Henrik Brun

• Andresen, Brith; Ohnstad, Mari Oma; Larsen, Marie Hamilton; Steindal, Simen A; Brun, Henrik & Eriksen, Katrine Onshuus [Vis alle 18 forfattere av denne artikkelen] (2026). Effectiveness of eHealth Interventions for Adolescents and Young Adults With Congenital Heart Disease: Systematic Review. Journal of Medical Internet Research (JMIR). ISSN 1439-4456. 28, s. 91424–91424. doi: 10.2196/91424. Fulltekst i vitenarkiv Vis sammendrag

  Background: Adolescents and young adults (AYAs) with complex congenital heart disease (CHD) may benefit from eHealth interventions, particularly when early signs of deterioration or self-management challenges arise. eHealth can enhance self-management skills and communication with health care professionals (HCPs). However, systematic reviews examining eHealth interventions for this population remain limited and heterogeneous, indicating a need for a systematic review of the literature to guide the development, implementation, and evaluation of such interventions. Objective: In this systematic review, we aimed to synthesize the content, theoretical foundations, outcomes, and effectiveness of eHealth interventions targeting AYAs with complex CHD that involve interaction with HCPs. Methods: We conducted this systematic review in accordance with the Cochrane Handbook for Systematic Reviews of Interventions. An a priori protocol was registered in PROSPERO (CRD42023400211). The review was reported according to the 2020 PRISMA (Preferred Reporting Items for Systematic Reviews and Meta-Analyses), the PRISMA-S (PRISMA Literature Search Extension), and the SWiM (Synthesis Without Meta-Analysis) checklists. The final comprehensive bibliographic search was conducted on March 16, 2026, across MEDLINE ALL (Ovid), Embase (Ovid), APA PsycInfo (Ovid), ERIC (EBSCOhost), CINAHL (EBSCOhost), and the Web of Science Core Collection (Clarivate). Studies were eligible if they included AYAs aged 10-29 years diagnosed with CHD who received eHealth interventions delivered by HCPs regardless of care setting; measured effects of eHealth interventions using experimental or quasiexperimental designs; and were published in English or a Scandinavian language. The researchers assessed eligibility in pairs, risk of bias using the Revised Cochrane risk-of-bias tool for randomized trials (RoB 2) for randomized studies and the Risk of Bias in Non-Randomized Studies of Exposures (ROBINS-E) for nonrandomized studies, and extracted data. Overall risk of bias was high. Due to heterogeneity among the included studies, a narrative synthesis was conducted. Results: We included 8 studies, with sample sizes ranging from 20 to 158, totaling 551 participants. Five studies reported improvements in the eHealth intervention groups, evaluating educational interventions to improve disease-specific knowledge, self-management, physical activity, psychosocial impact, and transition readiness in AYAs with CHD. However, the content, delivery mode and format, and target outcomes varied across studies. Seven studies lacked a theoretical foundation for the intervention. Conclusions: The evidence remains inconsistent and limited by heterogeneity, absence of theoretical foundations, risk of bias, and high dropout rates; further refinement is thus needed. Future research may benefit from theory-driven, user-centered, co-designed approaches with AYAs with CHD from the outset to enhance relevance, engagement, and long-term sustainability. Standardized outcome measures and long-term evaluations could clarify the long-term impact and implementation potential of eHealth interventions. This study emphasizes factors like tailoring content to medical complexity, integrating interactive interprofessional teams, and incorporating structured peer support in planning and developing eHealth intervention research in the future.

• Sajadi, Seyedmohammadreza; Tariverdi, Abbas; Brun, Henrik; Elle, Ole Jakob & Mathiassen, Kim (2026). Robotic transesophageal echocardiography: system design and deep learning-based kinematic modeling. Frontiers in Robotics and AI. 12. doi: 10.3389/frobt.2025.1705142. Fulltekst i vitenarkiv
• Cantinotti, Massimiliano; Voges, Inga; Salvo, Giovanni di; Ortiz-Garrido, Almudena; Bharucha, Tara & Grotenhuis, Heynric [Vis alle 32 forfattere av denne artikkelen] (2025). Hypoplastic Left Heart Syndrome Practice Variation Across 31 Centres From 20 European Countries. An AEPC Imaging Working Group Study. European Journal of Pediatrics. ISSN 0340-6199. 184, s. 1–11. doi: 10.1007/s00431-025-06175-9. Fulltekst i vitenarkiv Vis sammendrag

  Despite significant advances in knowledge and the development of guidelines, the management of hypoplastic left heart syndrome (HLHS) remains highly variable. A structured questionnaire was circulated across European Association of Paediatric & Congenital Cardiology (AEPC) affiliated centres. The aims were to evaluate standards in pre-operative assessment, types of surgery, follow-up and medical practices in children with HLHS. Thirty-one centres from 20 countries completed the survey. Delivery of babies with HLHS occurred in co-located maternity hospitals in 74% of centres; 29% were planned for spontaneous onset of labour, while 54% decided on a case-by-case basis. The preferred initial palliation was a right ventricle-pulmonary artery conduit in 55% of cases, modified Blalock-Thomas Taussig shunt (mBTTS) in 35%, and hybrid in 15% of cases. Timing for Glenn varied from 3 to 6 months of age and preoperative examination varied greatly: 65% performed cardiac catheterization and only 19% performed cardiac magnetic resonance. Stage III palliation was performed at a highly variable interval (2—6 years of age), nearly always employing an extracardiac conduit. Fenestration was routinely performed in 61% and reserved for borderline cases in 39%. All the centers adopted warfarin for the first 3–12 months after Fontan completion, and continued if a fenestration was present, while in non-fenestrated aspirin was left by most centers (e.g. 68%). However, there was a high disparity in the use of heart failure medications (e.g. in interstage I-II 35% use ACE-inhibitors, and only 26% digoxin). Follow-up practice also varied widely with only 60% employing specific protocols. Conclusion: This first multi-centre European survey from 31 centres from 20 different European countries highlighted a high practice variation in HLHS management across all the stages of Single Ventricle (Fontan) palliation. Major variations pertained to pre- and post-surgical investigations, surgical strategy for stage I and III, medical treatment regimens, and follow-up programs.

• Ramcharan, Tristan; Roest, Arno; Voges, Inga; Cantinotti, Massimiliano; Grotenhuis, Heynric & Garrido, Almudena Ortiz [Vis alle 34 forfattere av denne artikkelen] (2025). Pediatric Cross-Sectional Cardiac Imaging in Europe: Current Status, Disparities, and Potential Solutions: A Survey from the Association for European Pediatric and Congenital Cardiology (AEPC) Imaging Working Group. Pediatric Cardiology. ISSN 0172-0643. doi: 10.1007/s00246-025-04027-9. Fulltekst i vitenarkiv
• Diab, Simone; Rösner, Assami; Døhlen, Gaute; Brun, Henrik; Grindheim, Guro & Vithessonthi, Kanyalak [Vis alle 9 forfattere av denne artikkelen] (2025). Systolic Function in the Fontan Circulation Is Exercise, but Not Preload, Recruitable. Journal of the American Society of Echocardiography. ISSN 0894-7317. 38(4), s. 342–352. doi: 10.1016/j.echo.2024.11.005. Fulltekst i vitenarkiv Vis sammendrag

  Background - Fontan circulatory failure with impaired systolic function is well documented; however, its mechanisms are not fully understood. The aim of this study was to explore myocardial functional reserve in adolescent patients with Fontan circulation in response to exercise or acute preload increase.<p> <p>Methods - The study included 32 patients (median age, 16.7 years; range, 15.4–17.9 years; 12 female patients) with Fontan circulation. Echocardiographic imaging was performed during exercise using a recumbent cycle ergometer and during heart catheterization with a rapid infusion of 0.9% saline infusion at 5 mL/kg body weight. Myocardial peak longitudinal strain (LS) was measured in a four-chamber view during specific time intervals before, during, and after exercise (LS_stress) and volume load (LS_cath). During catheterization, central venous pressure and ventricular end-diastolic pressure were simultaneously recorded. A control group of 16 healthy individuals participated in the exercise test.<p> <p>Results - Mean LS_stress was less negative for patients than for control subjects (P ≤ .001 at all stages); however, it significantly improved from −18.4 ± 5.5% at baseline to −22.0 ± 6.5% (P = .004) at maximal loading. LS_stress at maximal loading did not correlate with changes in heart rate. During catheterization, mean LS_cath was −19.6 ± 6.0% at baseline and did not improve significantly at 1.00 to 2.00 minutes and at 4.00 to 6.00 minutes after saline infusion. In more than half of the patients, LS_cath worsened or improved by less than −2% after saline infusion. Worsening of LS_cath correlated with central venous pressure and ventricular end-diastolic pressure in all conditions (P ≤ .017). There was no difference in LS_stress or LS_cath between the morphologic right ventricle and the morphologic left ventricle.<p> <p>Conclusions - Patients with Fontan circulation demonstrate systolic myocardial functional reserve that can be recruited with exercise stress but not with an acute increase in preload.

• Lippert, Matthias; d’Albenzio, Gabriella; Suther, Lene Kathrine R; Dumont, Karl-Andreas; Palomar, Rafael & Odland, Hans Henrik [Vis alle 9 forfattere av denne artikkelen] (2024). HoloPatch: improving intracardiac patch fit through holographically modelled templates. European Heart Journal – Imaging Methods and Practice (EHJ-IMP). 2(3). doi: 10.1093/ehjimp/qyae103. Fulltekst i vitenarkiv Vis sammendrag

  Aims Structural heart defects, including congenital ventricular septal defect closure or intracardiac rerouting, frequently require surgical reconstruction using hand-cut patch materials. Digitally modelled patch templates may improve patch fit and reduce outflow tract obstruction, residual defect risk, and conduction system damage. In this study, we benchmarked mixed-reality and a desktop application against a digitalized model of a real implanted patch. Methods and results Ten patients scheduled for the repair of various defects consented to prospective inclusion in the study. After surgery, a digital model of the implanted patch was created from the residual material. Five clinical experts created 10 digital patches, 1 per patient, both in mixed-reality and desktop application, for comparison with the reference measurements, including the digitalized model of the real patch used during the surgery. Subjective residual shunt risk prediction was performed using both modalities. Digital patches created in mixed-reality closely matched the surgical material, whereas those created using desktop applications were significantly smaller. Different evaluators showed varying preferences for the application of the residual shunt risk and area. Conclusion Digitally created patches can assist surgeons in preoperatively sizing of patch implants, potentially reducing post-operative complications.

