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Sahrai Saeed

Professor II - Department of Cardiology

Email sahrai.saeed@medisin.uio.no

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Visiting address Kirkeveien 166 Bygning 3 0450 Oslo

Postal address Postboks 4956 Nydalen OUS HF Ullevål sykehus 0424 Oslo

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Publications

Scientific articles and book chapters
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Saeed, Sahrai; Lundetræ, Ragnhild Stokke; Romarheim, Andrea; Saxvig, Ingvild; Lehmann, Sverre & Bjorvatn, Bjørn (2026). Impact of obstructive sleep apnea and comorbid insomnia on all-cause mortality: a prospective cohort study of 2401 patients with 6-year follow-up. Journal of Clinical Sleep Medicine (JCSM). ISSN 1550-9389. 22(1). doi: 10.1007/s44470-026-00068-w. Full text in Research Archive Show summary
Study Objectives The impact of obstructive sleep apnea (OSA) on all-cause mortality needs further research as earlier data are inconclusive. Between 30 and 50% of patients with OSA have comorbid insomnia (COMISA), which may increase the risk of morbidity and mortality. The present study was aimed at investigating the association between OSA and COMISA and the subsequent risk of all-cause mortality in a cohort of patients recruited from a hospital sleep clinic setting. Methods Between January 2016 and December 2018, 2401 patients with suspected OSA underwent standard respiratory polygraphy and were recruited in the present analysis. OSA was categorized according to the respiratory event index (REI). Insomnia diagnosis was assessed with the Bergen Insomnia Scale. All-cause mortality was the primary endpoint. Results Mean age was 49.6 ± 14.0 years, 68.8% were males, and 36.2% had OSA with REI ≥ 15, 49.5% insomnia, and 16.9% COMISA (comorbid insomnia and OSA with REI ≥ 15). A progressive increase in the risk of all-cause mortality was observed with increasing OSA severity (REI < 5; 5–14.9; 15–29.9; ≥ 30). In a multivariable Cox regression analysis, OSA (REI ≥ 15) was independently associated with all-cause mortality (HR 2.65; 95% CI 1.12–6.30, p = 0.027). This relative risk was further increased to threefold (HR 3.02; 95% CI 1.30–7.04, p = 0.010) when OSA was replaced by COMISA in the same model. Conclusion This study demonstrates that OSA severity is an important determinant of long-term survival. Patients with moderate-to-severe OSA are at particularly increased risk, and the coexistence of insomnia appears to substantially amplify this risk. These findings underscore the prognostic significance of considering both sleep-disordered breathing and comorbid insomnia when assessing mortality risk in patients evaluated for OSA.
Saeed, Sahrai; Morild, Inge & Lilleng, Peer Kåre (2026). Burden of cardiovascular disease in victims of fatal intoxication: An autopsy study. Cardiovascular pathology. ISSN 1054-8807. 84. doi: 10.1016/j.carpath.2026.107836. Full text in Research Archive
Caidahl, Kenneth & Saeed, Sahrai (2026). Aortic Valve Sclerosis: More than an Incidental Echocardiographic Finding. Acta Haematologica. ISSN 0001-5792. p. 1–4. doi: 10.1159/000553214. Full text in Research Archive
Kitsou, Vasiliki; Dingen, Håvard; Lunde, Torbjørn; Engan, Britt; Macsali, Ferenc & Saeed, Sahrai (2026). Incidence, characteristics and long-term outcomes of peripartum cardiomyopathy: Insights from the Bergen peripartum cardiomyopathy study. Current problems in cardiology. ISSN 0146-2806. 51(4), p. 1–8. doi: 10.1016/j.cpcardiol.2026.103276. Full text in Research Archive Show summary
Background Peripartum cardiomyopathy (PPCM) is a rare but potentially fatal condition characterized by heart failure occurring at the end of pregnancy or within the first months after delivery in women without prior history of structural heart disease. This single-center case-control study aimed to describe the incidence, clinical profile, echocardiographic findings and outcomes of PPCM in a West-Norwegian population. Methods Between 2011 and 2023, a total of 15 cases of PPCM were identified at Haukeland University Hospital. The Bergen Birth Registry was used to determine the total number of births in the same period, and to recruit 30 age-matched healthy controls. Clinical characteristics, echocardiographic data, and outcomes were collected. Results The incidence rate of PPCM was 1 in 4,182 births. Risk factors included higher pre-pregnancy body mass index (BMI) (OR 1.25) and elevated systolic blood pressure at presentation (OR 1.11). The prevalence of pre-eclampsia and primiparity was significantly higher in PPCM patients compared to controls (p < 0.01). Mean left ventricular (LV) ejection fraction increased from 35% at presentation to 58% at the 6-month follow-up (p < 0.001). There were no maternal or neonatal mortalities. Three patients required ICU treatment, but none experienced major cardiovascular events. Conclusions The incidence of PPCM in this West-Norwegian study was relatively low. Higher pre-pregnancy BMI and elevated systolic blood pressure, both important modifiable cardiovascular risk factors, were identified as predictors of PPCM. All patients experienced successful clinical and LV function recovery. Future large collaborative studies are necessary to provide a reliable description of incidence and outcomes nationwide.
Chehab, Omar; Gummadavelly, Sudhamshu; Androshchuk, Vitaliy; Long, Edouard; Gill, Harminder S. & Montarello, Natalie Lina [Show all 13 contributors for this article] (2026). Racial trends in outcomes and access to treatment for mitral regurgitation: a South London population cohort study. Open heart. 13(1). doi: 10.1136/openhrt-2026-004095. Full text in Research Archive
Jordal, Stina; Dingen, Håvard; Wasim, Daanyaal; Hoem, Eli Leirdal; Skaar, Elisabeth & Kommedal, Øyvind [Show all 12 contributors for this article] (2026). Infective endocarditis after transcatheter aortic valve implantation: risk factors and mortality impact in a case-control study. Open heart. 13(1). doi: 10.1136/openhrt-2026-004079. Full text in Research Archive Show summary
Aims: Infective endocarditis following transcatheter aortic valve implantation (TAVI-IE) is an uncommon but clinically devastating complication. We aimed to identify risk factors for TAVI-IE and to estimate its association with all-cause mortality. Methods and results: We conducted a case-control study including patients who underwent TAVI at Haukeland University Hospital, Norway, between 2012 and 2023. Patients who developed TAVI-IE (n=71) were compared with age-matched and sex-matched controls without IE (n=213; 1:3 ratio). Death was treated as a competing event in analyses of IE, and we estimated the subdistribution HRs (SHR) for IE using Fine-Gray competing risk regression. Cox regression models with IE as a time-dependent covariate assessed the impact of infection on mortality. The incidence of TAVI-IE was 1.2% per patient-year with a median time from TAVI to infection of 13 months (IQR 4–29). In multivariable competing risk analysis, diabetes mellitus remained an independent predictor of TAVI-IE (SHR 2.08, 95% CI 1.19 to 3.65, p=0.010). Obesity (27% vs 15%, p=0.019) and balloon-expandable valve use (28% vs 13%, p=0.003) were more often observed in patients with TAVI-IE. Enterococcus faecalis was the most frequent pathogen (30%). TAVI-IE was associated with an approximately twofold increase in all-cause mortality (adjusted HR 2.13, 95% CI 1.48 to 3.07, p<0.001) with the highest risk in early infections. Conclusion: TAVI-IE is an infrequent but severe complication associated with excess mortality. Diabetes mellitus was the dominant independent risk factor and E. faecalis the leading pathogen. These findings may help target monitoring and prevention in patients at the highest risk.
Romarheim, Andrea; Lundetræ, Ragnhild Stokke; Saxvig, Ingvild; Lehmann, Sverre; Bjorvatn, Bjørn & Saeed, Sahrai (2026). Prevalence and Predictors of Obstructive Sleep Apnea in Men and Women from an Outpatient Clinic Cohort: Focus on Clinical Characteristics, Cardiovascular Disease, and Serum Biomarkers. Cardiology. ISSN 0008-6312. doi: 10.1159/000548872. Full text in Research Archive
Wasim, Daanyaal; Ali, Abukar Mohamed; Bleie, Øyvind; Løland, Kjetil Halvorsen; Packer, Erik & Herstad, Jon [Show all 7 contributors for this article] (2026). Impact of Sex Differences on Long-Term Survival Following TAVI in Patients With Aortic Stenosis: Insights From the TAVI-NOR Study. Heart, Lung and Circulation. ISSN 1443-9506. doi: 10.1016/j.hlc.2026.01.009. Full text in Research Archive
Montarello, Natalie; Page, Curtis; Bennett, Sophie; Androshchuk, Vitaliy; Saeed, Sahrai & Grigoryan, Karine [Show all 9 contributors for this article] (2026). Specialised heart valve clinics result in greater adherence to guideline-directed care: a comparative study. Open heart. 13(1). doi: 10.1136/openhrt-2025-003608. Full text in Research Archive
Saeed, Sahrai; Carlsen, Petter; Muralitharan, Praveen; Solli, Petrine Veierød; Kvidaland, Haakon Kristian & Vollsæter, Maria [Show all 8 contributors for this article] (2026). Prevalence and clinical significance of T-wave inversion on electrocardiogram in patients with exercise-induced laryngeal obstruction (EILO): A cross-sectional study. Journal of Electrocardiology. ISSN 0022-0736. 96, p. 1–7. doi: 10.1016/j.jelectrocard.2026.154261. Full text in Research Archive Show summary
Aims We aimed to systematically evaluate standard 12‑lead electrocardiograms (ECG) in young individuals with exercise-induced laryngeal obstruction (EILO), with a special focus on the prevalence and clinical significance of T-wave inversion (TWI). Methods and results 235 individuals (mean age 16.7 years, 85% females) presenting to the EILO Clinic, underwent 709 high-intensity cardiopulmonary exercise treadmill testing with continuous visualization of the larynx (CLE- Continuous Laryngoscopy Exercise). There was no adverse event during exercise tests. The prevalence of TWI (negatively deflected T-wave ≥1 mm (0.1 mV amplitude) in any 2 contiguous leads excluding aVR, III, and V1) was 42.6% (18.7% isolated in the inferior wall leads, 13.2% in the inferolateral leads, 5.1% in both the inferior and anterior leads, 3% both in the inferior and anteroseptal leads, 2.1% isolated in anteroseptal leads and 0.9% isolated in anterior wall leads). Age, body height and weight, exercise duration and peak oxygen uptake did not differ between individuals with versus without TWI (all p > 0.05). There was a trend towards lower total CLE score in individuals with TWI (4.2 vs 4.5, p = 0.070). Individuals with TWI had higher resting heart rate (98 vs 95 bpm, p = 0.05), shorter PQ-interval (124 vs 129 ms, p = 0.020) and achieved higher peak heart rate (193 vs 189 bpm, p = 0.005) and metabolic equivalents during exercise (13.4 vs 12.9, p = 0.028). Conclusions High-intensity CLE-test in individuals with EILO was not associated with any adverse cardiac findings. TWI was highly prevalent and particularly observed in the inferior or inferolateral wall leads but had no association with energetic decline or cardiac dysfunction.
