Hemodynamic and Clinical Determinants of Left Atrial Enlargement in Liver Transplant Candidates

• Published in: The American journal of cardiology 2022-06, Vol.172, p.121-129
• Main Authors: Remillard, Taylor C., Cronley, Apryl C., Pilch, Nicole A., Dubay, Derek A., Willner, Ira R., Houston, Brian A., Jackson, Gregory R., Inampudi, Chakradhari, Ramu, Bhavadharini, Kilic, Arman, Fudim, Marat, Wright, Stephen P., Hajj, Milad El, Tedford, Ryan J.
• Format: Article
• Language: English
• Subjects: Body mass index; Cardiovascular disease; Cardiovascular diseases; Catheterization; Congestive heart failure; Coronary artery disease; Coronary vessels; Demographics; Diabetes; Dyspnea; Echocardiography; Enlargement; Heart Atria - diagnostic imaging; Heart diseases; Heart Failure; Heart transplantation; Hemodynamics; Hemoglobin; Humans; Laboratories; Liver; Liver Transplantation; Liver transplants; Morbidity; Mortality; Peptides; Population; Pulmonary arteries; Pulmonary artery; Pulmonary hypertension; Pulmonary Wedge Pressure; Stroke volume; Transplantation; Ultrasonic imaging; Vein & artery diseases
• ISSN: 0002-9149; 1879-1913
• DOI: 10.1016/j.amjcard.2022.02.018

New-onset heart failure is a frequent complication after orthotopic liver transplantation (OLT). Left atrial enlargement (LAE) may be a sign of occult left heart disease. Our primary objective was to determine invasive hemodynamic and clinical predictors of LAE and then investigate its effect on post-transplant outcomes. Of 609 subjects who received OLT between January 1, 2010, and October 1, 2018, 145 who underwent preoperative right-sided cardiac catheterization and transthoracic echocardiography were included. Seventy-eight subjects (54%) had pretransplant LAE. Those with LAE had significantly lower systemic vascular resistance with higher cardiac and stroke volume index (61.0 vs 51.7 ml/m2; p