• Safi, Sanam; Hjortdal, Vibeke E.; Gewillig, Marc; Miller, Owen; Abumehdi, Mohammad Ryan & Cantinotti, Massimiliano [Vis alle 38 forfattere av denne artikkelen] (2024). Lymphatic Disorder Management in Pediatric Patients With Congenital Heart Disease in European Pediatric Cardiology Centers: Current Status, Disparities, and Future Considerations. Journal of the American Heart Association (JAHA). 13(22), s. 1–11. doi: 10.1161/JAHA.124.036597. Fulltekst i vitenarkiv
• Lippert, Matthias; Dumont, Karl-Andreas; Birkeland, Sigurd; Nainamalai, Varatharajan; Solvin, Håvard Bjerkeseth & Suther, Lene Kathrine R [Vis alle 9 forfattere av denne artikkelen] (2024). Cardiac anatomic digital twins: findings from a single national centre. The European Heart Journal – Digital Health (EHJ-DH). 5(6), s. 725–734. doi: 10.1093/ehjdh/ztae070. Fulltekst i vitenarkiv
• Cantinotti, Massimiliano; Voges, Inga; Miller, Owen; Raimondi, Francesca; Grotenhuis, Heynric & Bharucha, Tara [Vis alle 44 forfattere av denne artikkelen] (2024). Organisation of paediatric echocardiography laboratories and governance of echocardiography services and training in Europe: current status, disparities, and potential solutions. A survey from the Association for European Paediatric and Congenital Cardiology (AEPC) imaging working group. Cardiology in the Young. ISSN 1047-9511. 34(5), s. 1100–1108. doi: 10.1017/S1047951124000131. Fulltekst i vitenarkiv
• Rasooli, Reza; Holmstrøm, Henrik; Giljarhus, Knut Erik Teigen; Jolma, Ingunn Westvik; Vinningland, Jan Ludvig & Lange, Charlotte De [Vis alle 8 forfattere av denne artikkelen] (2024). In vitro hemodynamic performance of a blood pump for self-powered venous assist in univentricular hearts. Scientific Reports. 14(1). doi: 10.1038/s41598-024-57269-7. Fulltekst i vitenarkiv Vis sammendrag

  Univentricular heart anomalies represent a group of severe congenital heart defects necessitating early surgical intervention in infancy. The Fontan procedure, the final stage of single-ventricle palliation, establishes a serial connection between systemic and pulmonary circulation by channeling venous return to the lungs. The absence of the subpulmonary ventricle in this peculiar circulation progressively eventuates in failure, primarily due to chronic elevation in inferior vena cava (IVC) pressure. This study experimentally validates the effectiveness of an intracorporeally-powered venous ejector pump (VEP) in reducing IVC pressure in Fontan patients. The VEP exploits a fraction of aortic flow to create a jet-venturi effect for the IVC, negating the external power requirement and driveline infections. An invitro Fontan mock-up circulation loop is developed and the impact of VEP design parameters and physiological conditions is assessed using both idealized and patient-specific total cavopulmonary connection (TCPC) phantoms. The VEP performance in reducing IVC pressure exhibited an inverse relationship with the cardiac output and extra-cardiac conduit (ECC) size and a proportional relationship with the transpulmonary pressure gradient (TPG) and mean arterial pressure (MAP). The ideal VEP with fail-safe features provided an IVC pressure drop of 1.82 ± 0.49, 2.45 ± 0.54, and 3.12 ± 0.43 mm Hg for TPG values of 6, 8, and 10 mm Hg, respectively, averaged over all ECC sizes and cardiac outputs. Furthermore, the arterial oxygen saturation was consistently maintained above 85% during full-assist mode. These results emphasize the potential utility of the VEP to mitigate elevated venous pressure in Fontan patients.

• Chan, Raymond H.; Wal, Laurine Van Der; Liberato, Gabriela; Rowin, Ethan; Soslow, Jonathan & Maskatia, Shiraz [Vis alle 52 forfattere av denne artikkelen] (2024). Myocardial Scarring and Sudden Cardiac Death in Young Patients with Hypertrophic Cardiomyopathy: A Multicenter Cohort Study. JAMA cardiology. ISSN 2380-6583. 9(11), s. 1001–1008. doi: 10.1001/jamacardio.2024.2824. Fulltekst i vitenarkiv
• Brun, Henrik; Lippert, Matthias; Langø, Thomas; Sanchez-Margallo, Juan; Sanchez-Margallo, Francisco & Elle, Ole Jakob (2024). Comparing assisting technologies for proficiency in cardiac morphology: 3D printing and mixed reality versus CT slice images for morphological understanding of congenital heart defects by medical students. Anatomical Sciences Education. ISSN 1935-9772. 18(1), s. 68–76. doi: 10.1002/ase.2530. Fulltekst i vitenarkiv Vis sammendrag

  Learning cardiac morphology largely involves spatial abilities and studies indicate benefits from innovative 3D visualization technologies that speed up and increase the learning output. Studies comparing these teaching tools and their educational output are rare and few studies include complex congenital heart defects. This study compared the effects of 3D prints, mixed reality (MR) viewing of 3D meshes and standard cardiac CT slice images on medical students′ understanding of complex congenital heart defect morphology, measuring both objective level of understanding and subjective educational experience. The objective of this study was to compare morphological understanding and user experiences of 3D printed models, MR 3D visualization and axial 2D CT slices, in medical students examining morphological details in complex congenital heart defects. Medical students in the median 4th year of study (range 2nd to 6th) examined three of five different complex congenital heart defects by three different modalities: 3D printed model, MR viewed 3D mesh, and cardiac CT slices, answering a questionnaire on morphology and user experience. Time to complete task, diagnostic accuracy, and user experience data were collected and compared on group level. Task times were similar for all modalities. The percentage of correct answers was higher with MR visualization, which was also the preferred modality overall. Medical students both prefer and better understand the morphology of complex congenital heart disease with 3D models viewed using MR, without spending more time than with 3D prints or 2D CT images.

• Maddali, Dharani Dhar; Solvin, Håvard Bjerkeseth; Lippert, Matthias; Karabiyik, Yücel; Dahle, Gry & Hjelmervik, Jon Mikkelsen [Vis alle 9 forfattere av denne artikkelen] (2024). Monte Carlo-based rendering of 3D echocardiography for mixed reality-guided atrial septal puncture positioning. Computer Assisted Surgery. 29(1). doi: 10.1080/24699322.2024.2403444. Fulltekst i vitenarkiv Vis sammendrag

  Catheter-based intervention procedures contain complex maneuvers, and they are often performed using fluoroscopic guidance assisted by 2D and 3D echocardiography viewed on a flat screen that inherently limits depth perception. Emerging mixed reality (MR) technologies, combined with advanced rendering techniques, offer potential enhancement in depth perception and navigational support. The study aims to evaluate a MR-based guidance system for the atrial septal puncture (ASP) procedure utilizing a phantom anatomical model. A novel MR-based guidance system using a modified Monte Carlo-based rendering approach for 3D echocardiographic visualization was introduced and evaluated against standard clinical 3D echocardiographic display on a flat screen. The objective was to guide the ASP procedure by facilitating catheter placement and puncture across four specific atrial septum quadrants. To assess the system’s feasibility and performance, a user study involving four experienced interventional cardiologists was conducted using a phantom model. Results show that participants accurately punctured the designated quadrant in 14 out of 16 punctures using MR and 15 out of 16 punctures using the flat screen of the ultrasound machine. The geometric mean puncture time for MR was 31 s and 26 s for flat screen guidance. User experience ratings indicated MR-based guidance to be easier to navigate and locate tents of the atrial septum. The study demonstrates the feasibility of MR-guided atrial septal puncture. User experience data, particularly with respect to navigation, imply potential benefits for more complex procedures and educational purposes. The observed performance difference suggests an associated learning curve for optimal MR utilization.

• Solvin, Håvard Bjerkeseth; Diab, Simone; Elle, Ole Jakob; Holmstrøm, Henrik & Brun, Henrik (2023). Real-Time Remote-Mentored Echocardiography in Management of Newborns with Critical Congenital Heart Defects. Congenital Heart Disease. ISSN 1747-079X. 18(5), s. 551–559. doi: 10.32604/chd.2023.031537. Fulltekst i vitenarkiv Vis sammendrag

  Background: The management of suspected critical congenital heart defects (CCHD) relies on timely echocardiographic diagnosis. The availability of experienced echocardiographers is limited or even non-existent in many hospitals with obstetric units. This study evaluates remote-mentored echocardiography performed by physicians without experience in imaging of congenital heart defects (CHD). Methods: The setup included a pediatric cardiologist in a separate room, guiding a physician without experience in echocardiographic imaging of CHD in the examination of a symptomatic newborn. This remote-mentoring pair was blinded to the diagnosis of the newborn and presented with a simplified patient history. The echocardiographic images were streamed to the laptop of the mentor, along with a webcam feed showing the probe position. The task was to identify CCHD in need of immediate transfer to a pediatric cardiac surgical center. The result was compared to the previously completed echocardiographic report and the clinical decision of the patient-responsible pediatric cardiologist. Results: During 17 months, 15 newborns were recruited. All six newborns with CCHD were correctly labeled by the remotementoring pair. One newborn with Tetralogy of Fallot was erroneously labeled as needing immediate transfer. Eight newborns without CCHD were correctly labeled. Conclusions: Remote-mentored echocardiography performed by examiners without experience in imaging CHD identified all newborns with CCHD in need of immediate transfer for specialist care. The setup shows promising results for improving the management of CCHD in hospitals without continuous pediatric cardiology service.