Jonassen, Trygve Müller; Bjorvatn, Bjørn; Saeed, Sahrai; Eagan, Tomas Mikal Lind & Lehmann, Sverre (2026). Impact of obstructive lung disease and sleep apnea symptoms on cardiovascular risk and all-cause mortality: insights from a community-dwelling cohort. Sleep and Breathing. ISSN 1520-9512. 30(1). doi: 10.1007/s11325-025-03564-0. Full text in Research Archive Show summary
Purpose Chronic obstructive pulmonary disease (COPD) and obstructive sleep apnea (OSA) are prevalent conditions with overlapping pathophysiological mechanisms. Their coexistence, termed overlap syndrome, is thought to amplify cardiometabolic risk. This study examined the 10-year risk of major adverse cardiovascular events (MACE) and all-cause mortality in individuals with COPD and OSA symptoms in a community-based cohort. Methods Baseline data (1998–1999) from the Hordaland Health Study were linked to national registries on mortality and cardiovascular events. Of 7,456 eligible adults born 1925–1927 and 1950–1951, a random sample of 5,100 was invited, and 3,305 with valid spirometry were included. OSA symptoms were assessed by questionnaire, and chronic airway obstruction (CAO) was defined as post-bronchodilator FEV₁/FVC < 0.70. Cox regression estimated hazard ratios (HR) for MACE and all-cause mortality. Results CAO independently predicted both MACE (HR 1.48, 95% CI 1.12–1.97, p < 0.006) and all-cause mortality (HR 1.78, 95% CI 1.44–2.22, p < 0.001). Excessive daytime sleepiness (EDS) was associated with increased mortality (HR 1.37, 95% CI 1.01–1.85, p = 0.045). A significant interaction was found between CAO and habitual snoring, with participants displaying both having more than a twofold increased risk of mortality (HR 2.22, 95% CI 1.31–3.76, p = 0.003). Conclusions CAO and EDS emerged as independent predictors of mortality, while the coexistence of CAO and snoring conferred synergistic risk. These findings highlight the need to recognize OSA symptoms in patients with obstructive lung disease, as they may identify a vulnerable subgroup at heightened risk. Future studies using objective sleep assessments are warranted to clarify mechanisms and guide preventive strategies.
Putaala, Jukka; Martinez-Majander, Nicolas; Leppert, Michelle; Tulkki, Lauri; Pirinen, Jani & Tolppanen, Heli [Show all 97 contributors for this article] (2025). Burden of Modifiable Risk Factors in Young-Onset Cryptogenic Ischemic Stroke by High-Risk Patent Foramen Ovale. Stroke. ISSN 0039-2499. 56(6), p. 1428–1440. doi: 10.1161/STROKEAHA.124.049855. Full text in Research Archive Show summary
Background: The incidence of young-onset ischemic stroke is rising, driven by cryptogenic ischemic stroke (CIS) and patients without vascular risk factors. This study examines the burden and associations of modifiable traditional, nontraditional, and female sex–specific risk factors with young-onset CIS, stratified by clinically relevant patent foramen ovale (PFO), defined by high-risk features of atrial septal aneurysm or large right-to-left shunt. Methods: We enrolled consecutive patients aged 18 to 49 years with recent CIS and frequency-matched stroke-free controls of the same age and sex from 19 European sites. Logistic regression assessed the association of risk factor counts (12 traditional, 10 nontraditional, 5 female sex–specific) and individual risk factors, stratified by PFO. Analyses were stratified by sex and age (18–39 and 40–49 years), with computation of population-attributable risk. Results: We included 523 patients (median age, 41 years; 47.3% women; 196 [37.5%] with PFO) and 523 controls. In patients with CIS without PFO, each additional traditional (odds ratio, 1.417 [95% CI, 1.282–1.568]), nontraditional (odds ratio, 1.702 [95% CI, 1.338–2.164]), and female sex–specific risk factor (odds ratio, 1.700 [95% CI, 1.107.1–2.611]) increased CIS risk. For patients with CIS with PFO, each traditional risk factor increased the risk (odds ratio, 1.185 [1.057–1.328]), but only nontraditional risk factors remained significant when fully adjusted (odds ratio, 2.656 [2.036–3.464]). Population-attributable risks for CIS without PFO were 64.7%, 26.5%, and 18.9% for traditional, nontraditional, and female sex–specific risk factors. For CIS with PFO, population-attributable risks were 33.8%, 49.4%, and 21.8%, respectively. Migraine with aura was the most significant contributor, with population-attributable risks of 45.8% for CIS with PFO and 22.7% for CIS without PFO, showing a stronger impact in women. Conclusion: Despite the initial cryptogenic label of these strokes, traditional risk factors significantly contribute to CIS without PFO, while nontraditional factors seem more critical for CIS with PFO. Migraine with aura plays a prominent role in young-onset CIS development, particularly in women.
Romarheim, Andrea; Lehmann, Sverre; Bjorvatn, Bjørn & Saeed, Sahrai (2025). Overcoming an underdiagnosed respiratory condition: should more patients with cardiovascular complications be screened for obstructive sleep apnea? Expert Review of Cardiovascular Therapy. ISSN 1477-9072. 23(10), p. 601–606. doi: 10.1080/14779072.2025.2551668. Full text in Research Archive
Ali, Abukar Mohamed; Khamis, Khamis Mustafa; Andemichael, Ghirmay; Mahmoud, Muhiddin Abdi; Aboyans, Victor & Saeed, Sahrai (2025). Abdominal Aorta Screening During Routine Transthoracic Echocardiography in Zanzibar, Tanzania: The Zanzibar Heart Survey. Global Heart. ISSN 2211-8160. 20(1). doi: 10.5334/gh.1432. Full text in Research Archive Show summary
Background and objectives: Abdominal aortic (AA) aneurysms (AAA) are often incidental findings and preceded by a long period of subclinical growth in diameter. Patients may present with life-threatening complications. Therefore, screening programmes for AAA in primary care are proposed in several European countries, and opportunistic AAA screening during echocardiography is also advocated. However, data on the interest of such an approach in the sub-Saharan African population are unknown. Methods: In 2022, a total of 189 patients with cardiac symptoms visiting the Mnazi Mmoja Referral Hospital (MMH) in Zanzibar underwent standard transthoracic echocardiography (TTE). Demographics and clinical data were recorded. AA diameter was routinely assessed in 137 patients. AA was measured by the leading-edge-to-leading-edge method from a longitudinal plane, and AAA was defined as an AA diameter of ≥3.0 cm. SPSS version 29.0 was used for data analysis. The prevalence of AAA was estimated as the number of AAA cases divided by the number of all screened subjects. Correlates of AA diameter were tested in univariate and multivariate linear regression analyses. Results: AA could be visualized in 128 (93.4%) patients (43% of men and 57% of women). The mean age was 54.4 ± 15.9 years. The mean AA diameter was 2.1 ± 0.3 cm in the entire study population and was significantly greater in men than women (2.2 ± 0.3 vs 2.1 ± 0.3 cm, p = 0.005) and in individuals aged ≥60 years than those aged <60 years (2.3 ± 0.3 vs 2.1 ± 0.3 cm, p = 0.003). The prevalence of AAA was 1.6%. In a multivariate linear regression analysis, higher age, male gender, atrial fibrillation and left ventricular (LV) mass were independent correlates of greater AA diameter, adjusted for clinic systolic blood pressure, ascending aortic diameter and LV ejection fraction (multiple R2 = 0.38, p < 0.001). Conclusions: Abdominal aorta screening during routine TTE is feasible in Africa. Patients in Zanzibar have relatively smaller abdominal aorta diameters with a 1.6% prevalence of AAA. Abdominal aorta screening by routine echocardiography may be beneficial, provided that access to care and vascular surgery facility/expertise with appropriate follow-up is available for patients with AAA identified during screening.
Jibril, Khuluud Abdi; Kuiper, Karel Kier-Jan; Nawaz, Beenish Adeel Chaudry; Næss, Halvor; Fromm, Annette & Øygarden, Halvor [Show all 14 contributors for this article] (2025). Burden of Coronary Artery Disease as a Predictor of New Vascular Events and Mortality in Patients With Ischemic Stroke: Insights From the Norwegian Stroke in the Young Study. Journal of the American Heart Association (JAHA). 14(6). doi: 10.1161/JAHA.124.038899. Full text in Research Archive Show summary
Background Studies in young patients with stroke identified coronary artery disease (CAD) as a main contributor to mortality. In the present NOR‐SYS (Norwegian Stroke in the Young Study), we aimed to investigate the prevalence of CAD, and the impact on new vascular events and mortality. Methods A total of 385 patients with ischemic stroke, aged ≤60 years, were included. CAD was defined as a history of CAD or positive coronary imaging (computed tomography or coronary angiography). Results Mean age was 49.6 years, and 68.1% were men. The prevalence of CAD was 25.2% (n=97) (nonobstructive, 9.6% [n=37]; and obstructive, 15.6% [n=60]). In the subsample of patients without clinical CAD but with femoral plaque on ultrasound (n=58) who underwent cardiac computed tomography, 46% (n=27) had nonobstructive CAD and 28% (n=16) had obstructive CAD. During a median follow‐up of 10.1 years, 36 patients (9.4%) died, 84 (21.8%) reached a composite end point of new stroke, myocardial infarction, or death, whereas 64 (16.6%) had a composite end point of new stroke or death. Event‐free survival was significantly lower in patients with obstructive CAD versus no CAD or nonobstructive CAD (log‐rank P<0.001). In the multivariable Cox regression models, CAD was a strong and independent predictor of all‐cause mortality (hazard ratio [HR], 2.20 [95% CI, 1.05–4.60]; P=0.037) and the composite end point of death or recurrent ischemic stroke (HR, 3.24 [95% CI, 1.46–7.20]; P=0.004). Conclusions In young and middle‐aged ischemic stroke survivors, a quarter of patients had CAD. CAD was an independent predictor of recurrent stroke and mortality. In patients without previous CAD, but femoral plaque on ultrasound, nearly a half had nonobstructive and one‐fourth had obstructive CAD. Systematic screening with cardiac computed tomography may identify high‐risk patients after ischemic stroke. Registration
Farah, Mohamad Jamal; Nawaz, Beenish Adeel Chaudry; Fromm, Annette; Saeed, Sahrai; Martinez-Majander, Nicolas & Putaala, Jukka [Show all 8 contributors for this article] (2025). Post-stroke fatigue and its consequences in young adults: The Norwegian Stroke in the Young Study II. eNeurologicalSci. 41. doi: 10.1016/j.ensci.2025.100593. Full text in Research Archive Show summary
Background Fatigue is a prevalent and disabling consequence of ischemic stroke in young adults, yet its multifactorial nature and impact on recovery remain underexplored. This study investigates predictors of post-stroke fatigue and association with return to work (RTW) and other variables at a one-year follow-up (1y-FU) after ischemic stroke. Methods We analysed data from 130 patients aged 15–49 years with MRI-confirmed acute ischemic stroke enrolled in the Norwegian Stroke in Young Study II. Fatigue and cognitive symptoms were assessed using standardized self-report and clinical evaluations at 1y-FU. Multivariable logistic regression identified independent predictors of persistent fatigue, adjusting for age, sex, and stroke severity. Results At 1y-FU, 50 % of patients reported persistent fatigue. Fatigue was independently associated with failure to RTW (OR 3.2, 95 % CI 1.8–5.6), migraine without aura (OR 2.1, 95 % CI 1.3–3.4), hearing difficulties (OR 2.0, 95 % CI 1.1–3.8), concentration problems (OR 2.4, 95 % CI 1.5–4.0), and pain (OR 2.6, 95 % CI 1.5–4.5). Patients with resolved fatigue were significantly more likely to RTW (65.9 %) compared to those with persistent symptoms (34.2 %, p < 0.001). Cognitive impairment at admission was common (45.9 %), and among these patients, 52.2 % reported persistent deficits at 1y-FU. Fatigue severity was not associated with educational attainment but increased with age and NIHSS score. Conclusions Fatigue affects half of young ischemic stroke survivors after 1 year, substantially hindering RTW. Novel associations with migraine, hearing and cognitive deficits, and pain suggest underrecognized contributors that may be amenable to individually targeted rehabilitation. Integration of fatigue management into early stroke rehabilitation programs, with a focus on cognitive, sensory, and pain-related domains, may help optimize vocational and functional outcomes.
