Thor Edvardsen

• Andresen, Kristoffer; Selmer, Lisa Marie; Espeland, Torvald; Fadnes, Solveig; Løvstakken, Lasse & Beitnes, Jan Otto [Vis alle 9 forfattere av denne artikkelen] (2026). Mechanical Wave Velocities by High Frame Rate Echocardiography Identifies Myocardial Dysfunction in Acute Coronary Syndrome. Journal of the American Society of Echocardiography. ISSN 0894-7317. doi: 10.1016/j.echo.2026.09.005. Fulltekst i vitenarkiv Vis sammendrag

  Background: Mechanical waves propagating within the myocardium offer insight into tissue stiffness that can be measured by high frame rate echocardiography. This may provide information on myocardial tissue properties in acute myocardial infarction (AMI) incremental to traditional echocardiographic metrics. Objectives: To investigate whether natural mechanical wave velocities in the left ventricle (LV) are altered in AMI and to establish the feasibility of measuring mechanical wave velocities in all LV regions in AMI patients. Methods: We examined 60 patients (66±9 years, 72% male) with AMI by high frame rate echocardiography within one day after revascularisation therapy. Natural mechanical waves generated by the atrial kick (AK), mitral valve closure (MVC) and aortic valve closure (AVC) were analysed by clutter filter wave imaging for all LV regions. Results: AK wave velocities were faster in regions with wall motion abnormalities (WMA) compared to regions without (2.9 (2.1-4.6) m/s vs. 2.2 (1.7-2.8) m/s, p=0.004), whereas no differences were observed for MVC or AVC waves. Elevated AK wave velocities were associated with myocardial dysfunction assessed by LV longitudinal strain (β=0.49 (0.26-0.71), p<0.001) and WMA (OR 1.6 (1.3-2.0), p<0.001) by multivariable mixed-model regression analyses adjusting for age, gender and parameters of diastolic function, and for WMA also adjusted for LV longitudinal strain (OR 1.4 (1.0-1.8), p=0.022). Feasibility for measuring AK waves was high in all regions (mean 89%), but lower for MVC/AVC waves (mean 44% and 46%, respectively, p<0.001). Feasibility was lower from basal to apical segments for all wave types (p<0.001). Conclusions: AK wave velocities were faster in infarcted territories of AMI patients and were independently associated with myocardial dysfunction assessed by LV longitudinal strain and WMA. AK waves could be measured with good feasibility in all LV regions. The lower feasibility for MVC and AVC waves suggests differences in propagation dynamics or intrinsic wave properties.

• Madssen, Erik; Sverre, Elise Christine Bjørkholen; Nyen, Johanne E; Holmager, Therese L F; Kristensen, Anna M D & Bakken, Arnhild [Vis alle 13 forfattere av denne artikkelen] (2026). Beta-blocker therapy and physical activity after myocardial infarction: a preplanned sub-study of the BETAMI trial. European Journal of Preventive Cardiology (EJPC). ISSN 2047-4873. doi: 10.1093/eurjpc/zwag412. Fulltekst i vitenarkiv Vis sammendrag

  Abstract Aims To investigate the effect of long-term beta-blocker therapy on physical activity (PA) level after myocardial infarction (MI) in patients without heart failure. Method The BETAMI trial, randomised patients hospitalised with a MI without heart failure (LVEF ≥40%) to beta-blocker or no beta-blocker. In this pre-planned sub-study PA level was assessed by guideline-recommended PA level (≥30 minutes moderate activity ≥5 days/week) or not and self-reported hours/week with light to moderate and vigorous PA. Between-group differences in PA from baseline before randomisation to 18-months were estimated by linear mixed models. Exploratory analysis assessed treatment effects on a composite of all-cause mortality and major adverse cardiovascular events using Cox proportional hazards model. Results Of the 2867 randomised patients, 2185 (76%) responded to the PA questions and were included in this analysis. Mean age was 62.5 (SD 10.1) years, 20.6% were women. No differences in guideline-recommended PA level or mean hours of light to moderate and vigorous PA were reported between the beta-blocker and non-beta-blocker group at baseline or during 18-months follow-up. At 12-month follow-up, 37.0% in the beta-blocker group and 36.7% in the no beta-blocker group reported guideline-recommended PA level (OR 0.97, 95% CI 0.69-1.37). Exploratory, hypothesis-generating analyses did not demonstrate a statistically significant interaction (p for interaction = 0.06) between treatment assignment and baseline PA level for recurrent clinical events. Conclusions Beta-blocker therapy did not result in a change in PA level in post-MI patients without heart failure during the 18 months follow-up.

• Gude, Sigurd; Kleiven, Øyunn & Edvardsen, Thor (2026). Dilated Cardiomyopathy in a Woman With SPG4-Associated Hereditary Spastic Paraplegia. JACC: Case Reports. doi: 10.1016/j.jaccas.2026.108746. Fulltekst i vitenarkiv
• Kristensen, Anna Meta Dyrvig; Jortveit, Jarle; Holmager, Therese; Atar, Dan; Olsen, Michael Hecht & Bakken, Arnhild [Vis alle 14 forfattere av denne artikkelen] (2026). Outcomes in the BETAMI-DANBLOCK trial compared with a Norwegian nationwide myocardial infarction population. European Heart Journal. ISSN 0195-668X. doi: 10.1093/eurheartj/ehag348. Fulltekst i vitenarkiv Vis sammendrag

  Abstract Background and Aims In patients with myocardial infarction (MI), no heart failure, and left ventricular ejection fraction (LVEF) ≥ 40%, the combined BETAMI-DANBLOCK trial showed that beta-blockers reduced the risk of all-cause mortality or major adverse cardiovascular events. This study evaluated the representativeness of the trial. Methods Participants in BETAMI (n = 2867) and DANBLOCK (n = 2707) were compared with a cohort of revascularized MI patients with LVEF ≥40%, and no heart failure from the Norwegian Myocardial Infarction Registry (the NORMI cohort)(n = 20 804). Baseline characteristics were evaluated, and absolute risks of all-cause mortality and/or MI were estimated. A transportability analysis was conducted by weighting the BETAMI-DANBLOCK population according to the NORMI cohort. Results Median age was 66 years (interquartile range [IQR]: 57–74) in the NORMI cohort and 63 years (IQR: 55–70) in BETAMI and DANBLOCK. Patients in the NORMI cohort had a higher prevalence of diabetes, previous coronary artery disease, and LVEF 40–49%, compared with trial participants. At 3-year follow-up, the absolute risk of all-cause mortality or MI was 12.0% in the NORMI cohort, 7.7% in BETAMI, and 7.8% in DANBLOCK. Corresponding risks of MI were 6.3%, 5.6%, and 4.3%, respectively. The treatment effects of beta-blockers were similar when the trial population was weighted according to the characteristics of the NORMI cohort. Conclusions Compared with the NORMI cohort, participants in BETAMI and DANBLOCK were younger, had a lower proportion of certain comorbidities, and experienced a lower risk of all-cause mortality and MI. Despite these differences, the effect of beta-blockers remained consistent when the trial population was weighted according to the NORMI cohort.

• Nguyen, Thuy Mi Tran; Melichova, Daniela; Aabel, Eivind Westrum; Salte, Ivar Mjåland; Gjertsen, Erik & Heggelund, Geir [Vis alle 10 forfattere av denne artikkelen] (2026). Temporal trends in the primary prevention of implantable cardioverter-defibrillator selection and long-term outcomes in patients with non-ischaemic dilated cardiomyopathy and ischaemic cardiomyopathy. Europace. ISSN 1099-5129. 28(4). doi: 10.1093/europace/euag062. Fulltekst i vitenarkiv
• Dukefoss, Henrik B.; Andresen, Kristoffer; Harbo, Markus Borge; Hasselberg, Nina Eide; Grødem, Herman & Korsæth, Truls [Vis alle 18 forfattere av denne artikkelen] (2026). Validation of shear wave elastography for assessing myocardial fibrosis in patients with end-stage heart failure. European Heart Journal-Cardiovascular Imaging. ISSN 2047-2404. 27(4), s. 778–787. doi: 10.1093/ehjci/jeaf375. Fulltekst i vitenarkiv
• Abdullah, Rang; Bjørnebekk, Astrid Kristine; Hauger, Lisa Evju; Hullstein, Ingunn Riise; Edvardsen, Thor & Haugaa, Kristina Ingrid Helena Hermann [Vis alle 7 forfattere av denne artikkelen] (2026). Evaluating ECG Criteria for Diagnosing Left Ventricular Hypertrophy in Anabolic-Androgenic Steroid Users. JACC: Advances. 5(2). doi: 10.1016/j.jacadv.2025.102499. Fulltekst i vitenarkiv
• Luksic, Vlatka Reskovic; Paakkanen, Riitta; Podlesnikar, Tomaz; Androulakis, Emmanuel; Uusitalo, Valtteri & Moscatelli, Sara [Vis alle 10 forfattere av denne artikkelen] (2025). EACVI survey on the role, structure, and implementation of heart teams in current cardiology practice. European Heart Journal – Imaging Methods and Practice (EHJ-IMP). 3(4). doi: 10.1093/ehjimp/qyaf124. Fulltekst i vitenarkiv Vis sammendrag

  Aims The Heart Team (HT) concept is underscored in multiple guidelines, but the practical application is still challenging. Objective This survey, endorsed by the European Association of Cardiovascular Imaging (EACVI) Scientific Initiatives Committee and conducted by the EACVI Leaders of Tomorrow, aimed to explore the structure and dynamics of contemporary HTs in real-life clinical practice. Methods and results The Survey comprised 24 questions, including single-choice, multiple-choice, and open-labeled formats. It addressed all cardiologists and associated specialists involved in the HT meetings via online platform. A total of 233 responses were collected from 48 countries, 203 (87%) from Europe. Most respondents were imaging specialists (38%) and general cardiologists (29%), with 85% actively engaged in HT meetings. Twelve distinct HT configurations were identified. Core HT members included general and interventional cardiologists, cardiac surgeons, and imaging specialists. Complex cases are usually discussed at HT meetings, and ESC guidelines serve as a guiding framework (87%). Leadership within HTs is inconsistent and regular HT audits are lacking in 53% of centers. The Heart Team predominantly focus on treatment planning (97%) rather than outcome review (45%) or education (36%). Key perceived benefits include structured decision-making (74%), optimized management of complex cases (69%), and reduced specialty bias (67%). Recognized barriers included scheduling constraints, resource limitations, and communication inefficiencies. Conclusion This survey shows the important role of multidisciplinary HTs in contemporary clinical practice but reveals several areas of potential improvement. Addressing common challenges could result in more efficient HT practices and improve the care of complex patient cases in various cardiology subspecialty areas.

• Tveten, Ingrid Elisabeth; Nyberg, John; Grue, Jahn Frederik; Helland, Ragnhild Holden; Melichova, Daniela & Nguyen, Thuy Mi [Vis alle 13 forfattere av denne artikkelen] (2025). Deep Learning Segmentation and Quantification of the Left Ventricle from the Parasternal Short-Axis View in Echocardiography. Ultrasound in Medicine and Biology. ISSN 0301-5629. 52(2), s. 385–400. doi: 10.1016/j.ultrasmedbio.2025.10.005. Fulltekst i vitenarkiv Vis sammendrag

  Objective: Quantitative measurements remain under-used in echocardiography due to measurement variability and time consumption. This study aimed to develop a deep learning (DL) pipeline for the automatic extraction of clinically relevant quantitative measurements from the parasternal short-axis (PSAX) view. Methods: We trained an nnU-Net model to segment the left ventricle (LV) lumen and myocardium in PSAX images. Based on end-diastole (ED) and end-systole (ES) frames in the echocardiograms, we calculated the LV lumen area, LV fractional area change, mean wall thickness (MWT) and global circumferential strain. Segmentations and measurements were validated through comparison with two manual observers. Results: Compared with manual references, the nnU-Net model achieved a high grade of similarity for the LV lumen and myocardium, with Dice coefficients of 0.93 ± 0.04 and 0.84 ± 0.08, and 95th percentile Hausdorff distances of 3.2±1.9 mm and 3.4±1.7 mm, respectively. The Dice coefficients and 95th percentile Hausdorff distances were on par or better for the evaluation dataset. DL-based measurements were in line with interobserver precision and variability. Automatic timing of ED and ES frames based on echocardiograms and LV lumen area produced similar results to using manual timing by experts. The subject-level feasibility was 90.4%. Furthermore, DL-based measurement of MWT at ED differentiated subjects with and without hypertension (p < 0.001). Conclusion: Our DL-based measurement pipeline for PSAX achieved performance comparable to expert annotators, positioning it as a possible substitute for tedious manual measurements. DL-derived MWT was able to differentiate hypertensive from non-hypertensive subjects, which indicates the potential clinical utility of fully automated PSAX measurements.

• Ruddox, Vidar; Norum, Ingvild Billehaug; Hjelmesæth, Jøran Sture; Edvardsen, Thor & Otterstad, Jan Erik (2025). The Influence of Gender on Long-Term Cardiovascular Outcomes in Patients Undergoing Percutaneous Coronary Intervention for Acute Myocardial Infarction and the Association with Cardiac Left Ventricular Function. Diagnostics (Basel). 15(22). doi: 10.3390/diagnostics15222901. Fulltekst i vitenarkiv Vis sammendrag

  Background/Objectives: Traditionally, women have been observed to have older age, more co-morbidities, and poorer long-term clinical outcomes following acute myocardial infarction (AMI) when compared to men. However, age-adjusted analyses have demonstrated that gender differences are often attenuated, and the potential influence of left ventricular function and structure have been infrequently studied. The aim of the present study was to evaluate how LV function could influence gender differences in the long-term incidence of a composite of clinically relevant cardiovascular outcomes. Methods: Patients treated with early PCI for AMI were examined with echocardiography 2–4 days after the index AMI and followed by a mean 73 (±13) months. The primary endpoint was the incidence of a composite of total death, recurrent myocardial infarction, hospitalization for angina pectoris with an angiogram documenting progression of coronary artery stenoses, new heart failure, evidence of stroke/transient ischemic attack (TIA), and ventricular arrhythmia. Results: Among the 236 patients studied, 179 (76%) were men, with an average age of 66 (±11) years, and 57 were women (24%), with an age of 65 (±10) years. Men exhibited a higher incidence of anterior STEMI (p = 0.030), lower left ventricular ejection fraction (LVEF) (p = 0.02), reduced global longitudinal strain (p = 0.001), and larger left ventricular end-systolic volume index (LVESVI) (p = 0.007) compared to women. Both genders had similar peak troponin T values and symptom-to-needle times, as well as an equivalent number of stents implanted, prevalence of co-morbidities, and discharge medication. After sixyears of follow-up, Kaplan–Meier curves revealed better long-term cardiovascular outcome-free survival among women (log-rank p = 0.041). Cox regression analysis indicated that neither age nor LVEF influenced this gender difference, which, however, was reduced and became non-significant when LVESVI was added (HR 1.747 (95% CI 0.89–3.43)). No difference in mortality was observed, but men had significantly higher rates of heart failure (p = 0.03). Conclusions: This study demonstrated that men with a previous PCI-treated AMI had a two-fold (HR 2.155) higher risk of a composite long-term cardiovascular outcome as compared with women. The detrimental effect of male gender remained significant after adjustments for age and LVEF, but the male gender effect was reduced and became insignificant after adjustment for age and LVESVI. In view of this, our findings indicate that higher LVESVI may partly explain the detrimental effect of male gender on cardiovascular outcomes after PCI-treated AMI.

• Melichova, Daniela; Nyberg, John; Nguyen, Thuy Mi; Salte, Ivar Mjåland; Brunvand, Harald & Haugaa, Kristina Ingrid Helena Hermann [Vis alle 11 forfattere av denne artikkelen] (2025). Clinical validation of a novel fully automated measurement method for echocardiographic mechanical dispersion using deep learning. European Heart Journal-Cardiovascular Imaging. ISSN 2047-2404. 26(Supplement_1). doi: 10.1093/ehjci/jeae333.024. Fulltekst i vitenarkiv Vis sammendrag

  Abstract Background Evaluation of left ventricular (LV) function by strain echocardiography and mechanical dispersion (MD) has demonstrated improved prediction of ventricular arrhythmia in patients with heart failure (HF) and reduced ejection fraction. However, analyzing MD is both time consuming and operator dependent, thus its clinical use remains limited. Fully automated measurements of MD using a novel deep learning (DL) method may be a solution to facilitate clinical implementation. Purpose We aimed to validate a novel DL based method for fully automated measurements of MD, by evaluating its correlation and agreement with manual reference measurements in a large cohort of patients with heart failure and left ventricular ejection fraction (LVEF) &lt;40%. Methods In this prospective multicenter follow-up study, we consecutively included patients with recently diagnosed heart failure of all causes with LVEF ≤ 40%. All patients were treated according to contemporary guidelines with optimal medical therapy and revascularization if necessary. Two experienced cardiologists recorded all echocardiograms using Vivid E9 or E95 scanners (GE HealthCare, Horten, Norway). Measurements of MD were performed both by an experienced cardiologist using a commercial semi-automatic method, and an in-house developed fully automated deep learning-based method. Results MD was measured in 200 patients (73 ± 14 years old, 33% females). Mean LVEF was 32% ± 6. Mean MD by reference measurements was 61 ± 17ms and by the deep learning method 63 ± 19 ms . Deep learning-based measurements of MD had excellent agreement with reference, with bias of 2ms and Limits of Agreement only 28ms (Figure 1). The correlation between methods was good, with R2 46%, p&lt;0.001. Calculation time for automated measurements of MD per patient was only 6.4 ± 2.5 seconds per echocardiogram. Conclusion The novel fully automated deep learning-based method provides rapid measurements of MD and excellent agreement with manual reference measurements, and may thus facilitate clinical implementation of MD for improved risk stratification in patients with HF.

• Thomas, James D.; Edvardsen, Thor; Abraham, Theodore; Appadurai, Vinesh; Badano, Luigi & Banchs, Jose [Vis alle 24 forfattere av denne artikkelen] (2025). Clinical Applications of Strain Echocardiography: A Clinical Consensus Statement From the American Society of Echocardiography Developed in Collaboration With the European Association of Cardiovascular Imaging of the European Society of Cardiology. Journal of the American Society of Echocardiography. ISSN 0894-7317. 38(11), s. 985–1020. doi: 10.1016/j.echo.2025.07.007. Fulltekst i vitenarkiv
• Liga, Riccardo; Gimelli, Alessia; Podlesnikar, Tomaž; Cvijić, Marta; Pontone, Gianluca & Miglioranza, Marcelo Haertel [Vis alle 514 forfattere av denne artikkelen] (2025). Treatment and outcomes of chronic coronary syndromes: the EORP EURECA imaging registry. European Heart Journal. ISSN 0195-668X. 46(39), s. 3922–3927. doi: 10.1093/eurheartj/ehaf594. Fulltekst i vitenarkiv
• Savelev, Aleksei A.; Aabel, Eivind Westrum; Svensson, Anneli; Dahlberg, Pia; Christensen, Alex Hørby & Madsen, Trine [Vis alle 14 forfattere av denne artikkelen] (2025). Signal‐Averaged ECG in the Diagnostic Workup for Arrhythmogenic Cardiomyopathy: Insights From the Nordic ARVC Registry. Journal of the American Heart Association (JAHA). 14. doi: 10.1161/jaha.124.037544. Fulltekst i vitenarkiv Vis sammendrag

  Background The diagnostic role of signal‐averaged ECG (SAECG) in arrhythmogenic right ventricular cardiomyopathy (ARVC) has lately been questioned. We assessed the value of SAECG‐derived late ventricular potentials (LP) in ARVC diagnosis and its association with disease manifestations. Methods and Results Patients with definite ARVC diagnosis or genotype‐positive family members who underwent SAECG were included in register‐based observational study (n=357, mean age 41 years, 47% female, 43% probands). LP and terminal activation duration (TAD) were defined by Task Force Criteria 2010. We assessed the association of TAD and LP with structural RV abnormalities and ventricular tachycardia (VT), defined as sustained VT, appropriate implantable cardioverter‐defibrillator shock, aborted cardiac arrest, or sudden cardiac death, at diagnosis. LP were documented in 210 patients (59%) and abnormal TAD in 66 patients (18%). Each of the SAECG parameters was significantly associated with definite ARVC diagnosis in receiver‐operator characteristics curve analysis with area under the curve between 0.67 and 0.74. Exclusion of SAECG from diagnostic workup led to reclassification of 37 patients (16%) from definite to borderline ARVC (13 probands, 9 of whom had prevalent VT). Ninety patients (25%) had history of VT. LP, but not TAD, were associated with VT (adjusted odds ratio [OR adj ], 2.42 [95%CI, 1.07–5.48]). LP had lower specificity (72% versus 97%) but higher sensitivity (71% versus 25%) for association with RV structural abnormalities than TAD. Conclusions In the Nordic ARVC cohort SAECG‐derived LP are associated with VT and structural RV abnormalities and were critical for ascertainment of ARVC diagnosis in 16% of patients with narrow QRS complexes, including 8% of all probands.

• Stokke, Thomas Muri; Haugaa, Kristina Ingrid Helena Hermann; Russell, Kristoffer; Edvardsen, Thor & Sarvari, Sebastian (2025). Three-Dimensional Speckle Tracking Echocardiography for Detection of Acute Coronary Occlusions in Non-ST-Elevation Acute Coronary Syndrome Patients. Diagnostics (Basel). 15(15). doi: 10.3390/diagnostics15151864. Fulltekst i vitenarkiv Vis sammendrag

  Objectives: This study aimed to evaluate the ability of three-dimensional (3D) speckle tracking echocardiography (STE) to detect acute coronary occlusions in patients with non-ST-segment elevation acute coronary syndrome (NSTE-ACS) and its potential diagnostic advantage over two-dimensional (2D) STE. Methods: Fifty-six patients with NSTE-ACS (mean age 64 ± 11 years; 80% male) underwent 2D and 3D transthoracic echocardiography prior to coronary angiography. Global longitudinal strain (GLS), global circumferential strain (GCS), and 3D ejection fraction (EF) were analyzed. Acute coronary occlusion was defined as TIMI flow 0–1 in the presumed culprit artery. Results: Acute coronary occlusion was present in 16 patients (29%). Patients with occlusion had significantly more impaired strain compared to those without: 3D GLS (−12.5 ± 2.7% vs. −15.5 ± 2.1%, p < 0.001), 2D GLS (−12.6 ± 2.8% vs. −15.6 ± 2.0%, p < 0.001), 3D GCS (−24.8 ± 4.4% vs. −27.8 ± 4.3%, p = 0.02), and 2D GCS (−18.1 ± 5.5% vs. −22.9 ± 4.7%, p = 0.002). In contrast, 3D EF did not differ significantly between groups (52.5 ± 4.7% vs. 54.7 ± 5.7%, p = 0.16). Receiver operating characteristic analysis showed that 3D and 2D GLS had the highest diagnostic performance (AUCs 0.81 and 0.78), while 3D EF had the lowest (AUC 0.61). Feasibility was lower for 3D STE (86%) than for 2D longitudinal strain (95%, p = 0.03). Conclusions: Both 3D and 2D GLS showed higher diagnostic accuracy than 3D EF in identifying acute coronary occlusion in NSTE-ACS patients. While 3D STE enables simultaneous assessment of multiple parameters, it did not offer incremental diagnostic value over 2D STE and had lower feasibility.

• Munkhaugen, John; Kristensen, Anna Meta D.; Halvorsen, Sigrun; Holmager, Therese; Olsen, Michael Hecht & Bakken, Arnhild [Vis alle 64 forfattere av denne artikkelen] (2025). Beta-Blockers after Myocardial Infarction in Patients without Heart Failure. New England Journal of Medicine. ISSN 0028-4793. 393(19), s. 1901–1911. doi: 10.1056/nejmoa2505985. Fulltekst i vitenarkiv Vis sammendrag

  Background: The evidence supporting beta-blocker therapy after myocardial infarction was established before the introduction of modern coronary reperfusion therapy and secondary prevention strategies. Methods: In an open-label, randomized trial with blinded end-point evaluation, conducted in Denmark and Norway, we assigned patients who had had a myocardial infarction and who had a left ventricular ejection fraction of at least 40%, in a 1:1 ratio, to receive long-term beta-blocker therapy within 14 days after the event or no beta-blocker therapy. The primary end point was a composite of death from any cause or major adverse cardiovascular events (new myocardial infarction, unplanned coronary revascularization, ischemic stroke, heart failure, or malignant ventricular arrhythmias). Results: A total of 5574 patients underwent randomization and were included in the main analyses - 2783 in the beta-blocker group and 2791 in the no-beta-blocker group. After a median follow-up of 3.5 years (interquartile range, 2.2 to 4.6), a primary end-point event had occurred in 394 patients (14.2%) in the beta-blocker group and in 454 patients (16.3%) in the no-beta-blocker group (hazard ratio, 0.85; 95% confidence interval [CI], 0.75 to 0.98; P = 0.03). Death from any cause occurred in 4.2% of the patients in the beta-blocker group and in 4.4% of those in the no-beta-blocker group; myocardial infarction occurred in 5.0% and 6.7%, respectively (hazard ratio, 0.73; 95% CI, 0.59 to 0.92), unplanned coronary revascularization in 3.9% and 3.9%, ischemic stroke in 1.6% and 1.3%, heart failure in 1.5% and 1.9%, and malignant ventricular arrhythmias in 0.5% and 0.6%. No apparent differences in safety outcomes were observed between the groups. Conclusions: Among patients with a myocardial infarction and a left ventricular ejection fraction of at least 40%, beta-blocker therapy led to a lower risk of death or major adverse cardiovascular events than no beta-blocker therapy

• Grendstad, Halvard; Skarstad, Sigrun Ådnegard; Edvardsen, Thor & Hallén, Jostein (2025). A Prospective Study on Maximal Oxygen Uptake and Cardiovascular Functions in 12-Year-Old Endurance Athletes and Their Non-Endurance-Trained Peers. Scandinavian Journal of Medicine & Science in Sports. ISSN 0905-7188. 35(1). doi: 10.1111/sms.70016. Fulltekst i vitenarkiv
• Sade, Leyla Elif; Faletra, Francesco Fluvio; Pontone, Gianluca; Gerber, Bernhard Lothar Marie; Muraru, Denisa & Edvardsen, Thor [Vis alle 27 forfattere av denne artikkelen] (2025). The role of multi-modality imaging for the assessment of left atrium and left atrial appendage: a clinical consensus statement of the European Association of Cardiovascular Imaging (EACVI), European Heart Rhythm Association (EHRA) of the European Society of Cardiology (ESC). European Heart Journal-Cardiovascular Imaging. ISSN 2047-2404. 26(3), s. 385–413. doi: 10.1093/ehjci/jeaf014. Fulltekst i vitenarkiv
• Tangen, Jorun; Nguyen, Thuy Mi Tran; Melichova, Daniela; Klæboe, Lars Gunnar; Forså, Marianne Inngjerdingen & Andresen, Kristoffer [Vis alle 13 forfattere av denne artikkelen] (2024). Left atrial volume assessed by echocardiography identifies patients with high risk of adverse outcome after acute myocardial infarction. Echo Research & Practice. 11(1). doi: 10.1186/s44156-024-00060-1. Fulltekst i vitenarkiv Vis sammendrag

  Background The left atrial (LA) volume has been demonstrated to be an important predictor of adverse outcome in patients with various cardiac conditions, including acute myocardial infarction (AMI). However, new treatment strategies in patients with AMI have led to better patient outcomes. We hypothesised that increased LA size could still predict mortality in patients with AMI despite improved treatment strategies. Methods We included patients with AMI in a prospective multicenter cohort study and the study patients were enrolled from 2014 to 2022. We recorded echocardiographic and clinical data during their index hospitalisation. Indexed LA volume (LAVi) was assessed in all patients and was used as a continuous variable in the univariate and multivariate Cox regression analysis. The study took place over a period of five years and median follow-up time was 3.8 years (range 3.1 to 5.0 years). The primary study outcomes were all-cause mortality and major adverse cardiac events (MACE). MACE was defined as hospital readmission due to myocardial infarction, cardiac arrest, stroke, heart failure, or onset of new atrial fibrillation. Results We included 487 patients (69 ± 12 years old, 26% female) with AMI. During the follow-up period all-cause mortality was 50 (10.3%) and patients who reached the primary outcomes were 153 (31.4%). The deceased patients had higher LAVi compared to survivors (40.0 ± 12.9 mL/m2 vs. 29.7 ± 11.2 mL/m2, p < 0.001). Factors associated with all-cause mortality and MACE were age, year of enrollment, left ventricular (LV) ejection fraction, LV global longitudinal strain (GLS), LV filling pressure, moderate or severe mitral regurgitation and LAVi. GLS and EF were segregated into two distinct models due to their moderately high correlation (r = 0.57, p < 0.001). LAVi remained as an independent echocardiographic predictor of primary outcomes after adjusting for the covariates above in two separates multivariable Cox regression models (hazard ratio 1.02/1.02 mL/m2 [95% CI 1.01–1.03/1.01–1.03], p = 0.006/0.003). Conclusions Our study demonstrated that LA dilatation is an independent echocardiographic predictor of mortality and MACE in patients with AMI despite improved treatment strategies. This finding highlights the potential of using LAVi as a marker for prognostication in these patients.