• Rasooli, Reza; Giljarhus, Knut Erik Teigen; Hiorth, Aksel; Jolma, Ingunn Westvik; Vinningland, Jan Ludvig & Lange, Charlotte de [Vis alle 8 forfattere av denne artikkelen] (2023). In Silico Evaluation of a Self-powered Venous Ejector Pump for Fontan Patients. Cardiovascular Engineering and Technology. ISSN 1869-408X. 14(3), s. 428–446. doi: 10.1007/s13239-023-00663-5. Fulltekst i vitenarkiv Vis sammendrag

  Purpose The Fontan circulation carries a dismal prognosis in the long term due to its peculiar physiology and lack of a subpulmonic ventricle. Although it is multifactorial, elevated IVC pressure is accepted to be the primary cause of Fontan's high mortality and morbidity. This study presents a self-powered venous ejector pump (VEP) that can be used to lower the high IVC venous pressure in single-ventricle patients. Methods A self-powered venous assist device that exploits the high-energy aortic flow to lower IVC pressure is designed. The proposed design is clinically feasible, simple in structure, and is powered intracorporeally. The device's performance in reducing IVC pressure is assessed by conducting comprehensive computational fluid dynamics simulations in idealized total cavopulmonary connections with different offsets. The device was finally applied to complex 3D reconstructed patient-specific TCPC models to validate its performance. Results The assist device provided a significant IVC pressure drop of more than 3.2 mm Hg in both idealized and patient-specific geometries, while maintaining a high systemic oxygen saturation of more than 90%. The simulations revealed no significant caval pressure rise (< 0.1 mm Hg) and sufficient systemic oxygen saturation (> 84%) in the event of device failure, demonstrating its fail-safe feature. Conclusions A self-powered venous assist with promising in silico performance in improving Fontan hemodynamics is proposed. Due to its passive nature, the device has the potential to provide palliation for the growing population of patients with failing Fontan.

• Solvin, Håvard; Lippert, Matthias; Holmstrøm, Henrik; Elle, Ole Jakob & Brun, Henrik (2023). Real-time Remote Expert-guided Echocardiography by Medical Students. Ultrasound Journal. 15(1). doi: 10.1186/s13089-023-00328-3. Fulltekst i vitenarkiv Vis sammendrag

  Background Echocardiography is a highly specialised examination performed by experienced healthcare professionals. These experienced healthcare professionals may not be available to patients during all hours in rural healthcare facilities. Remote-guided echocardiography could improve the availability of specialised care for patients living in rural areas. This study examined the feasibility of real-time remote guidance for medical students to perform an echocardiographic assessment of the left side of the heart. Thirteen healthy volunteers were recruited for remote-guided echocardiography, which was performed by 13 medical students. Student examinations/images were compared to reference echocardiography. Measurements of left ventricular fractional shortening and mitral valve blood flow velocity were also compared. Furthermore, guidance through a smartphone videoconference was compared to designated remote guidance software. Results Two-thirds of the images acquired by students were rated as medium or good quality and usable to evaluate two thirds of the cardiac structures. No significant bias was found for left ventricular fractional shortening. The measurements from the students’ exams had a variation coefficient of 14.8% compared to the reference. The calculated deviation of the insonation angle was above 25° for both E and A-wave mitral valve blood flow velocity measurements. Images acquired by guidance through smartphone videoconference were of lower quality than those obtained using the designated remote guidance software. Conclusion Real-time remote-guided echocardiography performed by medical students has limited value for clinical screening but could be useful for educational purposes. Graphical Abstract

• Engan, Britt; Diab, Simone; Brun, Henrik; Raastad, Truls; Torsvik, Ingrid Kristin & Omdal, Tom Roar [Vis alle 11 forfattere av denne artikkelen] (2023). Systolic myocardial function measured by echocardiographic speckle-tracking and peak oxygen consumption in pediatric childhood cancer survivors—a PACCS study. Frontiers in Cardiovascular Medicine. 10. doi: 10.3389/fcvm.2023.1221787. Fulltekst i vitenarkiv Vis sammendrag

  Background: Cancer therapy-related cardiotoxicity is a major cause of cardiovascular morbidity in childhood cancer survivors. The aims of this study were to investigate systolic myocardial function and its association to cardiorespiratory fitness in pediatric childhood cancer survivors. Methods: In this sub-study of the international study “Physical Activity and fitness in Childhood Cancer Survivors” (PACCS), echocardiographic measures of left ventricular global longitudinal strain (LV-GLS) and right ventricular longitudinal strain (RV-LS) were measured in 128 childhood cancer survivors aged 9–18 years and in 23 age- and sex-matched controls. Cardiorespiratory fitness was measured as peak oxygen consumption achieved on treadmill and correlated to myocardial function. Results: Mean LV-GLS was reduced in the childhood cancer survivors compared to the controls, −19.7% [95% confidence interval (CI) −20.1% to −19.3%] vs. −21.3% (95% CI: −22.2% to −20.3%) (p = 0.004), however, mainly within normal range. Only 13% of the childhood cancer survivors had reduced LV longitudinal strain z-score. Mean RV-LS was similar in the childhood cancer survivors and the controls, −23.2% (95% CI: −23.7% to −22.6%) vs. −23.3% (95% CI: −24.6% to −22.0%) (p = 0.8). In the childhood cancer survivors, lower myocardial function was associated with lower peak oxygen consumption [correlation coefficient (r) = −0.3 for LV-GLS]. Higher doses of anthracyclines (r = 0.5 for LV-GLS and 0.2 for RV-LS) and increasing time after treatment (r = 0.3 for LV-GLS and 0.2 for RV-LS) were associated with lower myocardial function. Conclusions: Left ventricular function, but not right ventricular function, was reduced in pediatric childhood cancer survivors compared to controls, and a lower left ventricular myocardial function was associated with lower peak oxygen consumption. Furthermore, higher anthracycline doses and increasing time after treatment were associated with lower myocardial function, implying that long-term follow-up is important in this population at risk.

• Engelsen, Peder Christian Grendstad; Heyerdahl, Fridtjof; Maddali, Dharani Dhar; Akhavi, Medhi Sadat; Undseth, Ragnhild Marie & Elle, Ole Jakob [Vis alle 7 forfattere av denne artikkelen] (2023). Ascending with ultrasound: telementored eFAST in flight—a feasibility study. Emergency Radiology. ISSN 1070-3004. 31, s. 25–31. doi: 10.1007/s10140-023-02186-x. Fulltekst i vitenarkiv Vis sammendrag

  Abstract Purpose Teleultrasound uses telecommunication technologies to transmit ultrasound images from a remote location to an expert who guides the acquisition of images and interprets them in real time. Multiple studies have demonstrated the feasibility of teleultrasound. However, its application during helicopter flight using long-term evolution (LTE) for streaming has not been studied. Therefore, we conducted a study to examine the feasibility of teleultrasound in an Airbus H145 helicopter. Methods Four anesthesiologists and one military physician were recruited to perform telementored extended Focused Assessment with Sonography in Trauma (eFAST) during nine helicopter flights, each with a unique healthy volunteer. A radiologist was recruited as a remote expert, guiding the physicians in their examinations. The examining physicians reported the user experience of telementored eFAST on a questionnaire, while the remote expert rated the diagnostic quality of the images on a 1–5 Likert scale. In addition, we measured the duration of the examinations and key LTE network parameters including signal strength, quality, and continuity. Results The images were rated to an average of 4.9 by the remote expert, corresponding to good diagnostic quality. The average duration of telementored eFAST was 05:54 min. LTE coverage was negatively affected by proximity to urban areas and ceased above 2000 ft altitude. Occasional audio problems were addressed by using the Voice over LTE network for communication. The examining physicians unanimously reported on the questionnaire that they would use telementored eFAST on patients. Conclusion Telementored eFAST is feasible in ambulance helicopters and can produce images of good diagnostic quality. However, it relies on stable LTE coverage, which is influenced by many factors, including the helicopter’s altitude and flight path. Furthermore, its benefit on patient outcomes remains to be proven. Graphical abstract

• Holten-Andersen, Mads Nikolaj; Lippert, Matthias; Holmstrøm, Henrik; Brun, Henrik & Døhlen, Gaute (2022). Current outcomes of live-born children with double outlet right ventricle in Norway. European Journal of Cardio-Thoracic Surgery. ISSN 1010-7940. 63(1). doi: 10.1093/ejcts/ezac560. Fulltekst i vitenarkiv Vis sammendrag

  Objectives: This population-based, comprehensive, retrospective study presented the clinical outcomes of all children born in Norway between 2003 and 2017 with double outlet right ventricle (DORV). Methods: All children born with DORV between 2003 and 2017 were identified in the Oslo University Hospital registry. Patients' characteristics, interventions, complications and deaths were recorded. Echocardiographic data were reviewed for classification according to current standards. We investigated time-dependent surgical reintervention and mortality using Kaplan-Meier analyses and determinants of treatment complications, reintervention and death using regression analyses. Results: Ninety-three children with DORV represented an annual median prevalence of 1.18 per 10 000 births in Norway. Six children received palliative care. With an intention to treat, a surgical route with the primary biventricular repair was followed for 62 children, staged biventricular repair for 15 and univentricular repair for 10 children. Major complications occurred in 1.0% and 6.2% of children following catheter or surgical intervention, respectively. No significant determinants of the complications were identified. Overall survival following treatment was 91.9%, 90.8%, 89.5% and 89.5% and corresponding freedom from surgical reintervention was 88.0%, 79.0%, 74.9% and 69.4% at 1, 2, 5 and 10 years, respectively. The presence of atrioventricular septal defect predicted an increased risk of mortality (hazard ratio: 7.16) but did not increase the risk of surgical reintervention. Conclusions: In Norway, most children receive tailored treatment for DORV with low rates of complications, surgical reinterventions and mortality. However, atrioventricular septal defect remains a potential determinant of postoperative death. Keywords: Biventricular; Complication; DORV; Double outlet right ventricle; Reintervention; Univentricular. © The Author(s) 2022. Published by Oxford University Press on behalf of the European Association for Cardio-Thoracic Surgery.