Dingen, Håvard; Jordal, Stina; Dalén, Magnus; Bratt, Sorosh; Jakobsen, Øyvind & Svenarud, Peter [Show all 11 contributors for this article] (2025). The Impact of Left Ventricular Structure and Function on Mortality in Patients with Aortic Valve Infective Endocarditis Treated with Aortic Valve Replacement. Cardiology. ISSN 0008-6312. doi: 10.1159/000549459. Full text in Research Archive Show summary
Introduction: Left ventricular (LV) ejection fraction (LVEF) and LV end-diastolic diameter (LVEDd) are well-established predictors of adverse cardiovascular events. However, the possible association with survival in patients with infective endocarditis (IE) treated with aortic valve replacement (AVR) is underexplored. Additionally, it is important to investigate whether sex modifies these associations. Methods: We retrospectively recruited 170 consecutive patients with IE treated with AVR from three cardiac surgery tertiary hospitals in Scandinavia. Echocardiography was performed both pre- and postoperatively. Baseline characteristics, preoperative blood samples, postoperative complications, echocardiographic, and angiographic data were compared between surviving and deceased patients at both short- (1-year) and long-term (5-year) follow-up. Results: The mean age in the entire study population was 58.5 ± 15.1 years, and 80.0% were males. The mean LVEF was 54 ± 11% preoperatively, decreasing to 51 ± 11% postoperatively. The mean baseline LVEDd was 5.8 ± 0.9 cm in males and 5.0 ± 0.9 cm in females (p < 0.001), decreasing to 5.2 ± 0.9 cm in males and 4.7 ± 0.6 cm in females after surgery (p = 0.006). At short-term follow-up, reduced postoperative LVEF (<50%) was more common in non-survivors (46.2% vs. 26.2%, p = 0.040), with the strongest association observed in females (71.4% vs. 25.9%, p = 0.025). Similarly, during long-term follow-up, deceased female patients had a higher prevalence of reduced preoperative LVEF (<50%) compared to surviving female patients (30.0% vs. 4.2%, p = 0.033). LVEDd was significantly greater in female non-survivors compared to survivors at both short-term (5.7 ± 1.1 cm vs. 4.9 ± 0.8 cm, p = 0.043) and long-term follow-up (5.5 ± 0.9 cm vs. 4.8 ± 0.8 cm, p = 0.046), an association not observed in male patients. Conclusion: Our study found that both pre- and postoperative LVEF, as well as preoperative LVEDd, were associated with poorer outcomes in patients with IE undergoing AVR, particularly among female patients. These results highlight the importance of tailored clinical management strategies based on sex-specific risk profiles. Further research is needed to validate these findings and develop interventions to mitigate the observed risks.
Lundetræ, Ragnhild S.; Lehmann, Sverre; Saxvig, Ingvild W.; Saeed, Sahrai; Gislason, Thorarinn & Bjorvatn, Bjørn (2025). Severity of obstructive sleep apnea is related to C-reactive protein levels: The influence of comorbidities and self-reported sleep duration. Sleep Medicine. ISSN 1389-9457. 131, p. 106529–106529. doi: 10.1016/j.sleep.2025.106529. Full text in Research Archive
Wasim, Daanyaal; Ali, Abukar Mohamed; Bleie, Øyvind; Packer, Erik; Eriksen, Erlend & Keilegavlen, Håvard [Show all 9 contributors for this article] (2025). Prevalence and predictors of permanent pacemaker implantation in patients with aortic stenosis undergoing transcatheter aortic valve implantation: a prospective cohort study. BMJ Open. 15(2). doi: 10.1136/bmjopen-2024-093073. Full text in Research Archive Show summary
Objectives: The primary objectives were to identify the predictors of new permanent pacemaker implantation in patients with aortic stenosis (AS) undergoing transcatheter aortic valve implantation (TAVI). The secondary objectives were to investigate the temporal changes in permanent pacemaker implantation following TAVI and its impact on long-term prognosis. Design: Prospective observational cohort study of patients with AS undergoing TAVI. Setting: Single-centre study conducted at a tertiary hospital in Western Norway between 2012 and 2019. Participants: Among 600 consecutive patients with severe AS who were treated with TAVI, 52 patients with permanent pacemaker prior to TAVI were excluded. The remaining 548 patients were included in the present study. Baseline measures: An evaluation of baseline risk factors, 12-lead ECG and echocardiography. Primary outcome measures: The need for a new pacemaker implantation ≤30 days following TAVI and all-cause death. Results: The mean age was 80.6±6.7 years, and 50% were males. Among the 548 eligible patients, 173 (31.6%) underwent pacemaker implantation ≤30 days following TAVI, evenly distributed between females and males (29.6% vs 33.6%, p=0.317), with higher implant rates at low-volume phase (2012–2015) and lower implant rates at high-volume phase (2016–2019) (45.8% vs 23.9%, p<0.001). On multivariable analysis, an abnormal electrocardiogram (OR 1.73; 95% CI 1.14 to 2.63, p=0.010), right bundle branch block (OR 2.23; 95% CI 1.09 to 4.59, p=0.028) and atrial fibrillation (OR 1.89; 95% CI 1.24 to 2.88, p=0.003) at baseline were strong predictors of pacemaker implantation. The type of bioprosthesis, but not size, was associated with permanent pacemaker implantation (mechanically expandable valves OR 3.48, 95% CI 2.16 to 5.59; balloon-expandable valves OR 0.07, 95% CI 0.02 to 0.29, both p<0.001)—irrespective of age and sex. During a median follow-up of 60.4 months (range 3–131 months), permanent pacemaker implantation following TAVI was not associated with all-cause mortality (HR 0.89; 95% CI 0.69 to 1.16, p=0.403). Conclusions: In the current study, the rates of permanent pacemaker implantation following TAVI decreased substantially from the early low-volume phase to the late high-volume phase. An abnormal baseline ECG, right bundle branch block, atrial fibrillation and bioprosthesis selection remained important predictors of permanent pacemaker implantation. Permanent pacemaker implantation following TAVI had no impact on short or long-term survival.
Kellermair, Joerg; Blessberger, Hermann; Ott, Helmut W.; Kammler, Juergen; Kiblboeck, Daniel & Reiter, Christian [Show all 9 contributors for this article] (2025). Prognostic Impact of High-Molecular-Weight von Willebrand Factor Multimer Ratio in Classical Low-Flow Low-Gradient Aortic Stenosis. Cardiology. ISSN 0008-6312. 150(1), p. 63–71. doi: 10.1159/000539731. Full text in Research Archive
Saeed, Sahrai; Eriksen, Erlend; Aukrust, Pål; Halvorsen, Bente; Løland, Kjetil Halvorsen & Bleie, Øyvind [Show all 7 contributors for this article] (2025). Clinical outcomes and patients' perspective of fatigue following spontaneous coronary artery dissection. Coronary Artery Disease. ISSN 0954-6928. 36(6), p. e62–e63. doi: 10.1097/MCA.0000000000001499. Full text in Research Archive
Myrmel, Gard Mikael Saele; Waje-Andreassen, Ulrike; Pirinen, Jani; Sinisalo, Juha; Järvinen, Vesa & Putaala, Jukka [Show all 7 contributors for this article] (2025). Multimodality Cardiac Imaging in Ischemic Stroke: Insights into the Heart-Brain Interaction. Cardiology. ISSN 0008-6312. 150(5), p. 525–539. doi: 10.1159/000543170. Full text in Research Archive Show summary
Background: Approximately 7.6 million individuals experience a new ischemic stroke each year, and roughly 25% of all ischemic strokes are cardiogenic in origin, carrying a high risk of recurrence, death, and disability. To prevent future ischemic strokes, especially in younger individuals, it is crucial to detect and treat direct and indirect cardioembolic sources. Summary: Cardiac imaging is a rapidly evolving field, and post-stroke cardiac imaging is no longer limited to echocardiography but also includes other imaging techniques, such as cardiac magnetic resonance imaging and cardiac computed tomography. Clinicians must be familiar with numerous cardiac and systemic disorders related to stroke and consider the possibilities that imaging diagnostics have to offer. Additional diagnostic tests, such as pre- and transcranial ultrasound with a bubble test, can also increase the diagnostic accuracy for detecting right-left shunt embolisms. Moreover, a patent foramen ovale (PFO) has traditionally been considered as a minor or uncertain risk factor for ischemic stroke. However, PFO-associated strokes are a distinct category among the cardioembolic sources, as in most cases, we do not assume that the thrombus has been developed in situ in the PFO structure or elsewhere intracardially, rather, the PFO merely acts as a mediator for a paradoxical, venous embolism. The article has two parts: Part I, the heart-brain axis, describes multimodality cardiac imaging in the assessment of cardioembolic sources of ischemic stroke, with a special focus on disorders that traditionally have received little attention in the literature. Part II discusses the brain-heart axis, namely, when acute cerebrovascular events lead to cardiac dysfunction, for example, neurogenic stunned myocardium and Takotsubo syndrome. Key Messages: Advances in cardiovascular imaging have significantly enhanced the detection of cardiac disorders associated with stroke. Clinicians involved in post-stroke workup need to be aware of the capabilities of different imaging modalities to ensure high diagnostic accuracy in order to effectively treat and prevent stroke recurrence.