• Kaya, Esra; Andresen, Kristoffer; Lie, Øyvind Haugen; Aaberge, Lars; Haugaa, Kristina Ingrid Helena Hermann & Edvardsen, Thor [Vis alle 7 forfattere av denne artikkelen] (2024). Left ventricular mechanical dispersion as a predictor of the need for pacemaker implantation after transcatheter aortic valve implantation: MeDiPace TAVI study. European Heart Journal-Cardiovascular Imaging. ISSN 2047-2404. 25(4), s. 539–547. doi: 10.1093/ehjci/jead315. Fulltekst i vitenarkiv Vis sammendrag

  Aims Permanent pacemaker (PM) implantation is common after transcatheter aortic valve implantation (TAVI). Left ventricular mechanical dispersion (MeDi) by speckle tracking echocardiography is a marker of fibrosis that causes alterations in the conduction system. We hypothesized that MeDi can be a predictor of the need for PM implantation after TAVI. Methods and results Consecutively, 200 TAVI patients were enrolled. Transthoracic echocardiography and electrocardiography examinations were recorded before TAVI to evaluate global longitudinal strain (GLS), MeDi, and conduction disturbances. PM implantation information was obtained 3 months after TAVI. Patients were stratified into PM or no PM group. Mean age was 80 + 7 years (44% women). Twenty-nine patients (16%) received PM. MeDi, QRS duration, existence of right bundle branch abnormality (RBBB), and first-degree atrioventricular (AV) block were significantly different between groups. MeDi was 57 ± 15 ms and 48 ± 12 ms in PM and no PM groups, respectively (P < 0.001). In multivariate analysis, MeDi predicted the need for PM after TAVI independently of GLS, QRS duration, RBBB, and first-degree AV block [odds ratio (OR): 1.73, 95% confidence interval (CI): 1.22–2.45] with an area under the curve (AUC) of 0.68 in receiver operating characteristic (ROC) curves. Moreover, RBBB was an independent predictor of PM need after TAVI (OR: 8.98, 95% CI: 1.78–45.03). When added to RBBB, MeDi had an incremental predictive value with an AUC of 0.73 in ROC curves (P = 0.01). Conclusion MeDi may be used as an echocardiographic functional predictor of the need for PM after TAVI.

• Klæboe, Lars Gunnar; Lie, Øyvind Haugen; Brekke, Pål Haugar; Bosse, Gerhard; Hopp, Einar & Haugaa, Kristina Ingrid Helena Hermann [Vis alle 7 forfattere av denne artikkelen] (2024). Differentiation of Myocardial Properties in Physiological Athletic Cardiac Remodeling and Mild Hypertrophic Cardiomyopathy. Biomedicines. 12(2). doi: 10.3390/biomedicines12020420. Fulltekst i vitenarkiv Vis sammendrag

  Clinical differentiation between athletes’ hearts and those with hypertrophic cardiomyopathy (HCM) can be challenging. We aimed to explore the role of speckle tracking echocardiography (STE) and cardiac magnetic resonance imaging (CMR) in the differentiation between athletes’ hearts and those with mild HCM. We compared 30 competitive endurance elite athletes (7% female, age 41 ± 9 years) and 20 mild phenotypic mutation-positive HCM carriers (15% female, age 51 ± 12 years) with left ventricular wall thickness 13 ± 1 mm. Mechanical dispersion (MD) was assessed by means of STE. Native T1-time and extracellular volume (ECV) were assessed by means of CMR. MD was higher in HCM mutation carriers than in athletes (54 ± 16 ms vs. 40 ± 11 ms, p = 0.001). Athletes had a lower native T1-time (1204 (IQR 1191, 1234) ms vs. 1265 (IQR 1255, 1312) ms, p < 0.001) and lower ECV (22.7 ± 3.2% vs. 25.6 ± 4.1%, p = 0.01). MD > 44 ms optimally discriminated between athletes and HCM mutation carriers (AUC 0.78, 95% CI 0.65–0.91). Among the CMR parameters, the native T1-time had the best discriminatory ability, identifying all HCM mutation carriers (100% sensitivity) with a specificity of 75% (AUC 0.83, 95% CI 0.71–0.96) using a native T1-time > 1230 ms as the cutoff. STE and CMR tissue characterization may be tools that can differentiate athletes’ hearts from those with mild HCM.

• Erevik, Christine Bjørkvik; Kleiven, Øyunn; Frøysa, Vidar; Bjørkavoll-Bergseth, Magnus; Chivulescu, Ana Monica & Klæboe, Lars Gunnar [Vis alle 14 forfattere av denne artikkelen] (2024). Echocardiographic assessment of myocardial efficiency predicts exercise performance. European Journal of Sport Science (EJSS). ISSN 1746-1391. 24(3), s. 319–329. doi: 10.1002/ejsc.12082. Fulltekst i vitenarkiv Vis sammendrag

  Cardiac function is a major determinant of cardiopulmonary fitness. This study aimed to determine if novel echocardiographic myocardial function and efficiency parameters at rest can predict exercise performance during different types of prolonged high-intensity endurance exercise. Echocardiography was performed before exercise in 40 healthy (75% males) 50.3 ± 9.1-year-old recreational athletes. Echocardiographic parameters at rest were compared with exercise performance assessed by power output during two different exercises: A lactate threshold and cardiopulmonary exercise test (La-CPET) and a 91-km mountain bike sport cycling race. The La-CPET had a median duration of 43 (40, 45) minutes and a mean power output of 2.9 ± 0.5 W/kg. The race had a median duration of 236 (214, 268) minutes and a mean power output of 2.1 ± 0.5 W/kg. There was moderate left ventricular (LV) dilatation in individuals with the highest performance. The myocardial efficiency parameter, global wasted work (GWW), was positively correlated with race duration (rho = 0.42, p = 0.008) and negatively correlated with mean power output during both the La-CPET (rho = −0.43, p = 0.007) and the race (rho = −0.44, p = 0.005). In multivariable models, including LV volumes, left GWW remained an independent predictor of race duration (beta = 0.40, p = 0.007) and of mean power output during the La-CPET (beta = −0.40, p = 0.006) and the race (beta = −0.43, p = 0.003). The novel echocardiographic myocardial efficiency parameter, GWW, measured at rest, is an independent predictor of prolonged high-intensity endurance exercise performance in healthy middle-aged athletes. These findings suggest that resting myocardial efficiency parameters may aid the identification of exercise-induced LV dilatation.

• Gregersen, Ida; Scarth, Morgan Elizabeth; Abdullah, Rang; Thorsby, Per Medbøe; Hauger, Lisa Evju & Haugaa, Kristina Ingrid Helena Hermann [Vis alle 14 forfattere av denne artikkelen] (2024). Elevated interleukin 8 and matrix metalloproteinase 9 levels are associated with myocardial pathology in users of anabolic-androgenic steroids. European Journal of Preventive Cardiology (EJPC). ISSN 2047-4873. 31(12), s. 1469–1476. doi: 10.1093/eurjpc/zwae126. Fulltekst i vitenarkiv Vis sammendrag

  Aims In the current paper, we aim to explore the effect of both current and former long-term anabolic-androgenic steroid (AAS) use on regulation of systemic inflammatory markers and mediators of extracellular matrix (ECM) remodelling and their association with hormones and echocardiographic myocardial pathology in weightlifters. Methods and results In a cross-sectional study, 93 weightlifting AAS users, of whom 62 were current and 31 were past users, with at least 1-year cumulative AAS use (mean 11 ± 7 accumulated years of AAS use), were compared with 54 non-using weightlifting controls (WLCs) using clinical interview, blood pressure measurements, and echocardiography. Serum levels of interleukin (IL)-6, IL-8, tumour necrosis factor (TNF), interferon (IFN)-γ, growth differentiation factor (GDF)-15, and matrix metalloproteinase (MMP)-9, sex hormones, and lipids were analysed. It was found that serum levels of IL-8, GDF-15, and MMP-9 were significantly increased in current AAS users compared with former users and WLCs. Matrix metalloproteinase 9, but not IL-8, correlated consistently with sex hormone levels, and sex hormone levels correlated consistently with mean wall thickness, in current users. Moreover, HDL cholesterol was significantly lower in current vs. former AAS users and significantly inversely correlated with MMP-9 in current users. Further, in current users, MMP-9 and IL-8 correlated with markers of myocardial strain, and MMP-9 also correlated with indices of cardiac mass, which was not seen in former users. Mediation analyses suggested that MMP-9 could partly explain hormone-induced alterations in markers of myocardial damage in current users. Conclusion Long-term AAS is associated with increased levels of markers of inflammation and ECM remodelling, which seems to have a hormone-dependent (MMP-9) and a hormone-independent (IL-8) association with markers of myocardial dysfunction.

• Ross, Stian Balnagown; Lie, Øyvind Haugen; Odland, Hans Henrik; Håland, Trine Synnøve Fink; Edvardsen, Thor & Haugaa, Kristina Ingrid Helena Hermann [Vis alle 7 forfattere av denne artikkelen] (2024). Changes in electrical delay is associated with the hemodynamic response to cardiac pacing. Heart Rhythm O2. 5(5), s. 338–340. doi: 10.1016/j.hroo.2024.03.013. Fulltekst i vitenarkiv
• Erevik, Christine Bjørkvik; Kleiven, Øyunn; Frøysa, Vidar; Bjørkavoll-Bergseth, Magnus; Chivulescu, Ana Monica & Klæboe, Lars Gunnar [Vis alle 14 forfattere av denne artikkelen] (2024). Exercise-Induced Cardiac Troponin I Elevation Is Associated With Regional Alterations in Left Ventricular Strain in High-Troponin Responders. Journal of the American Heart Association (JAHA). 13(16), s. e034382–e034382. doi: 10.1161/JAHA.124.034382. Fulltekst i vitenarkiv Vis sammendrag

  Background The implications of exercise‐induced cardiac troponin elevation in healthy individuals are unclear. This study aimed to determine if individuals with a high exercise‐induced cardiac troponin I (cTnI) response have alterations in myocardial function following high‐intensity endurance exercise compared with normal‐cTnI responders. Methods and Results Study individuals were recruited from previous participants in a 91‐km mountain bike cycling race (the North Sea Race) and were classified as high‐ (n=34) or normal‐cTnI responders (n=25) based on maximal cTnI values after the recruitment race. The present study exposed all participants to 2 prolonged high‐intensity exercises: a combined lactate threshold and cardiopulmonary exercise test and repeated participation in the North Sea Race. Echocardiography was performed before, immediately after, and 24 hours following exercise. All study individuals (n=59) had normal coronary arteries, and were aged 51±10 years; 46 (74%) were men. There were no differences in baseline characteristics between the high‐ and normal‐cTnI responders. Maximal cTnI levels 3 hours after exercise were significantly higher in the high‐ compared with normal‐cTnI group (P<0.001–0.027). Following exercise, there were no differences in global ventricular function between the 2 groups. In contrast, high‐cTnI responders had significantly lower regional strain in the anteroseptal segments following exercise, with more profound changes after the race. Conclusions High‐cTnI responders had lower anteroseptal segmental strain shortly after exercise than normal‐cTnI responders. However, there were no permanent alterations in myocardial strain, indicating no short‐ or long‐term adverse consequences of these exercise‐induced alterations in myocardial function.

• Henriksen, Hans Christian Bordado; Havnes, Ingrid Amalia; Jørstad, Marie Lindvik; Abdullah, Rang; Thorsby, Per Medbøe & Hauger, Lisa Evju [Vis alle 10 forfattere av denne artikkelen] (2024). Treatment-seeking behavior and cardiovascular morbidity among men with anabolic-androgenic steroid use: A cross-sectional study. Scandinavian Journal of Medicine & Science in Sports. ISSN 0905-7188. 34(1). doi: 10.1111/sms.14554. Fulltekst i vitenarkiv Vis sammendrag

  Aims To determine associations between anabolic-androgenic steroid (AAS) use-related morbidity including cardiovascular disease (CVD) and engagement to health services. Methods In this cross-sectional study, 90 males with at least 12 months cumulative current or former use of AAS were included. The participants were divided into a treatment-seeking group (TSG) and a non-treatment seeking group (non-TSG) based on their responses to a self-report web questionnaire. All participants were screened for symptoms that could be indicative of CVD through a clinical interview, and examined with blood samples, blood pressure measurements and transthoracic echocardiography. Results In the total sample (n = 90), mean age was 39 ± 11 years with cumulative AAS use of 12 ± 9 years. Among men in the TSG with current use there were higher prevalence of dyspnoea (50% vs 7%) and reduced left ventricular ejection fraction (LVEF) in conjunction with left ventricular hypertrophy (LVH) (36 vs. 9%) and/or high blood pressure (55% vs. 19%) compared to men in the non-TSG. Among men with current AAS use and established LVEF <50% (n = 25) or LVH (n = 21), 44% (11) and 43% (9) respectively, had never engaged health services due to AAS-related adverse effects. Deviant liver- and kidney parameters were frequently observed in the total sample but without between-group differences. Conclusions Treatment-seeking behavior among current AAS users may be associated with increased levels of dyspnoea and established CVD. Despite objective signs of severe CVD among a substantial amount of study participants, it is of great concern that the majority had never sought treatment for AAS-related concerns.

• Otterstad, Jan Erik; Munkhaugen, John; Ruddox, Vidar; Edvardsen, Thor & Hjelmesæth, Jøran Sture (2024). Association of normal body mass index and weight loss with long-term major cardiovascular events after PCI for myocardial infarction. Scandinavian Cardiovascular Journal. ISSN 1401-7431. 58(1). doi: 10.1080/14017431.2024.2386984. Fulltekst i vitenarkiv Vis sammendrag

  Objectives: To investigate whether normal body mass index (BMI) shortly after percutaneous coronary intervention (PCI) for myocardial infarction is associated with increased risk of long-term major cardiovascular events (MACE), and to explore potential clinical determinants of long-term weight loss (WL) after PCI. Methods: Single-center cohort study with 5-year follow-up of patients treated with PCI for myocardial infarction between 2016 and 2018. Categorical WL was defined as > 0 kg body weight reduction from baseline to end of follow-up. Results: Of 236 patients (24% women), mean age was 64.9 ± 10.2 years and mean BMI within 4 days after PCI was 27.1 ± 4.3 kg/m2. Seventy-five patients (32%) had at least one MACE, equally distributed between those with normal weight (31%), overweight (32%), and obesity (31%). Patients with overweight or obesity had a lower crude mortality rate than their normal weight counterparts (7.4% vs 16.4%, p = 0.049), but the relative hazard of death did not differ from those with normal weight, HR 0.50, 95% CI 0.22-1.15. Patients with either a long-term WL (n = 112) or no WL (n = 95) had a comparable incidence of non-fatal MACE (27% vs 22%, p = 0.518). The proportion of patients reporting unintentional weight loss was significantly higher in the normal weight group (82%) compared with those with overweight (41%) or obesity (28%), p < 0.001. Conclusion: Our results did not confirm any association between normal BMI after PCI and long-term MACE. However, patients with normal BMI at baseline had a higher incidence of unintentional WL than those with elevated BMI. Trial registration: Current research information system in Norway (CRISTIN): ID 542528

• Andresen, Kristoffer; Klæboe, Lars Gunnar; Lie, Øyvind Haugen; Broch, Kaspar; Kvaslerud, Anette Borger & Bosse, Gerhard [Vis alle 10 forfattere av denne artikkelen] (2024). No adverse association between exercise exposure and diffuse myocardial fibrosis in male endurance athletes. Scientific Reports. 14(1). doi: 10.1038/s41598-024-57233-5. Fulltekst i vitenarkiv Vis sammendrag

  The potential association between endurance exercise and myocardial fibrosis is controversial. Data on exercise exposure and diffuse myocardial fibrosis in endurance athletes are scarce and conflicting. We aimed to investigate the association between exercise exposure and markers of diffuse myocardial fibrosis by cardiovascular magnetic resonance imaging (CMR) in endurance athletes. We examined 27 healthy adult male competitive endurance athletes aged 41 ± 9 years and 16 healthy controls in a cross sectional study using 3 Tesla CMR including late gadolinium enhancement and T1 mapping. Athletes reported detailed exercise history from 12 years of age. Left ventricular total mass, cellular mass and extracellular mass were higher in athletes than controls (86 vs. 58 g/m2, 67 vs. 44 g/m2 and 19 vs. 13 g/m2, all p < 0.01). Extracellular volume (ECV) was lower (21.5% vs. 23.8%, p = 0.03) and native T1 time was shorter (1214 ms vs. 1268 ms, p < 0.01) in the athletes. Increasing exercise dose was independently associated with shorter native T1 time (regression coefficient − 24.1, p < 0.05), but expressed no association with ECV. Our results indicate that diffuse myocardial fibrosis has a low prevalence in healthy male endurance athletes and do not indicate an adverse dose–response relationship between exercise and diffuse myocardial fibrosis in healthy athletes.

• Bjerring, Anders W.; Smeland, Knut Bjøro; Stokke, Thomas Muri; Haugaa, Kristina Ingrid Helena Hermann; Holte, Espen & Rösner, Assami [Vis alle 9 forfattere av denne artikkelen] (2024). Long-term cardiac effects of modern treatment for Hodgkin’s lymphoma. Cardio-Oncology. 10(1). doi: 10.1186/s40959-024-00222-4. Fulltekst i vitenarkiv Vis sammendrag

  Background Hodgkin’s lymphoma (HL) is a hematological malignancy that affects both children and young adults. Traditional treatment is associated with a life-time prevalence of cardiac disease exceeding 50%. In the late 1990s protocols were modified to reduce cancer therapy-related adverse cardiac effects. This study aimed to assess the long-term impact of advances in treatment protocols on the cardiac health of HL survivors (HLS). Methods HLS (n = 246) treated between 1997 and 2007 with anthracycline-based chemotherapy in three centers in Norway were included. Of these, 132 (53%) had also received mediastinal radiotherapy. HLS were compared to controls (n = 58) recruited from the general population and matched for sex, age, smoking status, and heredity for coronary artery disease. All subjects underwent echocardiography, clinical assessment, and blood sampling. Results The HLS were 46 ± 9 years old and had been treated 17 ± 3 years before inclusion in the study. There was no significant difference between HLS and controls in ejection fraction (EF) (58%±5 vs. 59%±4, p = 0.08) or prevalence of heart failure. HLS treated with both anthracyclines and mediastinal radiotherapy (AC + MRT) had slightly worse left ventricular global longitudinal strain than controls (-19.3 ± 2.5% vs. -20.8 ± 2.0%, p < 0.001), but those treated with only anthracyclines did not. HLS treated with AC + MRT had a higher prevalence of valve disease than those treated only with anthracyclines (12% vs. 4%, p < 0.05). Conclusions HLS treated with anthracyclines after the late 1990s have similar cardiac function and morphology as age-matched controls, apart from higher rates of valvular disease in those who also underwent mediastinal radiotherapy.

• Tangen, Jorun; Nguyen, Thuy Mi; Melichova, Daniela; Klæboe, Lars Gunnar; Forså, Marianne Inngjerdingen & Andresen, Kristoffer [Vis alle 12 forfattere av denne artikkelen] (2024). The Prognostic Value of Left Atrial Function in Patients with Acute Myocardial Infarction. Diagnostics (Basel). 14(18). doi: 10.3390/diagnostics14182027. Fulltekst i vitenarkiv Vis sammendrag

  The prognostic value of left atrial (LA) volume is well-established in acute myocardial infarction (AMI) patients. LA strain provides further patophysological insights. In the present study, we evaluated LA volume and LA strain in AMI patients including those with atrial fibrillation (AF). The aim of the study was to determine if LA strain provide additional prognostic value. Patients with AMI underwent two-dimensional echocardiography within 72 h of admission. The primary outcome was a composite of all-cause mortality and major adverse cardiovascular events. Cox regression analyses were performed. We included 501 patients and during follow-up, 132 patients (26.4%) met the primary outcome. Left ventricular (LV) global longitudinal strain (GLS) (HR 0.94 [95% CI 0.88–0.99], p = 0.029), indexed LA volume (LAVi) (HR 1.02 [95% CI 1.00–1.04], p = 0.015), and LA reservoir strain (HR 0.96 [95% CI 0.93–0.99], p = 0.017) were all independently associated with the primary outcome. A univariate Cox model conducted on the AF patients (n = 32) revealed that LA reservoir strain remained significantly associated with the primary outcome, while LV GLS and LAVi were not significant. The prognostic value of LA reservoir strain was comparable to LA volume and LV GLS, and might even be better in AF patients.

• Bijl, Pieter Van der; Stassen, Jan; Haugaa, Kristina Ingrid Helena Hermann; Essayagh, Benjamin; Basso, Cristina & Thiene, Gaetano [Vis alle 13 forfattere av denne artikkelen] (2024). Mitral Annular Disjunction in the Context of Mitral Valve Prolapse: Identifying the At-Risk Patient. JACC Cardiovascular Imaging. ISSN 1936-878X. 17(10). doi: 10.1016/j.jcmg.2024.03.006. Fulltekst i vitenarkiv Vis sammendrag

  Mitral annular disjunction (MAD), a separation between the left atrium/mitral valve annulus and the left ventricular myocardium, is frequently seen in patients with arrhythmic mitral valve prolapse. Although an association exists between MAD and ventricular arrhythmias, little is known regarding the identification of individuals at high risk. Multimodality imaging including echocardiography, computed tomography, cardiac magnetic resonance, and positron emission tomography can play an important role in both the diagnosis and risk stratification of MAD. Due to a paucity of data, clinical decision making in a patient with MAD is challenging and remains largely empirical. Although MAD itself can be corrected surgically, the prevention and treatment of associated arrhythmias may require medical therapy, catheter ablation, and an implantable cardioverter-defibrillator. Prospective data are required to define the role of implantable cardioverter-defibrillators, targeted catheter ablation, and surgical correction in selected, at-risk patients.

• Wazzan, Adrien AL; Taconne, Marion; Rolle, Virginie Le; Forså, Marianne Inngjerdingen; Haugaa, Kristina Ingrid Helena Hermann & Galli, Elena [Vis alle 9 forfattere av denne artikkelen] (2024). Risk profiles for ventricular arrhythmias in hypertrophic cardiomyopathy through clustering analysis including left ventricular strain. International Journal of Cardiology. ISSN 0167-5273. 409. doi: 10.1016/j.ijcard.2024.132167. Fulltekst i vitenarkiv
• Almeida, Ana G.; Grapsa, Julia; Gimelli, Alessia; Bucciarelli-Ducci, Chiara; Gerber, Bernhard & Ajmone-Marsan, Nina [Vis alle 26 forfattere av denne artikkelen] (2024). Cardiovascular multimodality imaging in women: a scientific statement of the European Association of Cardiovascular Imaging of the European Society of Cardiology. European Heart Journal-Cardiovascular Imaging. ISSN 2047-2404. 25(4), s. E116–E136. doi: 10.1093/ehjci/jeae013. Fulltekst i vitenarkiv
• Skulstad, Helge; Andresen, Kristoffer; Aaberge, Lars; Haugaa, Kristina Ingrid Helena Hermann; Edvardsen, Thor & Kaya, Esra (2024). Early reverse remodeling by echocardiography after transcatheter aortic valve implantation. Echocardiography. ISSN 0742-2822. 41(6). doi: 10.1111/echo.15865. Fulltekst i vitenarkiv Vis sammendrag

  Introduction Oslo University Hospital is a tertiary center conducting a significant number of transcatheter aortic valve implantation (TAVI) procedures per year. In this follow-up MediPace study, we aimed to investigate early echocardiographic changes in systolic and diastolic functions after TAVI in these patients. Methods All patients enrolled in the previous study were contacted 3 months after TAVI for echocardiographic evaluation. Detailed echocardiography was performed 3.5 ± 1.6 months after TAVI, and compared with baseline evaluations. Results A total of 101 patients were analyzed. Mean age was 80.1 ± 6.8 years and 40% of the patients were female. We observed a significant improvement in global longitudinal strain (GLS) (pre-TAVI −16.8 ± 4.1%, post-TAVI −17.8 ± 3.6%, p < .001), with no notable change in LVEF. More than half of the patients (52%) experienced a significant reverse remodeling with ≥10% decrease in left ventricular mass index (LVMi) following TAVI (pre-TAVI 123.6 ± 32.1 vs. 109.7 ± 28.9 g/m2 post-TAVI, p < .001). Pre-TAVI LVMi was a positive predictor, whereas history of HT was a negative predictor of LVMi reduction. There was no significant improvement in diastolic function following TAVI. Highest degree of paravalvular leakage was mild to moderate and was observed in only 2%. Conclusions A significant improvement in GLS and LVMi was found following TAVI. History of hypertension and baseline LVMi were predictors of LVMi change. There was no notable change in diastolic function, including left atrial strain.

• Mirmaksudov, Mirakhmadjon; Ross, Stian Balnagown; Kongsgård, Erik & Edvardsen, Thor (2024). Enhancing cardiac pacing strategies: a review of conduction system pacing compared with right and biventricular pacing and their influence on myocardial function. European Heart Journal-Cardiovascular Imaging. ISSN 2047-2404. 25(7), s. 879–887. doi: 10.1093/ehjci/jeae090. Fulltekst i vitenarkiv Vis sammendrag

  Traditional right ventricular pacing (RVP) has been linked to the deterioration of both left ventricular diastolic and systolic function. This worsening often culminates in elevated rates of hospitalization due to heart failure, an increased risk of atrial fibrillation, and increased morbidity. While biventricular pacing (BVP) has demonstrated clinical and echocardiographic improvements in patients afflicted with heart failure and left bundle branch block, it has also encountered significant challenges such as a notable portion of non-responders and procedural failures attributed to anatomical complexities. In recent times, the interest has shifted towards conduction system pacing, initially, His bundle pacing, and more recently, left bundle branch area pacing, which are seen as promising alternatives to established methods. In contrast to other approaches, conduction system pacing offers the advantage of fostering more physiological and harmonized ventricular activation by directly stimulating the His–Purkinje network. This direct pacing results in a more synchronized systolic and diastolic function of the left ventricle compared with RVP and BVP. Of particular note is the capacity of conduction system pacing to yield a shorter QRS, conserve left ventricular ejection fraction, and reduce rates of mitral and tricuspid regurgitation when compared with RVP. The efficacy of conduction system pacing has also been found to have better clinical and echocardiographic improvement than BVP in patients requiring cardiac resynchronization. This review will delve into myocardial function in conduction system pacing compared with that in RVP and BVP.

• Rogstadkjernet, Magnus; Zha, Sigurd Zijun; Klæboe, Lars Gunnar; Larsen, Camilla Kjellstad; Aalen, John & Scheirlynck, Esther [Vis alle 14 forfattere av denne artikkelen] (2024). A deep learning based method for left ventricular strain measurements: repeatability and accuracy compared to experienced echocardiographers. BMC Medical Imaging. 24(1). doi: 10.1186/s12880-024-01470-7. Fulltekst i vitenarkiv Vis sammendrag

  Background Speckle tracking echocardiography (STE) provides quantification of left ventricular (LV) deformation and is useful in the assessment of LV function. STE is increasingly being used clinically, and every effort to simplify and standardize STE is important. Manual outlining of regions of interest (ROIs) is labor intensive and may influence assessment of strain values. Purpose We hypothesized that a deep learning (DL) model, trained on clinical echocardiographic exams, can be combined with a readily available echocardiographic analysis software, to automate strain calculation with comparable fidelity to trained cardiologists. Methods Data consisted of still frame echocardiographic images with cardiologist-defined ROIs from 672 clinical echocardiographic exams from a university hospital outpatient clinic. Exams included patients with ischemic heart disease, heart failure, valvular disease, and conduction abnormalities, and some healthy subjects. An EfficientNetB1-based architecture was employed, and different techniques and properties including data set size, data quality, augmentations, and transfer learning were evaluated. DL predicted ROIs were reintroduced into commercially available echocardiographic analysis software to automatically calculate strain values. Results DL-automated strain calculations had an average absolute difference of 0.75 (95% CI 0.58–0.92) for global longitudinal strain (GLS), and 1.16 (95% CI 1.03–1.29) for single-projection longitudinal strain (LS), compared to operators. A Bland–Altman plot revealed no obvious bias, though there were fewer outliers in the lower average LS ranges. Techniques and data properties yielded no significant increase/decrease in performance. Conclusion The study demonstrates that DL-assisted, automated strain measurements are feasible, and provide results within interobserver variation. Employing DL in echocardiographic analyses could further facilitate adoption of STE parameters in clinical practice and research, and improve reproducibility.