• Sajadi, Seyed Mohammad Reza; Mathiassen, Kim; Brun, Henrik & Elle, Ole Jakob (2022). Design, Kinematic Modeling, and Validation of a Robotic-Assisted Transesophageal Echocardiography System, 2022 IEEE/SICE International Symposium on System Integration (SII 2022) : January 9-12, 2022 (Virtual Conference) Narvik, Norway. IEEE (Institute of Electrical and Electronics Engineers). ISSN 9781665445405. doi: 10.1109/SII52469.2022.9708810. Fulltekst i vitenarkiv
• Maddali, Dharani Dhar; Brun, Henrik; Kiss, Gabriel; Hjelmervik, Jon M. & Elle, Ole Jakob (2022). Spatial Orientation in Cardiac Ultrasound Images Using Mixed Reality: Design and Evaluation. Frontiers in Virtual Reality. 3. doi: 10.3389/frvir.2022.881338. Fulltekst i vitenarkiv Vis sammendrag

  Spatial orientation is an important skill in structural cardiac imaging. Until recently, 3D cardiac ultrasound has been visualized on a flat screen by using volume rendering. Mixed reality devices enhance depth perception, spatial awareness, interaction, and integration in the physical world, which can prove advantageous with 3D cardiac ultrasound images. In this work, we describe the design of a system for rendering 4D (3D + time) cardiac ultrasound data as virtual objects and evaluate it for ease of spatial orientation by comparing it with a standard clinical viewing platform in a user study. The user study required eight participants to do timed tasks and rate their experience. The results showed that virtual objects in mixed reality provided easier spatial orientation and morphological understanding despite lower perceived image quality. Participants familiar with mixed reality were quicker to orient in the tasks. This suggests that familiarity with the environment plays an important role, and with improved image quality and increased use, mixed reality applications may perform better than conventional 3D echocardiography viewing systems.

• Sajadi, Seyed Mohammad Reza; Karbasi, Seyed Mojtaba; Brun, Henrik; Tørresen, Jim; Elle, Ole Jakob & Mathiassen, Kim (2022). Towards Autonomous Robotic Biopsy—Design, Modeling and Control of a Robot for Needle Insertion of a Commercial Full Core Biopsy Instrument. Frontiers in Robotics and AI. 9. doi: 10.3389/frobt.2022.896267. Fulltekst i vitenarkiv Vis sammendrag

  This paper presents the design, control, and experimental evaluation of a novel fully automated robotic-assisted system for the positioning and insertion of a commercial full core biopsy instrument under guidance by ultrasound imaging. The robotic system consisted of a novel 4° of freedom (DOF) add-on robot for the positioning and insertion of the biopsy instrument that is attached to a UR5-based teleoperation system with 6 DOF. The robotic system incorporates the advantages of both freehand and probe-guided biopsy techniques. The proposed robotic system can be used as a slave robot in a teleoperation configuration or as an autonomous or semi-autonomous robot in the future. While the UR5 manipulator was controlled using a teleoperation scheme with force controller, a reinforcement learning based controller using the Deep Deterministic Policy Gradient (DDPG) algorithm was developed for the add-on robotic system. The dexterous workspace analysis of the add-on robotic system demonstrated that the system has a suitable workspace within the US image. Two sets of comprehensive experiments including four experiments were performed to evaluate the robotic system’s performance in terms of the biopsy instrument positioning, and the insertion of the needle inside the ultrasound plane. The experimental results showed the ability of the robotic system for in-plane needle insertion. The overall mean error of all four experiments in the tracking of the needle angle was 0.446°, and the resolution of the needle insertion was 0.002 mm.

• McMahon, Colin J.; Heying, Ruth; Budts, Werner; Cavigelli-Brunner, Anna; Shkolnikova, Maria & Michel-Behnke, Ina [Vis alle 38 forfattere av denne artikkelen] (2022). Paediatric and adult congenital cardiology education and training in Europe. Cardiology in the Young. ISSN 1047-9511. doi: 10.1017/S104795112100528X. Fulltekst i vitenarkiv
• Nainamalai, Varatharajan; Lippert, Matthias; Brun, Henrik; Elle, Ole Jakob & Kumar, Rahul Prasanna (2022). Local integration of deep learning for advanced visualization in congenital heart disease surgical planning. Intelligence-Based Medicine. 6. doi: 10.1016/j.ibmed.2022.100055. Fulltekst i vitenarkiv
• Möller, Thomas; Klungerbo, Vibeke; Diab, Simone; Holmstrøm, Henrik; Edvardsen, Elisabeth & Grindheim, Guro [Vis alle 11 forfattere av denne artikkelen] (2021). Circulatory Response to Rapid Volume Expansion and Cardiorespiratory Fitness in Fontan Circulation. Pediatric Cardiology. ISSN 0172-0643. doi: 10.1007/s00246-021-02802-y. Fulltekst i vitenarkiv Vis sammendrag

  The role of dysfunction of the single ventricle in Fontan failure is incompletely understood. We aimed to evaluate hemodynamic responses to preload increase in Fontan circulation, to determine whether circulatory limitations in different locations identified by experimental preload increase are associated with cardiorespiratory fitness (CRF), and to assess the impact of left versus right ventricular morphology. In 38 consecutive patients (median age = 16.6 years, 16 females), heart catheterization was supplemented with a rapid 5-mL/kg body weight volume expansion. Central venous pressure (CVP), ventricular end-diastolic pressure (VEDP), and peak systolic pressure were averaged for 15‒30 s, 45‒120 s, and 4‒6 min (steady state), respectively. CRF was assessed by peak oxygen consumption (VO2peak) and ventilatory threshold (VT). Median CVP increased from 13 mmHg at baseline to 14.5 mmHg (p < 0.001) at steady state. CVP increased by more than 20% in eight patients. Median VEDP increased from 10 mmHg at baseline to 11.5 mmHg (p < 0.001). Ten patients had elevated VEDP at steady state, and in 21, VEDP increased more than 20%. The transpulmonary pressure difference (CVP‒VEDP) and CVP were consistently higher in patients with right ventricular morphology across repeated measurements. CVP at any stage was associated with VO2peak and VT. VEDP after volume expansion was associated with VT. Preload challenge demonstrates the limitations beyond baseline measurements. Elevation of both CVP and VEDP are associated with impaired CRF. Transpulmonary flow limitation was more pronounced in right ventricular morphology. Ventricular dysfunction may contribute to functional impairment after Fontan operation in young adulthood.

• Suther, Lene Kathrine R; Lange, Charlotte de; Brun, Henrik; Svendsmark, Rolf Georg; Nguyen, Bac & Larsen, Stig [Vis alle 10 forfattere av denne artikkelen] (2021). 3.0T MR coronary angiography after arterial switch operation for transposition of the great arteries—Gd-FLASH versus non-enhanced SSFP. A feasibility study. Congenital Heart Disease. ISSN 1747-079X. 16(2), s. 107–121. doi: 10.32604/CHD.2021.014164. Fulltekst i vitenarkiv Vis sammendrag

  Background: Patency of the coronary arteries is an issue after reports of sudden cardiac death in patients with transposition of the great arteries (TGA) operated with arterial switch (ASO). Recent studies give rise to concern regarding the use of ionising radiation in congenital heart disease, and assessment of the coronary arteries with coronary MR angiography (CMRA) might be an attractive non-invasive, non-ionising imaging alternative in these patients. Theoretically, the use of 3.0T CMRA should improve the visualisation of the coronary arteries. The objective of this study was to assess feasibility of 3.0T CMRA at the coronary artery origins by comparing image quality with non-contrast CMRA in ASO TGA patients to healthy age-matched controls, and by comparing image quality with non-contrast CMRA to contrast enhanced CMRA in the patient group. Material and methods: Twelve patients, 9-15 years (mean 11.9 years, standard deviation 1.5 years), and 12 age-matched controls (mean 12.7 years, standard deviation 1.7 years) were examined with 3D balanced steady-state free precession (SSFP). Nine of twelve patients had Gadolinium-enhanced fast low-angle shot (Gd-FLASH) performed after SSFP. Image quality at the coronary artery origins was evaluated subjectively with a 10 cm figurative visual analogue scale (fVAS) and objectively by signal-to-noise and contrast-to-noise ratio (SNR, CNR). Results: All, but one, coronary artery origins were identified. No significant difference in image quality scores was found between patients and controls with SSFP (mean values 6.5 cm—9.1 cm in patients and 7.0 cm—8.0 cm in controls, p-values > 0.1). With SSFP, intra-observer fVAS mean score was 6.7 cm—8.6 cm and with Gd-FLASH 7.7 cm—8.7 cm. CNR was higher with Gd-FLASH (p < 0.03). Intra-observer agreement index (AI) with SSFP was moderate-to-good (0.43–0.71) and with Gd-FLASH good (0.64–0.79) in all origins. Inter-observer AI was good in the left main stem (LMS) with SSFP (0.65). With Gd-FLASH inter-observer AI was good in LMS (0.78) and moderate (0.5) in the left anterior descending artery, but lacking in the other origins though with a good agreement on Bland-Altman plots. Conclusions: Our findings indicate a better, more reproducible image quality with Gd-FLASH than with non-contrast SSFP CMRA on 3.0T for evaluation of the coronary artery origins in ASO TGA children and adolescents.