Kitsou, Vasiliki; Lunde, Torbjørn; Solholm, Atle; Blomberg, Bjørn & Saeed, Sahrai (2024). Complete recovery after fulminant myocarditis in a patient with COVID-19. Pakistan Journal of Medical Sciences. ISSN 1682-024X. 40(4), p. 785–789. doi: 10.12669/pjms.40.4.8685. Full text in Research Archive
Wasim, Daanyaal; Ali, Abukar Mohamed; Bleie, Øyvind; Løland, Kjetil Halvorsen; Rajani, Ronak & Rotevatn, Svein [Show all 7 contributors for this article] (2024). Electrocardiographic Strain and Relationship with Left Ventricular Remodelling and Clinical Outcomes in Patients with Aortic Stenosis Undergoing Transcatheter Aortic Valve Implantation. Cardiology. ISSN 0008-6312. doi: 10.1159/000542529. Full text in Research Archive
Halimi, Jean-Michel; Sarafidis, Pantelis; Azizi, Michel; Bilo, Grzegorz; Burkard, Thilo & Bursztyn, Michael [Show all 85 contributors for this article] (2024). Screening and management of hypertensive patients with chronic kidney disease referred to Hypertension Excellence Centres among 27 countries. A pilot survey based on questionnaire. Journal of Hypertension. ISSN 0263-6352. 42(9), p. 1544–1554. doi: 10.1097/HJH.0000000000003756. Full text in Research Archive
Halimi, Jean-Michel; Sarafidis, Pantelis; Azizi, Michel; Bilo, Grzegorz; Burkard, Thilo & Bursztyn, Michael [Show all 85 contributors for this article] (2024). Management of patients with hypertension and chronic kidney disease referred to Hypertension Excellence Centres among 27 countries. On behalf of the European Society of Hypertension Working Group on Hypertension and the Kidney. Blood Pressure. ISSN 0803-7051. 33(1). doi: 10.1080/08037051.2024.2368800. Full text in Research Archive
Ali, Abukar Mohamed; Khamis, Khamis Mustafa; Hauge, Ståle Wågen; Hovstad, Thomas; Haaverstad, Rune & Andemichael, Ghirmay [Show all 8 contributors for this article] (2024). The Zanzibar Heart Survey: A special report from a humanitarian cardiology program at the Mnazi Mmoja referral hospital, Zanzibar, United Republic of Tanzania by Haukeland University Hospital in Bergen, Norway. Current problems in cardiology. ISSN 0146-2806. 49(2). doi: 10.1016/j.cpcardiol.2023.102339. Full text in Research Archive Show summary
A Norwegian cardiology delegation comprised of Cardiologists and Researchers travelled voluntarily to Zanzibar to undertake 4 humanitarian missions in 2022. The principal aims of this were to: 1) Train local cardiologists in transthoracic echocardiography and perform echocardiographic screening in patients with cardiac symptoms who had not undergone any prior cardiac imaging, 2) Conduct a hypertension survey to improve awareness, treatment and control of hypertension and 3) Implant permanent pacemakers in patients with significant bradyarrhythmias for the first time in the Archipelago. The current report details our experience at the Mnazi Mmoja Referral Hospital. We describe the challenges in managing common cardiovascular conditions such as hypertension, cardiomyopathies, coronary artery disease and rhythm disturbances. Furthermore, we propose that improvement to care may be achieved by implementing systematic access to echocardiography and hypertension services to the island. In our survey, we found that hypertension and hypertension-mediated target organ damage were highly prevalent and hypertension was poorly controlled in Zanzibar. The common reasons for poor BP control were reported to be partly the issue of cost, affordability and availability of antihypertensive medications, and partly due to lack of awareness. Women were on average 10 years younger than men and were more likely to be obese, while men had higher burden of established cardiovascular disease (CAD, stroke, chronic kidney disease, and atrial fibrillation). Humanitarian healthcare missions by Western countries provide invaluable contributions to the healthcare of patients elsewhere in the world. Although their impact can be felt immediately, there is the propensity for these benefits to dissipate rapidly following the departure of visiting delegations. There is a need for more sustainable solutions whereby local healthcare systems are empowered to develop their own local capacities and initiate a system whereby local training can occur, the utilisation of facilities can be maximised and new skills can be transferred to health care practitioners to ensure universal access to diagnostics and treatments of cardiovascular diseases in Zanzibar. Our report indicates that measurable changes can be achieved in a relatively short time frame. These may in turn translate to improvements in access and quality of healthcare to the local population.
Khan, Umael; Saeed, Nasir; Rajani, Ronak; Solheim, Eivind; Käsk, Lauri & Saeed, Sahrai [Show all 7 contributors for this article] (2024). “Ion-Flux”: The natural course of ECG changes in severe hypokalemia. Current problems in cardiology. ISSN 0146-2806. 49(1). doi: 10.1016/j.cpcardiol.2023.102158. Full text in Research Archive Show summary
Whereas the electrocardiogram (ECG) changes in hypokalemia are well known, they often receive less attention than the more striking features of hyperkalemia. Furthermore, there is a need for further discussion as to the subtleties of ECG changes that can aid in the differential diagnoses. This case study presents the ECG changes of a patient with severe hypokalemia due to diarrhea. It highlights how bifid T-waves in hypokalemia can be distinguished from other conditions such as coronary artery disease or pericarditis. Furthermore, it also shows the gradual reversal of ECG changes in the same patient when potassium is normalized.
Kolseth, Solveig Moss; Saeed, Sahrai; Salminen, Pirjo-Riitta; Ellensen, Vegard Skalstad; Kvalheim, Venny Lise & Ali, Abukar Mohamed [Show all 7 contributors for this article] (2024). A rapid deployment valve option for failing Medtronic Freestyle full root: a single centre experience. Journal of Cardiothoracic Surgery. 19. doi: 10.1186/s13019-024-03178-9. Full text in Research Archive Show summary
Background There are several high-risk treatment options for valve failure of a biological full root replacement. When tailoring the best treatment option for the patient, implantation of a rapid deployment valve (RDV) should be considered. Case presentation Six patients presented with aortic regurgitation in a full root Freestyle bioprosthesis. Three had a history of valve endocarditis, while the remaining had non-infectious structural valve deterioration with leaflet and commissural tears. All patients were treated with a rapid deployment EDWARDS INTUITY Elite valve. Follow-up was complete for all patients. Postoperative echocardiography showed well-functioning valve prostheses with no paravalvular leaks and acceptable pressure gradients. Echocardiographic follow-up demonstrated excellent pressure gradients and a considerable decrease in the left ventricular mass index and left ventricular end-diastolic dimensions. Follow-up cardiac CT showed no signs of coronary obstruction or other pathology. During a median follow-up of 30 months neither biological valve failure, nor any events within the composite endpoint of major adverse cardiac and cerebrovascular events occurred. Conclusions This case series presents the EDWARDS INTUITY valve as a good treatment option in patients with failing Freestyle roots.
Dingen, Håvard; Jordal, Stina; Bratt, Sorosh; Aukrust, Pål; Busund, Rolf & Jakobsen, Øyvind [Show all 12 contributors for this article] (2024). Clinical profile, microbiology and outcomes in infective endocarditis treated with aortic valve replacement: a multicenter case-control study. BMC Infectious Diseases. 24(1). doi: 10.1186/s12879-024-09782-3. Full text in Research Archive Show summary
Background Aortic valve infective endocarditis (IE) is associated with significant morbidity and mortality. We aimed to describe the clinical profile, risk factors and predictors of short- and long-term mortality in patients with aortic valve IE treated with aortic valve replacement (AVR) compared with a control group undergoing AVR for non-infectious valvular heart disease. Methods Between January 2008 and December 2013, a total of 170 cases with IE treated with AVR (exposed cohort) and 677 randomly selected non-infectious AVR-treated patients with degenerative aortic valve disease (controls) were recruited from three tertiary hospitals with cardiothoracic facilities across Scandinavia. Crude and adjusted hazard ratios (HR) were estimated using Cox regression models. Results The mean age of the IE cohort was 58.5 ± 15.1 years (80.0% men). During a mean follow-up of 7.8 years (IQR 5.1-10.8 years), 373 (44.0%) deaths occurred: 81 (47.6%) in the IE group and 292 (43.1%) among controls. Independent risk factors associated with IE were male gender, previous heart surgery, underweight, positive hepatitis C serology, renal failure, previous wound infection and dental treatment (all p < 0.05). IE was associated with an increased risk of both short-term (≤ 30 days) (HR 2.86, [1.36–5.98], p = 0.005) and long-term mortality (HR 2.03, [1.43–2.88], p < 0.001). In patients with IE, chronic obstructive pulmonary disease (HR 2.13), underweight (HR 4.47), renal failure (HR 2.05), concomitant mitral valve involvement (HR 2.37) and mediastinitis (HR 3.98) were independent predictors of long-term mortality. Staphylococcus aureus was the most prevalent microbe (21.8%) and associated with a 5.2-fold increased risk of early mortality, while enterococci were associated with the risk of long-term mortality (HR 1.78). Conclusions In this multicenter case-control study, IE was associated with an increased risk of both short- and long-term mortality compared to controls. Efforts should be made to identify, and timely treat modifiable risk factors associated with contracting IE, and mitigate the predictors of poor survival in IE.
Putaala, Jukka; Sarnowski, Bettina von; Schminke, Ulf; Busch, Raila; Martinez-Majander, Nicolas & Ylikotila, Pauli [Show all 39 contributors for this article] (2024). Association of Hypertension With Early-Onset Cryptogenic Ischemic Stroke by the Presence of Patent Foramen Ovale: A Case-Control Study. Journal of the American Heart Association (JAHA). 13(21), p. e036254–e036254. doi: 10.1161/JAHA.124.036254. Full text in Research Archive
Ingebrigtsen, Andreas; Saeed, Sahrai; Larsen, Terje Hjalmar & Reikvam, Håkon (2024). Clinical and imaging characteristics of patients with cardiac amyloidosis- a single center observational study. Scandinavian Journal of Clinical and Laboratory Investigation. ISSN 0036-5513. 84(3), p. 193–201. doi: 10.1080/00365513.2024.2346908. Full text in Research Archive Show summary
Amyloidosis is a disease characterized by the deposition of protein fibrils. Cardiac involvement is a significant factor in determining prognosis. This study aimed to examine the clinical profile, outcomes, and long-term mortality rates in patients with transthyretin (ATTR) and amyloid light-chain (AL) amyloidosis. The retrospective cohort study included 94 patients with amyloidosis (69 with AL and 25 with ATTR amyloidosis) diagnosed between 2010 and 2022. The study involved multimodality imaging (ECG, echocardiography and cardiac magnetic resonance (CMR) data and survival analyses. Patients with ATTR amyloidosis were older and had a higher proportion of males compared to those with AL amyloidosis. Cardiac involvement was more prevalent in the ATTR group, including atrial fibrillation (AF), while pleural and pericardial effusion were more frequent in the AL group. Biomarkers such as NT-proBNP and troponin T were significantly elevated in both groups and were associated with all-cause mortality only in univariate analyses. CMR data, especially typical late gadolinium enhancement (LGE) was not associated with increased mortality, while pleural effusion and left atrial dilatation on echocardiography were identified as powerful predictors of mortality. In conclusion, both AL and ATTR amyloidosis exhibited poor outcomes. Cardiac involvement, particularly dilated left atrium and pleural effusion on echocardiography were associated with an increased risk of mortality, while typical LGE on CMR was not.