• Nyberg, John; Østvik, Andreas; Salte, Ivar Mjåland; Olaisen, Sindre Hellum; Karlsen, Sigve & Dahlslett, Thomas [Vis alle 14 forfattere av denne artikkelen] (2024). Deep learning improves test–retest reproducibility of regional strain in echocardiography. European Heart Journal – Imaging Methods and Practice (EHJ-IMP). 2(4). doi: 10.1093/ehjimp/qyae092. Fulltekst i vitenarkiv Vis sammendrag

  Aims: The clinical utility of regional strain measurements in echocardiography is challenged by suboptimal reproducibility. In this study, we aimed to evaluate the test–retest reproducibility of regional longitudinal strain (RLS) per coronary artery perfusion territory (RLSTerritory) and basal-to-apical level of the left ventricle (RLSLevel), measured by a novel fully automated deep learning (DL) method based on point tracking. Methods and results: We measured strain in a dual-centre test–retest data set that included 40 controls and 40 patients with suspected non-ST elevation acute coronary syndrome. Two consecutive echocardiograms per subject were recorded by different operators. The reproducibility of RLSTerritory and RLSLevel measured by the DL method and by three experienced observers using semi-automatic software (2D Strain, EchoPAC, GE HealthCare) was evaluated as minimal detectable change (MDC). The DL method had MDC for RLSTerritory and RLSLevel ranging from 3.6 to 4.3%, corresponding to a 33–35% improved reproducibility compared with the inter- and intraobserver scenarios (MDC 5.5–6.4% and 4.9–5.4%). Furthermore, the DL method had a lower variance of test–retest differences for both RLSTerritory and RLSLevel compared with inter- and intraobserver scenarios (all P < 0.001). Bland–Altman analyses demonstrated superior reproducibility by the DL method for the whole range of strain values compared with the best observer scenarios. The feasibility of the DL method was 93% and measurement time was only 1 s per echocardiogram. Conclusion: The novel DL method provided fully automated measurements of RLS, with improved test–retest reproducibility compared with semi-automatic measurements by experienced observers. RLS measured by the DL method has the potential to advance patient care through a more detailed, more efficient, and less user-dependent clinical assessment of myocardial function.

• Ntaios, George; Baumgartner, Helmut; Doehner, Wolfram; Donal, Erwan; Edvardsen, Thor & Healey, Jeff S. [Vis alle 16 forfattere av denne artikkelen] (2024). Embolic strokes of undetermined source: a clinical consensus statement of the ESC Council on Stroke, the European Association of Cardiovascular Imaging and the European Heart Rhythm Association of the ESC. European Heart Journal. ISSN 0195-668X. 45(19), s. 1701–1715. doi: 10.1093/eurheartj/ehae150. Fulltekst i vitenarkiv Vis sammendrag

  One in six ischaemic stroke patients has an embolic stroke of undetermined source (ESUS), defined as a stroke with unclear aetiology despite recommended diagnostic evaluation. The overall cardiovascular risk of ESUS is high and it is important to optimize strategies to prevent recurrent stroke and other cardiovascular events. The aim of clinicians when confronted with a patient not only with ESUS but also with any other medical condition of unclear aetiology is to identify the actual cause amongst a list of potential differential diagnoses, in order to optimize secondary prevention. However, specifically in ESUS, this may be challenging as multiple potential thromboembolic sources frequently coexist. Also, it can be delusively reassuring because despite the implementation of specific treatments for the individual pathology presumed to be the actual thromboembolic source, patients can still be vulnerable to stroke and other cardiovascular events caused by other pathologies already identified during the index diagnostic evaluation but whose thromboembolic potential was underestimated. Therefore, rather than trying to presume which particular mechanism is the actual embolic source in an ESUS patient, it is important to assess the overall thromboembolic risk of the patient through synthesis of the individual risks linked to all pathologies present, regardless if presumed causally associated or not. In this paper, a multi-disciplinary panel of clinicians/researchers from various backgrounds of expertise and specialties (cardiology, internal medicine, neurology, radiology and vascular surgery) proposes a comprehensive multi-dimensional assessment of the overall thromboembolic risk in ESUS patients through the composition of individual risks associated with all prevalent pathologies.

• Salte, Ivar Mjåland; Østvik, Andreas; Olaisen, Sindre Hellum; Karlsen, Sigve; Dahlslett, Thomas & Smistad, Erik [Vis alle 13 forfattere av denne artikkelen] (2023). Deep Learning for Improved Precision and Reproducibility of Left Ventricular Strain in Echocardiography: A Test-Retest Study. Journal of the American Society of Echocardiography. ISSN 0894-7317. 36(7), s. 788–799. doi: 10.1016/j.echo.2023.02.017. Fulltekst i vitenarkiv Vis sammendrag

  Aims Assessment of left ventricular (LV) function by echocardiography is hampered by modest test-retest reproducibility. A novel artificial intelligence (AI) method based on deep learning provides fully automated measurements of LV global longitudinal strain (GLS) and may improve the clinical utility of echocardiography by reducing user-related variability. The aim of this study was to assess within-patient test-retest reproducibility of LV GLS measured by the novel AI method in repeated echocardiograms recorded by different echocardiographers and to compare the results to manual measurements. Methods Two test-retest data sets (n = 40 and n = 32) were obtained at separate centers. Repeated recordings were acquired in immediate succession by 2 different echocardiographers at each center. For each data set, 4 readers measured GLS in both recordings using a semiautomatic method to construct test-retest interreader and intrareader scenarios. Agreement, mean absolute difference, and minimal detectable change (MDC) were compared to analyses by AI. In a subset of 10 patients, beat-to-beat variability in 3 cardiac cycles was assessed by 2 readers and AI. Results Test-retest variability was lower with AI compared with interreader scenarios (data set I: MDC = 3.7 vs 5.5, mean absolute difference = 1.4 vs 2.1, respectively; data set II: MDC = 3.9 vs 5.2, mean absolute difference = 1.6 vs 1.9, respectively; all P < .05). There was bias in GLS measurements in 13 of 24 test-retest interreader scenarios (largest bias, 3.2 strain units). In contrast, there was no bias in measurements by AI. Beat-to-beat MDCs were 1,5, 2.1, and 2.3 for AI and the 2 readers, respectively. Processing time for analyses of GLS by the AI method was 7.9 ± 2.8 seconds. Conclusion A fast AI method for automated measurements of LV GLS reduced test-retest variability and removed bias between readers in both test-retest data sets. By improving the precision and reproducibility, AI may increase the clinical utility of echocardiography.

• Aabel, Eivind Westrum; Dejgaard, Lars; Chivulescu, Ana Monica; Helle-Valle, Thomas Michael; Edvardsen, Thor & Hasselberg, Nina Eide [Vis alle 9 forfattere av denne artikkelen] (2023). Flecainide in patients with arrhythmic mitral valve syndrome: A case series. Heart Rhythm. ISSN 1547-5271. s. 1–2. doi: 10.1016/j.hrthm.2022.12.024. Fulltekst i vitenarkiv
• Erevik, Christine Bjørkvik; Kleiven, Øyunn; Frøysa, Vidar; Bjørkavoll-Bergseth, Magnus; Chivulescu, Ana Monica & Klæboe, Lars Gunnar [Vis alle 14 forfattere av denne artikkelen] (2023). Myocardial inefficiency is an early indicator of exercise-induced myocardial fatigue. Frontiers in Cardiovascular Medicine. 9, s. 1–12. doi: 10.3389/fcvm.2022.1081664. Fulltekst i vitenarkiv Vis sammendrag

  Background: The effect of prolonged, high-intensity endurance exercise on myocardial function is unclear. This study aimed to determine the left ventricular (LV) response to increased exercise duration and intensity using novel echocardiographic tools to assess myocardial work and fatigue.Materials and methods: LV function was assessed by echocardiography before, immediately, and 24 h after a cardiopulmonary exercise test (CPET) and a 91-km mountain bike leisure race. Cardiac Troponin I (cTnI) was used to assess myocyte stress.Results: 59 healthy recreational athletes, 52 (43–59) years of age, 73% males, were included. The race was longer and of higher intensity generating higher cTnI levels compared with the CPET (p < 0.0001): Race/CPET: exercise duration: 230 (210, 245)/43 (40, 45) minutes, mean heart rate: 154 ± 10/132 ± 12 bpm, max cTnI: 77 (37, 128)/12 (7, 23) ng/L. Stroke volume and cardiac output were higher after the race than CPET (p < 0.005). The two exercises did not differ in post-exercise changes in LV ejection fraction (LVEF) or global longitudinal strain (GLS). There was an increase in global wasted work (p = 0.001) following the race and a persistent reduction in global constructive work 24 h after exercise (p = 0.003).Conclusion: Increased exercise intensity and duration were associated with increased myocardial wasted work post-exercise, without alterations in LVEF and GLS from baseline values. These findings suggest that markers of myocardial inefficiency may precede reduction in global LV function as markers of myocardial fatigue.

• Nguyen, Thuy Mi; Melichova, Daniela; Aabel, Eivind Westrum; Lie, Øyvind Haugen; Klæboe, Lars Gunnar & Grenne, Bjørnar Leangen [Vis alle 10 forfattere av denne artikkelen] (2023). Mortality in Patients with Acute Coronary Syndrome—A Prospective 5-Year Follow-Up Study. Journal of Clinical Medicine. 12(20). doi: 10.3390/jcm12206598. Fulltekst i vitenarkiv Vis sammendrag

  Our objective was to compare long-term outcomes in patients with non-ST-elevation myocardial infarction (NSTEMI) and ST-elevation myocardial infarction (STEMI) between two time periods in Southern Norway. There are limited contemporary data comparing long-term follow-up after revascularization in the last decades. This prospective follow-up study consecutively included both NSTEMI and STEMI patients during two time periods, 2014–2015 and 2004–2009. Patients were followed up for a period of 5 years. The primary outcome was all-cause mortality after 1 and 5 years. A total of 539 patients with acute myocardial infarction (AMI), 316 with NSTEMI (234 included in 2014 and 82 included in 2007) and 223 with STEMI (160 included in 2014 and 63 included in 2004). Mortality after NSTEMI was high and remained unchanged during the two time periods (mortality rate at 1 year: 3.5% versus 4.9%, p = 0.50; and 5 years: 11.4% versus 14.6%, p = 0.40). Among STEMI patients, all-cause mortality at 1 year was reduced in 2014 compared to 2004 (1.3% versus 11.1%, p < 0.001; and 5 years: 7.0% versus 22.2%, p = 0.004, respectively). Time to coronary angiography in NSTEMI patients remained unchanged between 2014 and 2007 (28.2 h [IQR 18.1–46.3] versus 30.3 h [IQR 18.0–48.3], p = 0.20), while time to coronary angiography in STEMI patients was improved in 2014 compared with 2004 (2.8 h [IQR 2.0–4.8] versus 21.7 h [IQR 5.4–27.1], p < 0.001), respectively. During one decade of AMI treatment, mortality in patients with NSTEMI remained unchanged while mortality in STEMI patients decreased, both at 1 and 5 years.

• Santoro, Ciro; Donal, Erwan; Magne, Julien; Sade, Leyla Elif; Penicka, Martin & Katbeh, Asim [Vis alle 36 forfattere av denne artikkelen] (2023). Inter-center reproducibility of standard and advanced echocardiographic parameters in the EACVI-AFib echo registry. Echocardiography. ISSN 0742-2822. doi: 10.1111/echo.15640. Fulltekst i vitenarkiv
• Andreassen, Kristine; Rixon, Chloe Louise; Haugsten, Marie Hansen; Hauge-Iversen, Ida Marie; Zhang, Lili & Sadredini, Mani [Vis alle 13 forfattere av denne artikkelen] (2023). Beneficial effects of exercise initiated before development of hypertrophic cardiomyopathy in genotype-positive mice. American Journal of Physiology. Heart and Circulatory Physiology. ISSN 0363-6135. 324(6), s. H881–H892. doi: 10.1152/ajpheart.00701.2022. Fulltekst i vitenarkiv
• Neglia, Danilo; Liga, Riccardo; Gimelli, Alessia; Podlesnikar, Tomaž; Cvijić, Marta & Pontone, Gianluca [Vis alle 30 forfattere av denne artikkelen] (2023). Use of cardiac imaging in chronic coronary syndromes: the EURECA Imaging registry. European Heart Journal. ISSN 0195-668X. 44(2), s. 142–158. doi: 10.1093/eurheartj/ehac640. Fulltekst i vitenarkiv
• Cosyns, Bernard; Sade, Leyla Elif; Gerber, Bernhard L.; Gimelli, Alessia; Muraru, Denisa & Maurer, Gerald [Vis alle 7 forfattere av denne artikkelen] (2023). The year 2021 in the European Heart Journal: Cardiovascular Imaging Part II. European Heart Journal-Cardiovascular Imaging. ISSN 2047-2404. 24(3), s. 276–284. doi: 10.1093/ehjci/jeac273. Fulltekst i vitenarkiv
• Pezel, Théo; Coisne, Augustin; Michalski, Błażej; Soliman, Hatem; Ajmone, Nina & Nijveldt, Robin [Vis alle 14 forfattere av denne artikkelen] (2023). EACVI SIMULATOR-online study: evaluation of transoesophageal echocardiography knowledge and skills of young cardiologists. European Heart Journal-Cardiovascular Imaging. ISSN 2047-2404. 24(3), s. 285–292. doi: 10.1093/ehjci/jeac195. Fulltekst i vitenarkiv
• Abdullah, Rang; Bjørnebekk, Astrid Kristine; Hauger, Lisa Evju; Hullstein, Ingunn Riise; Edvardsen, Thor & Haugaa, Kristina Ingrid Helena Hermann [Vis alle 7 forfattere av denne artikkelen] (2023). Severe biventricular cardiomyopathy in both current and former long-term users of anabolic-androgenic steroids. European Journal of Preventive Cardiology (EJPC). ISSN 2047-4873. 31(5), s. 599–608. doi: 10.1093/eurjpc/zwad362. Fulltekst i vitenarkiv Vis sammendrag

  Abstract Aims This study aims to explore the cardiovascular effects of long-term anabolic–androgenic steroid (AAS) use in both current and former weightlifting AAS users and estimate the occurrence of severe reduced myocardial function and the impact of duration and amount of AAS. Methods and results In this cross-sectional study, 101 weightlifting AAS users with at least 1 year cumulative AAS use (mean 11 ± 7 accumulated years of AAS use) were compared with 71 non-using weightlifting controls (WLC) using clinical data and echocardiography. Sixty-nine were current, 30 former (&amp;gt;1 year since quitted), and 2 AAS users were not available for this classification. Anabolic–androgenic users had higher left ventricular mass index (LVMI) (106 ± 26 vs. 80 ± 15 g/m2, P &amp;lt; 0.001), worse left ventricular ejection fraction (LVEF) (49 ±7 vs. 59 ± 5%, P &amp;lt; 0.001) and right ventricular global longitudinal strain (−17.3 ± 3.5 vs. −22.8 ± 2.0%, P &amp;lt; 0.001), and higher systolic blood pressure (141 ± 17 vs. 133 ± 11 mmHg, P &amp;lt; 0.001) compared with WLC. In current users, accumulated duration of AAS use was 12 ± 7 years and in former 9 ± 6 years (quitted 6 ± 6 years earlier). Compared with WLC, LVMI and LVEF were pathological in current and former users (P &amp;lt; 0.05) with equal distribution of severely reduced myocardial function (LVEF ≤40%) (11 vs. 10%, not significant (NS)). In current users, estimated lifetime AAS dose correlated with reduced LVEF and LVGLS, P &amp;lt; 0.05, but not with LVMI, P = 0.12. Regression analyses of the total population showed that the strongest determinant of reduced LVEF was not coexisting strength training or hypertension but history of AAS use (β −0.53, P &amp;lt; 0.001). Conclusion Long-term AAS users showed severely biventricular cardiomyopathy. The reduced systolic function was also found upon discontinued use.

• Forså, Marianne Inngjerdingen; Bjerring, Anders W.; Haugaa, Kristina Ingrid Helena Hermann; Smedsrud, Marit Kristine; Sarvari, Sebastian & Landgraff, Hege Elisabeth W. [Vis alle 8 forfattere av denne artikkelen] (2023). Young athlete's growing heart: sex differences in cardiac adaptation to exercise training during adolescence. Open heart. 10(1). doi: 10.1136/openhrt-2022-002155. Fulltekst i vitenarkiv Vis sammendrag

  Background: Athlete’s heart is a condition of exercise-induced cardiac remodelling. Adult male endurance athletes more often remodel beyond reference values. The impact of sex on remodelling through adolescence remains unclear. Paediatric reference values do not account for patient sex or exercise history. We aimed to study the effect of sex on cardiac remodelling throughout adolescence. Methods: We recruited 76 male (M) and female (F) 12-year-old cross-country skiers in a longitudinal cohort study. Echocardiography was performed and analysed according to guidelines at age 12 (48 M, 28 F), 15 (34 M, 14 F) and 18 (23 M, 11 F). Repeated echocardiographic measurements were analysed by linear mixed model regression. Results: Males displayed greater indexed left ventricular end-diastolic volumes (LV EDVi) from age 12 (M 81±7 vs F 76±7, mL/m², p≤0.01), and progressed further until follow-up at age 18 (M 2.3±9.7 vs F −3.9±4.5 ΔmL/m², p≤0.01). LV EDVi remained above adult upper reference values in both groups. Males increased LV Mass Index from age 12 to 18 (M 33±27 vs F 4±19, Δg/m², p≤0.01). Males displayed LV mass above paediatric reference values at ages 15 and 18. A subset of males (35%) and females (25%) displayed wall thickness above paediatric reference values at age 12. Cardiac function was normal. There was no sex difference in exercise hours. Conclusion: Sex-related differences in athlete’s heart were evident from age 12, and progressed throughout adolescence. Remodelling beyond reference values was more frequent than previously reported, particularly affecting males. Age, sex and exercise history may assist clinicians in distinguishing exercise-induced remodelling from pathology in adolescents.

• Forså, Marianne Inngjerdingen; Smedsrud, Marit Kristine; Haugaa, Kristina Ingrid Helena Hermann; Bjerring, Anders W.; Fruh, Andreas & Sarvari, Sebastian [Vis alle 9 forfattere av denne artikkelen] (2023). Distinguishing left ventricular hypertrophy from hypertrophic cardiomyopathy in adolescents: a longitudinal observation study. European Journal of Preventive Cardiology (EJPC). ISSN 2047-4873. 31(5), s. 591–598. doi: 10.1093/eurjpc/zwad361. Fulltekst i vitenarkiv Vis sammendrag

  Aims: Echocardiographic characteristics to distinguish physiological left ventricular (LV) hypertrophy from pathology are warranted in early adolescent athletes. This study aimed to explore the phenotype, progression, and potential grey zone of LV hypertrophy during adolescence in athletes and hypertrophic cardiomyopathy (HCM) genotype–positive patients. Methods and results: In this longitudinal observation study, we compared seventy-six 12-year-old athletes with 55 age-matched and sex-matched HCM genotype–positive patients. Echocardiographic parameters were evaluated by using paediatric reference values (Z-scores). Hypertrophic cardiomyopathy genotype–positive patients were included if they had no or mild LV hypertrophy [maximum wall thickness <13 mm, Z-score <6 for interventricular septum diameter (ZIVSd), or posterior wall thickness]. We collected clinical data, including data on cardiac events. The mean follow-up-time was 3.2 ± 0.8 years. At baseline, LV hypertrophy was found in 28% of athletes and 21% of HCM genotype–positive patients (P = 0.42). Septum thickness values were similar (ZIVSd 1.4 ± 0.9 vs. 1.0 ± 1.3, P = 0.08) and increased only in HCM genotype–positive patients {ZIVSd progression rate −0.17 [standard error (SE) 0.05], P = 0.002 vs. 0.30 [SE 0.10], P = 0.001}. Left ventricular volume Z-scores (ZLVEDV) were greater in athletes [ZLVEDV 1.0 ± 0.6 vs. −0.1 ± 0.8, P < 0.001; ZLVEDV progression rate −0.05 (SE 0.04), P = 0.21 vs. −0.06 (SE 0.04), P = 0.12]. Cardiac arrest occurred in two HCM genotype–positive patients (ages 13 and 14), with ZIVSd 8.2–11.5. Conclusion: Left ventricular hypertrophy was found in a similar proportion in early adolescence but progressed only in HCM genotype–positive patients. A potential grey zone of LV hypertrophy ranged from a septum thickness Z-score of 2.0 to 3.3. Left ventricular volumes remained larger in athletes. Evaluating the progression of wall thickness and volume may help clinicians distinguish physiological LV hypertrophy from early HCM.

• Sade, Leyla Elif; Joshi, Shruti S.; Cameli, Matteo; Cosyns, Bernard; Delgado, Victoria & Donal, Erwan [Vis alle 14 forfattere av denne artikkelen] (2023). Current clinical use of speckle-tracking strain imaging: insights from a worldwide survey from the European Association of Cardiovascular Imaging (EACVI). European Heart Journal-Cardiovascular Imaging. ISSN 2047-2404. 24(12), s. 1583–1592. doi: 10.1093/ehjci/jead170. Fulltekst i vitenarkiv
• Zha, Sigurd Zijun; Rogstadkjernet, Magnus; Klæboe, Lars Gunnar; Skulstad, Helge; Singstad, Bjørn-Jostein & Gilbert, Andrew David [Vis alle 9 forfattere av denne artikkelen] (2023). Deep learning for automated left ventricular outflow tract diameter measurements in 2D echocardiography. Cardiovascular Ultrasound. 21(1), s. 1–11. doi: 10.1186/s12947-023-00317-5. Fulltekst i vitenarkiv Vis sammendrag

  Background Measurement of the left ventricular outflow tract diameter (LVOTd) in echocardiography is a common source of error when used to calculate the stroke volume. The aim of this study is to assess whether a deep learning (DL) model, trained on a clinical echocardiographic dataset, can perform automatic LVOTd measurements on par with expert cardiologists. Methods Data consisted of 649 consecutive transthoracic echocardiographic examinations of patients with coronary artery disease admitted to a university hospital. 1304 LVOTd measurements in the parasternal long axis (PLAX) and zoomed parasternal long axis views (ZPLAX) were collected, with each patient having 1–6 measurements per examination. Data quality control was performed by an expert cardiologist, and spatial geometry data was preserved for each LVOTd measurement to convert DL predictions into metric units. A convolutional neural network based on the U-Net was used as the DL model. Results The mean absolute LVOTd error was 1.04 (95% confidence interval [CI] 0.90–1.19) mm for DL predictions on the test set. The mean relative LVOTd errors across all data subgroups ranged from 3.8 to 5.1% for the test set. Generally, the DL model had superior performance on the ZPLAX view compared to the PLAX view. DL model precision for patients with repeated LVOTd measurements had a mean coefficient of variation of 2.2 (95% CI 1.6–2.7) %, which was comparable to the clinicians for the test set. Conclusion DL for automatic LVOTd measurements in PLAX and ZPLAX views is feasible when trained on a limited clinical dataset. While the DL predicted LVOTd measurements were within the expected range of clinical inter-observer variability, the robustness of the DL model requires validation on independent datasets. Future experiments using temporal information and anatomical constraints could improve valvular identification and reduce outliers, which are challenges that must be addressed before clinical utilization. Graphical Abstract

• Edvardsen, Thor; Donal, Erwan; Muraru, Denisa; Gimelli, Alessia; Fontes-Carvalho, Ricardo & Maurer, Gerald [Vis alle 8 forfattere av denne artikkelen] (2022). The year 2021 in the European Heart Journal-Cardiovascular Imaging: Part I. European Heart Journal-Cardiovascular Imaging. ISSN 2047-2404. 23(12), s. 1576–1583. doi: 10.1093/ehjci/jeac210. Fulltekst i vitenarkiv
• Smedsrud, Marit Kristine; Chivulescu, Ana Monica; Forså, Marianne Inngjerdingen; Castrini, Anna Isotta; Aabel, Eivind Westrum & Rootwelt-Norberg, Christine [Vis alle 11 forfattere av denne artikkelen] (2022). Highly malignant disease in childhood-onset arrhythmogenic right ventricular cardiomyopathy. European Heart Journal. ISSN 0195-668X. 43(45), s. 4694–4703. doi: 10.1093/eurheartj/ehac485. Fulltekst i vitenarkiv
• Baigent, Colin; Windecker, Stephan; Andreini, Daniele; Arbelo, Elena; Barbato, Emanuele & Bartorelli, Antonio L. [Vis alle 67 forfattere av denne artikkelen] (2022). ESC guidance for the diagnosis and management of cardiovascular disease during the COVID-19 pandemic: part 2-care pathways, treatment, and follow-up. European Heart Journal. ISSN 0195-668X. 43(11), s. 1059–1103. doi: 10.1093/eurheartj/ehab697. Fulltekst i vitenarkiv
• Baigent, Colin; Windecker, Stephan; Andreini, Daniele; Arbelo, Elena; Barbato, Emanuele & Bartorelli, Antonio L. [Vis alle 67 forfattere av denne artikkelen] (2022). European Society of Cardiology guidance for the diagnosis and management of cardiovascular disease during the COVID-19 pandemic: part 1 - epidemiology, pathophysiology, and diagnosis. Cardiovascular Research (CVR). ISSN 0008-6363. 118(6), s. 1385–1412. doi: 10.1093/cvr/cvab342. Fulltekst i vitenarkiv
• Aabel, Eivind Westrum; Chivulescu, Ana Monica; Lie, Øyvind Haugen; Hopp, Einar; Gjertsen, Erik & Ribe, Margareth [Vis alle 11 forfattere av denne artikkelen] (2022). Ventricular arrhythmias in arrhythmic mitral valve syndrome - a prospective continuous long-term cardiac monitoring study. Europace. ISSN 1099-5129. 25(2), s. 506–516. doi: 10.1093/europace/euac182. Fulltekst i vitenarkiv Vis sammendrag

  Aims Arrhythmic mitral valve syndrome is linked to life-threatening ventricular arrhythmias. The incidence, morphology and methods for risk stratification are not well known. This prospective study aimed to describe the incidence and the morphology of ventricular arrhythmia and propose risk stratification in patients with arrhythmic mitral valve syndrome. Methods Arrhythmic mitral valve syndrome patients were monitored for ventricular tachyarrhythmias by implantable loop recorders (ILR) and secondary preventive implantable cardioverter-defibrillators (ICD). Severe ventricular arrhythmias included ventricular fibrillation, appropriate or aborted ICD therapy, sustained ventricular tachycardia and non-sustained ventricular tachycardia with symptoms of hemodynamic instability. Results During 3.1 years of follow-up, severe ventricular arrhythmia was recorded in seven (12%) of 60 patients implanted with ILR [first event incidence rate 4% per person-year, 95% confidence interval (CI) 2–9] and in four (20%) of 20 patients with ICD (re-event incidence rate 8% per person-year, 95% CI 3–21). In the ILR group, severe ventricular arrhythmia was associated with frequent premature ventricular complexes, more non-sustained ventricular tachycardias, greater left ventricular diameter and greater posterolateral mitral annular disjunction distance (all P < 0.02). Conclusions The yearly incidence of ventricular arrhythmia was high in arrhythmic mitral valve syndrome patients without previous severe arrhythmias using continuous heart rhythm monitoring. The incidence was even higher in patients with secondary preventive ICD. Frequent premature ventricular complexes, non-sustained ventricular tachycardias, greater left ventricular diameter and greater posterolateral mitral annular disjunction distance were predictors of first severe arrhythmic event.

• Baigent, Colin; Windecker, Stephan; Andreini, Daniele; Arbelo, Elena; Barbato, Emanuele & Bartorelli, Antonio L. [Vis alle 67 forfattere av denne artikkelen] (2022). European Society of Cardiology guidance for the diagnosis and management of cardiovascular disease during the COVID-19 pandemic: part 1-epidemiology, pathophysiology, and diagnosis. European Heart Journal. ISSN 0195-668X. 43(11), s. 1033–1058. doi: 10.1093/eurheartj/ehab696. Fulltekst i vitenarkiv
• Marwick, Thomas H.; Gimelli, Alessia; Plein, Sven; Bax, Jeroen J; Charron, Phillippe & Delgado, Victoria [Vis alle 25 forfattere av denne artikkelen] (2022). Multimodality imaging approach to left ventricular dysfunction in diabetes: An expert consensus document from the European Association of Cardiovascular Imaging. European Heart Journal-Cardiovascular Imaging. ISSN 2047-2404. 23(2), s. E62–E84. doi: 10.1093/ehjci/jeab220. Fulltekst i vitenarkiv
• Joshi, Shruti S.; Stankovic, Ivan; Demirkiran, Ahmet; Haugaa, Kristina Ingrid Helena Hermann; Maurovich-Horvat, Pal & Popescu, Bogdan A [Vis alle 12 forfattere av denne artikkelen] (2022). EACVI survey on burnout amongst cardiac imaging specialists during the 2019 coronavirus disease pandemic. European Heart Journal-Cardiovascular Imaging. ISSN 2047-2404. 23(4), s. 441–446. doi: 10.1093/ehjci/jeac002. Fulltekst i vitenarkiv
• Benfari, Giovanni; Mandoli, Giulia Elena; Magne, Julien; Miglioranza, Marcelo Haertel; Ancona, Roberta & Luksic, Vlatka Reskovic [Vis alle 16 forfattere av denne artikkelen] (2022). Left atrial strain determinants and clinical features according to the heart failure stages. New insight from EACVI MASCOT registry. The International Journal of Cardiovascular Imaging. ISSN 1569-5794. doi: 10.1007/s10554-022-02669-x. Fulltekst i vitenarkiv Vis sammendrag

  Abstract Few studies analyzed left atrial (LA) peak atrial longitudinal strain (PALS) determinants, particularly across heart failure (HF) stages. We aimed to analyze the pathophysiological and clinical PALS correlates in a large multicentric prospective study. This is a multicenter prospective observational study enrolling 745 patients with HF stages. Data included PALS and left ventricular global longitudinal strain (LV-GLS). Exclusion criteria were: valvular prosthesis; atrial fibrillation; cardiac transplantation; poor acoustic window. Median global PALS was 17% [24–32]. 29% of patients were in HF-stage 0/A, 35% in stage-B, and 36% in stage-C. Together with age, the echocardiographic determinants of PALS were LA volume and LV-GLS (overall model R 2  = 0.50, p &lt; 0.0001). LV-GLS had the strongest association with PALS at multivariable analysis (beta: −3.60 ± 0.20, p &lt; 0.0001). Among HF stages, LV-GLS remained the most important PALS predictor (p &lt; 0.0001) whereas age was only associated with PALS in lower HF-stage 0/A or B (R = − 0.26 p &lt; 0.0001, R = − 0.23 p = 0.0001). LA volume increased its association to PALS moving from stage 0/A (R = − 0.11; P = 0.1) to C (R = − 0.42; P &lt; 0.0001). PALS was the single most potent echocardiographic parameter in predicting the HF stage (AUC for B vs. 0/A 0.81, and AUC vs. 0/A for C 0.76). PALS remained independently associated with HF stages after adjusting for ejection fraction, E/e′ ratio, and mitral regurgitation grade (p &lt; 0.0001). Although influenced by LV-GLS and LA size across HF stages, PALS is incrementally and independently associated with clinical status. LA function may reflect a substantial part of the hemodynamic consequences of ventricular dysfunction.