• Gul, Kiran Aftab; Strand, Janne Maren; Pettersen, Rolf Dagfinn; Brun, Henrik & Abrahamsen, Tore G (2020). T-cell Receptor Excision Circles in Newborns with Heart Defects. Pediatric Cardiology. ISSN 0172-0643. 41(4), s. 809–815. doi: 10.1007/s00246-020-02317-y. Fulltekst i vitenarkiv Vis sammendrag

  Abstract In the fetus, the cardiac neural crest gives rise to both the thymus and the conotruncus of the heart. In newborn screening for severe T-cell lymphopenia neonates with congenital heart defects may be detected. In this study, we investigated the occurrence of T-cell lymphopenia in neonates with or without 22q11.2 deletion syndrome (del) suffering from heart defects. This retrospective cohort study included 125 patients with heart defects. T-cell receptor excision circles (TRECs), a measure for T-cell lymphopenia, were quantified by RT-PCR using stored newborn screening blood spots. Three patient groups were compared: non-conotruncal defects ( n  = 57), conotruncal defects ( n  = 42), and 22q11.2 del with conotruncal defects ( n  = 26). Significantly lower TREC values were detected in patients with 22q11.2 del and conotruncal heart defects compared to those with non-syndromic conotruncal ( p  &lt; 0.001) and non-conotruncal ( p  &lt; 0.001) defects. In contrast, no significant difference was found between patients with non-syndromic conotruncal and non-conotruncal heart defects ( p  = 0.152). Low TREC levels were obtained in neonates treated with heart surgery/intervention within 2 weeks after birth and in those with a fatal outcome ( p  = 0.02) independent of patient group. A correlation was found between low TREC numbers and oxygen saturation, SpO 2 below 95% ( p  = 0.017). The SpO 2 was significantly lower in the non-syndromic conotruncal group compared to non-conotruncal ( p  &lt; 0.001) and 22q11.2 del group ( p  = 0.015). No correlation was found between low neonatal TRECs and infections needing hospitalization later in life ( p  = 0.135). Patients with 22q11.2 del and conotruncal defects have significantly lower TREC levels compared to patients with heart defects without this syndrome.

• Thorsteinsdottir, Hjørdis; Christensen, Jacob J.; Holven, Kirsten Bjørklund; Tveiterås, Målfrid; Brun, Henrik & Åsberg, Anders [Vis alle 7 forfattere av denne artikkelen] (2020). Cardiovascular risk factors are inversely associated with omega-3 polyunsaturated fatty acid plasma levels in pediatric kidney transplant recipients. Journal of renal nutrition. ISSN 1051-2276. 31(3), s. 278–285. doi: 10.1053/j.jrn.2020.06.002. Fulltekst i vitenarkiv Vis sammendrag

  Objectives High plasma levels of the omega-3 fatty acids eicosapentaenoic acid (EPA), docosahexaenoic acid, and docosapentaenoic acid associates with positive outcomes in adult renal transplant recipients. However, data from pediatric populations are scarce. The aim of the study was to assess the fatty acid profile in a pediatric renal transplantation cohort and to examine the associations between plasma omega-3 fatty acids and cardiovascular disease (CVD) risk factors. Methods In this cross-sectional study comprising 53 children (median age, 12.2 years; 32 boys) with a renal transplant, we assessed the prevalence of CVD risk factors as well as markers of end organ damage: carotid intima-media thickness (cIMT) and left ventricular mass index. The associations between plasma omega-3 fatty acids and CVD risk factors were assessed. Results Twenty-five (47%) patients were preemptively transplanted. Seventy-six percent had dyslipidemia and 51% had hypertension. The mean left ventricular mass index was 40.4 ± 14.3 g/m 2.7, and 14% had left ventricular hypertrophy. The mean cIMT was 0.41 ± 0.04 mm. In a multivariate linear regression, EPA levels were inversely associated to blood pressure (β coeff. = −0.37, P = .007), triglycerides (β coeff. = −0.44, P = .01), and high-density lipoprotein cholesterol (β coeff. = −0.41, P = .01). Conclusion EPA levels are inversely associated with components of the metabolic syndrome, which may provide support for specific dietary advice or supplementation in this patient population. cIMT is less pronounced in our cohort than in comparable cohorts with lower rate of preemptive transplantations. Our results need replication in prospective cohorts.

• Kumar, Rahul Prasanna; Pelanis, Egidijus; Bugge, Robin Antony Birkeland; Brun, Henrik; Palomar, Rafael & Aghayan, Davit [Vis alle 9 forfattere av denne artikkelen] (2020). Use of mixed reality for surgery planning: Assessment and development workflow. Journal of Biomedical Informatics: X. 8. doi: 10.1016/j.yjbinx.2020.100077. Fulltekst i vitenarkiv Vis sammendrag

  Meticulous preoperative planning is an important part of any surgery to achieve high levels of precision and avoid complications. Conventional medical 2D images and their corresponding three-dimensional (3D) reconstructions are the main components of an efficient planning system. However, these systems still use flat screens for visualisation of 3D information, thus losing depth information which is crucial for 3D spatial understanding. Currently, cutting-edge mixed reality systems have shown to be a worthy alternative to provide 3D information to clinicians. In this work, we describe development details of the different steps in the workflow for the clinical use of mixed reality, including results from a qualitative user evaluation and clinical use-cases in laparoscopic liver surgery and heart surgery. Our findings indicate a very high general acceptance of mixed reality devices with our applications and they were consistently rated high for device, visualisation and interaction areas in our questionnaire. Furthermore, our clinical use-cases demonstrate that the surgeons perceived the HoloLens to be useful, recommendable to other surgeons and also provided a definitive answer at a multi-disciplinary team meeting.

• Bjerring, Anders W.; Landgraff, Hege Elisabeth W.; Stokke, Thomas Muri; Murbræch, Klaus; Leirstein, Svein & Aaeng, Anette [Vis alle 11 forfattere av denne artikkelen] (2019). The developing athlete's heart: a cohort study in young athletes transitioning through adolescence. European Journal of Preventive Cardiology (EJPC). ISSN 2047-4873. s. 1–8. doi: 10.1177/2047487319862061. Fulltekst i vitenarkiv Vis sammendrag

  Background Athlete's heart is a term used to describe physiological changes in the hearts of athletes, but its early development has not been described in longitudinal studies. This study aims to improve our understanding of the effects of endurance training on the developing heart. Methods Cardiac morphology and function in 48 cross-country skiers were assessed at age 12 years (12.1 ± 0.2 years) and then again at age 15 years (15.3 ± 0.3 years). Echocardiography was performed in all subjects including two-dimensional speckle-tracking strain echocardiography and three-dimensional echocardiography. All participants underwent cardiopulmonary exercise testing at both ages 12 and 15 years to assess maximal oxygen uptake and exercise capacity. Results Thirty-one (65%) were still active endurance athletes at age 15 years and 17 (35%) were not. The active endurance athletes had greater indexed maximal oxygen uptake (62 ± 8 vs. 57 ± 6 mL/kg/min, P < 0.05) at follow-up. There were no differences in cardiac morphology at baseline. At follow-up the active endurance athletes had greater three-dimensional indexed left ventricular end-diastolic (84 ± 11 mL/m2 vs. 79 ± 10 mL/m2, P < 0.05) and end-systolic volumes (36 ± 6 mL/m2 vs. 32 ± 3 mL/m2, P < 0.05). Relative wall thickness fell in the active endurance athletes, but not in those who had quit (–0.05 ΔmL/m2 vs. 0.00 mL/m2, P = 0.01). Four active endurance athletes had relative wall thickness above the upper reference values at baseline; all had normalised at follow-up. Conclusion After an initial concentric remodelling in the pre-adolescent athletes, those who continued their endurance training developed eccentric changes with chamber dilatation and little change in wall thickness. Those who ceased endurance training maintained a comparable wall thickness, but did not develop chamber dilatation.

• Pelanis, Egidijus; Kumar, Rahul Prasanna; Aghayan, Davit; Palomar, Rafael; Fretland, Åsmund Avdem & Brun, Henrik [Vis alle 8 forfattere av denne artikkelen] (2019). Use of mixed reality for improved spatial understanding of liver anatomy. MITAT. Minimally invasive therapy & allied technologies. ISSN 1364-5706. s. 1–7. doi: 10.1080/13645706.2019.1616558. Fulltekst i vitenarkiv Vis sammendrag

  Introduction: In liver surgery, medical images from pre-operative computed tomography and magnetic resonance imaging are the basis for the decision-making process. These images are used in surgery planning and guidance, especially for parenchyma-sparing hepatectomies. Though medical images are commonly visualized in two dimensions (2D), surgeons need to mentally reconstruct this information in three dimensions (3D) for a spatial understanding of the anatomy. The aim of this work is to investigate whether the use of a 3D model visualized in mixed reality with Microsoft HoloLens increases the spatial understanding of the liver, compared to the conventional way of using 2D images. Material and methods: In this study, clinicians had to identify liver segments associated to lesions. Results: Twenty-eight clinicians with varying medical experience were recruited for the study. From a total of 150 lesions, 89 were correctly assigned without significant difference between the modalities. The median time for correct identification was 23.5 [4–138] s using the magnetic resonance imaging images and 6.00 [1–35] s using HoloLens (p < 0.001). Conclusions: The use of 3D liver models in mixed reality significantly decreases the time for tasks requiring a spatial understanding of the organ. This may significantly decrease operating time and improve use of resources.