Jordal, Stina; Kommedal, Øyvind; Haaverstad, Rune; Saeed, Sahrai; Davidsen, Einar Skulstad & Salminen, Pirjo-Riitta [Show all 8 contributors for this article] (2024). Epidemiological and microbial trends of infective endocarditis in western Norway: a 7-year prospective observational study. BMC Infectious Diseases. 24(1). doi: 10.1186/s12879-024-09596-3. Full text in Research Archive Show summary
Background In this prospective, observational study, we aimed to investigate epidemiologic and microbial trends of infective endocarditis in western Norway. Methods Clinical and microbiological characteristics of 497 cases of infective endocarditis from 2016 through 2022 were investigated. Categorical data were analysed using Chi-squared tests. Survival data were analysed using multiple Cox regression and reported using hazard ratios. Results The mean age was 67 years, and 74% were men. The annual incidence rates varied from 10.4 to 14.1 per 100,000 inhabitants per year. Infective endocarditis on native valves was observed in 257 (52%) of the cases, whereas infective endocarditis on prosthetic valves and/or cardiac implantable electronic devices was observed in 240 (48%) of the cases: infection on surgically implanted bioprostheses was observed in 124 (25%) of the patients, infection on transcatheter aortic valve implantation was observed in 47 (10%) patients, and infection on mechanical valves was observed in 34 (7%) cases. Infection related to cardiac implantable electronic devices was observed in a total of 50 (10%) cases. Staphylococcus aureus and viridans streptococci were the most common microbial causes, and isolated in 145 (29%) and 130 (26%) of the cases, respectively. Enterococcal endocarditis showed a rising trend during the study period and constituted 90 (18%) of our total cases of infective endocarditis, and 67%, 47%, and 26% of the cases associated with prosthetic material, transcatheter aortic valve implantation and cardiac implantable electronic devices, respectively. There was no significant difference in 90-day mortality rates between the native valve endocarditis group (12%) and the group with infective endocarditis on prosthetic valves or cardiac implants (14%), p = 0.522. In a model with gender, age, people who inject drugs, microbiology and type of valve affected, only advanced age was significantly associated with fatal outcome within 90 days. Conclusions The incidence of infective endocarditis, and particularly enterococcal endocarditis, increased during the study period. Enterococci appeared to have a particular affinity for prosthetic cardiac material. Advanced age was the only independent risk factor for death within 90 days.
Khan, Umael; Urheim, Stig & Saeed, Sahrai (2023). Post-systolic shortening in the context of peri-myocarditis: two clinical imaging vignettes. European Heart Journal-Cardiovascular Imaging. ISSN 2047-2404. 24(11), p. e294–e294. doi: 10.1093/ehjci/jead201. Full text in Research Archive
Dhar, Indu; Svingen, Gard Frodahl Tveitevåg; Bjørnestad, Espen Øglænd; Ulvik, Arve; Saeed, Sahrai & Nygård, Ottar Kjell (2023). B-vitamin Treatment Modifies the Mortality Risk Associated with Calcium Channel Blockers in Patients with Suspected Stable Angina Pectoris: A Prospective Cohort Study. American Journal of Clinical Nutrition. ISSN 0002-9165. 118(1), p. 77–84. doi: 10.1016/j.ajcnut.2023.04.033. Full text in Research Archive Show summary
Background Calcium channel blockers (CCBs) are used for the treatment of cardiovascular disease (CVD), including angina pectoris, and hypertension; however, the effect on survival remains uncertain. CCBs impair fibrinolysis and have been linked to elevated plasma homocysteine (Hcy), a CVD risk marker. Objective We explored the association between CCB use and mortality in a large prospective cohort of patients with suspected stable angina pectoris (SAP), and potential effect modifications by Hcy-lowering B-vitamin treatment (folic acid, B12, and/or B6) as 61.8% of the patients participated in a randomized placebo-controlled B-vitamin intervention trial. Methods Patient baseline continuous characteristics according to CCB treatment were tested by linear regression. Hazard ratios (HRs) for mortality associated with CCB treatment, also according to B-vitamin intervention, were examined using Cox regression analysis. The multivariable model included CVD risk factors, medical histories, and the use of CVD medications. Results A total of 3991 patients (71.5 % men) were included, of whom 907 were prescribed CCBs at discharge. During 10.3 years of median follow-up, 20.6% died and 8.9% from cardiovascular- and 11.7% from non-cardiovascular causes. Patients treated with CCBs had higher plasma Hcy, fibrinogen levels, and erythrocyte sedimentation rate (all P<0.001). Furthermore, CCB use was positively associated with mortality, also after multivariable adjustments (HRs [95% CIs]: 1.34 [1.15,1.57], 1.35 [1.08,1.70], and 1.33 [1.09,1.64] for total, CVD, and non-CVD death, respectively). Numerically stronger associations were observed among patients not treated with B-vitamins (HR [95% CI]: 1.54 [1.25, 1.88], 1.69 [1.25, 2.30], and 1.41 [1.06, 1.86] for total, CVD deaths, and non-CVD deaths, respectively), whereas no association was seen in patients treated with B-vitamins (HR [95% CI]: 1.15 [0.91, 1.46], 1.09 [0.76, 1.57], and 1.20 [0.88, 1.65]). Conclusions In patients with suspected SAP, CCB treatment was associated with increased mortality risk primarily among patients not treated with B-vitamins.
Hjertaas, Johannes Just; Einarsen, Eigir; Gerdts, Eva; Kokorina, Marina Victorovna; Moen, Christian Arvei & Urheim, Stig [Show all 8 contributors for this article] (2023). Impact of aortic valve stenosis on myocardial deformation in different left ventricular levels: A three-dimensional speckle tracking echocardiography study. Echocardiography. ISSN 0742-2822. 40(10). doi: 10.1111/echo.15668. Full text in Research Archive Show summary
Background: Global systolic left ventricular (LV) myocardial function progressively declines as degenerative aortic valve stenosis (AS) progresses. Whether this results in uniformly distributed deformation changes from base to apex has not been investigated. Methods: Eighty-five AS patients underwent three-dimensional (3D) echocardiography in this cross-sectional study. Patients were grouped by peak jet velocity into mild (n = 32), moderate (n = 31), and severe (n = 22) AS. 3D speckle tracking derived strain, rotation, twist, and torsion were obtained to assess global LV function and myocardial function at the apical, mid, and basal levels. Results: Global longitudinal strain (GLS) was lower in patients with severe AS (-16.1 ± 2.4% in mild, -15.5 ± 2.5% in moderate, and -13.5 ± 3.0% in severe AS [all p < .01]). Peak basal and mid longitudinal strain (LS), basal rotation and twist from apical to basal level followed the same pattern, while peak apical LS was higher in moderate AS compared to severe AS (all p < .05). In multivariate analyses, lower GLS was particularly associated with male sex, higher body mass index and peak aortic jet velocity, lower basal LS with higher filling pressure (E/e’) and LV mass, lower mid LS with higher RWT and presence of AS symptoms, and lower apical LS with male sex and higher systolic blood pressure, respectively (all p < .05). Conclusion: Using 3D speckle tracking echocardiography reveals regional and global changes in LV mechanics in AS related to the severity of AS, LV remodeling and presence of cardiovascular risk factors.
Eriksen, Erlend; Neghabat, Omeed; Saeed, Sahrai; Herstad, Jon; Nordrehaug, Jan Erik & Tuseth, Vegard [Show all 14 contributors for this article] (2023). Everolimus-eluting bioresorbable scaffold versus everolimus-eluting metallic stent in primary percutaneous coronary intervention of ST-segment elevation myocardial infarction: A randomized controlled trial. Coronary Artery Disease. ISSN 0954-6928. 34(1), p. 1–10. doi: 10.1097/MCA.0000000000001202. Full text in Research Archive
Risnes, Ivar; Aukrust, Pål; Lundblad, Runar; Ueland, Thor; Rynning, Stein Erik & Solheim, Eivind [Show all 7 contributors for this article] (2023). Troponin T and N-Terminal Pro-Brain Natriuretic Peptide Are Associated with Long-Term All-Cause Mortality in Patients with Post-Sternotomy Mediastinitis following Coronary Artery Bypass Grafting: A 15-Year Follow-Up Study. Cardiology. ISSN 0008-6312. 148(6), p. 599–603. doi: 10.1159/000533631. Full text in Research Archive
Ali, Abukar Mohamed; Packer, Erik; Omdal, Tom Roar; Kitsou, Vasiliki; Urheim, Stig & Saeed, Sahrai (2023). Echocardiography Assessment of Rheumatic Heart Disease: Implications for Percutaneous Balloon Mitral Valvuloplasty. Current problems in cardiology. ISSN 0146-2806. 48(12). doi: 10.1016/j.cpcardiol.2023.102021. Full text in Research Archive
Dingen, Håvard; Urheim, Stig; Jordal, Stina & Saeed, Sahrai (2023). Echocardiographic assessment in infective endocarditis: Transthoracic or transesophageal echocardiography, or both?: Echocardiography in endocarditis. Current problems in cardiology. ISSN 0146-2806. 49(1). doi: 10.1016/j.cpcardiol.2023.102151. Full text in Research Archive
Saeed, Sahrai; Rajani, Ronak & Solheim, Eivind (2023). A BRASH Diagnosis With a Timely Intervention. Current problems in cardiology. ISSN 0146-2806. 48(11). doi: 10.1016/j.cpcardiol.2023.101984. Full text in Research Archive
Risnes, Ivar; Aukrust, Pål; Lundblad, Runar; Rødevand, Olaf; Ueland, Thor & Rynning, Stein Erik [Show all 7 contributors for this article] (2023). Increased levels of NT-proBNP and troponin T 2 years after coronary artery bypass grafting complicated by mediastinitis. Frontiers in Cardiovascular Medicine. 10. doi: 10.3389/fcvm.2023.1008825. Full text in Research Archive Show summary
Background Mediastinitis after coronary bypass grafting (CABG) increases the risk of the internal mammary artery (IMA) graft obstruction, and has a detrimental effect on long-term survival. The pathogenesis for this increased mortality is poorly understood. In the present study, we aimed to investigate the relationship between mediastinitis and persistently elevated cardiac-specific biomarkers [troponin T (TnT) and N-terminal pro-brain natriuretic peptide (NT-proBNP)] and C-reactive protein (CRP) at mid-term follow-up following CABG. Material and methods The epidemiologic design was of an exposed (mediastinitis, n = 41) vs. randomly selected non-exposed (non-mediastinitis) controls ( n = 41) cohort. Serum samples for measurements of NT-proBNP, TnT, and CRP were obtained at a median follow up time of 2.7 (range 0.5–5.2) years after CABG surgery. Results NT-proBNP (mean 65.0 pg/ml vs. 34.8 pg/ml, p = 0.007) and TnT levels (mean 14.7 ng/L vs. 11.2 ng/L, p = 0.004) were significantly higher in the mediastinitis group than in the control group. Patients with mediastinitis had also higher body mass index (BMI) and were more likely to have diabetes and previous myocardial infarction. There was no difference in serum CRP level between the groups. After controlling for potential confounders (previous myocardial infarction, age, and BMI), the presence of mediastinitis was associated with higher levels of log NT-proBNP ( p = 0.02) and log TnT ( p = 0.04). Conclusion Mediastinitis increases the concentrations of cardiac-specific biomarkers NT-proBNP and TnT at mid-term follow-up, representing persistent myocardial injury and impaired cardiac function.
Saeed, Sahrai; Ali, Abukar Mohamed; Wasim, Daanyaal; Risnes, Ivar & Urheim, Stig (2023). Correlation between Murmurs and Echocardiographic Findings; From an Imaging Cardiologist Point of View. Current problems in cardiology. ISSN 0146-2806. 48(2). doi: 10.1016/j.cpcardiol.2022.101479. Full text in Research Archive Show summary
A heart murmur in adults is a common reason for referral for echocardiography at most general cardiology clinics in Europe. A murmur may indicate either a mild age-related valvular calcification or regurgitation, or represent a significant heart valve disease requiring valvular intervention. Generally, the correlation between murmurs by auscultation and severity of heart valve disease by echocardiography is poor. Particularly, the severity and characterization of diastolic murmurs by auscultation may poorly correlate with echocardiographic findings. This narrative review aims to summarize the differential diagnoses of physiological and pathological murmurs, describes the current referral practice of murmur patients for echocardiography, and presents a single-center experience on the correlation of auscultation and echocardiographic findings with a particular focus on aortic and mitral valve diseases. A careful auscultation of the heart prior to the echocardiogram is mandatory and may help to predict the echocardiographic findings and their interpretation in view of the clinical information. The correlation between clinical examination, point of care ultrasound and standard echocardiography is a matter of continued exploration.