• Norum, Ingvild Billehaug; Otterstad, Jan Erik; Ruddox, Vidar; Bendz, Bjørn & Edvardsen, Thor (2022). Novel regional longitudinal strain by speckle tracking to detect significant coronary artery disease in patients admitted to the emergency department for chest pain suggestive of acute coronary syndrome. Journal of Echocardiography. ISSN 1349-0222. 20(3), s. 166–177. doi: 10.1007/s12574-022-00568-7. Fulltekst i vitenarkiv Vis sammendrag

  Background Global longitudinal strain has shown variable results in detecting ischemia in patients admitted to the emergency department with chest pain, but without other clear evidence of coronary artery disease (CAD). Our aim was to investigate whether assessment of regional longitudinal myocardial function could assist in detecting significant CAD in these patients. Methods Clinical evaluation, electrocardiogram, echocardiogram and troponin T were evaluated in 126 patients admitted with chest pain. A subsequent invasive coronary angiography divided patients into two groups: significant CAD (CAD+) or non-significant CAD (CAD−). Global and regional myocardial function were evaluated by speckle tracking echocardiography. Regional longitudinal strain was defined as the highest longitudinal strain values in four adjacent left ventricular segments and termed 4AS. Results CAD+ was found in 37 patients (29%) of which 51% had elevated troponin. Mean 4AS was − 13.1% (± 3.5) in the CAD+ and − 15.2% (± 2.7) (p = 0.002) in the CAD− group. Predictors for CAD+ were age [OR 1.06 (1.01–1.11, p = 0.026)], smoking [OR 3.39 (1.21–9.51, p = 0.020)], troponin [OR 3.32 (1.28–8.60, p = 0.014)) and 4AS (OR 1.24 (1.05–1.46, p = 0.010)]. A cutoff for 4AS of > − 15% showed the best diagnostic performance with event-reclassification of 0.41 (p < 0.001), non-event-reclassification of − 0.34 (p < 0.001) and net reclassification improvement 0.07 (p = 0.60). Conclusion Decreased myocardial function in four adjacent LV segments assessed by strain has the potential to detect significant CAD in patients admitted with chest pain and negative/slightly elevated initial troponin.

• Andreassen, Kristine; Dejgaard, Lars; Lie, Øyvind Haugen; Håland, Trine Synnøve Fink; Lunde, Ida Gjervold & Edvardsen, Thor [Vis alle 8 forfattere av denne artikkelen] (2022). Exercise training during childhood and adolescence is associated with favorable diastolic function in hypertrophic cardiomyopathy. International Journal of Cardiology. ISSN 0167-5273. 364, s. 65–71. doi: 10.1016/j.ijcard.2022.06.042. Fulltekst i vitenarkiv Vis sammendrag

  Background Diastolic dysfunction is an important part of the clinical phenotype in hypertrophic cardiomyopathy (HCM). While exercise training is known to improve left ventricular (LV) diastolic function in normal hearts, the effects of exercise training during childhood and adolescence in carriers of HCM-associated genetic variants are unknown. Methods In a cross-sectional and retrospective study, we combined clinical and echocardiographic data with history of exercise training from childhood to time of examination in 187 participants with HCM or an HCM-causative genotype. Multiple linear regression was used to identify correlations between exercise training performed prior to 20 years of age and LV diastolic parameters from echocardiography. Results Exercise training during childhood and adolescence was correlated with a favorable e’, E/e’, E deceleration time, and end-diastolic volume (EDV), when adjusting for the effects of age at examination, and presence of left ventricular hypertrophy (LVH). This correlation was evident both in patients with a HCM phenotype (HCM LVH+), and in individuals with an HCM-causative genotype without LV hypertrophy (G+ LVH-). None of the diastolic parameters correlated unfavorably with increasing exercise exposure. Conclusion More exercise training during childhood and adolescence was associated with favorable LV diastolic function in both HCM LVH+ and G+ LVH- groups, regardless of presence of hypertrophy at the time of examination. These results indicate that exercise training initiated during childhood and adolescence has positive effects on cardiac function later in life for individuals with HCM or an HCM-causative genotype.

• Myhre, Peder Langeland; Røsjø, Helge Rørvik; Sarvari, Sebastian; Ukkonen, Heikki; Rademakers, Frank & Engvall, Jan E. [Vis alle 14 forfattere av denne artikkelen] (2022). Cardiac troponin T and NT-proBNP for detecting myocardial ischemia in suspected chronic coronary syndrome. International Journal of Cardiology. ISSN 0167-5273. 361, s. 14–17. doi: 10.1016/j.ijcard.2022.05.027. Fulltekst i vitenarkiv Vis sammendrag

  Background Elevated N-terminal pro-B-type natriuretic peptides (NT-proBNP) and cardiac troponin T (cTnT) are associated with poor outcome in patients with chronic coronary syndrome (CCS). The performance of these biomarkers in diagnosing ischemia, and their association with myocardial hypoperfusion and hypokinesis is unclear. Methods Patients with suspected CCS (history of angina, estimated cardiovascular risk >15% or a positive stress test) were included in the prospective, multi-center DOPPLER-CIP study. Patients underwent Single Positron Emission Computed Tomography for assessment of ischemia and NT-proBNP and cTnT were measured in venous blood samples. Results We included 430 patients (25% female) aged 64 ± 8 years. Reversible hypoperfusion and hypokinesis were present in 139 (32%) and 89 (21%), respectively. Concentrations of NT-proBNP and cTnT correlated moderately (rho = 0.50, p < 0.001). NT-proBNP and cTnT concentrations (median [IQR]) were higher in patients with versus without reversible ischemia: 150 (73–294) versus 87 (44–192) ng/L and 10 (6–13) versus 7 (4–11) ng/L, respectively (p < 0.001 for both), and the associations persisted after adjusting for possible confounders. The C-statistics to discriminate ischemia ranged from 63%–73%, were comparable for cTnT and NT-proBNP, and higher for hypokinesis than hypoperfusion, and both were superior to exercise electrocardiography and stress echocardiography. Very low concentrations (≤5 ng/L cTnT and ≤ 60 ng/L NT-proBNP) ruled out reversible hypokinesis with negative predictive value >90%. Conclusion cTnT and NT-proBNP are associated with irreversible and reversible ischemia in patients with suspected CCS, particularly hypokinesis. The diagnostic performance was comparable between the biomarkers, and very low concentrations may reliably rule out ischemia.

• Kvaslerud, Anette Borger; Bardan, Sara; Andresen, Kristoffer; Kløve, Sophie Foss; Fagerland, Morten & Edvardsen, Thor [Vis alle 8 forfattere av denne artikkelen] (2022). Intravenous iron supplement for iron deficiency in patients with severe aortic stenosis scheduled for transcatheter aortic valve implantation: results of the IIISAS randomised trial. European Journal of Heart Failure. ISSN 1388-9842. 24(7), s. 1269–1279. doi: 10.1002/ejhf.2557. Fulltekst i vitenarkiv Vis sammendrag

  Aims The aim of this trial was to evaluate whether intravenous iron could provide benefit beyond transcatheter aortic valve implantation (TAVI) in iron-deficient patients with severe aortic stenosis. Methods and results In this randomised, placebo-controlled, double-blind, single-centre trial, we enrolled patients with severe aortic stenosis and iron deficiency (defined as ferritin <100 µg/L, or 100–299 µg/L with a transferrin saturation <20%) who were evaluated for TAVI. Patients were randomly assigned (1:1) to receive intravenous ferric derisomaltose or placebo ∼3 months before TAVI. The primary endpoint was the between-group, baseline-adjusted 6-min walk distance measured 3 months after TAVI. Secondary outcomes included quality of life, iron stores, hand grip strength, New York Heart Association (NYHA) class, and safety. Between January 2020 and September 2021, we randomised 74 patients to ferric derisomaltose and 75 patients to placebo. The modified intention-to-treat population comprised the 104 patients who completed the 6-min walk test at baseline and 3 months after successful TAVI. Iron stores were restored in 76% of the patients allocated to iron and 13% of the patients allocated to placebo (p < 0.001). There was no difference in the baseline-adjusted 6-min walk distance between the two treatment arms (p = 0.82). The number of serious adverse events, quality of life, hand grip strength, and NYHA class did not differ between the treatment arms. Conclusion Treatment with intravenous iron did not provide clinical benefit beyond TAVI in iron-deficient patients with severe aortic stenosis. Clinical Trial Registration: ClinicalTrials.gov NCT04206228.

• Edvardsen, Thor; Asch, Federico M.; Davidson, Brian; Delgado, Victoria; DeMaria, Anthony & Dilsizian, Vasken [Vis alle 20 forfattere av denne artikkelen] (2022). Non-invasive imaging in coronary syndromes: recommendations of the European Association of Cardiovascular Imaging and the American Society of Echocardiography, in collaboration with the American Society of Nuclear Cardiology, Society of Cardiovascular Computed Tomography, and Society for Cardiovascular Magnetic Resonance. European Heart Journal-Cardiovascular Imaging. ISSN 2047-2404. 23(2), s. e6–e33. doi: 10.1093/ehjci/jeab244. Fulltekst i vitenarkiv
• Smiseth, Otto A.; Morris, Daniel A.; Cardim, Nuno; Cikes, Maja; Delgado, Victoria & Donal, Erwan [Vis alle 19 forfattere av denne artikkelen] (2022). Multimodality imaging in patients with heart failure and preserved ejection fraction: an expert consensus document of the European Association of Cardiovascular Imaging. European Heart Journal-Cardiovascular Imaging. ISSN 2047-2404. 23(2), s. e34–e61. doi: 10.1093/ehjci/jeab154. Fulltekst i vitenarkiv
• Karlsen, Sigve; Melichova, Daniela; Dahlslett, Thomas; Grenne, Bjørnar; Sjøli, Benthe & Smiseth, Otto A. [Vis alle 8 forfattere av denne artikkelen] (2022). Increased deformation of the left ventricle during exercise test measured by global longitudinal strain can rule out significant coronary artery disease in patients with suspected unstable angina pectoris. Echocardiography. ISSN 0742-2822. 39(2), s. 233–239. doi: 10.1111/echo.15295. Fulltekst i vitenarkiv Vis sammendrag

  Background Noninvasive identification of significant coronary artery disease (CAD) in patients with unstable angina pectoris (UAP) is challenging. Exercise stress testing has been used for years in patients with suspected CAD but has low diagnostic accuracy. The use of Global longitudinal strain (GLS) by speckle tracking echocardiography is a highly sensitive and reproducible parameter for detection of myocardial ischemia. Our aim was to study if identification of normal or ischemic myocardium by measurement of GLS immediately after an ordinary bicycle exercise stress testing in patients with suspected UAP could identify or rule out significant CAD. Methods Seventy-eight patients referred for coronary angiography from outpatient clinics and the emergency department with chest pain, inconclusive ECG and normal values of Troponin-T was included. All patients underwent echocardiographic examination at rest and immediately after maximum stress by exercise on a stationary bicycle. Significant CAD was defined by diameter stenosis > 90% by coronary angiography. In patients with coronary stenosis between 50–90%, fractional flow reserve (FFR) was measured and defined abnormal < .80. Analysis of echocardiographic data were performed blinded for angiographic data. Patients were discharged diagnosed with CAD (n = 34) or non-coronary chest pain (NCCP, n = 44). Results In patients with NCCP, GLS at rest was -21.1 ± 1.7% and -25.5 ± 2.6% at maximum stress (P < .01). In patients with CAD, GLS at rest was -16.8 ± 4.0% and remained unchanged at maximum stress (-16.6 ± 4.6%, P = .69). In patients with NCCP, LVEF was 56.1% ± 6.0 and increased to 61.8% 5.2, P < .01. In CAD patients, LVEF at rest was 54.7% ± 8.6 and increased to 58.2% ± 9.5 during stress, P = .16. In NCCP patients, Wall Motion Score index decreased .02 ± .07, P = .03 during stress and was without significant changes in patients with CAD. Area under the curve (AUC) for distinguishing CAD for was .97 (.95-1.00), .63 (.49-.76), and .71 (.59-.83) for GLS, LVEF, and WMSi, respectively. Conclusion In patients with suspected UAP, increased deformation of the left ventricle measured by GLS immediately after exercise stress testing identified normal myocardium without CAD. Reduced LV contractile function by GLS without increase after exercise identified significant CAD.

• Castrini, Anna Isotta; Skjølsvik, Eystein Theodor Ek; Estensen, Mette-Elise; Almaas, Vibeke Marie; Skulstad, Helge & Lyseggen, Erik [Vis alle 11 forfattere av denne artikkelen] (2022). Pregnancy and progression of cardiomyopathy in women With LMNA genotype-positive. Journal of the American Heart Association (JAHA). 11:e024960(8), s. 1–12. doi: 10.1161/JAHA.121.024960. Fulltekst i vitenarkiv
• Chivulescu, Ana Monica; Aabel, Eivind Westrum; Gjertsen, Erik; Hopp, Einar; Scheirlynck, Esther Steffie & Cosyns, Bernard [Vis alle 11 forfattere av denne artikkelen] (2022). Electrical markers and arrhythmic risk associated with myocardial fibrosis in mitral valve prolapse. Europace. ISSN 1099-5129. 24(7), s. 1156–1163. doi: 10.1093/europace/euac017. Fulltekst i vitenarkiv Vis sammendrag

  Abstract Aims We aimed to characterize the substrate of T-wave inversion (TWI) using cardiac magnetic resonance (CMR) and the association between diffuse fibrosis and ventricular arrhythmias (VA) in patients with mitral valve prolapse (MVP). Methods and results TWI was defined as negative T-wave ≥0.1 mV in ≥2 adjacent ECG leads. Diffuse myocardial fibrosis was assessed by T1 relaxation time and extracellular volume (ECV) fraction by T1-mapping CMR. We included 162 patients with MVP (58% females, age 50 ± 16 years), of which 16 (10%) patients had severe VA (aborted cardiac arrest or sustained ventricular tachycardia). TWI was found in 34 (21%) patients. Risk of severe VA increased with increasing number of ECG leads displaying TWI [OR 1.91, 95% CI (1.04–3.52), P = 0.04]. The number of ECG leads displaying TWI increased with increasing lateral ECV (26 ± 3% for TWI 0-1leads, 28 ± 4% for TWI 2leads, 29 ± 5% for TWI ≥3leads, P = 0.04). Patients with VA (sustained and non-sustained ventricular tachycardia) had increased lateral T1 (P = 0.004), also in the absence of late gadolinium enhancement (LGE) (P = 0.008). Conclusions Greater number of ECG leads with TWI reflected a higher arrhythmic risk and higher degree of lateral diffuse fibrosis by CMR. Lateral diffuse fibrosis was associated with VA, also in the absence of LGE. These results suggest that TWI may reflect diffuse myocardial fibrosis associated with VA in patients with MVP. T1-mapping CMR may help risk stratification for VA.

• Azevedo, A.C.A.; Barros, M.V.L.; Klaboe, L.G.; Edvardsen, Thor; Costa, H.S. & Paixao, G.M.M. [Vis alle 9 forfattere av denne artikkelen] (2021). Association between myocardial mechanical dispersion and ventricular arrhythmogenicity in chagas cardiomyopathy. The International Journal of Cardiovascular Imaging. ISSN 1569-5794. 37(9), s. 2727–2734. doi: 10.1007/s10554-021-02246-8. Fulltekst i vitenarkiv
• Budts, Werner; Miller, Owen; Babu-Narayan, Sonya V.; Li, Wei; Buechel, Emanuela Valsangiacomo & Frigiola, Alessandra [Vis alle 20 forfattere av denne artikkelen] (2021). Imaging the adult with simple shunt lesions: Position paper from the EACVI and the ESC WG on ACHD. Endorsed by AEPC (Association for European Paediatric and Congenital Cardiology). European Heart Journal-Cardiovascular Imaging. ISSN 2047-2404. 22(6), s. E58–E70. doi: 10.1093/ehjci/jeaa314. Fulltekst i vitenarkiv
• Rootwelt-Norberg, Christine; Lie, Øyvind Haugen; Chivulescu, Ana Monica; Castrini, Anna Isotta; Sarvari, Sebastian I. & Lyseggen, Erik [Vis alle 10 forfattere av denne artikkelen] (2021). Sex differences in disease progression and arrhythmic risk in patients with arrhythmogenic cardiomyopathy. Europace. ISSN 1099-5129. 23(7), s. 1084–1091. doi: 10.1093/europace/euab077. Fulltekst i vitenarkiv Vis sammendrag

  Abstract Aims We aimed to assess sex-specific phenotypes and disease progression, and their relation to exercise, in arrhythmogenic cardiomyopathy (AC) patients. Methods and results In this longitudinal cohort study, we included consecutive patients with AC from a referral centre. We performed echocardiography at baseline and repeatedly during follow-up. Patients’ exercise dose at inclusion was expressed as metabolic equivalents of task (MET)-h/week. Ventricular arrhythmia (VA) was defined as aborted cardiac arrest, sustained ventricular tachycardia, or appropriate therapy by implantable cardioverter-defibrillator. We included 190 AC patients (45% female, 51% probands, age 41 ± 17 years). Ventricular arrhythmia had occurred at inclusion or occurred during follow-up in 85 patients (33% of females vs. 55% of males, P = 0.002). Exercise doses were higher in males compared with females [25 (interquartile range, IQR 14–51) vs. 12 (IQR 7–22) MET-h/week, P &amp;lt; 0.001]. Male sex was a marker of proband status [odds ratio (OR) 2.6, 95% confidence interval (CI) 1.4–5.0, P = 0.003] and a marker of VA (OR 2.6, 95% CI 1.4–5.0, P = 0.003), but not when adjusted for exercise dose and age (adjusted OR 1.8, 95% CI 0.9–3.6, P = 0.12 and 1.5, 95% CI 0.7–3.1, P = 0.30, by 5 MET-h/week increments). In all, 167 (88%) patients had ≥2 echocardiographic examinations during 6.9 (IQR 4.7–9.8) years of follow-up. We observed no sex differences in deterioration of right or left ventricular dimensions and functions. Conclusion Male AC patients were more often probands and had higher prevalence of VA than female patients, but not when adjusting for exercise dose. Importantly, disease progression was similar between male and female patients.

• Stankovic, Ivan; Muraru, Denisa; Fox, Kevin; Salvo, Giovanni Di; Hasselberg, Nina E & Breithardt, Ole-A [Vis alle 11 forfattere av denne artikkelen] (2021). Level 1 of Entrustable Professional Activities in adult echocardiography: A position statement from the EACVI regarding the training and competence requirements for selecting and interpreting echocardiographic examinations. European Heart Journal-Cardiovascular Imaging. ISSN 2047-2404. 22(10), s. 1091–1097. doi: 10.1093/ehjci/jeab143. Fulltekst i vitenarkiv
• Bjerring, Anders W.; Fosså, Sophie Dorothea; Haugnes, Hege Sagstuen; Nome, Ragnhild Veline; Stokke, Thomas Muri & Haugaa, Kristina [Vis alle 9 forfattere av denne artikkelen] (2021). The cardiac impact of cisplatin-based chemotherapy in survivors of testicular cancer: A 30-year follow-up. European Heart Journal-Cardiovascular Imaging. ISSN 2047-2404. 22(4), s. 443–450. doi: 10.1093/ehjci/jeaa289. Fulltekst i vitenarkiv Vis sammendrag

  Aims - Cisplatin-based chemotherapy (CBCT) is essential in the treatment of metastatic testicular cancer (TC) but has been associated with long-term risk of cardiovascular morbidity and mortality. Furthermore, cisplatin can be detected in the body decades after treatment. We aimed to evaluate the long-term impact of CBCT on cardiac function and morphology in TC survivors 30 years after treatment.<p> <p>Methods and results - TC survivors treated with CBCT (1980–94) were recruited from the longitudinal Norwegian Cancer Study in Testicular Cancer Survivors and compared with a control group matched for sex, age, smoking status, and heredity for coronary artery disease. All participants underwent laboratory tests, blood pressure measurement, and 2D and 3D echocardiography including 2D speckle-tracking strain analyses. Ninety-four TC survivors, on average 60 ± 9 years old, received a median cumulative cisplatin dose of 780 mg (IQR 600–800). Compared with controls, TC survivors more frequently used anti-hypertensive (55% vs. 24%, P < 0.001) and lipid-lowering medication (44% vs. 18%, P < 0.001). TC survivors had worse diastolic function parameters with higher E/e′-ratio (9.8 ± 3.2 vs. 7.7 ± 2.5, P < 0.001), longer mitral deceleration time (221 ± 69 vs. 196 ± 57ms, P < 0.01), and higher maximal tricuspid regurgitation velocity (25 ± 7 vs. 21 ± 4 m/s, P = 0.001). The groups did not differ in left or right ventricular systolic function, prevalence of arrhythmias, or valvular heart disease. Cumulative cisplatin dose did not correlate with cardiac parameters.<p> <p>Conclusion - No signs of overt or subclinical reduction in systolic function were identified. Long-term cardiovascular adverse effects three decades after CBCT may be limited to metabolic dysfunction and worse diastolic function in TC survivors.

• 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), s. 1316–1318. doi: 10.1097/HJH.0000000000002844. Fulltekst i vitenarkiv
• Cohen, Ariel; Donal, Erwan; Delgado, Victoria; Pepi, Mauro; Tsang, Teresa & Gerber, Bernhard L. [Vis alle 17 forfattere av denne artikkelen] (2021). EACVI recommendations on cardiovascular imaging for the detection of embolic sources: endorsed by the Canadian Society of Echocardiography. European Heart Journal-Cardiovascular Imaging. ISSN 2047-2404. 22(6), s. e24–e57. doi: 10.1093/ehjci/jeab008. Fulltekst i vitenarkiv
• 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), s. 774–776. doi: 10.1111/echo.14991. Fulltekst i vitenarkiv Vis sammendrag

  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.

• Mullens, Wilfried; Auricchio, Angelo; Martens, Pieter; Witte, Klaus; Cowie, Martin R. & Delgado, Victoria [Vis alle 29 forfattere av denne artikkelen] (2021). Optimized implementation of cardiac resynchronization therapy: a call for action for referral and optimization of care. Europace. ISSN 1099-5129. 23(8), s. 1324–1342. doi: 10.1093/europace/euaa411. Fulltekst i vitenarkiv
• Svensson, Anneli; Platonov, Pyotr G.; Haugaa, Kristina Ingrid Helena Hermann; Zareba, Wojciech; Jensen, Henrik Kjærulf & Bundgaard, Henning [Vis alle 16 forfattere av denne artikkelen] (2021). Genetic Variant Score and Arrhythmogenic Right Ventricular Cardiomyopathy Phenotype in Plakophilin-2 Mutation Carriers. Cardiology. ISSN 0008-6312. 146(6), s. 763–771. doi: 10.1159/000519231. Fulltekst i vitenarkiv Vis sammendrag

  Introduction: Whether detailed genetic information contributes to risk stratification of patients with arrhythmogenic right ventricular cardiomyopathy (ARVC) remains uncertain. Pathogenic genetic variants in some genes seem to carry a higher risk for arrhythmia and earlier disease onset than others, but comparisons between variants in the same gene have not been done. Combined Annotation Dependent Depletion (CADD) score is a bioinformatics tool that measures the pathogenicity of each genetic variant. We hypothesized that a higher CADD score is associated with arrhythmic events and earlier age at ARVC manifestations in individuals carrying pathogenic or likely pathogenic genetic variants in plakophilin-2 (PKP2). Methods: CADD scores were calculated using the data from pooled Scandinavian and North American ARVC cohorts, and their association with cardiac events defined as ventricular tachycardia/ventricular fibrillation (VT/VF) or syncope and age at definite ARVC diagnosis were assessed. Results: In total, 33 unique genetic variants were reported in 179 patients (90 males, 71 probands, 96 with definite ARVC diagnosis at a median age of 35 years). Cardiac events were reported in 76 individuals (43%), of whom 53 had sustained VT/VF (35%). The CADD score was neither associated with age at cardiac events (HR 1.002, 95% CI: 0.953–1.054, p = 0.933) nor with age at definite ARVC diagnosis (HR 0.992, 95% CI: 0.947–1.039, p = 0.731). Conclusion: No correlation was found between CADD scores and clinical manifestations of ARVC, indicating that the score has no additional risk stratification value among carriers of pathogenic or likely pathogenic PKP2 genetic variants.

• Quattrone, Alessia; Lie, Øyvind Haugen; Nestaas, Eirik; Lange, Charlotte de; Try, Kirsti & Lindberg, Harald L [Vis alle 11 forfattere av denne artikkelen] (2021). Impact of pregnancy and risk factors for ventricular arrhythmias in women with tetralogy of Fallot. Open heart. 8(1). doi: 10.1136/openhrt-2020-001400. Fulltekst i vitenarkiv Vis sammendrag

  Objective: Patients with tetralogy of Fallot (TOF) have high survival rates 30 years after surgical repair. Many patients experience pregnancy; however, the effects of pregnancy on the long-term cardiovascular outcome are not well known. We investigated the association of pregnancy and cardiac function with occurrence of ventricular arrhythmia (VA) in women with TOF. Methods: We recruited 80 women with repaired TOF from the national database. Holter monitoring or implanted devices detected VA, defined as non-sustained or sustained ventricular tachycardia or aborted cardiac arrest. All patients underwent echocardiography. Blood tests included NT-proBNP (N-terminal pro-brain natriuretic peptide). Results: 55 (69%) women had experienced pregnancy. Mean age was lower in nulliparous compared with those with children (30±9 vs 40±9, p<0.01).VA had occurred in 17 (21%) women. Prevalence of VA was higher in women who had experienced pregnancy (n=16, 94%) compared with nulliparous (n=1, 6%) (p=0.02), also when adjusted for age (OR 12.9 (95% CI 1.5 to 113.2), p=0.02).Right ventricular mechanical dispersion was more pronounced in patients with VA (50±8 ms vs 39±14 ms, p=0.01, age-adjusted OR 2.1 (95% CI 1.3 to 7.5), p=0.01). NT-proBNP was also a marker of VA (211 ng/L (127 to 836) vs 139 ng/L (30 to 465), p=0.007). NT-proBNP >321 ng/L (normal values <170 ng/L) detected women with VA (p=0.019), also independent of age (OR 7.2 (95% CI 1.7 to 30.1), p=0.007). Conclusion: Pregnancy was associated with higher prevalence of VA among women with TOF. Right ventricular mechanical dispersion and NT-proBNP were age-independent markers of VA. These may have importance for pregnancy counselling and risk stratification. Keywords: Fallots tetralogy; arrhythmias; echocardiography

• Bjerring, Anders Wold; Sarvari, Sebastian Imre; Edvardsen, Thor & Solberg, Erik Ekker (2021). Bør idreusutøvere screenes for hjertesykdom? Tidsskrift for Den norske legeforening (Tidsskriftet). ISSN 0029-2001. 141(11), s. 1–5. doi: 10.4045/tidsskr.21.0491. Fulltekst i vitenarkiv
• Bjørkavoll-Bergseth, Magnus; Erevik, Christine Bjørkvik; Kleiven, Øyunn; Eijsvogels, Thijs M. H.; Skadberg, Øyvind & Frøysa, Vidar [Vis alle 11 forfattere av denne artikkelen] (2021). Determinants of interindividual variation in exercise-induced cardiac troponin I levels. Journal of the American Heart Association (JAHA). 10(17), s. 1–14. doi: 10.1161/JAHA.121.021710. Fulltekst i vitenarkiv Vis sammendrag

  Background: Postexercise cardiac troponin levels show considerable interindividual variations. This study aimed to identify the major determinants of this postexercise variation in cardiac troponin I (cTnI) following 3 episodes of prolonged high‐intensity endurance exercise. Methods and Results: Study subjects were recruited among prior participants in a study of recreational cyclists completing a 91‐km mountain bike race in either 2013 or 2014 (first race). In 2018, study participants completed a cardiopulmonary exercise test 2 to 3 weeks before renewed participation in the same race (second race). Blood was sampled before and at 3 and 24 hours following all exercises. Blood samples were analyzed using the same Abbot high‐sensitivity cTnI STAT assay. Fifty‐nine individuals (aged 50±9 years, 13 women) without cardiovascular disease were included. Troponin values were lowest before, highest at 3 hours, and declining at 24 hours. The largest cTnI difference was at 3 hours following exercise between the most (first race) (cTnI: 200 [87–300] ng/L) and the least strenuous exercise (cardiopulmonary exercise test) (cTnI: 12 [7–23] ng/L; P<0.001). The strongest correlation between troponin values at corresponding times was before exercise (r=0.92, P<0.0001). The strongest correlations at 3 hours were between the 2 races (r=0.72, P<0.001) and at 24 hours between the cardiopulmonary exercise test and the second race (r=0.83, P<0.001). Participants with the highest or lowest cTnI levels showed no differences in race performance or baseline echocardiographic parameters. Conclusions: The variation in exercise‐induced cTnI elevation is largely determined by a unique individual cTnI response that is dependent on the duration of high‐intensity exercise and the timing of cTnI sampling.

