Due to copyright issues, an electronic copy of the thesis must be ordered from the faculty. For the faculty to have time to process the order, the order must be received by the faculty at the latest 2 days before the public defence. Orders received later than 2 days before the defence will not be processed. After the public defence, please address any inquiries regarding the thesis to the candidate.
Trial Lecture – time and place
See Trial Lecture.
Adjudication committee
- First opponent: Professor Elizabeth Selvin, Johns Hopkins Bloomberg School of Public Health, US
- Second opponent: Professor John William McEvoy, University of Galway, Ireland
- Third member and chair of the evaluation committee: Associate professor Rune Bruhn Jakobsen, University of Oslo
Chair of the Defence
Professor Haseem Ashraf, University of Oslo
Principal Supervisor
Professor Magnus Nakrem Lyngbakken, University of Oslo
Summary
Myocardial fibrosis is the pathophysiological hallmark of conditions converging in heart failure and is assessed by cardiovascular magnetic resonance (CMR) imaging. CMR imaging markers of myocardial fibrosis are associated with morbidity and mortality in the general population.
Data on the use of established and novel circulating biomarkers to identify myocardial fibrosis in the general population are sparse. The prognostic value of combinations of CMR markers of myocardial fibrosis and circulating biomarkers has not been evaluated in large community-based cohorts.
The aim of the thesis was to explore the relationship between established and novel circulating biomarkers and CMR imaging markers of myocardial fibrosis and determine associations of circulating biomarkers and CMR imaging markers of myocardial fibrosis with risk of incident cardiovascular events in the general population.
Growth differentiation factor 15, a marker of cellular stress, was associated with nonischemic focal myocardial fibrosis in a CMR substudy of the Akershus Cardiac Examination (ACE) 1950 Study of men and women born in 1950 from Akershus county, Norway.
Cardiac myosin binding protein C, a novel marker of myocardial injury, was associated with cardiovascular risk factors and myocardial remodeling and dysfunction in the ACE 1950 Study.
None of the examined biomarkers were associated with diffuse myocardial fibrosis, a type of myocardial fibrosis considered an early marker of disease, in the ACE 1950 Study.
Finally, the combination of CMR imaging markers of myocardial fibrosis and circulating biomarkers was strongly associated with adverse outcomes in a large U.S. cohort, the Multi-Ethnic Study of Atherosclerosis.
Overall, the results indicate that circulating biomarkers may be used in risk assessment of focal myocardial fibrosis in the general population and in combination with CMR markers identify community-dwelling individuals at particular risk of developing CVD.
Additional information
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