Eriksen, Erlend; Neghabat, Omeed; Larsen, Terje Hjalmar; Saeed, Sahrai & Bleie, Øyvind (2023). Long-term multimodality imaging follow-up of ST-segment elevation myocardial infarction patients treated with bioresorbable vascular scaffold: advantages and challenges. Coronary Artery Disease. ISSN 0954-6928. 34(6), p. 415–424. doi: 10.1097/MCA.0000000000001249. Full text in Research Archive
Saeed, Sahrai; Flygel, Malin Renee; Løland, Kjetil Halvorsen & Packer, Erik (2023). Catheter-induced Vasospasm of the Anatomically Normal Right Coronary Artery in a Patient With Non-ST Elevation Myocardial Infarction and Obstructive Disease in the Left Anterior Descending Artery; A Challenging Case Report and Review of the Literature. Current problems in cardiology. ISSN 0146-2806. 48(1). doi: 10.1016/j.cpcardiol.2022.101432. Full text in Research Archive
Ali, Abukar Mohamed; Yakupoglu, H. Yakup; Fuchs, Tobias A.; Larsen, Terje Hjalmar; Aukrust, Pål & Gunnarsson, Ragnar [Show all 7 contributors for this article] (2023). Cardiac Involvement in Systemic and Local Vasculitides: The Value of Noninvasive Multimodality Imaging. Current problems in cardiology. ISSN 0146-2806. 48(8). doi: 10.1016/j.cpcardiol.2023.101718. Full text in Research Archive Show summary
Despite significant advances in managing systemic vasculitides, cardiovascular morbidity, and mortality are still of primary concern. Advances in noninvasive imaging have broadened our understanding of the clinical heterogeneity of cardiac involvement in vasculitides. Common cardiovascular complications in primary or secondary vasculitides are; coronary artery aneurysms, acute coronary syndromes, myocarditis, pericarditis, endocarditis, and valvular dysfunction. Echocardiography, cardiac magnetic resonance , positron emission tomography, and computed tomography angiography are essential in identifying cardiac involvement and guiding treatment. Here, we present our experiences of cardiac involvement in systemic vasculitides, covering most aspects of common cardiac complications based on a multi-modality approach to challenging (real-world) cases. As many cardiac manifestations are clinically silent, heart function should be systemically assessed by a multimodality imaging-based approach, including ECG, serial echocardiograms with strain imaging and 3D, and cardiac magnetic resonance to detect early signs of cardiac manifestations. This enables timely intervention and optimal medical treatment, which is essential for a better prognosis. There is a need for better and closer collaboration in clinical practice and research fields between cardiologists and rheumatologists.
Lunde, Torbjørn; Gude, Einar; Myrmel, Gard Mikael Saele; Haaverstad, Rune & Saeed, Sahrai (2023). A case report of giant cell myocarditis complicated by severe heart failure: the value of early endomyocardial biopsy and mechanical circulatory support. Cardiovascular Diagnosis and Therapy (CDT). ISSN 2223-3652. 13(6), p. 1136–1146. doi: 10.21037/cdt-23-265. Full text in Research Archive
Saeed, Sahrai; Ali, Abukar Mohamed; Wasim, Daanyaal; Saeed, Nasir; Lunde, Torbjørn & Solheim, Eivind [Show all 8 contributors for this article] (2023). Natural Course of Electrocardiogram Changes and the Value of Multimodality Imaging in Acute Pericarditis. Cardiology. ISSN 0008-6312. 148(3), p. 219–227. doi: 10.1159/000530207. Full text in Research Archive
Saeed, Sahrai; Romarheim, Synnøve Andrea; Solheim, Eivind; Bjorvatn, Bjørn & Lehmann, Sverre (2022). Cardiovascular remodeling in obstructive sleep apnea: focus on arterial stiffness, left ventricular geometry and atrial fibrillation. Expert Review of Cardiovascular Therapy. ISSN 1477-9072. 20(6), p. 455–464. doi: 10.1080/14779072.2022.2081547. Full text in Research Archive
Sulo, Enxhela; Davidsen, Einar Skulstad; Lønnebakken, Mai Tone; Bleie, Øyvind & Saeed, Sahrai (2022). Paradoxical sinus deceleration during dobutamine stress echocardiography: case series and review of the literature. European Heart Journal - Case Reports. 6(10). doi: 10.1093/ehjcr/ytac180. Full text in Research Archive Show summary
Background: Dobutamine stress echocardiography is an established diagnostic modality for assessing myocardial ischaemia in patients with known or suspected coronary artery disease. Dobutamine infusion causes dose-dependent increase in heart rate and contractility. However, in some cases, it induces paradoxical sinus deceleration, whose underlying mechanism and clinical significance are not fully understood. Case summary: We present episodes of paradoxical sinus deceleration observed during dobutamine stress echocardiography in six (four males and two females) patients and described its patterns of occurrence and clinical and echocardiographic characteristics. Discussion: Paradoxical sinus deceleration occurred mostly at maximal dobutamine infusion was accompanied with a decline in blood pressure and resolved spontaneously following cessation of dobutamine infusion. Individuals experiencing paradoxical sinus deceleration had in common abnormal left ventricle geometry but differed with regard to age, sex, and cardiometabolic risk factors.
Kitsou, Vasiliki; Blomberg, Bjørn; Lunde, Torbjørn & Saeed, Sahrai (2022). Intermittent left bundle branch block with septal flash and postural orthostatic tachycardia syndrome in a young woman with long COVID-19. BMJ Case Reports. 15(6). doi: 10.1136/bcr-2022-249608. Full text in Research Archive
Myrmel, Gard Mikael Saele; Wasim, Daanyaal; Rajani, Ronak; Parkin, Denise; Chambers, John B. & Saeed, Sahrai (2022). Clinical significance and prognostic value of ST segment depression on ECG during exercise treadmill test in asymptomatic patients with moderate or severe aortic stenosis. Scandinavian Cardiovascular Journal. ISSN 1401-7431. 56(1), p. 231–235. doi: 10.1080/14017431.2022.2095437. Full text in Research Archive
Saeed, Sahrai; Karaji, Iman; Skromme, Kaia; Øksnes, Anja; Larsen, Terje Hjalmar & Bleie, Øyvind (2022). Right ventricular postsystolic shortening: Resolution after opening a totally occluded right coronary artery. Journal of Clinical Ultrasound. ISSN 0091-2751. 50(7), p. 899–902. doi: 10.1002/jcu.23251. Full text in Research Archive Show summary
Acute myocardial ischemia induces reduced systolic shortening and causes postsystolic shortening (PSS). Right ventricular (RV) PSS in coronary artery disease has been less studied. We present here the case of a 51-year-old woman admitted with a non-ST segment elevation myocardial infarction and significant PSS in the RV free-wall segments on two-dimensional speckle tracking echocardiography, suggesting ongoing ischemia. A cardiac CT demonstrated occluded proximal right coronary artery with a low-attenuated/soft plaque, confirmed by coronary angiography which was treated by percutaneous coronary intervention. At 3-week follow-up, there was complete resolution of the RV-PSS, with a more synchronized pattern of maximum myocardial shortening at systole.
Saeed, Sahrai; Skaar, Elisabeth; Romarheim, Andrea; Chambers, John B. & Bleie, Øyvind (2022). Shared Decision-Making and Patient-Reported Outcome Measures in Valvular Heart Disease. Frontiers in Cardiovascular Medicine. 9. doi: 10.3389/fcvm.2022.863040. Full text in Research Archive
Saeed, Sahrai & Imazio, Massimo (2022). Fabry disease: Definition, Incidence, Clinical presentations and Treatment-Focus on cardiac involvement. Pakistan Journal of Medical Sciences. ISSN 1682-024X. 38(8). doi: 10.12669/pjms.38.8.7063. Full text in Research Archive
Saeed, Sahrai & Imazio, Massimo (2022). Fabry disease in South and Central Asia: Is it truly a rare disease or underappreciated? Pakistan Journal of Medical Sciences. ISSN 1682-024X. 38(8). doi: 10.12669/pjms.38.8.7064. Full text in Research Archive
Høyland, Kjell; Ali, Abukar Mohamed; Vegsundvåg, Johnny Åge; Chambers, John B. & Saeed, Sahrai (2022). Echocardiographic features of left ventricular recess, cleft, diverticulum, and aneurysm: A systematic review. Journal of Clinical Ultrasound. ISSN 0091-2751. 50(3), p. 339–346. doi: 10.1002/jcu.23155. Full text in Research Archive Show summary
A pouch protruding into the wall of the left ventricle (LV) may be either a recess, cleft, diverticulum, or aneurysm. Being aware of these anomalies is essential to make accurate diagnosis and guide management decisions. Standard multimodality imaging of the heart enables detailed characterizations of LV fissures and outpouchings. They often present as an incidental finding on echocardiography, and the clinical significance can be difficult to address. We provide an overview of echocardiographic features of LV recess, cleft, diverticulum, pseudoaneurysms/aneurysms, and non-compaction based upon review of the literature as well as present some relevant clinical cases from our echocardiography labs.
Saeed, Sahrai; Käsk, Lauri; Rajani, Ronak & Larsen, Terje Hjalmar (2022). Incidence, clinical presentation, and management of Myocarditis following mRNA-based Covid-19 vaccines: A brief report. Cardiology. ISSN 0008-6312. 147(4), p. 406–412. doi: 10.1159/000522216. Full text in Research Archive
Dominici, Carmelo; Chello, Massimo & Saeed, Sahrai (2022). Outcomes of total arterial revascularization vs conventional revascularization in patients unergoing coronary artery bypass graft surgery: A narrative review of major stuies t. Pakistan Journal of Medical Sciences. ISSN 1682-024X. 38(5). doi: 10.12669/pjms.38.5.5674. Full text in Research Archive
Saeed, Sahrai & Chambers, John B. (2022). Exercise Testing in Aortic Stenosis: Safety, Tolerability, Clinical Benefits and Prognostic Value. Journal of Clinical Medicine. 11(17). doi: 10.3390/jcm11174983. Full text in Research Archive
Nawaz, Beenish Adeel Chaudhry; Fromm, Annette; Øygarden, Halvor; Eide, Geir Egil; Saeed, Sahrai & Meijer, Rudy [Show all 11 contributors for this article] (2022). Vascular risk factors and staging of atherosclerosis in patients and controls: The Norwegian Stroke in the Young Study. European Stroke Journal. ISSN 2396-9873. 7(3), p. 289–298. doi: 10.1177/23969873221098582. Full text in Research Archive Show summary
Objectives: We studied the prevalence of vascular risk factors (RFs) among 385 ischaemic stroke patients ⩽60 years and 260 controls, and their association with atherosclerosis in seven vascular areas. Methods: History of cardiovascular events (CVE), hypertension, diabetes mellitus (DM), dyslipidaemia, pack-years of smoking (PYS), alcohol, and physical inactivity were noted. Blood pressure, body mass index (BMI), waist-hip ratio (WHR), lipid profile, epicardial adipose tissue (EAT), visceral abdominal adipose tissue (VAT), and subcutaneous abdominal adipose tissue were measured. Numeric staging of atherosclerosis was done by standardized examination of seven vascular areas by right and left carotid and femoral intima-media thickness, electrocardiogram, abdominal aorta plaques, and the ankle-arm index. All results were age and sex-adjusted. Poisson regression analysis was applied. Results: At age ⩽49 years at least one RF was present in 95.6% patients versus 90.0% controls. Compared to controls, male patients and middle-aged female patients showed no significant differences. Young female patients compared to young female controls had a higher burden of RFs (94.3% vs 88.6%, p = 0.049). Poisson regression analysis combined for patients and controls, adjusted for age and sex, showed numeric staging of atherosclerosis associated with age, prior CVE, hypertension, DM, dyslipidaemia, PYS, alcohol, BMI, WHR, EAT, VAT, and an increased number of risk factors. Adjusted for all risk factors, numeric staging of atherosclerosis was associated with increasing age, hypertension, DM, PYS, and BMI. Conclusion: Vascular risk factors are highly prevalent in young- and middle-aged patients and controls, and are predictors of established atherosclerosis at study inclusion. Focus on main modifiable vascular RFs in primary prevention, and early and aggressive secondary treatment of patients are necessary to reduce further progression of atherosclerosis.