• Otterstad, Jan Erik; Norum, Ingvild Billehaug; Ruddox, Vidar; Le, An Chau Maria; Bendz, Bjørn & Munkhaugen, John [Vis alle 8 forfattere av denne artikkelen] (2021). Prognostic impact of non-improvement of global longitudinal strain in patients with revascularized acute myocardial infarction. The International Journal of Cardiovascular Imaging. ISSN 1569-5794. 37, s. 3477–3487. doi: 10.1007/s10554-021-02349-2. Fulltekst i vitenarkiv Vis sammendrag

  Global longitudinal strain (GLS) is a more sensitive prognostic factor than left ventricular ejection fraction (LVEF) in various cardiac diseases. Little is known about the clinical impact of GLS changes after acute myocardial infarction (AMI). The present study aimed to explore if non-improvement of GLS after 3 months was associated with higher risk of subsequent composite cardiovascular events (CCVE). Patients with AMI were consecutively included at a secondary care center in Norway between April 2016 and July 2018 within 4 days following percutaneous coronary intervention. Echocardiography was performed at baseline and after 3 months. Patients were categorized with non-improvement (0 to − 100%) or improvement (0 to 100%) in GLS relative to the baseline value. Among 214 patients with mean age 65 (± 10) years and mean LVEF 50% (± 8) at baseline, 50 (23%) had non-improvement (GLS: − 16.0% (± 3.7) to − 14.2% (± 3.6)) and 164 (77%) had improvement (GLS: − 14.0% (± 3.0) to − 16.9% (± 3.0%)). During a mean follow-up of 3.3 years (95% CI 3.2 to 3.4) 77 CCVE occurred in 52 patients. In adjusted Cox regression analyses, baseline GLS was associated with all recurrent CCVE (HR 1.1, 95% CI 1.0 to 1.2, p < 0.001) whereas non-improvement versus improvement over 3 months follow-up was not. Baseline GLS was significantly associated with the number of CCVE in revascularized AMI patients whereas non-improvement of GLS after 3 months was not. Further large-scale studies are needed before repeated GLS measurements may be recommended in clinical practice.

• Edvardsen, Thor; Donal, Erwan; Marsan, Nina A; Maurovich-Horvat, Pál; Dweck, Marc R & Maurer, Gerald [Vis alle 8 forfattere av denne artikkelen] (2021). The year 2020 in the European Heart Journal-Cardiovascular Imaging: Part i. European Heart Journal-Cardiovascular Imaging. ISSN 2047-2404. 22(11), s. 1219–1227. doi: 10.1093/ehjci/jeab148. Fulltekst i vitenarkiv
• Skjølsvik, Eystein Theodor Ek; Lie, Øyvind Haugen; Chivulescu, Ana Monica; Ribe, Margareth; Castrini, Anna Isotta & Broch, Kaspar [Vis alle 9 forfattere av denne artikkelen] (2021). Progression of cardiac disease in patients with lamin A/C mutations. European Heart Journal-Cardiovascular Imaging. ISSN 2047-2404. 23(4), s. 543–550. doi: 10.1093/ehjci/jeab057. Fulltekst i vitenarkiv Vis sammendrag

  Abstract Aims We aimed to study the progression of cardiac dysfunction in patients with lamin A/C mutations and explore markers of adverse cardiac outcome. Methods and results We followed consecutive lamin A/C genotype-positive patients divided into tertiles according to age. Patients underwent repeated clinical examinations, electrocardiograms (ECGs), and echocardiograms. We followed left ventricular (LV) and right ventricular (RV) size and function, and the severity atrioventricular-valve regurgitations. Outcome was death, LVAD implant, or cardiac transplantation. We included 101 patients [age 44 (29–54) years, 39% probands, 50% female]. We analysed 576 echocardiograms and 258 ECGs during a follow-up of 4.9 (interquartile range 2.5–8.2) years. The PR-interval increased at young age from 204 ± 73 to 212 ± 69 ms (P &amp;lt; 0.001), LV ejection fraction (LVEF) declined from middle age from 50 ± 12% to 47 ± 13% (P &amp;lt; 0.001), while LV volumes remained unchanged. RV function and tricuspid regurgitation worsened from middle age with accelerating rates. Progression of RV dysfunction [odds ratio (OR) 1.3, 95% confidence interval (CI) (1.03–1.65), P = 0.03] and tricuspid regurgitation [OR 4.9, 95% CI (1.64–14.9), P = 0.004] were associated with outcome when adjusted for age, sex, comorbidities, LVEF, and New York Heart Association functional class. Conclusion In patients with lamin A/C genotype, electrical disease started at young age. From middle age, LV function deteriorated progressively, while LV size remained unchanged. Worsening of RV function and tricuspid regurgitation accelerated in older age and were associated with outcome. Our systematic map on cardiac deterioration may help optimal monitoring and prognostication in lamin A/C disease.

• Østvik, Andreas; Salte, Ivar Mjåland; Smistad, Erik; Nguyen, Thuy Mi; Melichova, Daniela & Brunvand, Harald [Vis alle 10 forfattere av denne artikkelen] (2021). Myocardial Function Imaging in Echocardiography Using Deep Learning. IEEE Transactions on Medical Imaging. ISSN 0278-0062. 40(5), s. 1340–1351. doi: 10.1109/TMI.2021.3054566. Fulltekst i vitenarkiv Vis sammendrag

  Deformation imaging in echocardiography has been shown to have better diagnostic and prognostic value than conventional anatomical measures such as ejection fraction. However, despite clinical availability and demonstrated efficacy, everyday clinical use remains limited at many hospitals. The reasons are complex, but practical robustness has been questioned, and a large inter-vendor variability has been demonstrated. In this work, we propose a novel deep learning based framework for motion estimation in echocardiography, and use this to fully automate myocardial function imaging. A motion estimator was developed based on a PWC-Net architecture, which achieved an average end point error of (0.06±0.04) mm per frame using simulated data from an open access database, on par or better compared to previously reported state of the art. We further demonstrate unique adaptability to image artifacts such as signal dropouts, made possible using trained models that incorporate relevant image augmentations. Further, a fully automatic pipeline consisting of cardiac view classification, event detection, myocardial segmentation and motion estimation was developed and used to estimate left ventricular longitudinal strain in vivo. The method showed promise by achieving a mean deviation of (-0.7±1.6)% compared to a semi-automatic commercial solution for N=30 patients with relevant disease, within the expected limits of agreement. We thus believe that learning-based motion estimation can facilitate extended use of strain imaging in clinical practice.

• Salte, Ivar M.; Østvik, Andreas; Smistad, Erik; Melichova, Daniela; Nguyen, Thuy Mi & Karlsen, Sigve [Vis alle 11 forfattere av denne artikkelen] (2021). Artificial Intelligence for Automatic Measurement of Left Ventricular Strain in Echocardiography. JACC Cardiovascular Imaging. ISSN 1936-878X. 14(10), s. 1918–1928. doi: 10.1016/j.jcmg.2021.04.018. Fulltekst i vitenarkiv Vis sammendrag

  Objectives This study sought to examine if fully automated measurements of global longitudinal strain (GLS) using a novel motion estimation technology based on deep learning and artificial intelligence (AI) are feasible and comparable with a conventional speckle-tracking application. Background GLS is an important parameter when evaluating left ventricular function. However, analyses of GLS are time consuming and demand expertise, and thus are underused in clinical practice. Methods In this study, 200 patients with a wide range of left ventricle (LV) function were included. Three standard apical cine-loops were analyzed using the AI pipeline. The AI method measured GLS and was compared with a commercially available semiautomatic speckle-tracking software (EchoPAC v202, GE Healthcare. Results The AI method succeeded to both correctly classify all 3 standard apical views and perform timing of cardiac events in 89% of patients. Furthermore, the method successfully performed automatic segmentation, motion estimates, and measurements of GLS in all examinations, across different cardiac pathologies and throughout the spectrum of LV function. GLS was −12.0 ± 4.1% for the AI method and −13.5 ± 5.3% for the reference method. Bias was −1.4 ± 0.3% (95% limits of agreement: 2.3 to −5.1), which is comparable with intervendor studies. The AI method eliminated measurement variability and a complete GLS analysis was processed within 15 s. Conclusions Through the range of LV function this novel AI method succeeds, without any operator input, to automatically identify the 3 standard apical views, perform timing of cardiac events, trace the myocardium, perform motion estimation, and measure GLS. Fully automated measurements based on AI could facilitate the clinical implementation of GLS.

• Melichova, Daniela; Nguyen, Thuy Mi; Salte, Ivar M.; Klaeboe, Lars Gunnar; Sjøli, Benthe & Karlsen, Sigve [Vis alle 11 forfattere av denne artikkelen] (2021). Strain echocardiography improves prediction of arrhythmic events in ischemic and non-ischemic dilated cardiomyopathy. International Journal of Cardiology. ISSN 0167-5273. 342, s. 56–62. doi: 10.1016/j.ijcard.2021.07.044. Fulltekst i vitenarkiv Vis sammendrag

  Background Recent evidence suggests that an implantable cardioverter defibrillator (ICD) in non-ischemic cardiomyopathy (NICM) may not offer mortality benefit. We aimed to investigate if etiology of heart failure and strain echocardiography can improve risk stratification of life threatening ventricular arrhythmia (VA) in heart failure patients. Methods This prospective multi-center follow-up study consecutively included NICM and ischemic cardiomyopathy (ICM) patients with left ventricular ejection fraction (LVEF) <40%. We assessed LVEF, global longitudinal strain (GLS) and mechanical dispersion (MD) by echocardiography. Ventricular arrhythmia was defined as sustained ventricular tachycardia, sudden cardiac death or appropriate shock from an ICD. Results We included 290 patients (67 ± 13 years old, 74% males, 207(71%) ICM). During 22 ± 12 months follow up, VA occurred in 32(11%) patients. MD and GLS were both markers of VA in patients with ICM and NICM, whereas LVEF was not (p = 0.14). MD independently predicted VA (HR: 1.19; 95% CI 1.08–1.32, p = 0.001), with excellent arrhythmia free survival in patients with MD <70 ms (Log rank p < 0.001). Patients with NICM and MD <70 ms had the lowest VA incidence with an event rate of 3%/year, while patients with ICM and MD >70 ms had highest VA incidence with an event rate of 16%/year. Conclusion Patients with NICM and normal MD had low arrhythmic event rate, comparable to the general population. Patients with ICM and MD >70 ms had the highest risk of VA. Combining heart failure etiology and strain echocardiography may classify heart failure patients in low, intermediate and high risk of VA and thereby aid ICD decision strategies.

• Agricola, Eustachio; Ancona, Francesco; Brochet, Eric; Donal, Erwan; Dweck, Mark R. & Faletra, Francesco [Vis alle 20 forfattere av denne artikkelen] (2021). The structural heart disease interventional imager rationale, skills and training: a position paper of the European Association of Cardiovascular Imaging. European Heart Journal-Cardiovascular Imaging. ISSN 2047-2404. 22(5), s. 471–479. doi: 10.1093/ehjci/jeab005. Fulltekst i vitenarkiv
• Tangen, Jorun; Aukrust, Pål; Barratt-Due, Andreas; Skulstad, Helge & Edvardsen, Thor (2021). Reduced cardiac function by echocardiography in a minority of COVID-19 patients three months after hospitalization. Journal of the American Society of Echocardiography. ISSN 0894-7317. doi: 10.1016/j.echo.2021.10.014. Fulltekst i vitenarkiv
• Chivulescu, Ana Monica; Krohg-Sørensen, Kirsten; Scheirlynck, Esther Steffie; Lindberg, Beate; Dejgaard, Lars & Lie, Øyvind Haugen [Vis alle 12 forfattere av denne artikkelen] (2021). Mitral annulus disjunction is associated with adverse outcome in Marfan and Loeys-Dietz syndromes. European Heart Journal-Cardiovascular Imaging. ISSN 2047-2404. 22(9), s. 1035–1044. doi: 10.1093/ehjci/jeaa324. Fulltekst i vitenarkiv Vis sammendrag

  Abstract Aims We aimed to assess the prevalence of mitral annulus disjunction (MAD) and to explore the association with aortic disease and mitral valve surgery in patients with Marfan syndrome (MFS) and Loeys–Dietz syndrome (LDS). Methods and results We included consecutive MFS patients fulfilling Revised Ghent Criteria and LDS patients fulfilling Loeys–Dietz Revised Nosology. MAD was identified by echocardiography and was quantified as the longitudinal distance from the ventricular myocardium to the hinge point of the posterior mitral leaflet. Aortic events were defined as aortic dissection or prophylactic aortic surgery. We recorded the need of mitral valve surgery including mitral valve repair or replacement. We included 168 patients (103 with MFS and 65 with LDS). The prevalence of MAD was 41%. MAD was present in all age groups. Aortic events occurred in 112 (67%) patients (27 with dissections and 85 with prophylactic surgical interventions). Patients with MAD were younger at aortic event than those without MAD (log rank = 0.02) Patients with aortic events had greater MAD distance in posterolateral wall [8 (7–10) mm vs. 7 (6–8) mm, P = 0.04]. Mitral events occurred more frequently in patients with MAD (P &amp;lt; 0.001). Conclusion MAD was highly prevalent in patients with MFS and LDS. MAD was a marker of severe disease including aortic events at younger age and need of mitral valve surgery. Screening patients with MFS an LDS for MAD may provide prognostic information and may be relevant in planning surgical intervention. Detection of MAD in patients with MFS and LDS may infer closer clinical follow-up from younger age.

• Senior, Roxy; Lindner, Jonathan R.; Edvardsen, Thor & Cosyns, Bernard (2021). Ultrasound contrast agent hypersensitivity in patients allergic to polyethylene glycol: Position statement by the European Association of Cardiovascular Imaging. European Heart Journal-Cardiovascular Imaging. ISSN 2047-2404. 22(9), s. 959–960. doi: 10.1093/ehjci/jeab120. Fulltekst i vitenarkiv
• Cosyns, Bernard; Sade, Leyla Elif; Gerber, Bernhard L.; Gimelli, Alessia; Muraru, Denisa & Maurer, Gerald [Vis alle 7 forfattere av denne artikkelen] (2021). The year 2020 in the European Heart Journal—Cardiovascular Imaging: part II. European Heart Journal-Cardiovascular Imaging. ISSN 2047-2404. 22(12), s. 1351–1361. doi: 10.1093/ehjci/jeab225. Fulltekst i vitenarkiv
• Quattrone, Alessia; Lie, Øyvind Haugen; Nestaas, Eirik; Lange, Charlotte de; Try, Kirsti & Lindberg, Harald L [Vis alle 11 forfattere av denne artikkelen] (2021). Long-term follow-up and sex differences in adults operated for tetralogy of Fallot. Open heart. 8(2). doi: 10.1136/openhrt-2021-001738. Fulltekst i vitenarkiv Vis sammendrag

  Objective Adults operated for tetralogy of Fallot (TOF) have high risk of ventricular arrhythmias (VA). QRS duration >180 ms is an established risk factor for VA. We aimed to investigate heart function, prevalence of arrhythmias and sex differences in patients with TOF at long-term follow-up. Methods We included TOF-operated patients≥18 years from our centre’s registry. We reviewed medical records and the most recent echocardiographic exam. VA was recorded on ECGs, 24-hour Holter registrations and from implantable cardioverter defibrillator. Results We included 148 patients (age 37±10 years). Left ventricular global longitudinal strain (LV GLS, −15.8±3.1% vs −18.8±3.2%, p=0.001) and right ventricular (RV) GLS (−15.8±3.9% vs −19.1±4.1%, p=0.001) were lower in men at all ages compared with women. Higher RV D1 (4.3±0.5 cm vs 4.6±0.6 cm, p=0.01), lower ejection fraction (55%±8% vs 50%±9%, p=0.02), lower RV GLS (−18.1±4.0 ms vs −16.1±4.8 ms, p=0.04) and N-terminal pro-brain natriuretic peptide (NT-proBNP) over reference range (n=27 (23%) vs n=8 (77%), p<0.001) were associated with higher incidence of VA. QRS duration was longer in men (151±30 ms vs 128±25 ms, p<0.001). No patients had QRS duration >180 ms. QRS duration did not differ in those with and without VA (143±32 ms vs 137±28 ms, p=0.06). Conclusions Our results confirmed reduced RV function in adults operated for TOF. Male patients had impaired LV and RV function expressed by lower LV and RV GLS values at all ages. Reduced cardiac function and elevated NT-proBNP were associated with higher incidence of VA and may be important in risk assessment.

• Kleiven, Øyunn; Edvardsen, Thor & Ørn, Stein (2021). Echocardiography in the pre-participation evaluation of asymptomatic athletes: The never-ending story. European Journal of Preventive Cardiology (EJPC). ISSN 2047-4873. 28(10), s. 1068–1070. doi: 10.1177/2047487320932269. Fulltekst i vitenarkiv
• Scheirlynck, Esther; Chivulescu, Ana Monica; Lie, Øyvind Haugen; Motoc, Andreea; Koulalis, Jorgos & Asmundis, Carlo de [Vis alle 13 forfattere av denne artikkelen] (2020). Worse prognosis in Brugada syndrome patients with arrhythmogenic cardiomyopathy features. JACC: Clinical Electrophysiology. ISSN 2405-500X. 6(11), s. 1353–1363. doi: 10.1016/j.jacep.2020.05.026. Fulltekst i vitenarkiv
• Norum, Ingvild Billehaug; Edvardsen, Thor; Ruddox, Vidar; Günther, Anne; Dahle, Gry & Otterstad, Jan Erik (2020). Three-dimensional versus two-dimensional transthoracic echocardiography for left ventricular outflow tract measurements in severe aortic stenosis. A cross-sectional study using computer tomography and Haegar sizers as reference. Scandinavian Cardiovascular Journal. ISSN 1401-7431. 54(4), s. 220–226. doi: 10.1080/14017431.2020.1761559. Fulltekst i vitenarkiv Vis sammendrag

  Objectives. In grading of aortic stenosis, two-dimensional transthoracic echocardiography (2D TTE) routinely results in underestimation of the left ventricular outflow tract (LVOT) area, and hence the aortic valve area (AVA). We investigated whether three-dimensional (3D) TTE measurements of the LVOT would be more accurate. We evaluated the feasibility, agreement and inter-observer variability of 3D TTE LVOT measurements with computed tomography (CT) and Haegar sizers as reference. Design. Sixty-one patients with severe aortic stenosis were examined with 2D and 3D TTE. 41 had CT and 13 also had perioperative Haegar sizing. Pearson’s correlation and Bland-Altman plots were used to compare methods. Inter-observer variability was tested for 2D and 3D TTE. Trial registration: Current research information system in Norway (CRISTIN). Id: 555249. Results. Feasibility was 67% with 3D TTE and 100% with 2D TTE and CT. Mean LVOT area for 2D, 3D, CT and Haegar sizers were 3.7 ± 0.6 cm2, 4.0 ± 0.9 cm2, 5.2 ± 0.8 cm2 and 4.4 ± 1.0 cm2 respectively. Bias and limits of agreements for 2D TTE was 1.5 ± 1.3 cm2, compared with CT and 0.4 ± 1.5 cm2 with Haegar sizers. Corresponding results for 3D TTE were 1.2 ± 1.6 cm2 and 0.2 ± 1.8 cm2. Intraclass correlation coefficients for LVOT area were 0.62 for 3D and 0.86 for 2D. Conclusions. 2D TTE showed better feasibility and inter-observer variability in measurements of LVOT than 3D TTE. Both echocardiographic methods underestimated LVOT area compared to CT and Haegar sizers. These observations suggest that 2D TTE is still preferable to 3D TTE in the assessment of aortic stenosis.

• Chivulescu, Ana Monica; Lie, Øyvind Haugen; Popescu, Bogdan A.; Skulstad, Helge; Edvardsen, Thor & Jurcut, Ruxandra [Vis alle 7 forfattere av denne artikkelen] (2020). High penetrance and similar disease progression in probands and in family members with arrhythmogenic cardiomyopathy. European Heart Journal. ISSN 0195-668X. 41(14), s. 1401–1410. doi: 10.1093/eurheartj/ehz570. Fulltekst i vitenarkiv Vis sammendrag

  Aims We aimed to assess structural progression in arrhythmogenic cardiomyopathy (AC) patients and mutation-positive family members and its impact on arrhythmic outcome in a longitudinal cohort study. Methods and results Structural progression was defined as the development of new Task Force imaging criteria from inclusion to follow-up and progression rates as annual changes in imaging parameters. We included 144 AC patients and family members (48% female, 47% probands, 40 ± 16 years old). At genetic diagnosis and inclusion, 58% of family members had penetrant AC disease. During 7.0 [inter-quartile range (IQR) 4.5–9.4] years of follow-up, 47% of family members without AC at inclusion developed AC criteria, resulting in a yearly new AC penetrance of 8%. Probands and family members had a similar progression rate of right ventricular outflow tract diameter (0.5 mm/year vs. 0.6 mm/year, P = 0.28) by mixed model analysis of 598 echocardiographic examinations. Right ventricular fractional area change progression rate was even higher in family members (−0.6%/year vs. −0.8%/year, P < 0.01). Among 86 patients without overt structural disease or arrhythmic history at inclusion, a first severe ventricular arrhythmic event occurred in 8 (9%), of which 7 (88%) had concomitant structural progression. Structural progression was associated with higher incidence of severe ventricular arrhythmic events adjusted for age, sex, and proband status (HR 21.24, 95% CI 2.47–182.81, P < 0.01). Conclusion More than half of family members had AC criteria at genetic diagnosis and yearly AC penetrance was 8%. Structural progression was similar in probands and family members and was associated with higher incidence of severe ventricular arrhythmic events.

• Hetland, Sveinung Arild; Vistnes, Maria; Haugaa, Kristina; Liland, Kristian Hovde; Olseng, Margareth & Edvardsen, Thor (2020). Obstructive sleep apnea versus central sleep apnea: prognosis in systolic heart failure. Cardiovascular Diagnosis and Therapy (CDT). ISSN 2223-3652. 10(3), s. 396–404. doi: 10.21037/cdt.2020.03.02. Fulltekst i vitenarkiv Vis sammendrag

  Background: In chronic heart failure (CHF), obstructive sleep apnea (OSA) and Cheyne-Stokes respiration (CSR) are associated with increased mortality. The present study aimed to evaluate the prognostic effect of CSR compared to OSA, in otherwise similar groups of CHF patients. Methods: Screening for sleep-disordered breathing (SDB) was conducted among patients with CHF of New York Heart Association (NYHA) class II–IV, and left ventricular ejection fraction (LVEF) of ≤45%. The study included 43 patients (4 women) with >25% CSR during sleeping time, and 19 patients (2 women) with OSA and an apnea-hypopnea index (AHI) of ≥6. Patients were followed for a median of 1,371 days. The primary endpoint was mortality, and the secondary endpoint was combined mortality and hospital admissions. Results: Baseline parameters did not significantly differ between groups, but CSR patients were older and had higher AHI values than OSA patients. Five OSA patients (26%) died, and 14 (74%) met the combined end-point of death or hospitalization. CSR patients had significantly higher risk for both end-points, with 23 (53%) deaths [log-rank P=0.040; HR, 2.70 (1.01–7.22); P=0.047] and 40 (93%) deaths or readmissions [log-rank P=0.029; HR, 1.96 (1.06–3.63); P=0.032]. After adjustment for confounding risk factors, the association between CSR and death remained significant [HR, 4.73 (1.10–20.28); P=0.037], hospital admission rates were not significantly different. Conclusions: Among patients with CHF, CSR was associated with higher mortality than OSA independently of age and cardiac systolic function. CSR was also an age-independent predictor of unfavorable outcome, but hospital admission rates were not significantly different between the two groups after adjustment.

• Cosyns, Bernard; Haugaa, Kristina; Gerber, Bernrhard; Gimelli, Alessia; Sade, Leyla Elif & Maurer, Gerald [Vis alle 8 forfattere av denne artikkelen] (2020). The year 2019 in the European Heart Journal – Cardiovascular imaging: Part II. European Heart Journal-Cardiovascular Imaging. ISSN 2047-2404. 21(12), s. 1331–1340. doi: 10.1093/ehjci/jeaa292. Fulltekst i vitenarkiv
• Knuuti, Juhani; Wijns, William; Saraste, Antti; Capodanno, Davide; Barbato, Emanuele & Funck-Brentano, Christian [Vis alle 25 forfattere av denne artikkelen] (2020). 2019 ESC guidelines for the diagnosis and management of chronic coronary syndromes. European Heart Journal. ISSN 0195-668X. 41(3), s. 407–477. doi: 10.1093/eurheartj/ehz425. Fulltekst i vitenarkiv
• Dweck, Mark R.; Bularga, Anda; Hahn, Rebecca T.; Bing, Rong; Lee, Kuan Ken & Chapman, Andrew R. [Vis alle 17 forfattere av denne artikkelen] (2020). Global evaluation of echocardiography in patients with COVID-19. European Heart Journal-Cardiovascular Imaging. ISSN 2047-2404. 21(9), s. 949–958. doi: 10.1093/ehjci/jeaa178. Fulltekst i vitenarkiv
• Skjølsvik, Eystein Theodor Ek; Hasselberg, Nina Eide; Dejgaard, Lars; Lie, Øyvind Haugen; Andersen, Kjell & Holm, Torbjørn [Vis alle 8 forfattere av denne artikkelen] (2020). Exercise is Associated With Impaired Left Ventricular Systolic Function in Patients With Lamin A/C Genotype. Journal of the American Heart Association (JAHA). 9(2). doi: 10.1161/JAHA.119.012937. Fulltekst i vitenarkiv Vis sammendrag

  Background Lamin A/C cardiomyopathy is a malignant and highly penetrant inheritable cardiomyopathy. Competitive sports have been associated with adverse events in these patients, but data on recreational exercise are lacking. We aimed to explore associations between exercise exposure and disease severity in patients with lamin A/C genotype. Methods and Results Lamin A/C genotype positive patients answered a questionnaire on exercise habits from age 7 years until genetic diagnosis. We recorded exercise hours >3 metabolic equivalents and calculated cumulative lifetime exercise. Patients were grouped in active or sedate based on lifetime exercise hours above or below median. We performed echocardiography, 12‐lead ECG, Holter monitoring, and biomarkers including NT‐proBNP (N‐terminal pro‐B‐type natriuretic peptide). We defined left ventricular ejection fraction <45% as a clinically significant impairment of left ventricular function. We included 69 patients (age 42±14 years, 41% probands, 46% women) with median lifetime exercise 4160 (interquartile range 1041–6924) hours. Active patients were more frequently probands (53% versus 29%, P=0.04), had lower left ventricular ejection fraction (43±13% versus 51±11%, P=0.006), and higher NT‐proBNP (78 [interquartile range 32–219] pmol/L versus 30 [interquartile range 13–64] pmol/L, P=0.03) compared with sedate, while age did not differ (45±13 years versus 40±16 years, P=0.16). The decrease in left ventricular ejection fraction per tertile increment in lifetime exercise was 4% (95% CI −7% to −0.4%, P=0.03), adjusted for age and sex and accounting for dependence within families. Left ventricular ejection fraction <45% was observed at a younger age in active patients (log rank P=0.007). Conclusions Active lamin A/C patients had worse systolic function compared with sedate which occurred at younger age. Our findings may improve exercise recommendations in patients with lamin A/C.

• Magne, Julien; Bharucha, Tara; Cikes, Maya; Galderisi, Maurizio; Price, Suzanna & Sade, Leyla Elif [Vis alle 9 forfattere av denne artikkelen] (2020). EuroEcho 2019: Highlights. European Heart Journal-Cardiovascular Imaging. ISSN 2047-2404. 21(5), s. 469–478. doi: 10.1093/ehjci/jeaa037. Fulltekst i vitenarkiv Vis sammendrag

  Abstract The annual meeting of the European Association of Cardiovascular Imaging, EuroEcho 2019, was held in Vienna, Austria, in December 2019. In this article, we present a summary of the ‘Highlights’ session.

