Digital public defence: Anders Heiervang Tennøe
Cand.med. Anders Heiervang Tennøe at Institute of Clinical Medicine will be defending the thesis Cardiac Risk Profiling in Systemic Sclerosis for the degree of PhD (Philosophiae Doctor).
Foto: Øystein Horgmo, OUS
Digital trial lecture - time and place
- First opponent: Senior Consultant Jeska de Vries-Bouwstra, Leiden University Hospital, The Netherlands
- Second opponent: Professor Göran Rådegran, Lund University, Sweden
- Third member and chair of the evaluation committee: Associate Professor Marte Lie Høivik, Institute of Clinical Medicine, University of Oslo
Chair of defence
Professor II Tillmann Uhlig, Institute of Clinical Medicine, University of Oslo
Anna-Maria Hoffmann-Vold, Oslo University Hospital
Systemic sclerosis (SSc) presents the highest mortality among the connective tissue diseases. While the disease predominantly affects the skin, internal organs are frequently affected. Cardiac affection is reported common in SSc, but there are knowledge gaps regarding how cardiac function evolves over the disease course.
The aims of the thesis was to map systolic and diastolic function in patients with SSc, and evaluate the impact of cardiac dysfunction on mortality. Echocardiographies from early and late disease were analyzed to evaluate chronologic alterations in cardiac function. Clinical and echocardiographic parameters were investigated with respect to mortality-predicting ability. Additionally, potential serum markers were evaluated for association with cardiac affection and mortality-predicting ability.
333 SSc patients presented with one or more echocardiographies. SSc patients presented poorer systolic and diastolic function compared to controls. Left ventricular (LV) diastolic function and right ventricular (RV) systolic function deteriorated over three years of follow-up. Contrary, LV systolic function stabilized over the disease course. LV diastolic function and RV systolic function were strong independent predictors of mortality. LV diastolic function surpassed the mortality-predicting potential of the feared SSc-complication pulmonary arterial hypertension.
The serum marker TRAIL was associated with LV diastolic dysfunction, while TRAIL, osteopontin and angiopoietin-2 were associated with RV systolic dysfunction. Alterations of TRAIL, osteopontin and angiopoietin-2 levels were independent predictors of mortality.
In summary, LV diastolic function and RV systolic function strongly predicted mortality in patients with SSc. TRAIL, osteopontin and angiopoietin-2 are potential biomarkers of cardiac affection in SSc.
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