Public Digital Defence: John Moene Aalen

Cand.med. John Moene Aalen at Institute of Clinical Medicine will be defending the thesis Insights into left ventricular dyssynchrony: Consequences for myocardial function and response to cardiac resynchronization therapy for the degree of PhD (Philosophiae Doctor).

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Photo: Amalie Huth Hovland, UiO

The public defence will be held as a video conference over Zoom.

The defence will follow regular procedure as far as possible, hence it will be open to the public and the audience can ask ex auditorio questions when invited to do so.

Click here to participate in the public defence

Download Zoom here

Due to copyright reasons, an electronic copy of the thesis must be ordered from the faculty. In order for the faculty to have time to process the order, it must be received by the faculty no later than 2 days prior to the public defence. Orders received later than 2 days before the defence will not be processed. Inquiries regarding the thesis after the public defence must be addressed to the candidate.

Order a digital copy of the thesis here

Digital Trial Lecture – time and place

See Digital Trial Lecture.

Adjudication committee

  • First opponent: Associate Professor Assami Rösner, University Hospital of North Norway (UNN) and The Arctic University of Norway (UiT)
  • Second opponent: Associate Professor Joost Lumens, Maastricht University, the Netherlands
  • Third member and chair of the evaluation committee: Professor Torbjørn Omland, University of Oslo

Chair of the Defence

Professor II Dan Atar, University of Oslo

Principal Supervisor

Professor Emeritus Otto A. Smiseth, University of Oslo

Summary

Left bundle branch block (LBBB) is a common finding in clinical cardiology practice and may lead to or worsen heart failure. During LBBB, there is typically reduced function in the early-activated interventricular septum and compensatory increased function in the late-activated left ventricular (LV) lateral wall, but the effect of LBBB on global LV function is incompletely understood. In LBBB patients with symptomatic heart failure, cardiac resynchronization therapy (CRT) is indicated, but about one third of patients do not respond.
 
The aim of the present thesis was to study the effect of LBBB on LV function during increased blood pressure and ischemia, and to find a better method to select CRT candidates.
 
First, we found that patients with LBBB were hypersensitive to a moderate blood pressure increase as this caused a substantial reduction in LV ejection fraction, which was approximately twice of what was seen in age-matched controls. The underlying mechanism was septal dysfunction.
 
Second, we found that septal dysfunction in LBBB is highly dependent on contractions in the lateral wall. Thus, during lateral wall ischemia, septal function was markedly improved.  
 
Third, in a prospective multicenter study, we demonstrated how the presence of marked septal dysfunction with compensatory lateral wall hyperfunction identified patients who responded to CRT with added value to current guidelines. The mechanism of CRT response was increased septal function and consequently patients with septal scar responded poorly.
 
Overall, the findings in the thesis improve understanding of heart failure and CRT response in patients with LBBB.

Additional information

Contact the research support staff.

 

 

Published May 3, 2021 1:47 PM - Last modified May 11, 2021 9:06 AM