• Pezel, Théo; Coisne, Augustin; Mahmoud-Elsayed, Hani; Mandoli, Giulia Elena; Elgamal, Sarah Moharem & Podlesnikar, Tomaz [Vis alle 12 forfattere av denne artikkelen] (2020). EACVI communication paper: First international young dedicated multimodal cardiovascular imaging simulation education event organized by the ESC. European Heart Journal-Cardiovascular Imaging. ISSN 2047-2404. 21(2), s. 124–126. doi: 10.1093/ehjci/jez299. Fulltekst i vitenarkiv
• Cameli, Matteo; Miglioranza, Marcelo Haertel; Magne, Julien; Mandoli, Giulia Elena; Benfari, Giovanni & Ancona, Roberta [Vis alle 61 forfattere av denne artikkelen] (2020). Multicentric Atrial Strain COmparison between Two Different Modalities: MASCOT HIT Study. Diagnostics (Basel). doi: 10.3390/diagnostics10110946. Fulltekst i vitenarkiv Vis sammendrag

  Two methods are currently available for left atrial (LA) strain measurement by speckle tracking echocardiography, with two different reference timings for starting the analysis: QRS (QRS-LASr) and P wave (P-LASr). The aim of MASCOT HIT study was to define which of the two was more reproducible, more feasible, and less time consuming. In 26 expert centers, LA strain was analyzed by two different echocardiographers (young vs senior) in a blinded fashion. The study population included: healthy subjects, patients with arterial hypertension or aortic stenosis (LA pressure overload, group 2) and patients with mitral regurgitation or heart failure (LA volume–pressure overload, group 3). Difference between the inter-correlation coefficient (ICC) by the two echocardiographers using the two techniques, feasibility and analysis time of both methods were analyzed. A total of 938 subjects were included: 309 controls, 333 patients in group 2, and 296 patients in group 3. The ICC was comparable between QRS-LASr (0.93) and P-LASr (0.90). The young echocardiographers calculated QRS-LASr in 90% of cases, the expert ones in 95%. The feasibility of P-LASr was 85% by young echocardiographers and 88% by senior ones. QRS-LASr young median time was 110 s (interquartile range, IR, 78-149) vs senior 110 s (IR 78-155); for P-LASr, 120 s (IR 80-165) and 120 s (IR 90-161), respectively. LA strain was feasible in the majority of patients with similar reproducibility for both methods. QRS complex guaranteed a slightly higher feasibility and a lower time wasting compared to the use of P wave as the reference.

• Ross, Stian Balnagown; Nestaas, Eirik; Kongsgård, Erik; Odland, Hans Henrik; Håland, Trine Synnøve Fink & Hopp, Einar [Vis alle 8 forfattere av denne artikkelen] (2020). Septal contraction predicts acute haemodynamic improvement and paced QRS width reduction in cardiac resynchronization therapy. European Heart Journal-Cardiovascular Imaging. ISSN 2047-2404. 21(8), s. 845–852. doi: 10.1093/ehjci/jez315. Fulltekst i vitenarkiv Vis sammendrag

  Three distinct septal contraction patterns typical for left bundle branch block may be assessed using echocardiography in heart failure patients scheduled for cardiac resynchronization therapy (CRT). The aim of this study was to explore the association between these septal contraction patterns and the acute haemodynamic and electrical response to biventricular pacing (BIVP) in patients undergoing CRT implantation. Thirty-eight CRT candidates underwent speckle tracking echocardiography prior to device implantation. The patients were divided into two groups based on whether their septal contraction pattern was indicative of dyssynchrony (premature septal contraction followed by various amount of stretch) or not (normally timed septal contraction with minimal stretch). CRT implantation was performed under invasive left ventricular (LV) pressure monitoring and we defined acute CRT response as ≥10% increase in LV dP/dtmax. End-diastolic pressure (EDP) and QRS width served as a diastolic and electrical parameter, respectively. LV dP/dtmax improved under BIVP (737 ± 177 mmHg/s vs. 838 ± 199 mmHg/s, P < 0.001) and 26 patients (68%) were defined as acute CRT responders. Patients with premature septal contraction (n = 27) experienced acute improvement in systolic (ΔdP/dtmax: 18.3 ± 8.9%, P < 0.001), diastolic (ΔEDP: −30.6 ± 29.9%, P < 0.001) and electrical (ΔQRS width: −23.3 ± 13.2%, P < 0.001) parameters. No improvement under BIVP was observed in patients (n = 11) with normally timed septal contraction (ΔdP/dtmax: 4.0 ± 7.8%, P = 0.12; ΔEDP: −8.8 ± 38.4%, P = 0.47 and ΔQRS width: −0.9 ± 11.4%, P = 0.79).   Septal contraction patterns are an excellent predictor of acute CRT response. Only patients with premature septal contraction experienced acute systolic, diastolic, and electrical improvement under BIVP.

• Skulstad, Helge; Cosyns, Bernard; Popescu, Bogdan A.; Galderisi, Maurizio; Salvo, Giovanni Di & Donal, Erwan [Vis alle 23 forfattere av denne artikkelen] (2020). COVID-19 pandemic and cardiac imaging: EACVI recommendations on precautions, indications, prioritization, and protection for patients and healthcare personnel. European Heart Journal-Cardiovascular Imaging. ISSN 2047-2404. 21(6), s. 592–598. doi: 10.1093/ehjci/jeaa072. Fulltekst i vitenarkiv
• Stokke, Mathis Korseberg; Castrini, Anna Isotta; Aneq, Meriam Åström; Jensen, Henrik K.; Madsen, Trine & Hansen, Jim [Vis alle 12 forfattere av denne artikkelen] (2020). Absence of ECG Task Force Criteria does not rule out structural changes in genotype positive ARVC patients. International Journal of Cardiology. ISSN 0167-5273. doi: 10.1016/j.ijcard.2020.05.095. Fulltekst i vitenarkiv Vis sammendrag

  Aims In Arrhythmogenic Right Ventricular Cardiomyopathy (ARVC), electrophysiological pathology has been claimed to precede morphological and functional pathology. Accordingly, an ECG without ARVC markers should be rare in ARVC patients with pathology identified by cardiac imaging. We quantified the prevalence of ARVC patients with evidence of structural disease, yet without ECG Task Force Criteria (TFC). Methods and results We included 182 probands and family members with ARVC-associated mutations (40 ± 17 years, 50% women, 73% PKP2 mutations) from the Nordic ARVC Registry in a cross-sectional analysis. For echocardiography and cardiac MR (CMR), we differentiated between “abnormalities” and TFC. “Abnormalities” were defined as RV functional or structural measures outside TFC reference values, without combinations required to fulfill TFC. ECG TFC were used as defined, as these are not composite parameters. We found that only 4% of patients with ARVC fulfilled echocardiographic TFC without any ECG TFC. However, importantly, 38% of patients had imaging abnormalities without any ECG TFC. These results were supported by CMR data from a subset of 51 patients: 16% fulfilled CMR TFC without fulfilling ECG TFC, while 24% had CMR abnormalities without any ECG TFC. In a multivariate analysis, echocardiographic TFC were associated with arrhythmic events. Conclusion More than one third of ARVC genotype positive patients had subtle imaging abnormalities without fulfilling ECG TFC. Although most patients will have both imaging and ECG abnormalities, structural abnormalities in ARVC genotype positive patients cannot be ruled out by the absence of ECG TFC.

• Smistad, Erik; Østvik, Andreas; Salte, Ivar Mjåland; Melichova, Daniela; Nguyen, Thuy Mi & Haugaa, Kristina [Vis alle 12 forfattere av denne artikkelen] (2020). Real-Time Automatic Ejection Fraction and Foreshortening Detection Using Deep Learning. IEEE Transactions on Ultrasonics, Ferroelectrics and Frequency Control. ISSN 0885-3010. 67(12), s. 2595–2604. doi: 10.1109/TUFFC.2020.2981037. Fulltekst i vitenarkiv Vis sammendrag

  Volume and ejection fraction (EF) measurements of the left ventricle (LV) in 2-D echocardiography are associated with a high uncertainty not only due to interobserver variability of the manual measurement, but also due to ultrasound acquisition errors such as apical foreshortening. In this work, a real-time and fully automated EF measurement and foreshortening detection method is proposed. The method uses several deep learning components, such as view classification, cardiac cycle timing, segmentation and landmark extraction, to measure the amount of foreshortening, LV volume, and EF. A data set of 500 patients from an outpatient clinic was used to train the deep neural networks, while a separate data set of 100 patients from another clinic was used for evaluation, where LV volume and EF were measured by an expert using clinical protocols and software. A quantitative analysis using 3-D ultrasound showed that EF is considerably affected by apical foreshortening, and that the proposed method can detect and quantify the amount of apical foreshortening. The bias and standard deviation of the automatic EF measurements were -3.6 ± 8.1%, while the mean absolute difference was measured at 7.2% which are all within the interobserver variability and comparable with related studies. The proposed real-time pipeline allows for a continuous acquisition and measurement workflow without user interaction, and has the potential to significantly reduce the time spent on the analysis and measurement error due to foreshortening, while providing quantitative volume measurements in the everyday echo lab.

• Bjerring, Anders W.; Landgraff, Hege Elisabeth W.; Leirstein, Svein; Haugaa, Kristina; Edvardsen, Thor & Sarvari, Sebastian [Vis alle 7 forfattere av denne artikkelen] (2020). From talented child to elite athlete: The development of cardiac morphology and function in a cohort of endurance athletes from age 12 to 18. European Journal of Preventive Cardiology (EJPC). ISSN 2047-4873. s. 1–8. doi: 10.1177/2047487320921317. Fulltekst i vitenarkiv Vis sammendrag

  Background: Adult athletes undergo cardiac adaptions in what is known as the “athlete’s heart”. Cardiac adaptations in young athletes have not been described in longitudinal studies but have previously been believed to be uniform in nature. Methods: Seventy-six cross-country skiers were assessed at age 12. Forty-eight (63%) completed the first follow-up at age 15 and 36 (47%) the second follow-up at age 18. Comprehensive exercise data were collected. Echocardiography with three-dimensional measurements and cardiopulmonary exercise testing were performed at all time points. The cohort was divided into active and former endurance athletes, with an eight hours of weekly endurance exercise cut-off at age 18. Results: The athletes underwent eccentric remodelling between ages 12 and 15, and concentric remodelling between ages 15 and 18. At age 18, the active endurance athletes had greater increases in inter-ventricular wall thickness (1.8 ± 1.4 Δmm vs 0.6 ± 1.0 Δmm, p < 0.05), left ventricular (LV) posterior wall thickness (1.6 ± 1.2 Δmm vs 0.8 ± 0.8 Δmm, p < 0.05), LV mass (63 ± 30 Δg vs 27 ± 21 Δg, p < 0.01), right ventricular (RV) end-diastolic area (3.4 ± 4.0 Δcm2 vs 0.6 ± 3.5Δ cm2, p < 0.05), RV end-systolic area (1.0 ± 2.3 Δcm2 vs –0.9 ± 2.0 Δcm2, p < 0.05) and left atrial volume (24 ± 21 ΔmL vs 6±10 ΔmL, p < 0.05) and had greater indexed maximal oxygen uptake (66.3 ± 7.4 mL/min/kg vs 57.1 ± 8.2 mL/min/kg, p < 0.01). There was no significant difference for LV volumes. Conclusion: This study finds a shift in the development of the young athlete’s heart. Between ages 12 and 15, the active endurance athletes underwent eccentric remodelling. This dynamic switched to concentric remodelling between ages 15 and 18.

• Rodríguez-Palomares, José F.; Edvardsen, Thor; Almeida, Ana G. & Petersen, Stephen E. (2020). EuroCMR 2019 highlights. European Heart Journal-Cardiovascular Imaging. ISSN 2047-2404. 21(2), s. 127–131. doi: 10.1093/ehjci/jez307. Fulltekst i vitenarkiv
• Lie, Øyvind Haugen; Klæboe, Lars Gunnar; Dejgaard, Lars; Skjølsvik, Eystein Theodor Ek; Grimsmo, Jostein & Bosse, Gerhard [Vis alle 9 forfattere av denne artikkelen] (2020). Cardiac phenotypes and markers of adverse outcome in elite athletes with ventricular arrhythmias. JACC Cardiovascular Imaging. ISSN 1936-878X. s. 148–158. doi: 10.1016/j.jcmg.2020.07.039. Fulltekst i vitenarkiv Vis sammendrag

  Objectives This study describes the cardiac phenotypes and markers of adverse outcome in athletes with ventricular arrhythmias with no other discernable etiology than high exercise doses. Background Little is known about phenotypes and risk markers of life-threatening arrhythmic events in athletes with ventricular arrhythmia. Methods We compared high-performance athletes who have ventricular arrhythmia with healthy controls using clinical data and cardiac imaging. None of the patients had family history of arrhythmogenic cardiomyopathy or any other discernable etiology of ventricular arrhythmia. Right (RV) and left ventricular (LV) function was assessed by echocardiographic longitudinal strain (right ventricular free wall strain longitudinal [RVFWSL] and left ventricular global longitudinal strain [LVGLS]). Mechanical dispersion was defined as the standard deviation of time to peak strain in 16 LV segments. RV ejection fraction and presence of late gadolinium enhancement was assessed by cardiac magnetic resonance. Results We included 43 athletes (45 ± 14 years of age, 16% female) with ventricular arrhythmias and 30 healthy athletes (41 ± 9 years of age, 7% female). Athletes with ventricular arrhythmias had worse RV function than healthy athletes by echocardiography (RVFWSL: −22.9 ± 4.8% vs. −26.6 ± 3.3%; p < 0.001) and by cardiac magnetic resonance (RV ejection fraction 48 ± 7% vs. 52 ± 6%; p = 0.04), and had more late gadolinium enhancement (24% vs. 3%; p = 0.03). Life-threatening arrhythmic events (aborted cardiac arrest, sustained ventricular tachycardia, or appropriate implantable cardioverter-defibrillator therapy) had occurred in 23 (53%) athletes with ventricular arrhythmias. These had impaired LV function compared to those with less severe ventricular arrhythmias (LVGLS: -17.1 ± 3.0% vs. -18.8 ± 2.0%; p = 0.04). LV mechanical dispersion was an independent marker of life-threatening events (adjusted odds ratio: 2.2 [1.1 to 4.8] by 10 ms increments; p = 0.03). Conclusions Athletes with ventricular arrhythmias had impaired RV function and more myocardial fibrosis compared to healthy athletes. Athletes with life-threatening arrhythmic events had additional LV contraction abnormalities. These phenotypes mimic arrhythmogenic cardiomyopathy and may potentially be induced by high doses of exercise in susceptible individuals.

• Mullens, Wilfried; Auricchio, Angelo; Martens, Pieter; Witte, Klaus K.; Cowie, Martin R. & Delgado, Victoria [Vis alle 29 forfattere av denne artikkelen] (2020). Optimized implementation of cardiac resynchronization therapy: a call for action for referral and optimization of care: A joint position statement from the Heart Failure Association (HFA), European Heart Rhythm Association (EHRA), and European Association of Cardiovascular Imaging (EACVI) of the European Society of Cardiology. European Journal of Heart Failure. ISSN 1388-9842. 22(12), s. 2349–2369. doi: 10.1002/ejhf.2046. Fulltekst i vitenarkiv
• Edvardsen, Thor; Haugaa, Kristina; Petersen, Steffen E.; Gimelli, Alessia; Donal, Erwan & Maurer, Gerald [Vis alle 8 forfattere av denne artikkelen] (2020). The year 2019 in the European Heart Journal - Cardiovascular Imaging: Part i. European Heart Journal-Cardiovascular Imaging. ISSN 2047-2404. 21(11), s. 1208–1215. doi: 10.1093/ehjci/jeaa259. Fulltekst i vitenarkiv Vis sammendrag

  Abstract The European Heart Journal—Cardiovascular Imaging was launched in 2012 and has during these years become one of the leading multimodality cardiovascular imaging journals. The journal is now established as one of the top cardiovascular journals and is the most important cardiovascular imaging journal in Europe. The most important studies published in our Journal in 2019 will be highlighted in two reports. Part I of the review will focus on studies about myocardial function and risk prediction, myocardial ischaemia, and emerging techniques in cardiovascular imaging, while Part II will focus on valvular heart disease, heart failure, cardiomyopathies, and congenital heart disease.

• Cosyns, Bernard; Lochy, Stijn; Luchian, Maria Luiza; Gimelli, Alessia; Pontone, Gianluca & Allard, Sabine D. [Vis alle 11 forfattere av denne artikkelen] (2020). The role of cardiovascular imaging for myocardial injury in hospitalized COVID-19 patients. European Heart Journal-Cardiovascular Imaging. ISSN 2047-2404. 21(7), s. 709–714. doi: 10.1093/ehjci/jeaa136. Fulltekst i vitenarkiv
• Chair, Bogdan A. Popescu; Stefanidis, Alexandros; Fox, Kevin F.; Cosyns, Bernard; Delgado, Victoria & Salvo, Giovanni Di [Vis alle 13 forfattere av denne artikkelen] (2020). Training, competence, and quality improvement in echocardiography: the European Association of Cardiovascular Imaging Recommendations: update 2020. European Heart Journal-Cardiovascular Imaging. ISSN 2047-2404. 21(12), s. 1305–1319. doi: 10.1093/ehjci/jeaa266. Fulltekst i vitenarkiv
• Otterstad, Jan Erik; Norum, Ingvild Billehaug; Ruddox, Vidar; Bendz, Bjørn; Haugaa, Kristina & Edvardsen, Thor (2020). The impact of semi-automatic versus manually adjusted assessment of global longitudinal strain in post-myocardial infarction patients. The International Journal of Cardiovascular Imaging. ISSN 1569-5794. 36(7), s. 1283–1290. doi: 10.1007/s10554-020-01826-4. Fulltekst i vitenarkiv Vis sammendrag

  There are unresolved questions related to the proper use of editing the region of interest (ROI) for measurements of global longitudinal strain (GLS). The purpose of the present study was to compare the semi-automatic default GLS value by the vendor's software with manually adjusted GLS and test the impact on GLS measures with different ROI widths. We selected 25 patients post myocardial infarction treated with PCI who had excellent echocardiographic recordings after 2-5 days and 3 months. The different GLS values were assessed from these 50 analyses in three steps. The semi-automatically GLS by default ROIs was compared with manually adjusted ROIs widths selected by an expert and then with manual adjustments, but with fixed ROIs being narrow, medium and wide. Their mean age was 64 (+/- 12) years, 52% had ST elevation MI and mean LVEF was 52 (+/- 4)%. Mean default GLS was - 15.3 (+/- 2.5)% with the widest ROI level selected semi-automatically in 78% of all widths. The mean expert GLS with manually adjusted ROI was - 14.7 (+/- 2.4)%, and the medium ROI level was selected by the expert in 85% of all examinations. The mean adjusted GLS, but with fixed ROIs widths was - 15.0 (+/- 2.5%)% with narrow ROI, - 14.7 (+/- 2.6)% with medium and - 13.5 (+/- 2.3)% with wide ROI width (p < 0.001 vs. default GLS). The Intra Class Coefficient Correlation between default and manually adjusted expert GLS was 0.93 (p < 0.001). The difference between the default and the manually adjusted expert GLS was neglectable. These findings may represent a simplification of the assessment of GLS that might increase its use in clinical practice. The GLS measurements with a fixed wide ROIs were significantly different from the expert measurements and indicate that a wide ROI should be avoided

• Kleiven, Øyunn; Bjørkavoll-Bergseth, Magnus; Omland, Torbjørn; Aakre, Kristin Moberg; Frøysa, Vidar & Erevik, Christine Bjørkvik [Vis alle 12 forfattere av denne artikkelen] (2020). Endurance exercise training volume is not associated with progression of coronary artery calcification. Scandinavian Journal of Medicine & Science in Sports. ISSN 0905-7188. 30(6), s. 1024–1032. doi: 10.1111/sms.13643. Fulltekst i vitenarkiv Vis sammendrag

  Background Recent cross‐sectional studies have suggested a dose‐dependent relationship between lifelong exposure to physical activity and the burden of calcified coronary artery disease (CAD). No longitudinal studies have addressed this concern. Hypothesis Exercise volume is associated with progression of coronary artery calcium (CAC), defined as ≥10 units increase in CAC score. Methods Sixty‐one recreational athletes who were assessed by coronary computed tomography angiography (CCTA) as part of the NEEDED 2013/14 study were re‐assessed 4‐5 years later, in 2018. Results Subjects were 45.9 ± 9.6 years old at inclusion, and 46 (74%) were male. Between 2013 and 2018, the participants reported median 5 (range: 0‐20, 25th‐75th percentile: 4‐6) hours of high‐intensity exercise per week. None of the included subjects smoked during follow‐up. At inclusion, 21 (33%) participants had coronary artery calcifications. On follow‐up CCTA in 2018, 15 (25%) subjects had progressive coronary calcification (≥10 Agatston units increase in CAC). These subjects were older (53 ± 9 vs 44 ± 9 years old, P = .002) and had higher levels of low‐density lipoprotein at baseline (3.5 (2.9‐4.3) vs 2.9 (2.3‐3.5) mmol/L, P = .031) as compared to subjects with stable condition. No relationship was found between hours of endurance training per week and progression of coronary artery calcification. In multiple regression analysis, age and baseline CAC were the only significant predictors of progressive CAC. Conclusion No relationship between exercise training volume and the progression of coronary artery calcification was found in this longitudinal study of middle‐aged recreational athletes.

• Klæboe, Lars Gunnar; Brekke, Pål Haugar; Aaberge, Lars; Haugaa, Kristina & Edvardsen, Thor (2020). Impact of transcatheter aortic valve implantation on mechanical dispersion. Open heart. 7(1), s. 1–8. doi: 10.1136/openhrt-2019-001199. Fulltekst i vitenarkiv Vis sammendrag

  Objectives The physiological determinants of left ventricular (LV) mechanical dispersion (MD) are not fully explored. We aimed to investigate the impact of afterload reduction and changes in ventricular conduction on LV MD after transcatheter aortic valve implantation (TAVI). Methods Patients with severe aortic stenosis (AS) were examined in a prospective, repeated measures observational cohort study before and after an uncomplicated transfemoral TAVI in a single tertiary centre. LV MD was assessed by speckle tracking echocardiography. Valvulo-arterial impedance (ZVA) was used as a measure of global afterload. Results We included 140 consecutive patients (83±8 years old, 49% women, logistic EuroSCORE 16±10) with severe AS (valve area 0.7±0.2 cm 2 , mean transvalvular gradient 54±18 mm Hg) and a relatively preserved LV ejection fraction (52%±11%). After TAVI, we observed favourable changes in transvalvular gradients and ZVA in all patients. Compared with baseline, postprocedural MD was significantly lower in 108 patients with unchanged ventricular conduction (55±17 ms vs 51±17 ms, p=0.02) and higher in 28 patients with TAVI-induced left bundle branch block (51±13 ms vs 62±19 ms, p≤0.001). During 22±9 months observation, 22 patients died. Postprocedural MD was associated with mortality in a univariate Cox regression model (HR=1.24 (1.01–1.52), p&lt;0.04, per 10 ms increase). Conclusions Isolated afterload reduction was associated with reduction of MD, while concomitant impairment of ventricular conduction resulted in a more pronounced MD after TAVI, indicating that loading conditions and conduction should be considered when evaluating MD. A pronounced postprocedural LV MD was associated with mortality.

• Platonov, Pyotr G.; Castrini, Anna Isotta; Svensson, Anneli; Christiansen, Morten K.; Gilljam, Thomas & Bundgaard, Henning [Vis alle 15 forfattere av denne artikkelen] (2020). Pregnancies, ventricular arrhythmias, and substrate progression in women with arrhythmogenic right ventricular cardiomyopathy in the Nordic ARVC Registry. Europace. ISSN 1099-5129. 22(12), s. 1873–1879. doi: 10.1093/europace/euaa136. Fulltekst i vitenarkiv
• Pischke, Søren; Hestenes, Siv Merete; Johansen, Harald Thidemann; Fure, Hilde; Bugge, Jan F & Espinoza, Andreas Westenvik [Vis alle 12 forfattere av denne artikkelen] (2019). Sepsis causes right ventricular myocardial inflammation independent of pulmonary hypertension in a porcine sepsis model. PLOS ONE. 14:e0218624(6). doi: 10.1371/journal.pone.0218624. Fulltekst i vitenarkiv Vis sammendrag

  Introduction Right ventricular (RV) myocardial dysfunction is a common feature in septic shock. It can worsen outcome, but the etiology is poorly understood. Pulmonary artery hypertension (PAH) plays a part in the pathogenesis of the right heart dysfunction in sepsis but its importance is unknown. In pigs, PAH in sepsis is substantial and the translational value of porcine sepsis models therefore questioned. We hypothesized that porcine sepsis causes a myocardial inflammatory response which leads to myocardial dysfunction independent of PAH. Materials and methods Sepsis was induced by Escherichia coli-infusion in 10 pigs resulting in PAH and increased right ventricular pressure (RVP). The same degree of RVP was achieved by external pulmonary artery banding (PAB) in a consecutive series of 6 animals. Results Sepsis, but not PAB, led to increase in endothelial damage marker PAI-1 and cytokines TNF and IL-6 (all p<0.05) in plasma. In myocardium, TNF and IL-6 were significantly elevated in sepsis, TNF in both ventricles and IL-6 mostly in RV, while IL-1β, IL-18 and C5a were significantly higher in RV compared to LV after PAB (all p<0.05). Myocardial mRNA levels of IL-1β, IL-6, IL-18, IP-10, E-selectin and PAI-1 were significantly elevated in RV and LV during sepsis compared to PAB, while Caspase-1 was decreased in septic compared to PAB animals (all p<0.05). Cathepsin L activity was increased in RV by PAB, while sepsis inhibited this response. Escherichia coli-induced sepsis caused myocardial inflammation independent of PAH. Conclusion Prominent PAH should therefore not exclude porcine sepsis models to further our understanding of human sepsis.

• Cameli, Matteo; Marsan, Nina Ajmone; D'Andrea, Antonello; Dweck, Mark R.; Fontes-Carvalho, Ricardo & Manka, Robert [Vis alle 13 forfattere av denne artikkelen] (2019). EACVI survey on multimodality training in ESC countries. European Heart Journal-Cardiovascular Imaging. ISSN 2047-2404. 20(12), s. 1332–1336. doi: 10.1093/ehjci/jez200. Fulltekst i vitenarkiv Vis sammendrag

  One of the missions of the European Association of Cardiovascular Imaging (EACVI) is ‘to promote excellence in clinical diagnosis, research, technical development, and education in cardiovascular imaging’. The future of imaging involves multimodality so each imager should have the incentive and the possibility to improve its knowledge in other cardiovascular techniques. This article presents the results of a 20 questions survey carried out in cardiovascular imaging (CVI) centres across Europe. The aim of the survey was to assess the situation of experience and training of CVI in Europe, the availability and organization of modalities in each centre and to ask for vision about potential improvements in CVI at national and European level.

• Karlsen, Sigve; Dahlslett, Thomas; Grenne, Bjørnar; Sjøli, Benthe; Smiseth, Otto A. & Edvardsen, Thor [Vis alle 7 forfattere av denne artikkelen] (2019). Global longitudinal strain is a more reproducible measure of left ventricular function than ejection fraction regardless of echocardiographic training. Cardiovascular Ultrasound. 17(18). doi: 10.1186/s12947-019-0168-9. Fulltekst i vitenarkiv Vis sammendrag

  Background: Left ventricular ejection fraction (LVEF) is an established method for evaluation of left ventricular (LV)systolic function. Global longitudinal strain (GLS) by speckle tracking echocardiography seems to be an important additive method for evaluation of LV function with improved reproducibility compared with LVEF. Our aim was to compare reproducibility of GLS and LVEF between an expert and trainee both as echocardiographic examiner and analyst. Methods: Forty-seven patients with recent Acute Coronary Syndrome (ACS) underwent echocardiographic examination by both an expert echocardiographer and a trainee. Both echocardiographers, blinded for clinical data and each other’s findings, performed image analysis for evaluation of intra- and inter- observer variability. GLS was measured using speckle tracking echocardiography. LVEF was calculated by Simpson’s biplane method. Results: The trainee measured a GLS of−19.4% (±3.5%) and expert−18.7% (±3.2%) with an Intra class correlation coefficient (ICC) of 0.89 (0.74–0.95). LVEF by trainee was 50.3% (±8.2%) and by expert 53.6% (±8.6%), ICC coefficient was 0.63 (0.32–0.80). For GLS the systematic difference was 0.21% (−4.58–2.64) vs. 4.08% (−20.78–12.62) for LVEF. Conclusion: GLS is a more reproducible method for evaluation of LV function than LVEF regardless of echocardiographic training.