Saeed, Sahrai; Smith, Jenna; Grigoryan, Karine; Freitas, Dario; Bleie, Øyvind & Chambers, John B. [Show all 7 contributors for this article] (2022). Sex Differences in Right Ventricular Systolic Function and All-Cause Mortality in Tricuspid Regurgitation. Cardiology. ISSN 0008-6312. 147(4), p. 453–460. doi: 10.1159/000522587. Full text in Research Archive
Saeed, Sahrai; Romarheim, Synnøve Andrea; Mancia, Giuseppe; Saxvig, Ingvild W.; Gulati, Shashi & Lehmann, Sverre [Show all 7 contributors for this article] (2022). Characteristics of hypertension and arterial stiffness in obstructive sleep apnea: A Scandinavian experience from a prospective study of 6408 normotensive and hypertensive patients. The Journal of Clinical Hypertension. ISSN 1524-6175. 24(4), p. 385–394. doi: 10.1111/jch.14425. Full text in Research Archive
Pöyhönen, Pauli; Kuusisto, Jouni; Pirinen, Jani; Räty, Heli; Lehmonen, Lauri & Paakkanen, Riitta [Show all 12 contributors for this article] (2022). Orientation of the Atrial Septum to the Inferior Vena Cava May Contribute to the Persistent Patency of the Foramen Ovale. Cardiology. ISSN 0008-6312. 147(2), p. 169–178. doi: 10.1159/000522017. Full text in Research Archive
Romarheim, Synnøve Andrea; Larsen, Terje Hjalmar; Løland, Kjetil Halvorsen & Saeed, Sahrai (2022). The value of multimodality imaging in the management of Takotsubo syndrome: A case study. The Hellenic Journal of Cardiology. ISSN 1011-7970. 65, p. 59–60. doi: 10.1016/j.hjc.2022.04.001. Full text in Research Archive
Tadic, Marijana; Cuspidi, Cesare; Saeed, Sahrai; Lazic, Jelena Suzic; Vukomanovic, Vladan & Grassi, Guido [Show all 8 contributors for this article] (2021). The influence of left ventricular geometry on myocardial work in essential hypertension. Journal of Human Hypertension. ISSN 0950-9240. doi: 10.1038/s41371-021-00543-2. Full text in Research Archive
Saeed, Sahrai; Rajani, Ronak; Tadic, Marijana; Parkin, Denise & Chambers, John B. (2021). Left atrial volume index predicts adverse events in asymptomatic moderate or severe aortic stenosis. Echocardiography. ISSN 0742-2822. doi: 10.1111/echo.15225. Full text in Research Archive
Tadic, Marijana; Sala, Carla; Saeed, Sahrai; Grassi, Guido; Mancia, Giuseppe & Rottbauer, Wolfgang [Show all 7 contributors for this article] (2021). New antidiabetic therapy and HFpEF: light at the end of tunnel? Heart Failure Reviews. ISSN 1382-4147. doi: 10.1007/s10741-021-10106-9. Full text in Research Archive
Myrmel, Gard m s*; Lunde, Torbjørn; Dizdar, Vernesa; Larsen, Terje Hjalmar & Saeed, Sahrai (2021). Myocarditis in a Young Patient with Celiac Disease; A Case Report and Literature Review. Open Cardiovascular Medicine Journal. 15(1), p. 1–5. doi: 10.2174/1874192402115010001. Full text in Research Archive
Kellermair, Joerg; Saeed, Sahrai; Chambers, John B.; Kammler, Juergen; Blessberger, Hermann & Grund, Michael [Show all 9 contributors for this article] (2021). Predictors of true-severe classical low-flow low-gradient aortic stenosis at resting echocardiography. International Journal of Cardiology. ISSN 0167-5273. 335, p. 93–97. doi: 10.1016/j.ijcard.2021.02.070. Full text in Research Archive
Saeed, Sahrai & Edvardsen, Thor (2021). Basal septal hypertrophy in hypertension; about time to introduce an objective and reproducible quantification. Journal of Hypertension. ISSN 0263-6352. 39(7), p. 1316–1318. doi: 10.1097/HJH.0000000000002844. Full text in Research Archive
Wasim, Daanyaal; Alme, Bjørn Arild; Jordal, Stina; Eagan, Tomas Mikal Lind; Tadic, Marijana & Mancia, Giuseppe [Show all 8 contributors for this article] (2021). Characteristics of 24-hour ambulatory blood pressure monitoring in a COVID-19 survivor. Future Cardiology. ISSN 1479-6678. 17(8), p. 1321–1326. doi: 10.2217/fca-2020-0235. Full text in Research Archive
Riveland, Egil Aarstad; Larsen, Terje Hjalmar; Edvardsen, Thor & Saeed, Sahrai (2021). Metastatic tumor of the interventricular septum mimicking myocardial calcification: The role of multimodality imaging. Echocardiography. ISSN 0742-2822. 38(5), p. 774–776. doi: 10.1111/echo.14991. Full text in Research Archive Show summary
Recently, there has been focus on how a round-shaped metastatic or dystrophic myocardial calcification, a rare type of myocardial pathology with different imaging appearances, can mimic a tumor in the basal interventricular septum (IVS)1 on transthoracic echocardiography. However, we should also be focused on myocardial tumors without calcification. Here, we present a case of a 67-year-old woman with a tumor in the basal IVS detected by a routine echocardiography. She was previously diagnosed with a metastatic leiomyosarcoma, but did not have a known cardiovascular disorder. She did not have history of coronary artery disease, diabetes, or hypertension, and her blood pressure values at outpatient clinic were within normal range (<140/90 mmHg). A well-defined, round-shaped tumor (26 × 23 mm) was seen in the basal IVS (Supplementary data online, Videos 1 and 2) that was not present on an echocardiogram only 16 months earlier (Figure 1A), but evident t follow-up (Figure 1B-C). There was no signs of left ventricular hypertrophy or significant valvular heart disease. For better tissue characterization and assessment of the atrial septum and adjacent epicardium, a cardiac magnetic resonance (CMR) was performed (Figure 1E–G), confirming findings observed on echocardiography. In addition, it also identified two other tumors, one in the atrial septum (Figure 1G, white arrow) and another in the pericardium (Figure 1G, red arrow), highlighting the importance of multimodality imaging.
Nawaz, Beenish; Fromm, Annette; Øygarden, Halvor; Eide, Geir E; Saeed, Sahrai & Meijer, Rudy [Show all 11 contributors for this article] (2021). Prevalence of atherosclerosis and association with 5-year outcome: The Norwegian Stroke in the Young Study. European Stroke Journal. ISSN 2396-9873. 6(4), p. 374–384. doi: 10.1177/23969873211059472. Full text in Research Archive Show summary
Objectives: We studied the prevalence of atherosclerosis among ischaemic stroke patients ≤60 years and controls at the time of the index stroke, and its association with occurrence of new cardiovascular events (CVEs) and mortality at a 5-year follow-up. Methods: Prevalent atherosclerosis was assessed for 385 patients and 260 controls in seven vascular areas by electrocardiogram (ECG), ankle–arm index (AAI) and measurement of right and left carotid and femoral intima-media thickness (cIMT and fIMT) and abdominal aorta plaques (AAP). Clinical end-points were any new CVE (stroke, angina, myocardial infarction or peripheral arterial disease) or death from any cause at 5-year follow-up. All results were sex- and age-adjusted; logistic regression and Cox proportional hazards models were applied. Results: Young patients ≤49 years had prevalent atherosclerosis in 1/2 of males and 1/3 of females. Compared with controls, young female patients showed significantly higher prevalent atherosclerosis, p = 0.024. Ischaemic ECG and mean cIMT were higher in young and middle-aged female patients (p = 0.044, p = 0.020, p = 0.023 and p <0.001, respectively). Mean fIMT was higher in middle-aged female patients (p <0.001). Cardiovascular events were associated with ischaemic ECG; AAI ≤0.9, fIMT ≥0.9 mm and increased number of areas with atherosclerosis (NAA) among patients, and with AAP, cIMT ≥0.9 mm, fIMT ≥0.9 mm and NAA among controls. Mortality was associated with higher age, ischaemic ECG and NAA among patients, and cIMT ≥0.9 mm among controls. Conclusion: Atherosclerosis is highly prevalent even in young stroke patients. Some areas and increasing NAA are associated with CVEs and death.
Saeed, Sahrai; Holm, Hannes & Nilsson, Peter (2021). Ventricular-arterial coupling as a potential therapeutic target in diabetes. JOURNAL OF PAKISTAN MEDICAL ASSOCIATION. ISSN 0030-9982. 71(11), p. 2637–2640. doi: 10.47391/JPMA.01279. Full text in Research Archive
Ali, Abukar Mohamed; Wasim, Daanyaal; Larsen, Terje Hjalmar; Bogale, Nigussie; Bleie, Øyvind & Saeed, Sahrai (2021). Acute Myocardial Infarction Due to Microvascular Obstruction in a Young Woman Who Recently Recovered from COVID-19 Infection. Journal of Cardiovascular Development and Disease (JCDD). 8(6), p. 1–6. doi: 10.3390/jcdd8060066. Full text in Research Archive
Saeed, Sahrai & Vegsundvåg, Johnny Åge (2021). Usefulness of Stress Echocardiography in Assessment of Dynamic Left Ventricular Obstructions: Case Series and Review of the Literature. Cardiology. ISSN 0008-6312. 146(4), p. 441–450. doi: 10.1159/000516188. Full text in Research Archive Show summary
Dynamic left ventricular outflow tract obstruction (DLVOTO) or midcavity obstruction in patients with structurally normal hearts is not uncommon in routine clinical practice and can cause significant symptoms mimicking coronary artery disease or heart failure. Although exercise echocardiography is the gold standard for assessing DLVOTO, dobutamine stress echocardiography (DSE) may be valuable diagnostic modality in patients who are unable to exercise or have an uninterpretable 12-lead electrocardiogram. We provide an updated overview of the relevant literature regarding prevalence, pathophysiology, clinical significance, and prognostic impact of DLVOTO and midcavity obstruction in structurally normal hearts. We also present a clinical series of 4 cases of DLVOTO and midcavity obstruction documented by DSE and discuss the value of different kinds of modern stress imaging modalities involving: (1) contrast-enhanced DSE to assess myocardial perfusion and inducible ischemia; (2) adenosine stress echocardiography to assess coronary flow reserve/microvascular dysfunction; and (3) functional imaging with deformation echocardiography to assess subclinical myocardial dysfunction in patients with structurally normal heart and without significant coronary disease. Based upon our own experiences and a critical review of the current literature, we will then present a practical guidance for management of DLVOTO and midcavity obstruction.