• Nestaas, Eirik & Brun, Henrik (2019). Funksjonell ekkokardiografi hos barn og nyfødte. Hjerteforum. ISSN 0802-1465. 32(2), s. 73–82. Fulltekst i vitenarkiv
• Bjerring, Anders W.; Landgraff, Hege Elisabeth W.; Leirstein, Svein; Aaeng, Anette; Ansari, Hamza & Saberniak, Jørg [Vis alle 13 forfattere av denne artikkelen] (2018). Morphological changes and myocardial function assessed by traditional and novel echocardiographic methods in preadolescent athlete?s heart. European Journal of Preventive Cardiology (EJPC). ISSN 2047-4873. 25(9), s. 1000–1007. doi: 10.1177/2047487318776079. Fulltekst i vitenarkiv Vis sammendrag

  Background: Athlete’s heart is a term used to describe the morphological and functional changes in the hearts of athletes. Recent studies suggest that these changes may occur even in preadolescent athletes. This study aims to improve our understanding of the changes occurring in the preadolescent athlete’s heart. Design and methods: Cardiac morphology and function in 76 preadolescent cross-country skiers (aged 12.1 ± 0.2 years) were compared with 25 age-matched non-competing preadolescents. Echocardiography was performed in all subjects, including 2D speckle-tracking strain echocardiography and 3D echocardiography. All participants underwent cardiopulmonary exercise testing to assess oxygen uptake and exercise capacity. Results: Athletes had greater indexed VO2 max (62 ± 7 vs. 44 ± 5 mL/kg per min, p < 0.001), indexed left ventricular end-diastolic volume (79 ± 7 vs. 68 ± 7 mL/m2, p < 0.001), left ventricular mass (69 ± 12 vs. 57 ± 13 g/m2, p < 0.001), indexed right ventricular basal diameter (28.3 ± 3.0 vs. 25.4 ± 3.5 mm/m2, p < 0.001) and right atrial area (10.6 ± 1.4 vs. 9.7 ± 1.2 cm2/m2, p < 0.01). There was no difference in left ventricular ejection fraction, global longitudinal strain, and global circumferential strain and right ventricular fractional area change between the groups. Controls had higher right ventricular global longitudinal strain (−28.1 ± 3.5 vs. −31.1 ± 3.3%, p < 0.01). VO2 max was highly correlated to left ventricular end-diastolic volume (r = 0.76, p < 0.001). Conclusion: Athletes had greater left ventricular mass and greater left and right ventricular chamber dimensions compared with controls, while left ventricular function did not differ. Interestingly, right ventricular deformation was significantly lower compared with controls. This supports the notion that there is physiological, adaptive remodelling in preadolescent athlete’s heart.

• Brun, Henrik; Bugge, Robin Antony Birkeland; Suther, Lene Kathrine R; Birkeland, Sigurd; Kumar, Raj & Pelanis, Egidijus [Vis alle 7 forfattere av denne artikkelen] (2018). Mixed reality holograms for heart surgery planning: first user experience in congenital heart disease. European Heart Journal-Cardiovascular Imaging. ISSN 2047-2404. 0, s. 1–6. doi: 10.1093/ehjci/jey184. Fulltekst i vitenarkiv Vis sammendrag

  Aims: Proof of concept and feasibility study for preoperative diagnostic use of mixed reality (MR) holograms of individual 3D heart models from standard cardiac computed tomography angiograms (CTA) images. Optimal repair for complex congenital heart disease poses high demands on 3D anatomical imagination. Three-dimensional printed heart models are increasingly used for improved morphological understanding during surgical and interventional planning. Holograms are a dynamic and interactive alternative, probably with wider applications. Methods and results: A 3D heart model was segmented from CTA images in a patient with double outlet right ventricle and transposition of the great arteries (DORV-TGA). The hologram was visualized in the wearable MR platform HoloLens® for 36 paediatric heart team members who filled out a diagnostic and quality rating questionnaire. Morphological and diagnostic output from the hologram was assessed and the 3D experience was evaluated. Locally developed app tools such as hologram rotation, scaling, and cutting were rated. Anatomy identification and diagnostic output was high as well as rating of 3D experience. Younger and female users rated the app tools higher. Conclusion: This preliminary study demonstrates that MR holograms as surgical planning tool for congenital heart disease may have a high diagnostic value and contribute to understanding complex morphology. The first users experience of the hologram presentation was found to be very positive, with a preference among the female and the younger users. There is potential for improvement of the hologram manipulation tools.

• Suther, Lene Kathrine R; Hopp, Einar; Geier, Oliver; Brun, Henrik; Nguyen, Bac & Tomterstad, Anders [Vis alle 10 forfattere av denne artikkelen] (2018). Diffuse myocardial fibrosis in adolescents operated with arterial switch for transposition of the great arteries - A CMR study. International Journal of Cardiology. ISSN 0167-5273. 276, s. 100–106. doi: 10.1016/j.ijcard.2018.11.107. Fulltekst i vitenarkiv
• Beghetti, Maurice; Schulze-Neick, Ingram; Berger, Rolf M.F.; Ivy, Dunbar D.; Bonnet, Damien & Weintraub, Robert G. [Vis alle 14 forfattere av denne artikkelen] (2016). Haemodynamic characterisation and heart catheterisation complications in children with pulmonary hypertension: Insights from the Global TOPP Registry (tracking outcomes and practice in paediatric pulmonary hypertension). International Journal of Cardiology. ISSN 0167-5273. 203, s. 325–330. doi: 10.1016/j.ijcard.2015.10.087. Fulltekst i vitenarkiv
• Odland, Hans Henrik; Brun, Henrik; Saatvedt, Kjell & Kongsgård, Erik (2013). Cardiac Resynchronization by Repositioning of a Ventricular Epicardial Lead in a Patient With Hypoplastic Left Heart Syndrome. Pediatric Cardiology. ISSN 0172-0643. 34(8), s. 1982–1984. doi: 10.1007/s00246-012-0523-1. Fulltekst i vitenarkiv
• Neukamm, Ernst Christian; Try, Kirsti; Norgård, Gunnar & Brun, Henrik (2013). Right Ventricular Volumes Assessed by Echocardiographic Three-dimensional Knowledge-Based Reconstruction Compared with Magnetic Resonance Imaging in a clinical setting. Congenital Heart Disease. ISSN 1747-079X. 9(4), s. 333–342. doi: 10.1111/chd.12146. Fulltekst i vitenarkiv
• Brun, Henrik; Moller, Thomas; Freriksen, Per Morten; Thaulow, Erik; Pripp, Are Hugo & Holmstrøm, Henrik Alf B (2012). Mechanisms of Exercise-Induced Pulmonary Hypertension in Patients With Cardiac Septal Defects. Pediatric Cardiology. ISSN 0172-0643. 33(5), s. 782–790. doi: 10.1007/s00246-012-0216-9. Fulltekst i vitenarkiv
• Wæhre, Anne; Vistnes, Maria; Sjaastad, Ivar; Nygård, Ståle; Husberg, Cathrine & Lunde, Ida Gjervold [Vis alle 14 forfattere av denne artikkelen] (2012). Chemokines regulate small leucine-rich proteoglycans in the extracellular matrix of the pressure-overloaded right ventricle. Journal of applied physiology. ISSN 8750-7587. 112(8), s. 1372–1382. doi: 10.1152/japplphysiol.01350.2011. Fulltekst i vitenarkiv
• Odland, Hans Henrik; Brun, Henrik; Sejersted, Yngve; Dalen, Marit Lunde; Edvardsen, Thor & Saugstad, Ola Didrik [Vis alle 7 forfattere av denne artikkelen] (2012). Myocardial longitudinal peak systolic acceleration (pSac): relationship to ejection phase, pressure, and contractility. Echocardiography. ISSN 0742-2822. 29(5), s. 541–553. doi: 10.1111/j.1540-8175.2011.01628.x. Fulltekst i vitenarkiv Vis sammendrag

  Acceleration has been measured both noninvasively and invasively, during both isovolumic contraction and early ejection and has been shown to reflect contractility, especially through correlation with dP/dtmax. In this study timing and amplitude of mitral valve annulus acceleration assessed by tissue Doppler were measured and related to diastolic and systolic events. Invasive load independent measures of contractility, based on pressure–volume relationships, were derived, and pacing was done to modulate and control heart rate. Peak systolic acceleration (pSac) of the mitral valve annulus was shown to occur slightly later but timely related to dP/dtmax (P < 0.05), while peak preejection acceleration (pPac) was related to diastolic events. During inotropy and preload modulation dP/dtmax was found to be the strongest determinant of pSac (β = 0.9 ± 0.1; P < 0.001 and β = 1.3 ± 0.4; P < 0.001, respectively, log-transformed variables). PSac increased with pacing at a higher rate (β = 0.1 ± 0.0 cm/sec2, P = 0.03). Furthermore, pSac indexed to end-diastolic volume (EDV) was linearly correlated to load independent contractility parameters (Emax, R = 0.7; ESPVR, R = 0.7; and PRSW, R = 0.5), and proved stable toward changes in preload and afterload. The relation between dP/dtmax/EDV and pSac/EDV was stable throughout the study. In conclusion we found that peak systolic longitudinal acceleration (pSac) of the mitral valve annulus during aortic valve opening is strongly associated with dP/dtmax. Indexed to EDV, pSac may represent a load independent noninvasive contractility parameter. We consider pSac a candidate marker of long-axis contractility which should be viewed upon as the long-axis contribution to dP/dtmax