• Scheirlynck, Esther Steffie; Dejgaard, Lars; Skjølsvik, Eystein Theodor Ek; Lie, Øyvind Haugen; Motoc, Andreea & Hopp, Einar [Vis alle 14 forfattere av denne artikkelen] (2019). Increased levels of sST2 in patients with mitral annulus disjunction and ventricular arrhythmias. Open heart. 6:e001016(1), s. 1–8. doi: 10.1136/openhrt-2019-001016. Fulltekst i vitenarkiv Vis sammendrag

  Objective: Displacement of the mitral valve, mitral annulus disjunction (MAD), is described as a possible aetiology of sudden cardiac death. Stress-induced fibrosis in the mitral valve apparatus has been suggested as the underlying mechanism. We aimed to explore the association between stretch-related and fibrosis-related biomarkers and ventricular arrhythmias in MAD. We hypothesised that soluble suppression of tumourigenicity-2 (sST2) and transforming growth factor-β1 (TGFβ1) are markers of ventricular arrhythmias in patients with MAD. Methods: We included patients with ≥1 mm MAD on cardiac MRI. We assessed left ventricular ejection fraction (LVEF) and fibrosis by late gadolinium enhancement (LGE). The occurrence of ventricular arrhythmia, defined as aborted cardiac arrest, sustained or non-sustained ventricular tachycardia, was retrospectively assessed. We assessed circulating sST2 and TGFβ1 levels. Results: We included 72 patients with MAD, of which 22 (31%) had ventricular arrhythmias. Patients with ventricular arrhythmias had lower LVEF (60 % (±6) vs 63% (±6), p = 0.04), more frequently papillary muscle fibrosis (14 (64%) vs 10 (20%), p < 0.001) and higher sST2 levels (31.6 ± 10.1 ng/mL vs 25.3 ± 9.2 ng/mL, p = 0.01) compared with those without, while TGFβ1 levels did not differ (p = 0.29). Combining sST2 level, LVEF and papillary muscle fibrosis optimally detected individuals with arrhythmia (area under the curve 0.82, 95% CI 0.73 to 0.92) and improved the risk model (p < 0.05) compared with single parameters. Conclusion: Circulating sST2 levels were higher in patients with MAD and ventricular arrhythmias compared with arrhythmia-free patients. Combining sST2, LVEF and LGE assessment improved risk stratification in patients with MAD.

• Edvardsen, Thor (2019). EuroEcho-Imaging 2018: Thor Edvardsen FESC reports on the world’s largest cardiovascular imaging Congress that took place in December 2018 . European Heart Journal. ISSN 0195-668X. 40(14), s. 1098–1100. doi: 10.1093/eurheartj/ehz144. Fulltekst i vitenarkiv
• Kawakami, Hiroshi; Nerlekar, Nitesh; Haugaa, Kristina; Edvardsen, Thor & Marwick, Thomas H. (2019). Prediction of Ventricular Arrhythmias With Left Ventricular Mechanical Dispersion: A Systematic Review and Meta-Analysis. JACC Cardiovascular Imaging. ISSN 1936-878X. 13(2), s. 562–572. doi: 10.1016/j.jcmg.2019.03.025. Fulltekst i vitenarkiv
• Magne, Julien; Bharucha, Tara; Bucciarelli-Ducci, Chiara; Dahl, Jordi S.; Gimelli, Alessia & Haugaa, Kristina [Vis alle 10 forfattere av denne artikkelen] (2019). EuroEcho-imaging 2018: highlights. European Heart Journal-Cardiovascular Imaging. ISSN 2047-2404. 20(5), s. 489–497. doi: 10.1093/ehjci/jez042. Fulltekst i vitenarkiv
• Cosyns, Bernard; Haugaa, Kristina; Gerber, Bernhard L.; Gimelli, Alessia; Donal, Erwan & Maurer, Gerald [Vis alle 7 forfattere av denne artikkelen] (2019). The year 2018 in the European Heart Journal - Cardiovascular Imaging: Part II. European Heart Journal-Cardiovascular Imaging. ISSN 2047-2404. 20(12), s. 1337–1344. doi: 10.1093/ehjci/jez218. Fulltekst i vitenarkiv
• Munkhaugen, John; Ruddox, Vidar; Halvorsen, Sigrun; Dammen, Toril; Fagerland, Morten & Hernæs, Kjersti Helene [Vis alle 23 forfattere av denne artikkelen] (2019). BEtablocker Treatment After acute Myocardial Infarction in revascularized patients without reduced left ventricular ejection fraction (BETAMI): Rationale and design of a prospective, randomized, open, blinded end-point study. American Heart Journal. ISSN 0002-8703. 208, s. 37–46. doi: 10.1016/j.ahj.2018.10.005. Fulltekst i vitenarkiv Vis sammendrag

  Background - Current guidelines on the use of β-blockers in post–acute myocardial infarction (MI) patients without reduced left ventricular ejection fraction (LVEF) are based on studies before the implementation of modern reperfusion and secondary prevention therapies. It remains unknown whether β-blockers will reduce mortality and recurrent MI in contemporary revascularized post-MI patients without reduced LVEF. Design - BETAMI is a prospective, randomized, open, blinded end point multicenter study in 10,000 MI patients designed to test the superiority of oral β-blocker therapy compared to no β-blocker therapy. Patients with LVEF ≥40% following treatment with percutaneous coronary intervention or thrombolysis and/or no clinical signs of heart failure are eligible to participate. The primary end point is a composite of all-cause mortality or recurrent MI obtained from national registries over a mean follow-up period of 3 years. Safety end points include rates of nonfatal MI, all-cause mortality, ventricular arrhythmias, and hospitalizations for heart failure obtained from hospital medical records 30 days after randomization, and from national registries after 6 and 18 months. Key secondary end points include recurrent MI, heart failure, cardiovascular and all-cause mortality, and clinical outcomes linked to β-blocker therapy including drug adherence, adverse effects, cardiovascular risk factors, psychosocial factors, and health economy. Statistical analyses will be conducted according to the intention-to-treat principle. A prespecified per-protocol analysis (patients truly on β-blockers or not) will also be conducted. Conclusions - The results from the BETAMI trial may have the potential of changing current clinical practice for treatment with β-blockers following MI in patients without reduced LVEF. EudraCT number 2018-000590-75.

• Klæboe, Lars Gunnar; Brekke, Pål Haugar; Lie, Øyvind Haugen; Aaberge, Lars; Haugaa, Kristina & Edvardsen, Thor (2019). Classical mechanical dyssynchrony is rare in transcatheter aortic valve implantation-induced left bundle branch block. European Heart Journal-Cardiovascular Imaging. ISSN 2047-2404. 20(3), s. 271–278. doi: 10.1093/ehjci/jey127. Fulltekst i vitenarkiv Vis sammendrag

  Aims Left bundle branch block (LBBB) is a frequent conduction abnormality after transcatheter aortic valve implantation (TAVI). We aimed to investigate how TAVI procedure related conduction abnormalities influence ventricular mechanics and prognosis, with particular focus on new-onset persistent LBBB. Methods and results A total of 140 consecutive patients with severe aortic stenosis (83 ± 8 years old, 49% women) undergoing TAVI in a single tertiary centre were included in a repeated measures study. Changes in myocardial function and contraction patterns were investigated in relation to changes in electrical conduction and afterload by speckle tracking echocardiography. Whether patients with new-onset LBBB acquired classical dyssynchronous contractions was assessed by longitudinal strain in apical four-chamber view. Global longitudinal strain improvement was seen in all patients (−15.1 ± 4.3 vs. −16.1 ± 3.9%, P < 0.01, n = 140), and all subgroups, regardless of pre-existing or procedure-acquired conduction abnormalities immediately after TAVI. New-onset LBBB fulfilling strict electrocardiogram (ECG) criteria was observed in 28 patients (20%). The vast majority of new-onset LBBB patients (n = 26, 93%) had homogenous contractions. Classical dyssynchronous LBBB contractions were only observed in 2 patients (7%) with new-onset LBBB. Patients with new-onset LBBB and patients without acquired conduction disorders had similar mortality rates during 19 ± 9 months of follow-up [11.1, 95% confidence interval (CI) 4.6–26.8 vs. 8.1, 95% CI 4.8–13.7 per 100 patients years, P = 0.53]. Conclusion Classical dyssynchronous LBBB contractions were absent in most patients with new-onset post-TAVI LBBB, even when applying strict ECG criteria. Patients with and without new-onset LBBB experienced similar prognosis with regards to mortality.

• Haugaa, Kristina; Marsan, Nina Ajmone; Cameli, Matteo; D'Andrea, Antonello; Dweck, Mark R. & Carvalho, Ricardo Fontes [Vis alle 16 forfattere av denne artikkelen] (2019). Criteria for surveys: from the European Association of Cardiovascular Imaging Scientific Initiatives Committee. European Heart Journal-Cardiovascular Imaging. ISSN 2047-2404. 20(9), s. 963–966. doi: 10.1093/ehjci/jez193. Fulltekst i vitenarkiv Vis sammendrag

  The European Association of Cardiovascular Imaging (EACVI) is committed to maintaining the highest standards of professional excellence in all aspects of cardiovascular imaging. The mission of the EACVI is to promote excellence in clinical diagnosis, research, technical development, and education in cardiovascular imaging with a particular focus on education, training, scientific initiatives, and research. The EACVI established the Scientific Initiatives Committee (SIC) in December 2018. This committee has responsibility for surveys among imagers, patients’ surveys and surveys including data from clinical practice. The current document describes the aims of the EACVI SIC and the creation of the international EACVI survey network. This document summarizes the EACVI's standards for the survey questions and standards for writing the papers with the results of the surveys. These are in accordance with previous recommendations and were approved by the EACVI SIC and the EACVI Board in 2019.

• Kvisvik, Brede Alexander; Aagaard, Erika Nerdrum; Mørkrid, Lars; Røsjø, Helge; Lyngbakken, Magnus & Smedsrud, Marit Kristine [Vis alle 11 forfattere av denne artikkelen] (2019). Mechanical dispersion as a marker of left ventricular dysfunction and prognosis in stable coronary artery disease. The International Journal of Cardiovascular Imaging. ISSN 1569-5794. 35, s. 1265–1275. doi: 10.1007/s10554-019-01583-z. Fulltekst i vitenarkiv Vis sammendrag

  Assessment of global longitudinal strain (GLS) is superior to ejection fraction (EF) in the evaluation of left ventricular (LV) function in patients with stable coronary artery disease (CAD). However, the role of mechanical dispersion (MD) in this context remains unresolved. We aimed to evaluate the potential role of MD as a marker of LV dysfunction and long-term prognosis in stable CAD. EF, GLS and MD were assessed in 160 patients with stable CAD, 1 year after successful coronary revascularization. Serum levels of high-sensitivity cardiac troponin I (hs-cTnI) and amino-terminal pro B-type natriuretic peptide (NT-proBNP) were quantified as surrogate markers of LV dysfunction. The primary endpoint was defined as all-cause mortality, the secondary endpoint was defined as the composite of all-cause mortality and hospitalization for acute myocardial infarction or heart failure during follow-up. Whereas no associations between EF and the biochemical markers of LV function were found, both GLS and MD correlated positively with increasing levels of hs-cTnI (R = 0.315, P < 0.001 and R = 0.442, P < 0.001, respectively) and NT-proBNP (R = 0.195, P = 0.016 and R = 0.390, P < 0.001, respectively). Median MD was 46 ms (interquartile range [IQR] 37–53) and was successfully quantified in 96% of the patients. During a median follow-up of 8.4 (IQR 8.2–8.8) years, 14 deaths and 29 secondary events occurred. MD was significantly increased in non-survivors, and provided incremental prognostic value when added to EF and GLS. NT-proBNP was superior to the echocardiographic markers in predicting adverse outcomes. MD may be a promising marker of LV dysfunction and adverse prognosis in stable CAD.

• Castrini, Anna Isotta; Lie, Øyvind Haugen; Leren, Ida Skrinde; Estensen, Mette-Elise; Stokke, Mathis Korseberg & Klæboe, Lars Gunnar [Vis alle 8 forfattere av denne artikkelen] (2019). Number of pregnancies and subsequent phenotype in a cross-sectional cohort of women with arrhythmogenic cardiomyopathy. European Heart Journal-Cardiovascular Imaging. ISSN 2047-2404. 20(2), s. 192–198. doi: 10.1093/ehjci/jey061. Fulltekst i vitenarkiv Vis sammendrag

  Aims We aimed to assess the relation between number of pregnancies and cardiac structure, function, and arrhythmic events in women with arrhythmogenic cardiomyopathy (AC). Methods and results We included female AC patients in a cross-sectional study. Number of pregnancies and pregnancy related symptoms were recorded. Ventricular arrhythmias were defined as aborted cardiac arrest, sustained ventricular tachycardia, or appropriate implantable cardioverter-defibrillator therapy. Right and left ventricular dimensions and function, including strain analyses, were assessed by echocardiography and magnetic resonance imaging. We created a new AC severity score to grade the severity of AC disease. We included 77 women (age 47 ± 16, 43 probands and 34 AC mutation positive female relatives), 19 ± 14 years after last pregnancy. Median number of pregnancies was 2 (0–4); 19 had no previous pregnancies, 16 had 1 pregnancy, 30 had 2, and 12 had ≥3 pregnancies. Presence of a definite AC diagnosis (P = 0.36), severity of AC disease (P = 0.53), and arrhythmic events (P = 0.25) did not differ between groups of pregnancies. Number of pregnancies was related to increased right ventricular outflow tract diameter in single variable analyses [odds ratio (OR) 1.76, 95% confidence interval (CI) 1.08–2.87; P = 0.02], but not when adjusted for body surface area and age (OR 1.56, 95% CI 0.91–2.66; P = 0.11). The number of pregnancies was not associated with any other measures of cardiac structure and function. Conclusion Higher number of pregnancies did not seem to relate to a worse phenotype in women with AC.

• Moharem-Elgamal, Sarah; Cameli, Matteo; Muraru, Denisa; Brassart, Veronique; Esperou-Surrel, Audrey & Mahmoud-Elsayed, Hani [Vis alle 10 forfattere av denne artikkelen] (2019). HIT communication paper: Strategies and tips to increase your chances of winning an EACVI grant. European Heart Journal-Cardiovascular Imaging. ISSN 2047-2404. 20(7), s. 735–739. doi: 10.1093/ehjci/jez088. Fulltekst i vitenarkiv
• Barros, Márcio Vinicius Lins de; Macedo, Ariane Vieira Scarlatelli; Sarvari, Sebastian; Faleiros, Monica Hermont; Felipe, Patricia Tavares & Silva, José Luiz Padilha [Vis alle 7 forfattere av denne artikkelen] (2019). Left ventricular regional wall motion abnormality is a strong predictor of cardiotoxicity in breast cancer patients undergoing chemotherapy. Arquivos Brasileiros de Cardiologia. ISSN 0066-782X. 112(1), s. 50–56. doi: 10.5935/abc.20180220. Fulltekst i vitenarkiv Vis sammendrag

  Background: Chemotherapeutic agents of anthracyclines class and humanized monoclonal antibodies are effective treatments for breast cancer, however, they present a potential risk of cardiotoxicity. Several predictors have been recognized as predictors in the development of cardiac toxicity, and the evaluation of left ventricular segmental wall motion abnormalities (LVSWMA) has not been studied. Objective: To analyze prospectively the role of LVSWMA among echocardiographic parameters in the prediction of development of cardiotoxicity in breast cancer patients undergoing treatment with chemotherapy. Methods: Prospective cohort of patients diagnosed with breast cancer and in chemotherapy treatment with potential cardiotoxicity medications including doxorubicin and trastuzumab. Transthoracic echocardiograms including speckle tracking strain echocardiography were performed at standard times before, during and after the treatment to assess the presence (or lack thereof) of cardiotoxicity. Cardiotoxicity was defined by a 10% decrease in the left ventricular ejection fraction, on at least one echocardiogram. Multivariate logistic regression models were used to verify the predictors related to the occurrence of cardiotoxicity over time. Results: Of the 112 patients selected (mean age 51,3 ± 12,9 years), 18 participants (16.1%) had cardiotoxicity. In the multivariate analysis using the logistic regression model, those with LVWMA (OR = 6.25 [CI 95%: 1.03; 37.95], p < 0,05), LV systolic dimension (1.34 [CI 95%: 1.01; 1.79], p < 0,05) and global longitudinal strain by speckle tracking (1.48 [CI 95%: 1.02; 2.12], p < 0,05) were strongly associated with cardiotoxicity. Conclusion: In the present study, we showed that LVWMA, in addition to global longitudinal strains, were strong predictors of cardiotoxicity and could be useful in the risk stratification of these patients.

• Babic, Aleksandar; Odland, Hans Henrik; Lyseggen, Erik; Holm, Torbjørn; Ross, Stian Balnagown & Hopp, Einar [Vis alle 11 forfattere av denne artikkelen] (2019). An image fusion tool for echo‐guided left ventricular lead placement in cardiac resynchronization therapy: Performance and workflow integration analysis. Echocardiography. ISSN 0742-2822. 36(10), s. 1834–1845. doi: 10.1111/echo.14483. Fulltekst i vitenarkiv Vis sammendrag

  Background The response rate to cardiac resynchronization therapy (CRT) may be improved if echocardiographic‐derived parameters are used to guide the left ventricular (LV) lead deployment. Tools to visually integrate deformation imaging and fluoroscopy to take advantage of the combined information are lacking. Methods An image fusion tool for echo‐guided LV lead placement in CRT was developed. A personalized average 3D cardiac model aided visualization of patient‐specific LV function in fluoroscopy. A set of coronary venography‐derived landmarks facilitated registration of the 3D model with fluoroscopy into a single multimodality image. The fusion was both performed and analyzed retrospectively in 30 cases. Baseline time‐to‐peak values from echocardiography speckle‐tracking radial strain traces were color‐coded onto the fused LV. LV segments with suspected scar tissue were excluded by cardiac magnetic resonance imaging. The postoperative augmented image was used to investigate: (a) registration accuracy and (b) agreement between LV pacing lead location, echo‐defined target segments, and CRT response. Results Registration time (264 ± 25 seconds) and accuracy (4.3 ± 2.3 mm) were found clinically acceptable. A good agreement between pacing location and echo‐suggested segments was found in 20 (out of 21) CRT responders. Perioperative integration of the proposed workflow was successfully tested in 2 patients. No additional radiation, compared with the existing workflow, was required. Conclusions The fusion tool facilitates understanding of the spatial relationship between the coronary veins and the LV function and may help targeted LV lead delivery.

• 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.

• Saraste, Antti; Barbato, Emanuele; Capodanno, Davide; Edvardsen, Thor; Prescott, Eva & Achenbach, Stephan [Vis alle 9 forfattere av denne artikkelen] (2019). Imaging in ESC clinical guidelines: Chronic coronary syndromes. European Heart Journal-Cardiovascular Imaging. ISSN 2047-2404. 20(11), s. 1187–1197. doi: 10.1093/ehjci/jez219. Fulltekst i vitenarkiv
• Brynildsen, Jon; Myhre, Peder Langeland; Lyngbakken, Magnus; Klæboe, Lars Gunnar; Stridsberg, Mats & Christensen, Geir Arve [Vis alle 9 forfattere av denne artikkelen] (2019). Circulating secretoneurin concentrations in patients with moderate to severe aortic stenosis. Clinical Biochemistry. ISSN 0009-9120. 71, s. 17–23. doi: 10.1016/j.clinbiochem.2019.06.008. Fulltekst i vitenarkiv Vis sammendrag

  Background Secretoneurin (SN) concentrations provide important prognostic information in patients with myocardial dysfunction. Whether preoperative SN concentrations improve risk assessment in patients with moderate to severe aortic stenosis (AS) is unknown. Methods We included 57 patients with moderate to severe AS referred for presurgical evaluation. All patients were examined with comprehensive echocardiography, electrocardiogram (ECG), and biochemical measurements and compared to 10 age- and sex-matched healthy subjects. Results Median (quartile 1–3) SN concentrations were 141 (121–163) pmol/L in AS patients and 132 (106–148) pmol/L in control subjects (p = .17). Lower estimated creatinine clearance and use of diuretics, but not standard ECG or echocardiographic indices and cardiac biomarkers, were associated with increasing SN concentrations. Fifteen patients (26%) died during 3.5 years median follow-up. SN concentrations were higher in non-survivors than survivors: 156 (133–209) vs. 140 (116–155) pmol/L, p = .007. Higher SN concentrations were associated with increased risk of mortality also after adjustment for established risk indices, biomarkers, and status regarding valvular surgery: hazard ratio per lnSN 15.13 (95% CI 1.05–219.00); p = .046. Receiver operating characteristics area under the curve for SN to predict mortality was 0.74 (95% CI 0.60–0.88) compared to 0.73 (0.59–0.87) for high-sensitivity cardiac troponin T and 0.67 (0.51–0.82) for N-terminal pro-B-type natriuretic peptide. The previously identified cut-off of SN >204 pmol/L in cardiac surgical patients predicted mortality also in this cohort. Conclusions SN concentrations improve risk assessment in patients with moderate to severe AS by providing additional prognostic information to established risk indices such as echocardiography, ECG, and established cardiac biomarkers.

• Baturova, Maria A; Haugaa, Kristina; Jensen, Henrik K; Svensson, Anneli; Gilljam, Thomas & Bundgaard, Henning [Vis alle 14 forfattere av denne artikkelen] (2019). Atrial fibrillation as a clinical characteristic of arrhythmogenic right ventricular cardiomyopathy: Experience from the Nordic ARVC Registry. International Journal of Cardiology. ISSN 0167-5273. s. 39–43. doi: 10.1016/j.ijcard.2019.07.086. Fulltekst i vitenarkiv Vis sammendrag

  Abstract BACKGROUND: Recent studies in arrhythmogenic right ventricular cardiomyopathy (ARVC) patients have drawn attention to atrial fibrillation (AF) as an arrhythmic manifestation of ARVC and as an indicator of atrial involvement in the disease progression. We aimed to assess the prevalence of AF in the Scandinavian cohort of ARVC patients and to evaluate its association with disease clinical manifestations. METHODS: Study sample comprised of 293 definite ARVC patients by 2010 Task Force criteria (TFC2010) and 141 genotype-positive family members (total n = 434, 43% females, median age at ARVC diagnosis 41 years [interquartile range (IQR) 28-52 years]). ARVC diagnostic score was calculated as the sum of major (2 points) and minor (1 point) criteria in all categories of the TFC2010. RESULTS: AF was diagnosed in 42 patients (10%): in 41 patients with definite ARVC diagnosis (14%) vs in one genotype-positive family member (1%), p < 0.001. The median age at AF onset was 51 (IQR 38-58) years. The prevalence of AF was related to the ARVC diagnostic score: it significantly increased starting with the diagnostic score 4 (2% in those with score 3 vs 13% in those with score 4, p = 0.023) and increased further with increased diagnostic score (Somer's d value is 0.074, p < 0.001). CONCLUSION: AF is seen in 14% of definite ARVC patients and is related to the severity of disease phenotype thus suggesting AF being an arrhythmic manifestation of this cardiomyopathy indicating atrial myocardial involvement in the disease progression.

• Kvåle, Kaja Frøysaa; Salles, Sebastien; Brekke, Pål Haugar; Remme, Espen W.; Aalen, John & Edvardsen, Thor [Vis alle 7 forfattere av denne artikkelen] (2019). Comparison of two methods for mechanical activation detection using high frame rate ultrasound imaging. Proceedings - IEEE Ultrasonics Symposium. ISSN 1948-5719. 2019-October, s. 1410–1413. doi: 10.1109/ULTSYM.2019.8925759. Fulltekst i vitenarkiv
• Edvardsen, Thor; Haugaa, Kristina; Petersen, Steffen E.; Gimelli, Alessia; Donal, Erwan & Maurer, Gerald [Vis alle 8 forfattere av denne artikkelen] (2019). The year 2018 in the European Heart Journal - Cardiovascular Imaging: Part I. European Heart Journal-Cardiovascular Imaging. ISSN 2047-2404. 20(8), s. 858–865. doi: 10.1093/ehjci/jez133. Fulltekst i vitenarkiv Vis sammendrag

  The European Heart Journal – Cardiovascular Imaging has become one of the leading multimodality cardiovascular imaging journal, since it was launched in 2012. The impact factor is an impressive 8.366 and it is now established as one of the top 10 cardiovascular journals. The journal is the most important cardiovascular imaging journal in Europe. The most important studies from 2018 will be highlighted in two reports. Part I of the review will focus on studies about myocardial function and risk prediction, myocardial ischaemia, and emerging techniques in cardiovascular imaging, while Part II will focus on valvular heart disease, heart failure, cardiomyopathies, and congenital heart disease.

• Rootwelt, Christine; Lie, Øyvind Haugen; Dejgaard, Lars; Chivulescu, Ana Monica; Leren, Ida Skrinde & Edvardsen, Thor [Vis alle 7 forfattere av denne artikkelen] (2019). Life-threatening arrhythmic presentation in patients with arrhythmogenic cardiomyopathy before and after entering the genomic era; a two-decade experience from a large volume center. International Journal of Cardiology. ISSN 0167-5273. s. 79–83. doi: 10.1016/j.ijcard.2018.12.066. Fulltekst i vitenarkiv Vis sammendrag

  Background: Arrhythmogenic cardiomyopathy (AC) is an inheritable progressive heart disease with high risk of life-threatening ventricular arrhythmia (VA). We aimed to explore the prevalence of VA as presenting event in patients with AC over two decades, symptoms preceding VA and compare the clinical presentations and rate of AC-diagnosis over time. Methods: We included consecutive AC-patients from our tertiary referral center. We recorded clinical history, VA (aborted cardiac arrest, sustained ventricular tachycardia or appropriate implantable cardioverter-defibrillator therapy), cardiac symptoms preceding VA in AC, and compared the history of patients diagnosed before and after implementation of genetic testing. Results: We included 179 consecutive AC-patients and mutation-positive family members (95 [53%] probands, 84 [45%] female, 49 ± 17 years), 33 (18%) diagnosed before and 146 (82%) after genetic testing became available. VA led to the AC-diagnosis in 46 (26%), and was less prevalent after implementation of genetic testing (17[52%] vs. 29[20%], p < 0.001), also when adjusted for proband status (Adjusted OR 2.7, 95% CI 1.1–6.7, p = 0.03). Yearly rate of AC-diagnosis increased after implementation of genetic testing in probands (2.7 ± 1.3 vs. 6.8 ± 4.3, p = 0.01) and family members (0.7 ± 1.1 vs. 7.7 ± 5.9, p = 0.002). Most patients with VA (92%) reported cardiac symptoms prior to event, and exercise-induced syncope was the strongest marker of subsequent VA (Adjusted OR 5.3, 95% CI 1.7–16.4, p = 0.004). Conclusion: VA led to AC-diagnosis in 46% of probands and was preceded by cardiac symptoms in the majority of cases. Yearly rate of AC-diagnoses increased after the implementation of genetic testing and life-threatening presentation of AC-disease seemed to decrease.

• Kvåle, Kaja Frøysaa; Bersvendsen, Jørn; Remme, Espen W.; Salles, Sebastien; Aalen, John & Brekke, Pål Haugar [Vis alle 8 forfattere av denne artikkelen] (2019). Detection of regional mechanical activation of the left ventricular myocardium using high frame rate ultrasound imaging. IEEE Transactions on Medical Imaging. ISSN 0278-0062. 38:8682078(11), s. 2665–2675. doi: 10.1109/TMI.2019.2909358. Fulltekst i vitenarkiv
• Håland, Trine Synnøve Fink & Edvardsen, Thor (2019). The role of echocardiography in management of hypertrophic cardiomyopathy. Journal of Echocardiography. ISSN 1349-0222. s. 1–9. doi: 10.1007/s12574-019-00454-9. Fulltekst i vitenarkiv
• Kvåle, Kaja Frøysaa; Salles, Sebastien; Brekke, Pål Haugar; Edvardsen, Thor & Samset, Eigil (2019). Velocity estimation of naturally occurring mechanical waves in the left ventricle in healthy persons. Proceedings - IEEE Ultrasonics Symposium. ISSN 1948-5719. 2019-October, s. 1425–1428. doi: 10.1109/ULTSYM.2019.8926213. Fulltekst i vitenarkiv
• Edvardsen, Thor & Klæboe, Lars Gunnar (2019). Imaging and heart failure: Myocardial strain. Current Opinion in Cardiology. ISSN 0268-4705. 34(5), s. 490–494. doi: 10.1097/HCO.0000000000000653. Fulltekst i vitenarkiv
• Christiansen, Morten K; Haugaa, Kristina; Svensson, Anneli; Gilljam, Thomas; Madsen, Trine & Hansen, Jim [Vis alle 12 forfattere av denne artikkelen] (2019). Incidence, Predictors, and Success of Ventricular Tachycardia Catheter Ablation in Arrhythmogenic Right Ventricular Cardiomyopathy (from the Nordic ARVC Registry). American Journal of Cardiology. ISSN 0002-9149. 125, s. 803–811. doi: 10.1016/j.amjcard.2019.11.026. Fulltekst i vitenarkiv Vis sammendrag

  Catheter ablation may reduce ventricular tachycardia (VT) burden in arrhythmogenic right ventricular cardiomyopathy (ARVC) patients. However, little is known about factors predicting need for ablation. Therefore, we sought to investigate predictors and use of VT ablation and to evaluate the postprocedural outcome in ARVC patients. We studied 435 patients from the Nordic ARVC registry including 220 probands with definite ARVC according to the 2010 task force criteria and 215 mutation-carrying relatives identified through cascade screening. Patients were followed until first-time VT ablation, death, heart transplantation, or January 1st 2018. Additionally, patients undergoing VT ablation were further followed from the time of ablation for recurrent ventricular arrhythmias. The cumulative use of VT ablation was 4% (95% confidence interval [CI] 3% to 6%) and 11% (95% CI 8% to 15%) after 1 and 10 years. All procedures were performed in probands in whom cumulative use was 8% (95% CI 5% to 12%) and 20% (95% CI 15% to 26%). In adjusted analyses among probands, only young age predicted ablation. In patients undergoing ablation, risk of recurrent arrhythmias was 59% (95% CI 44% to 71%) and 74% (95% CI 59% to 84%) 1 and 5 years after the procedure. Despite high recurrence rates, the burden of ventricular arrhythmias was reduced after ablation (p = 0.0042). Young age, use of several antiarrhythmic drugs and inducibility to VT after ablation were associated with an unfavorable outcome. In conclusion, twenty percent of ARVC probands developed a clinical indication for VT ablation within 10 years whereas mutation-carrying relatives were without such need. Although the burden of ventricular arrhythmias decreased after ablation, risk of recurrence was substantial.