Saeed, Sahrai; Gu, Haotian; Rajani, Ronak; Chowienczyk, Phil & Chambers, John B. (2021). First phase ejection fraction in aortic stenosis: A useful new measure of early left ventricular systolic dysfunction. Journal of Clinical Ultrasound. ISSN 0091-2751. doi: 10.1002/jcu.23063. Full text in Research Archive
Saeed, Sahrai; Wasim, Daanyaal; Ali, Abukar Mohamed; Bleie, Øyvind & Chambers, John B. (2021). The electrocardiogram: Still a useful marker for LV fibrosis in aortic stenosis. Journal of Electrocardiology. ISSN 0022-0736. 65, p. 82–87. doi: 10.1016/j.jelectrocard.2021.01.008. Full text in Research Archive
Ali, Abukar Mohamed; Wasim, Daanyaal; Løland, Kjetil Halvorsen; Rotevatn, Svein; Bleie, Øyvind & Saeed, Sahrai (2021). Impact of transcatheter aortic valve implantation on left ventricular function recovery, mass regression and outcome in patients with aortic stenosis: Protocol of the TAVI-NOR prospective study. BMJ Open. 11(1), p. 1–7. doi: 10.1136/bmjopen-2020-039961. Full text in Research Archive
Saeed, Sahrai; Tadic, Marijana; Grytaas, Marianne; Mancia, Giuseppe & Larsen, Terje H. (2021). The value of multimodality imaging in hypertensive heart disease. Journal of Hypertension. ISSN 0263-6352. 39(5), p. 1040–1043. doi: 10.1097/HJH.0000000000002726. Full text in Research Archive
Saeed, Sahrai; Holm, Hannes & Nilsson, Peter M. (2021). Ventricular-arterial coupling: definition, pathophysiology and therapeutic targets in cardiovascular disease. Expert Review of Cardiovascular Therapy. ISSN 1477-9072. 19(8), p. 753–761. doi: 10.1080/14779072.2021.1955351. Full text in Research Archive
Saeed, Sahrai & Rajani, Ronak (2021). The cardiovascular complications in COVID-19: Focus on acute cardiac injury. Pakistan Journal of Medical Sciences. ISSN 1682-024X. 37(3), p. 908–912. doi: 10.12669/pjms.37.3.4063. Full text in Research Archive
Saeed, Sahrai; Haaverstad, Rune; Blomberg, Bjørn; Bleie, Øyvind & Lunde, Torbjørn (2021). Long-term echocardiographic follow-up of a patient with constrictive pericarditis treated with antituberculosis drugs and pericardiectomy. BMJ Case Reports. 14(8), p. 1–7. doi: 10.1136/bcr-2021-244665. Full text in Research Archive
Saeed, Sahrai; Waje-Andreassen, Ulrike; Næss, Halvor; Fromm, Annette & Nilsson, Peter M. (2021). The impact of age and 24-h blood pressure on arterial health in acute ischemic stroke patients: The Norwegian stroke in the young study. The Journal of Clinical Hypertension. ISSN 1524-6175. 23(10), p. 1922–1929. doi: 10.1111/jch.14361. Full text in Research Archive
Saeed, Sahrai; Vamvakidou, Anastasia; Zidros, Spyridon; Papasozomenos, George; Lysne, Vegard & Khattar, Rajdeep [Show all 7 contributors for this article] (2021). Sex differences in transaortic flow rate and association with all-cause mortality in patients with severe aortic stenosis. European Heart Journal-Cardiovascular Imaging. ISSN 2047-2404. 22(9), p. 977–982. doi: 10.1093/ehjci/jeab045. Full text in Research Archive

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Flygel, Malin Renee; Bogale, Nigussie; Lundemoen, Steinar; Leiva, Rafael Alexander Mo; Larsen, Terje Hjalmar & Saeed, Sahrai [Show all 8 contributors for this article] (2025). Acute Coronary Stent Infection With Pseudoaneurysm Formation and Stent Separation After Percutaneous Coronary Intervention. doi: 10.1016/j.jaccas.2025.103909. Full text in Research Archive Show summary
Clinical Condition: We present a case of an extremely rare condition of acute stent infection in a patient with multiple previous coronary interventions who underwent a successful percutaneous coronary intervention for chronic total occlusion with stent implantation in his right coronary artery. He developed fever the day after the procedure, and blood culture showed growth of Staphylococcus aureus. Positron emission tomography–computed tomography showed fluorodeoxyglucose uptake in relation to the right coronary artery stent, and follow-up computed tomography showed the development of a pseudoaneurysm and suspicion of stent separation. Key Questions: Is the S aureus bacteremia in his blood culture related to the procedure? What do positron emission tomography–computed tomography findings indicate? Can the devolvement of a pseudoaneurysm cause stent separation? Outcome: After a broad multidisciplinary discussion and fear of pseudoaneurysm rupture with lethal outcomes, a successful open-heart surgery was performed, involving the removal of the pseudoaneurysm and stents. The patient is currently doing well with only mild symptoms. Take-Home Messages: The current work highlights the importance of close surveillance of patients presenting with signs and symptoms of septicemia after coronary intervention. It also underscores the value of a broad and dynamic multidisciplinary discussion and action during the management of such a rare complication with mycotic coronary aneurysms.
Saeed, Sahrai; Eriksen, Erlend & Chen, Jian (2025). ST-Segment Elevation Myocardial Infarction Due to Left Circumflex Artery Injury During Catheter Ablation. JACC: Case Reports. 30(22). doi: 10.1016/j.jaccas.2025.104554. Full text in Research Archive Show summary
The risk of ablation-induced coronary artery injury is low, but may increase with the anatomic proximity and increasing frequencies of redo procedures or when catheter ablation is performed in the coronary sinus branches. We present the case of a 53-year-old woman with a history of 5 ablations over the past 12 years. Owing to recurrence of highly symptomatic atrial flutter, a repeat ablation was performed in the coronary sinus. She developed chest pain accompanied by ST-segment elevation in the inferior leads. Coronary angiography demonstrated an occluded mid-circumflex artery, which we believe was induced by direct thermal injury. This was successfully treated with a drug-eluting stent.
Saeed, Sahrai; Rajani, Ronak & Solheim, Eivind (2024). Correction to: A BRASH Diagnosis with a timely intervention. Current problems in cardiology. ISSN 0146-2806. 49(2). doi: 10.1016/j.cpcardiol.2023.102356. Full text in Research Archive
Saeed, Nasir; TAULE, ERLEND MOEN; Vetti, Nils; Saeed, Sahrai; Leirgul, Elisabeth & Reikvam, Håkon (2024). En kvinne i 30-årene med dyspné to uker etter bukplastikkoperasjon. Tidsskrift for Den norske legeforening (Tidsskriftet). ISSN 0029-2001. 144(7). doi: 10.4045/tidsskr.23.0742. Full text in Research Archive
Saeed, Sahrai & Bleie, Øyvind (2024). Prognostic validation of first-phase ejection fraction in patients with heart failure: A new piece of evidence. International Journal of Cardiology. ISSN 0167-5273. doi: 10.1016/j.ijcard.2023.131692. Full text in Research Archive
Saeed, Sahrai; Ali, Abukar Mohamed; Mahmoud, Muhiddin Abdi & Nilsson, Peter M. (2023). Risk factors of newly detected and masked untreated hypertension in a South Asian population of Type-2 diabetes patients. Pakistan Journal of Medical Sciences. ISSN 1682-024X. 39(3), p. 631–633. doi: 10.12669/pjms.39.3.7666. Full text in Research Archive
Saeed, Sahrai; Eriksen, Erlend & Larsen, Terje Hjalmar (2023). Quantitative evaluation of cardiac magnetic resonance feature tracking (CMR-FT) derived strain in patients with ST-elevation myocardial infarction. Pakistan Journal of Medical Sciences. ISSN 1682-024X. 39(3), p. 629–630. doi: 10.12669/pjms.39.3.7571. Full text in Research Archive
Myrmel, Gard M. S.; Lunde, Torbjørn & Saeed, Sahrai (2022). Clinical spectrum of Celiac disease from a cardiology perspective. Pakistan Journal of Medical Sciences. ISSN 1682-024X. 38(4), p. 782–784. doi: 10.12669/pjms.38.4.6129. Full text in Research Archive
Käsk, Lauri; Larsen, Terje Hjalmar; Rajani, Ronak & Saeed, Sahrai (2022). Reply to "Myocarditis following mRNA-Based COVID-19 Vaccines: Correspondence". Cardiology. ISSN 0008-6312. 147(4), p. 419–420. doi: 10.1159/000524049. Full text in Research Archive
Saeed, Sahrai & Rajani, Ronak (2022). The association of pre-existing comorbid conditions with COVID-19 severity and post-COVID complications; insights from South Asia. Pakistan Journal of Medical Sciences. ISSN 1682-024X. 38(3), p. 439–441. doi: 10.12669/pjms.38.3.5719. Full text in Research Archive
Saeed, Sahrai & Mancia, Giuseppe (2021). Arterial stiffness and COVID-19: A bidirectional cause-effect relationship. The Journal of Clinical Hypertension. ISSN 1524-6175. 23(6), p. 1099–1103. doi: 10.1111/jch.14259. Full text in Research Archive
Saeed, Sahrai; Bleie, Øyvind & Chambers, John B. (2021). Dobutamine stress echocardiography for low gradient aortic stenosis: Current practice in Poland. Kardiologia Polska. ISSN 0022-9032. 79(5), p. 491–492. doi: 10.33963/KP.2021.0014. Full text in Research Archive
Saeed, Sahrai & Emmanuel, Yaso (2021). Burden of vsd associated aortic valve cusp prolapse with aortic regurgitation and the impact of early surgery on clinical outcomes in south Asia. Pakistan Journal of Medical Sciences. ISSN 1682-024X. 37(5), p. 1259–1261. doi: 10.12669/pjms.37.5.4845. Full text in Research Archive
Saeed, Sahrai; Bleie, Øyvind & Chambers, John B. (2021). Exercise testing in patients with aortic stenosis: Clinically useful. Polish Archives of Internal Medicine. ISSN 0032-3772. 131(4), p. 324–325. doi: 10.20452/pamw.15978. Full text in Research Archive

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Published Feb. 17, 2025 3:10 PM - Last modified Apr. 8, 2025 1:30 PM