar 

  29. Mustafa K, Ibrahim HT, Enbiya A et al (2012) Relation of left ventricular end-diastolic pressure and N-terminal pro-brain natriuretic peptide level with left atrial deformation parameters. Eur Heart J Cardiovasc Imaging 13:524–530

    Article  Google Scholar 

  30. Morgan JA, Edwards NM (2005) Orthotopic cardiac transplantation: comparison of outcome using biatrial, bicaval, and total techniques. J Thorac Cardiovasc Surg 20:102–106

    Google Scholar 

  31. Zhu S, Sun W, Qiao WH et al (2020) Real time three-dimensional echocardiographic quantification of left atrial volume in orthotopic heart transplant recipients: comparisons with cardiac magnetic resonance imaging. Echocardiography 37:1243–1250

    Article  Google Scholar 

Download references

Funding

This work was supported by the National Natural Science Foundation of China (Grant Nos. 81922033, 81727805, 81530056 and 81671705), the Fundamental Research Funds for the Central Universities (Grant No. 5003530082) and the Key Research and Development Program of Hubei (Grant No: 2020DCD015).

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Author notes

  1. Shuangshuang Zhu and Yuji Xie contributed equally.

Authors and Affiliations

  1. Department of Ultrasound, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, 1277 Jiefang Avenue, Wuhan, 430022, China

    Shuangshuang Zhu, Yuji Xie, Fangyan Tian, Wei Sun, Chun Wu, He Li, Luyang Yi, Yi Zhong, Yuman Li, Mingxing Xie & Li Zhang

  2. Clinical Research Center for Medical Imaging in Hubei Province, Wuhan, China

    Shuangshuang Zhu, Yuji Xie, Fangyan Tian, Wei Sun, Chun Wu, He Li, Luyang Yi, Yi Zhong, Yuman Li, Mingxing Xie & Li Zhang

  3. Hubei Province Key Laboratory of Molecular Imaging, Wuhan, China

    Shuangshuang Zhu, Yuji Xie, Fangyan Tian, Wei Sun, Chun Wu, He Li, Luyang Yi, Yi Zhong, Yuman Li, Mingxing Xie & Li Zhang

  4. Department of Cardiovascular Surgery, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China

    Weihua Qiao, Yixuan Wang & Nianguo Dong

Authors
  1. Shuangshuang Zhu
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  2. Yuji Xie
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  3. Weihua Qiao
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  7. Chun Wu
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  8. He Li
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  10. Yi Zhong
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  11. Nianguo Dong
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  12. Yuman Li
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  13. Mingxing Xie
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  14. Li Zhang
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Contributions

Conception and design of the study: SZ, YX, WQ, YL, MX, LZ. Acquisition of data: SZ, YX, WQ, YW, ND. Analysis and interpretation of data: SZ, FT, HL, CW, WS. Drafting the article: SZ, YX. Revising the article: SZ, YX, WQ, LZ, MX. Final approval of the article: SZ, YX, WQ, LY, YZ, LZ.

Corresponding authors

Correspondence to Yuman Li, Mingxing Xie or Li Zhang.

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Zhu, S., Xie, Y., Qiao, W. et al. Impaired left atrial function in clinically well heart transplant patients. Int J Cardiovasc Imaging 37, 1937–1945 (2021). https://doi.org/10.1007/s10554-021-02177-4

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  • DOI: https://doi.org/10.1007/s10554-021-02177-4

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