• Brun, Henrik; Ueland, Thor; Thaulow, Erik; Damås, Jan Kristian; Yndestad, Arne & Aukrust, Pål [Vis alle 7 forfattere av denne artikkelen] (2011). No Inflammatory Response Related to Pulmonary Hemodynamics in Children with Systemic to Pulmonary Shunts. Congenital Heart Disease. ISSN 1747-079X. 6(4), s. 338–346. doi: 10.1111/j.1747-0803.2011.00505.x. Fulltekst i vitenarkiv
• Odland, Hans Henrik; Brun, Henrik; Sejersted, Yngve; Dalen, Marit Lunde; Edvardsen, Thor & Saugstad, Ola Didrik [Vis alle 7 forfattere av denne artikkelen] (2011). Longitudinal Myocardial Contribution to Peak Systolic Flow and Stroke Volume in the Neonatal Heart. Pediatric Research. ISSN 0031-3998. 70(4), s. 345–351. doi: 10.1203/PDR.0b013e318229032b. Fulltekst i vitenarkiv
• Møller, Thomas Friedrich; Brun, Henrik; Fredriksen, Per-Morten; Holmstrøm, Henrik Alf B; Pettersen, Eirik & Thaulow, Erik (2010). Moderate Altitude Increases Right Ventricular Pressure and Oxygen Desaturation in Adolescents with Surgically Closed Septal Defect. Congenital Heart Disease. ISSN 1747-079X. 5(6), s. 556–564. doi: 10.1111/j.1747-0803.2010.00425.x. Fulltekst i vitenarkiv
• Møller, Thomas; Brun, Henrik; Fredriksen, Per Morten; Holmstrøm, Henrik Alf B; Peersen, Kari & Pettersen, Eirik [Vis alle 9 forfattere av denne artikkelen] (2010). Right Ventricular Systolic Pressure Response During Exercise in Adolescents Born With Atrial or Ventricular Septal Defect. American Journal of Cardiology. ISSN 0002-9149. 105(11), s. 1610–1616. doi: 10.1016/j.amjcard.2010.01.024. Fulltekst i vitenarkiv
• Brun, Henrik; Holmstrøm, Henrik Alf B; Thaulow, Erik; Damås, Jan Kristian; Yndestad, Arne & Aukrust, Pål [Vis alle 7 forfattere av denne artikkelen] (2009). Patients with Pulmonary Hypertension Related to Congenital Systemic-to-Pulmonary Shunts are Characterized by Inflammation Involving Endothelial Cell Activation and Platelet-mediated Inflammation. Congenital Heart Disease. ISSN 1747-079X. 4(1), s. 153–159. Fulltekst i vitenarkiv
• Brun, Henrik; Thaulow, Erik; Fredriksen, Per Morten & Holmstrøm, Henrik Alf B (2007). Treatment of patients with Eisenmenger's syndrome with Bosentan. Cardiology in the Young. ISSN 1047-9511. 17(3), s. 288–294. doi: 10.1017/S1047951107000522. Fulltekst i vitenarkiv Vis sammendrag

  We treated prospectively 14 patients with Eisenmenger's syndrome, with a mean age of 10 years, ranging from 3 to 18 years. Treatment continued for 12 months, and demonstrated a lasting symptomatic improvement, but no improvement in terms of mean saturation of oxygen over 24 hours. Exercise capacity, as judged by peak uptake of oxygen, worsened in the six patients able to perform a treadmill test. The symptomatic benefit from dual blockage of endothelin receptors in these patients may be due to mechanisms other than selective pulmonary vasodilatation alone.

• Lang, Astri Maria; Brun, Henrik; Kaaresen, Per Ivar & Klingenberg, Claus (2007). A population based 10-year study of neonatal air transport in North Norway. Acta Paediatrica. ISSN 0803-5253. 96(7), s. 995–999. doi: 10.1111/j.1651-2227.2007.00320.x. Fulltekst i vitenarkiv Vis sammendrag

  Aim: This study audits the activity of the neonatal air transport team in Norway's two northernmost counties. Methods: Data on all air transports to or from the regional Neonatal Intensive Care (NICU) Unit within a 10-year period were collected. Results: Two hundred and thirty-eight acute transports were conducted during the study period; 169 referrals to the NICU and 69 transfers to national surgical and cardiac centres. Only 13 very low birth weight infants were transported; the in utero transport rate was 95% for this patient population. The adjusted risk of death and/or intracranial haemorrhage for outborn very low birth weight infants was five-fold increased compared to those not transported postnatally. Babies with congenital heart disease comprised the one-fourth of all transports. The long-term mortality was 14% for the whole study population, and 29% for infants with congenital heart disease. Only seven deaths (3.2%) were defined as being transport-related; death during or within 24 h after transport. However, preventable complications like temperature instability, hypoglycaemia and hypo-/hypercapnia occurred in 10–20% of all transports. Conclusion: The transport related mortality was low in this study, however very low birth weight infants and infants with major congenital heart disease showed a relatively poor outcome.

• Brun, Henrik; Holmstrøm, Henrik Alf B & Thaulow, Erik (2005). Sudden death during a change in treatment for pulmonary hypertension. Cardiology in the Young. ISSN 1047-9511. 15(2), s. 223–225. Fulltekst i vitenarkiv Vis sammendrag

  We describe an infant with an atrioventricular septal defect and separate valvar orifices for the right and left ventricles, the so-called primum defect, who presented with serious pulmonary hypertension. Treatment with sildenafil was changed to intravenous epoprostenol due to lack of any measurable effects of the initial therapy as shown by echocardiography. The girl died three days after the change in treatment. We suggest that a mismatch between ventilation and perfusion contributed significantly to her death

• Brun, Henrik (2004). Pulmonal hypertensjon. Ductus. ISSN 1504-0895. s. 2–26. Fulltekst i vitenarkiv
• Brun, Henrik; Holmstrøm, Henrik Alf B; Greve, G & Thaulow, Erik (2004). Pulmonal hypertensjon hos barn (del 1). Hjerteforum. ISSN 0802-1465. 16, s. 35–44. Fulltekst i vitenarkiv
• Brun, Henrik; Holmstrøm, Henrik Alf B; Greve, G & Thaulow, Erik (2004). Pulmonal hypertensjon hos barn (del 2). Hjerteforum. ISSN 0802-1465. 17, s. 36–45. Fulltekst i vitenarkiv

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• Engelsen, Peder Christian Grendstad; Heyerdahl, Fridtjof; Maddali, Dharani Dhar; Akhavi, Mehdi Sadat; Undseth, Ragnhild Marie & Elle, Ole Jakob [Vis alle 7 forfattere av denne artikkelen] (2024). Correction to: Ascending with ultrasound: telementored eFAST in flight—a feasibility study (Emergency Radiology, (2023), 31, 1, (25-31), 10.1007/s10140-023-02186-x). Emergency Radiology. ISSN 1070-3004. 31(4), s. 629–629. doi: 10.1007/s10140-024-02265-7. Fulltekst i vitenarkiv
• Lie, Hanne Cathrine; Anderssen, Sigmund Alfred; Rueegg, Corina Silvia; Raastad, Truls; Grydeland, May & Thorsen, Lene [Vis alle 21 forfattere av denne artikkelen] (2022). The Physical Activity and Fitness in Childhood Cancer Survivors (PACCS) Study: Protocol for an International Mixed Methods Study. JMIR Research Protocols. 11(3). doi: 10.2196/35838. Fulltekst i vitenarkiv Vis sammendrag

  Methods Results Discussion References Abbreviations Copyright Abstract Background: Survivors of childhood cancer represent a growing population with a long life expectancy but high risks of treatment-induced morbidity and premature mortality. Regular physical activity (PA) may improve their long-term health; however, high-quality empirical knowledge is sparse. Objective: The Physical Activity and Fitness in Childhood Cancer Survivors (PACCS) study comprises 4 work packages (WPs) aiming for the objective determination of PA and self-reported health behavior, fatigue, and quality of life (WP 1); physical fitness determination (WP 2); the evaluation of barriers to and facilitators of PA (WP 1 and 3); and the feasibility testing of an intervention to increase PA and physical fitness (WP 4). Methods: The PACCS study will use a mixed methods design, combining patient-reported outcome measures and objective clinical and physiological assessments with qualitative data gathering methods. A total of 500 survivors of childhood cancer aged 9 to 18 years with ≥1 year after treatment completion will be recruited in follow-up care clinics in Norway, Denmark, Finland, Germany, and Switzerland. All participants will participate in WP 1, of which approximately 150, 40, and 30 will be recruited to WP 2, WP3, and WP 4, respectively. The reference material for WP 1 is available from existing studies, whereas WP 2 will recruit healthy controls. PA levels will be measured using ActiGraph accelerometers and self-reports. Validated questionnaires will be used to assess health behaviors, fatigue, and quality of life. Physical fitness will be measured by a cardiopulmonary exercise test, isometric muscle strength tests, and muscle power and endurance tests. Limiting factors will be identified via neurological, pulmonary, and cardiac evaluations and the assessment of body composition and muscle size. Semistructured, qualitative interviews, analyzed using systematic text condensation, will identify the perceived barriers to and facilitators of PA for survivors of childhood cancer. In WP 4, we will evaluate the feasibility of a 6-month personalized PA intervention with the involvement of local structures. Results: Ethical approvals have been secured at all participating sites (Norwegian Regional Committee for Medical Research Ethics [2016/953 and 2018/739]; the Oslo University Hospital Data Protection Officer; equivalent institutions in Finland, Denmark [file H-19032270], Germany, and Switzerland [Ethics Committee of Northwestern and Central Switzerland, project ID: 2019-00410]). Data collection for WP 1 to 3 is complete. This will be completed by July 2022 for WP 4. Several publications are already in preparation, and 2 have been published. Conclusions: The PACCS study will generate high-quality knowledge that will contribute to the development of an evidence-based PA intervention for young survivors of childhood cancer to improve their long-term care and health. We will identify physiological, psychological, and social barriers to PA that can be targeted in interventions with immediate benefits for young survivors of childhood cancer in need of rehabilitation.

• Sajadi, Seyed Mohammad Reza; Mathiassen, Kim; Brun, Henrik & Elle, Ole Jakob (2022). Design, Kinematic Modeling, and Validation of a Robotic-Assisted Transesophageal Echocardiography System. Fulltekst i vitenarkiv Vis sammendrag

  Transesophageal Echocardiography is a safe and minimally invasive tool to provide high-quality anatomic and hemodynamic information of the heart and its structures. However, the risk of exposure to a significant level of radiation during combined fluoroscopy and TEE-guided examinations and musculoskeletal disorders due to holding the probe for prolonged periods of time are two main shortcomings of using TEE manually. This paper presents the design, kinematic modeling, and validation of a novel 6 DOF robotic-assisted transesophageal echocardiography system to overcome the above mentioned shortcomings. The robotic system has been designed based on a commercially available TEE probe with 5 actuated Degrees of freedom on the TEE handle and an extra DOF to control the imaging plane. The constant curvature model is employed for the forward and inverse kinematic modeling of the robotic system. The kinematic model and the performance of the robotic system are validated with an experimental setup using a 6DOF OptiTrack real-time tracking system.

• Suther, Lene Kathrine R; Hopp, Einar; Geier, Oliver; Brun, Henrik; Nguyen, Bac & Tomterstad, Anders Høye [Vis alle 11 forfattere av denne artikkelen] (2017). 3T MR T1 mapping after arterial switch operation in patients with transposition of the great arteries (TGA). Fulltekst i vitenarkiv
• Mcleod, Kristin; Suther, Lene Kathrine R; Brun, Henrik; Smevik, Bjarne; Fiane, Arnt E & Lindberg, Harald L [Vis alle 8 forfattere av denne artikkelen] (2016). Ventricular Shape In TGA Patients Differs Significantly From Controls. Fulltekst i vitenarkiv
• Wyller, Vegard Bruun; Jacobsen, Kristine; Dahl, Mai Britt; Nilsen, Hilde; Proske, Simone & Horter, Thorsten [Vis alle 7 forfattere av denne artikkelen] (2016). Interferon gamma may improve cardiac function in Friedreich's ataxia cardiomyopathy. International Journal of Cardiology. ISSN 0167-5273. 221, s. 376–378. doi: 10.1016/j.ijcard.2016.06.288. Fulltekst i vitenarkiv
• Suther, Lene Kathrine Ryden; Hopp, Einar; Brun, Henrik; Larsen, Stig; Nguyen, Bac & Tomterstad, Anders Høye [Vis alle 9 forfattere av denne artikkelen] (2016). Image quality assessment of 3T MR coronary angiography (3D SSFP) in patients operated for transposition of the great arteries with three qualitative methods. Fulltekst i vitenarkiv
• Odland, Hans Henrik; Brun, Henrik; Dalen, Marit Lunde; Sejersted, Yngve; Edvardsen, Thor & Saugstad, Ola Didrik [Vis alle 7 forfattere av denne artikkelen] (2010). Determinants of mitral annulus peak systolic velocity - a study in piglets. Fulltekst i vitenarkiv Vis sammendrag

  Background: Systolic long axis myocardial dysfunction is an important determinant for mortality in adults. This study aimed at defining hemodynamic determinants of tissue Doppler derived, long-axis function, parameters in the newborn. Methods: Ten newborn pigs were studied under general anesthesia. Modulation of inotropy (dobutamine, esmolol), preload and afterload was done. Heart rate was increased by atrial pacing at each stage of inotropy. Tissue Doppler velocities in the mitral valve annulus were measured at each stage. Invasive measurements included high fidelity pressures (Millar catheters) in the left ventricle (LV) and aorta, and volume (conductance) in the LV. Velocity was integrated into displacement, and stroke volume and pressure was derived into flow and dP/dt respectively. All data were integrated in a computer and analyzed on a beat to beat fashion. For statistical modelling we used linear mixed models. Statistical models included unique hemodynamic determinants (stroke volume, flow, heart rate, ejection time and maximum dP/dt, effective arterial elastance) to assess their effect on peak systolic velocity (S') and displacement (D). The parameter estimate (beta) indicates the magnitude and directional change in the tissue Doppler parameter for a 1-unit increase in the corresponding variable. Results: During inotropy modulation with dobutamine S' increased, while (D) did not change. There was no change in S' with pacing at a higher rate, while D decreased with pacing. The strongest determinants of S' included both peak systolic flow (PSF, beta= 0.09 cm/mL; P<0.001) and end-systolic pressure (ESP, beta= -0.07 cm/mL; P=0.003). At the same time a strong association was found between stroke volume (SV) and D (D, beta= 0.05cm/mL; P<0.001). Hemodynamic changes were evident during modulation of pre- and afterload. Ejection time, stroke volume, end-systolic pressure, maximum dP/dt and PSF were all found to influence S' and D during preload and afterload modulation. The ratio PSF/S' and SV/D were found to be stable under the different hemodynamic modulations. Conclusion: First, this study provides feasibility of tissue Doppler assessment of the lateral mitral valve annulus long axis velocity in the neonate, even at higher heart rates. Secondly it provides validity to the assumption that systolic mitral valve annulus displacement is the long axis contribution to stroke volume, and peak systolic mitral valve annulus velocity is the long axis contribution to peak systolic flow.

• Odland, Hans Henrik; Brun, Henrik; Dalen, Marit Lunde; Sejersted, Yngve; Edvardsen, Thor & Saugstad, Ola Didrik [Vis alle 7 forfattere av denne artikkelen] (2010). Peak systolic acceleration: a new marker of long axis contractility. Fulltekst i vitenarkiv Vis sammendrag

  Background: Myocardial and endomyocardial accelerations have been shown to relate to contractility in adults and children. This study was designed to assess and validate myocardial acceleration of the left ventricular lateral mitral valve annulus by tissue Doppler in neonatal pigs by comparison with invasive hemodynamic data. Methods: Ten newborn pigs were studied under general anesthesia. Modulation of inotropy (dobutamine,esmolol), preload and afterload was done. Heart rate was increased by atrial pacing at each stage of inotropy. Tissue Doppler velocities were measured at each stage of inotropy and again with increased heart rate. Invasive measurements consisted of high fidelity pressures (Millar catheters) in the left ventricle (LV) and aorta, and volume (conductance) in the LV. Velocity was derived into acceleration, and pressures and volume into dP/dt and Flow respectively. All data were integrated in a computer and analyzed on a beat to beat fashion. ESPVR, Emax, PRSW was extracted for each stage of inotropy. We used mixed linear models for statistical modelling. Statistical models included unique hemodynamic determinants and assessed their effect on systolic acceleration. Peak systolic acceleration (pSac) was measured after the onset of left ventricular pressure rise. The parameter estimate (beta) indicates the magnitude and directional change in the tissue Doppler parameter for a 1-unit increase in the corresponding variable. Results: Maximum dP/dt was found to be the strongest determinant of pSac (beta=0.9±0.1; P<0.001) during inotropy modulation. Log pSac was related to logarithmic transformed ESPVR, Emax and PRSW (beta= 0.35±0.11; P= 0.005, beta= 0.53±0.14; P= 0.001 and beta= 0.9±0.14; P< 0.001 respectively). During preload reduction pSac determined log dP/dtmax (beta= 1.33±0.37; P< 0.001), while during afterload increase log ET (beta= -0.76±0.33; P< 0.032) and log SW (beta= 0.26±0.10; P< 0.026) were the strongest determinants of pSac. Log pSac increased by 0.10±0.03 cm/s2 (P=0.03) with pacing at a higher rate. Accelerations occurring before and during the isovolumic period were not associated with inotropic parameters. Conclusion: A stable and constant relation towards maximum dP/dt and preload independent parameters could be established in this study. pSac is a marker of long axis contractility, and this study provides evidence that pSac should be viewed upon as the long axis contribution to maximum dP/dt.

• Odland, Hans Henrik; Brun, Henrik; Dalen, Marit Lunde; Sejersted, Yngve; Edvardsen, Thor & Saugstad, Ola Didrik [Vis alle 7 forfattere av denne artikkelen] (2010). Peak systolic acceleration: a new marker of long axis contractility. European Heart Journal. ISSN 0195-668X. 31, s. 860–861. Fulltekst i vitenarkiv
• Odland, Hans Henrik; Brun, Henrik; Dalen, M.; Sejersted, Yngve; Edvardsen, T & Saugstad, Ola Didrik [Vis alle 7 forfattere av denne artikkelen] (2010). Determinants of mitral annulus peak systolic velocity - a study in piglets. European Heart Journal. ISSN 0195-668X. 31(Supp. 1), s. 863–863. Fulltekst i vitenarkiv
• Brun, Henrik; Holmstrøm, Henrik Alf B; Fredriksen, Per Morten; Matthews, Iren; Lund, May Brit & Thaulow, Erik (2005). Behandlingsprogram ved Eisenmenger-syndrom- hvordan måle effekt? Paidos: Tidsskrift for Norsk barnelegeforening. ISSN 1503-5360. s. 10–10. Fulltekst i vitenarkiv Vis sammendrag

  Abstrakt fra Norsk Barnelegeforenings høstmøte 2004

• Matthews, Iren; Brun, Henrik; Rønnestad, Arild Erlend & Saugstad, Ola Didrik (2005). Mekonium aspirasjon øker NO i ekspirasjonsluft. Paidos: Tidsskrift for Norsk barnelegeforening. ISSN 1503-5360. s. 10–10. Fulltekst i vitenarkiv
• Brun, Henrik; Matthews, Iren; Rønnestad, Arild Erlend & Saugstad, Ola Didrik (2004). Hypoksi og Mekonium-aspirasjon øker NO i ekspirasjonsluft. Fulltekst i vitenarkiv

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