• Platonov, Pyotr G.; Haugaa, Kristina; Bundgaard, Henning; Svensson, Anneli; Gilljam, Thomas & Hansen, Jim [Vis alle 14 forfattere av denne artikkelen] (2019). Primary prevention of sudden cardiac death with implantable cardioverter-defibrillator therapy in patients with arrhythmogenic right ventricular cardiomyopathy. American Journal of Cardiology. ISSN 0002-9149. 123(7), s. 1156–1162. doi: 10.1016/j.amjcard.2018.12.049. Fulltekst i vitenarkiv Vis sammendrag

  Implantable cardioverter-defibrillator (ICD) therapy remains a corner stone of sudden cardiac death (SCD) prevention in patients with arrhythmogenic right ventricular cardiomyopathy (ARVC). We aimed to assess predictors of appropriate ICD therapies in the Scandinavian cohort of ARVC patients who received ICD for primary prevention of SCD. Study group comprised of 79 definite ARVC patients by 2010 Task Force criteria (60% male, age at ICD implant 39 ± 14 years) who were enrolled in the Nordic ARVC Registry and received an ICD for primary SCD prevention. The primary end point of appropriate ICD shock or death from any cause was assessed and compared with 137 definite ARVC patients who received ICD for secondary SCD prevention (74% male, age at ICD implant 42 ± 15 years). In the study group, 38% were ≤35 years of age at baseline, 25% had nonsustained ventricular tachycardia, and 29% had syncope at baseline. Major repolarization abnormality (hazard ratio = 4.00, 95% confidence interval 1.30 to 12.30, p = 0.015) and age ≤35 years (hazard ratio = 4.21, 95% confidence interval 1.49 to 11.85, p = 0.001) independently predicted the primary end point. The outcome did not differ between the primary prevention patients with either of these risk factors and the secondary prevention cohort (2% to 4% annual event rate) whereas patients without risk factors did not have any appropriate ICD shocks during follow-up. In conclusion, young age at ARVC diagnosis and major repolarization abnormality independently predict ICD shocks or death in the primary prevention ICD recipients and associated with the event rate similar to the one observed in the secondary prevention cohort. Our data indicate the benefit of ICD for primary prevention in patients with any of these risk factors.

• Chivulescu, Monica; Haugaa, Kristina; Lie, Øyvind Haugen; Edvardsen, Thor; Ginghină, Carmen & Popescu, Bogdan A. [Vis alle 7 forfattere av denne artikkelen] (2018). Right ventricular remodeling in athletes and in arrhythmogenic cardiomyopathy. Scandinavian Cardiovascular Journal. ISSN 1401-7431. 52(1), s. 13–19. doi: 10.1080/14017431.2017.1416158. 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.

• Hasselberg, Nina Eide; Håland, Trine Synnøve Fink; Saberniak, Jørg; Brekke, Pål Haugar; Berge, Knut Erik & Leren, Trond Paul [Vis alle 8 forfattere av denne artikkelen] (2018). Lamin A/C cardiomyopathy: Young onset, high penetrance, and frequent need for heart transplantation. European Heart Journal. ISSN 0195-668X. 39(10), s. 853–860. doi: 10.1093/eurheartj/ehx596. Fulltekst i vitenarkiv Vis sammendrag

  Aims: Lamin A/C (LMNA) mutations cause familial dilated cardiomyopathy (DCM) with frequent conduction blocks and arrhythmias. We explored the prevalence, cardiac penetrance, and expressivity of LMNA mutations among familial DCM in Norway. Furthermore, we explored the risk factors and the outcomes in LMNA patients. Methods and results: During 2003–15, genetic testing was performed in patients referred for familial DCM. LMNA genotype-positive subjects were examined by electrocardiography, Holter monitoring, cardiac magnetic resonance imaging, and echocardiography. A positive cardiac phenotype was defined as the presence of atrioventricular (AV) block, atrial fibrillation/flutter (AF), ventricular tachycardia (VT), and/or echocardiographic DCM. Heart transplantation was recorded and compared with non-ischaemic DCM of other origin. Of 561 unrelated familial DCM probands, 35 (6.2%) had an LMNA mutation. Family screening diagnosed an additional 93 LMNA genotype-positive family members. We clinically followed up 79 LMNA genotype-positive [age 42 ± 16 years, ejection fraction (EF) 45 ± 13%], including 44 (56%) with VT. Asymptomatic LMNA genotype-positive family members (age 31 ± 15 years) had a 9% annual incidence of a newly documented cardiac phenotype and 61% (19/31) of cardiac penetrance during 4.4 ± 2.9 years of follow-up. Ten (32%) had AV block, 7 (23%) AF, and 12 (39%) non-sustained VT. Heart transplantation was performed in 15 of 79 (19%) LMNA patients during 7.8 ± 6.3 years of follow-up. Conclusion: LMNA mutation prevalence was 6.2% of familial DCM in Norway. Cardiac penetrance was high in young asymptomatic LMNA genotype-positive family members with frequent AV block and VT, highlighting the importance of early family screening and cardiological follow-up. Nearly 20% of the LMNA patients required heart transplantation.

• Ross, Stian Balnagown; Odland, Hans Henrik; Fischer, Trent; Edvardsen, Thor; Gammelsrud, Lars Ove & Håland, Trine Synnøve Fink [Vis alle 9 forfattere av denne artikkelen] (2018). Contractility surrogates derived from three-dimensional lead motion analysis and prediction of acute haemodynamic response to CRT. Open heart. 5:e000874(2), s. 1–9. doi: 10.1136/openhrt-2018-000874. Fulltekst i vitenarkiv Vis sammendrag

  Patient-specific left ventricular (LV) lead optimisation strategies with immediate feedback on cardiac resynchronisation therapy (CRT) effectiveness are needed. The purpose of this study was to compare contractility surrogates derived from biventricular lead motion analysis to the peak positive time derivative of LV pressure (dP/dtmax) in patients undergoing CRT implantation.Twenty-seven patients underwent CRT implantation with continuous haemodynamic monitoring. The right ventricular (RV) lead was placed in apex and a quadripolar LV lead was placed laterally. Biplane fluoroscopy cine films facilitated construction of three-dimensional RV–LV interlead distance waveforms at baseline and under biventricular pacing (BIVP) from which the following contractility surrogates were derived; fractional shortening (FS), time to peak systolic contraction and peak shortening of the interlead distance (negative slope). Acute haemodynamic CRT response was defined as LV ∆dP/dtmax ≥ 10 %.We observed a mean increase in dP/dtmax under BIVP (899±205 mm Hg/s vs 777±180 mm Hg/s, p&lt;0.001). Based on ΔdP/dtmax, 18 patients were classified as acute CRT responders and nine as non-responders (23.3%±10.6% vs 1.9±5.3%, p&lt;0.001). The baseline RV–LV interlead distance was associated with echocardiographic LV dimensions (end diastole: R=0.61, p=0.001 and end systole: R=0.54, p=0.004). However, none of the contractility surrogates could discriminate between the acute CRT responders and non-responders (ΔFS: −2.5±2.6% vs − 2.0±3.1%, p=0.50; Δtime to peak systolic contraction: −9.7±18.1% vs −10.8±15.1%, p=0.43 and Δpeak negative slope: −8.7±45.9% vs 12.5±54.8 %, p=0.09).The baseline RV–LV interlead distance was associated with echocardiographic LV dimensions. In CRT recipients, contractility surrogates derived from the RV–LV interlead distance waveform could not discriminate between acute haemodynamic responders and non-responders.

• Mourik, Manouk J.W. van; Zaar, Danielle V.J.; Smulders, Martijn W.; Heijman, Jordi; Lumens, Joost & Dokter, Jeffrey E. [Vis alle 13 forfattere av denne artikkelen] (2018). Adding speckle-tracking echocardiography to visual assessment of systolic wall motion abnormalities improves the detection of myocardial infarction. Journal of the American Society of Echocardiography. ISSN 0894-7317. s. 1–9. doi: 10.1016/j.echo.2018.09.007. Fulltekst i vitenarkiv
• Myhre, Peder Langeland; Omland, Torbjørn; Sarvari, Sebastian; Ukkonen, Heikki; Rademakers, Frank & Engvall, Jan E. [Vis alle 14 forfattere av denne artikkelen] (2018). Cardiac troponin T concentrations, reversible myocardial ischemia, and indices of left ventricular remodeling in patients with suspected stable angina pectoris: A DOPPLER-CIP substudy. Clinical Chemistry. ISSN 0009-9147. 64(9), s. 1371–1379. doi: 10.1373/clinchem.2018.288894. Fulltekst i vitenarkiv
• Gimelli, Alessia; Achenbach, Stephan; Buechel, Ronny Ralf; Edvardsen, Thor; Francone, Marco & Gaemperli, Oliver [Vis alle 17 forfattere av denne artikkelen] (2018). Strategies for radiation dose reduction in nuclear cardiology and cardiac computed tomography imaging: a report from the European Association of Cardiovascular Imaging (EACVI), the Cardiovascular Committee of European Association of Nuclear Medicine (EANM), and the European Society of Cardiovascular Radiology (ESCR). European Heart Journal. ISSN 0195-668X. s. 286–296. doi: 10.1093/eurheartj/ehx582. Fulltekst i vitenarkiv
• Lie, Øyvind Haugen; Dejgaard, Lars; Saberniak, Jørg; Rootwelt, Christine; Stokke, Mathis Korseberg & Edvardsen, Thor [Vis alle 7 forfattere av denne artikkelen] (2018). Harmful effects of exercise intensity and exercise duration in patients with arrhythmogenic cardiomyopathy. JACC: Clinical Electrophysiology. ISSN 2405-500X. 4(6), s. 744–753. doi: 10.1016/j.jacep.2018.01.010. Fulltekst i vitenarkiv Vis sammendrag

  Objectives The goal of this study was to explore the association between exercise duration versus exercise intensity and adverse outcome in patients with arrhythmogenic cardiomyopathy (AC). Background Vigorous exercise aggravates and accelerates AC, but there are no data assessing the harmful effects of exercise intensity and duration in these patients. Methods Exercise habits at time of diagnosis were recorded by standardized interviews in consecutive AC patients. Exercise >6 metabolic equivalents was defined as high intensity, and exercise duration was categorized as long if above median. Life-threatening ventricular arrhythmia (VA) was defined as aborted cardiac arrest, documented sustained ventricular tachycardia, ventricular fibrillation, or appropriate implantable cardioverter-defibrillator therapy. Results We included 173 AC patients (53% probands; 44% female; 41 ± 16 years of age). Median weekly exercise duration was 2.5 h (interquartile range: 2.0 to 5.5 h), and 91 patients (52%) reported high-intensity exercise. VA had occurred in 83 patients (48%) and was more prevalent in patients with high-intensity exercise than low-intensity exercise (74% vs. 20%, p < 0.001), and more prevalent in long-duration than short-duration exercise (65% vs. 31%, p < 0.001). High-intensity exercise was a strong and independent marker of VA, even when adjusted for the interaction with long-duration exercise (odds ratio: 3.8; 95% confidence interval: 1.3 to 11.0, p < 0.001), whereas long-duration exercise was not. Conclusions High-intensity exercise was a strong and independent marker of life-threatening VA in AC patients, independent of exercise duration. AC patients could be advised to restrict their exercise intensity.

• Gilljam, Thomas; Haugaa, Kristina; Jensen, Henrik K; Svensson, Anneli; Bundgaard, Henning & Hansen, Jim [Vis alle 15 forfattere av denne artikkelen] (2018). Heart transplantation in arrhythmogenic right ventricular cardiomyopathy ? Experience from the Nordic ARVC Registry. International Journal of Cardiology. ISSN 0167-5273. 250, s. 201–206. doi: 10.1016/j.ijcard.2017.10.076. Fulltekst i vitenarkiv Vis sammendrag

  Objective: There is a paucity of data on heart transplantation (HTx) in patients with arrhythmogenic right ventricular cardiomyopathy (ARVC), and specific recommendations on indications for listing ARVC patients for HTx are lacking. In order to delineate features pertinent to HTx assessment, we explored the pre-HTx characteristics and clinical history in a cohort of ARVC patients who received heart transplants. Methods: Data from 31 ARVC/HTx patients enrolled in the Nordic ARVC Registry, transplanted between 1988 and 2014 at a median age of 46 years (14–65), were compared with data from 152 non-transplanted probands with Definite ARVC according to 2010 Task Force Criteria from the same registry. Results: The HTx patients were younger at presentation, median 31 vs. 38 years (p = 0.001). There was no difference in arrhythmia-related events. The indication for HTx was heart failure in 28 patients (90%) and ventricular arrhythmias in 3 patients (10%). During median follow-up of 4.9 years (0.04–28), there was one early death and two late deaths. Survival was 91% at 5 years after HTx. Age at first symptoms under 35 years independently predicted HTx in our cohort (OR = 7.59, 95% CI 2.69–21.39, p < 0.001). Conclusion: HTx in patients with ARVC is performed predominantly due to heart failure. This suggests that current 2016 International Society for Heart and Lung Transplantation heart transplant listing recommendations for other cardiomyopathies could be applicable in many cases when taking into account the haemodynamic consequences of right ventricular failure in conjunction with ventricular arrhythmia.

• Günther, Anne; Aaberge, Lars; Abildgaard, Andreas; Ragnarsson, Asgrimur; Edvardsen, Thor & Jakobsen, Jarl Åsbjørn [Vis alle 7 forfattere av denne artikkelen] (2018). Coronary computed tomography in heart transplant patients: detection of significant stenosis and cardiac allograft vasculopathy, image quality, and radiation dose. Acta Radiologica. ISSN 0284-1851. 59(9), s. 1066–1073. doi: 10.1177/0284185117748354. Fulltekst i vitenarkiv
• Nunes, Maria Carmo P; Badano, Luigi P.; Marin-Neto, J Antonio; Edvardsen, Thor; Fernández-Golfín, Covadonga & Bucciarelli-Ducci, Chiara [Vis alle 22 forfattere av denne artikkelen] (2018). Multimodality imaging evaluation of Chagas disease: an expert consensus of Brazilian Cardiovascular Imaging Department (DIC) and the European Association of Cardiovascular Imaging (EACVI). European Heart Journal-Cardiovascular Imaging. ISSN 2047-2404. 19(4), s. 1–16. doi: 10.1093/ehjci/jex154. Fulltekst i vitenarkiv
• Popescu, Bogdan A.; Petersen, Steffen E.; Maurovich-Horvat, Pál; Haugaa, Kristina; Donal, Erwan & Maurer, Gerald [Vis alle 7 forfattere av denne artikkelen] (2018). The year 2017 in the European Heart Journal - Cardiovascular Imaging: Part i. European Heart Journal-Cardiovascular Imaging. ISSN 2047-2404. 19(10), s. 1099–1106. doi: 10.1093/ehjci/jey109. Fulltekst i vitenarkiv
• Lie, Øyvind Haugen; Rootwelt, Christine; Dejgaard, Lars; Leren, Ida Skrinde; Stokke, Mathis Korseberg & Edvardsen, Thor [Vis alle 7 forfattere av denne artikkelen] (2018). Prediction of Life-Threatening Ventricular Arrhythmia in Patients With Arrhythmogenic Cardiomyopathy: A Primary Prevention Cohort Study. JACC Cardiovascular Imaging. ISSN 1936-878X. 11(10), s. 1377–1386. doi: 10.1016/j.jcmg.2018.05.017. Fulltekst i vitenarkiv Vis sammendrag

  Objectives: This study aimed to identify clinical, electrocardiographic (ECG) and cardiac imaging predictors of first-time life-threatening ventricular arrhythmia in patients with arrhythmogenic cardiomyopathy (AC). Background: The role of clinical, electrocardiographic, and cardiac imaging parameters in risk stratification of patients without ventricular arrhythmia is unclear. Methods: We followed consecutive AC probands and mutation-positive family members with no documented ventricular arrhythmia from time of diagnosis to first event. We assessed clinical, electrocardiographic, and cardiac imaging parameters according to Task Force Criteria of 2010 in addition to left ventricular (LV) and strain parameters. High-intensity exercise was defined as >6 metabolic equivalents. Results: We included 117 patients (29% probands, 50% female, age 40 ± 17 years). During 4.2 (interquartile range [IQR]: 2.4 to 7.4) years of follow-up, 18 (15%) patients experienced life-threatening ventricular arrhythmias. The 1-, 2-, and 5-year incidence was 6%, 9%, and 22%, respectively. History of high-intensity exercise, T-wave inversions ≥V3, and greater LV mechanical dispersion were the strongest risk markers (adjusted hazard ratio [HR]: 4.7 [95% confidence interval (CI): 1.2 to 17.5]; p = 0.02, 4.7 [95% CI: 1.6 to 13.9]; p = 0.005), and 1.4 [95% CI: 1.2 to 1.6] by 10-ms increments; p < 0.001, respectively). Median arrhythmia-free survival in patients with all risk factors was 1.2 (95% CI: 0.4 to 1.9) years, compared with an estimated 12.0 (95% CI: 11.5 to 12.5) years in patients without any risk factors. Conclusions: History of high-intensity exercise, electrocardiographic T-wave inversions ≥V3, and greater LV mechanical dispersion were strong predictors of life-threatening ventricular arrhythmia. Patients without any of these risk factors had minimal risk, whereas ≥2 risk factors increased the risk dramatically. This may help to make decisions on primary preventive implantable cardioverter defibrillator (ICD) therapy.

• Pelliccia, Antonio; Caselli, Stefano; Sharma, Sanjay; Basso, Cristina; Bax, Jeroen J. & Corrado, Domenico [Vis alle 22 forfattere av denne artikkelen] (2018). European Association of Preventive Cardiology (EAPC) and European Association of Cardiovascular Imaging (EACVI) joint position statement: recommendations for the indication and interpretation of cardiovascular imaging in the evaluation of the athlete's heart. European Heart Journal. ISSN 0195-668X. 39(21), s. 1949–1969. doi: 10.1093/eurheartj/ehx532. Fulltekst i vitenarkiv
• Galderisi, Maurizio; Donal, Erwan; Magne, Julien; Iudice, Francesco Lo; Agricola, Eustachio & Sade, Leyla Elif [Vis alle 17 forfattere av denne artikkelen] (2018). Rationale and design of the EACVI AFib Echo Europe Registry for assessing relationships of echocardiographic parameters with clinical thrombo-embolic and bleeding risk profile in non-valvular atrial fibrillation. European Heart Journal-Cardiovascular Imaging. ISSN 2047-2404. 19(3), s. 245–252. doi: 10.1093/ehjci/jex322. Fulltekst i vitenarkiv
• Dejgaard, Lars; Skjølsvik, Eystein Theodor Ek; Lie, Øyvind Haugen; Ribe, Margareth; Stokke, Mathis Korseberg & Hegbom, Finn [Vis alle 13 forfattere av denne artikkelen] (2018). The Mitral Annulus Disjunction Arrhythmic Syndrome. Journal of the American College of Cardiology. ISSN 0735-1097. 72(14), s. 1600–1609. doi: 10.1016/j.jacc.2018.07.070. Fulltekst i vitenarkiv Vis sammendrag

  Background: Mitral annulus disjunction (MAD) is an abnormal atrial displacement of the mitral valve leaflet hinge point. MAD has been associated with mitral valve prolapse (MVP) and sudden cardiac death. Objectives: The purpose of this study was to describe the clinical presentation, MAD morphology, association with MVP, and ventricular arrhythmias in patients with MAD. Methods: The authors clinically examined patients with MAD. By echocardiography, the authors assessed the presence of MVP and measured MAD distance in parasternal long axis. Using cardiac magnetic resonance (CMR), the authors assessed circumferential MAD in the annular plane, longitudinal MAD distance, and myocardial fibrosis. Aborted cardiac arrest and sustained ventricular tachycardia were defined as severe arrhythmic events. Results: The authors included 116 patients with MAD (age 49 ± 15 years; 60% female). Palpitations were the most common symptom (71%). Severe arrhythmic events occurred in 14 (12%) patients. Longitudinal MAD distance measured by CMR was 3.0 mm (interquartile range [IQR]: 0 to 7.0 mm) and circumferential MAD was 150° (IQR: 90° to 210°). Patients with severe arrhythmic events were younger (age 37 ± 13 years vs. 51 ± 14 years; p = 0.001), had lower ejection fraction (51 ± 5% vs. 57 ± 7%; p = 0.002) and had more frequently papillary muscle fibrosis (4 [36%] vs. 6 [9%]; p = 0.03). MVP was evident in 90 (78%) patients and was not associated with ventricular arrhythmia. Conclusions: Ventricular arrhythmias were frequent in patients with MAD. A total of 26 (22%) patients with MAD did not have MVP, and MVP was not associated with arrhythmic events, indicating MAD itself as an arrhythmogenic entity. MAD was detected around a large part of the mitral annulus circumference and was interspersed with normal tissue.

• Edvardsen, Thor; Haugaa, Kristina; Gerber, Bernhard L.; Maurovich-Horvat, Pál; Donal, Erwan & Maurer, Gerald [Vis alle 7 forfattere av denne artikkelen] (2018). The year 2017 in the European Heart Journal-Cardiovascular Imaging: Part II. European Heart Journal-Cardiovascular Imaging. ISSN 2047-2404. 19(11), s. 1222–1229. doi: 10.1093/ehjci/jey110. Fulltekst i vitenarkiv Vis sammendrag

  European Heart Journal – Cardiovascular Imaging was launched in 2012 as a multimodality cardiovascular imaging journal. It has gained an impressive impact factor of 8.366 during its first 5 years and is now established as one of the top 10 cardiovascular journals and has become the most important cardiovascular imaging journal in Europe. The most important studies from 2017 will be highlighted in two reports. Part I of the review will focus on studies about myocardial function and risk prediction, myocardial ischaemia, and emerging techniques in cardiovascular imaging, while Part II will focus on valvular heart disease, heart failure, cardiomyopathies, and congenital heart disease.

• Sprynger, Muriel; Rigo, Fausto; Moonen, Marie; Aboyans, Victor; Edvardsen, Thor & Alcantara, Monica L. de [Vis alle 13 forfattere av denne artikkelen] (2018). Focus on echovascular imaging assessment of arterial disease: Complement to the ESC guidelines (PARTIM 1) in collaboration with the Working Group on Aorta and Peripheral Vascular Diseases. European Heart Journal-Cardiovascular Imaging. ISSN 2047-2404. 19(11), s. 1195–1221. doi: 10.1093/ehjci/jey103. Fulltekst i vitenarkiv
• Figuera, Alba Marina Gonzalez; Aurlien, Dag; Larsson, Pål Gunnar; Olsen, Ketil Berg; Dahl, Iselin Teresa & Edvardsen, Thor [Vis alle 8 forfattere av denne artikkelen] (2018). Seizure-like episodes and EEG abnormalities in patients with long QT syndrome. Seizure. ISSN 1059-1311. 61, s. 214–220. doi: 10.1016/j.seizure.2018.08.020. Fulltekst i vitenarkiv
• Traaen, Gunn Marit; Aakerøy, Lars; Hunt, Tove Elisabeth F.; Øverland, Britt; Lyseggen, Erik & Aukrust, Pål [Vis alle 16 forfattere av denne artikkelen] (2018). Treatment of sleep apnea in patients with paroxysmal atrial fibrillation: design and rationale of a randomized controlled trial. Scandinavian Cardiovascular Journal. ISSN 1401-7431. 52(6), s. 372–377. doi: 10.1080/14017431.2019.1567933. Fulltekst i vitenarkiv Vis sammendrag

  Rationale. Atrial fibrillation is associated with increased mortality as well as morbidity. There is strong evidence for an association between atrial fibrillation and sleep apnea. It is not known whether treatment of sleep apnea with continuous positive airway pressure (CPAP) will reduce the burden of atrial fibrillation. Objective. The Treatment of Sleep Apnea in Patients with Paroxysmal Atrial Fibrillation study will investigate the effects of CPAP in patients with paroxysmal atrial fibrillation and sleep apnea. Design: The trial has a dual center, randomized, controlled, open-label, parallel design. Methods. Two centers will enroll a total of 100 patients with both paroxysmal atrial fibrillation and sleep apnea (apnea-hypopnea index [AHI] 15 events/h) who are scheduled for catheter ablation. Patients will be randomized in a 1:1 ratio to CPAP or control group (50 patients in each arm). The effects of CPAP treatment on atrial fibrillation will be determined using an implanted loop recorder (Reveal LINQTM, Medtronic) that detects all arrhythmia episodes. The primary endpoint is a reduction of the total burden of atrial fibrillation in the intervention group, after 5 months’ follow-up (preablation). Reduction in the arrhythmia recurrence rate after ablation is the main secondary endpoint. All patients will be followed up for 12 months after ablation. Conclusion. This study is the first randomized controlled trial that will provide data on the effects of CPAP therapy in patients with paroxysmal atrial fibrillation and sleep apnea. The results are expected to improve our understanding of the interaction between paroxysmal atrial fibrillation and sleep apnea.

• Delgado, Victoria; Cardim, Nuno; Cosyns, Bernard; Donal, Erwan; Flachskampf, Frank & Galderisi, Maurizio [Vis alle 17 forfattere av denne artikkelen] (2018). Criteria for recommendation, expert consensus, and appropriateness criteria papers: Update from the European Association of Cardiovascular Imaging Scientific Documents Committee. European Heart Journal-Cardiovascular Imaging. ISSN 2047-2404. 19(8), s. 835–837. doi: 10.1093/ehjci/jey079. Fulltekst i vitenarkiv
• Ruddox, Vidar; Otterstad, Jan Erik; Atar, Dan; Bendz, Bjørn & Edvardsen, Thor (2018). In Current Clinical Practice, after Percutaneous Coronary Intervention for Acute Myocardial Infarction, Are β-Blockers Prescribed for Heart Failure or as Secondary Prevention? A Pilot Study. Cardiology. ISSN 0008-6312. 140(3), s. 152–154. doi: 10.1159/000490656. Fulltekst i vitenarkiv
• Nešković, Aleksandar N.; Skinner, Henry; Price, Susanna; Via, Gabriele; Hert, Stefan De & Stanković, Ivan [Vis alle 19 forfattere av denne artikkelen] (2018). Focus cardiac ultrasound core curriculum and core syllabus of the European Association of Cardiovascular Imaging. European Heart Journal-Cardiovascular Imaging. ISSN 2047-2404. 19(5), s. 475–481. doi: 10.1093/ehjci/jey006. Fulltekst i vitenarkiv
• Badano, Luigi P.; Kolias, Theodore J.; Muraru, Denisa; Abraham, Theodore P.; Aurigemma, Gerard & Edvardsen, Thor [Vis alle 16 forfattere av denne artikkelen] (2018). Standardization of left atrial, right ventricular, and right atrial deformation imaging using two-dimensional speckle tracking echocardiography: A consensus document of the EACVI/ASE/Industry Task Force to standardize deformation imaging. European Heart Journal-Cardiovascular Imaging. ISSN 2047-2404. 19(6), s. 591–600. doi: 10.1093/ehjci/jey042. Fulltekst i vitenarkiv
• Klæboe, Lars Gunnar & Edvardsen, Thor (2018). Echocardiographic assessment of left ventricular systolic function. Journal of Echocardiography. ISSN 1349-0222. s. 1–7. doi: 10.1007/s12574-018-0405-5. Fulltekst i vitenarkiv Vis sammendrag

  Left ventricular (LV) ejection fraction (LVEF) is the most validated and commonly used echocardiographic measure of systolic function. LVEF has a unique position in cardiology having severed as selection criteria for therapeutic trials that constitute the evidence base of today’s treatment recommendations. Assessment of LV systolic function by global longitudinal strain (GLS) from speckle tracking echocardiography (STE) is a sensitive and feasible method that overcomes many of the limitations of LVEF, including reproducibility issues of serial testing and detection of LV dysfunction in pathologically remodeled hearts. This review discusses the role of STE as a complementary method to LVEF in estimation of LV systolic function.

• Dejgaard, Lars; Håland, Trine Synnøve Fink; Lie, Øyvind Haugen; Ribe, Margareth; Bjune, Thea & Leren, Ida Skrinde [Vis alle 9 forfattere av denne artikkelen] (2018). Vigorous exercise in patients with hypertrophic cardiomyopathy. International Journal of Cardiology. ISSN 0167-5273. 250, s. 157–163. doi: 10.1016/j.ijcard.2017.07.015. Fulltekst i vitenarkiv Vis sammendrag

  Background: We aimed to investigate if history of vigorous exercise was associated with changes in left ventricular morphology, left ventricular function and ventricular arrhythmias (VAs) in hypertrophic cardiomyopathy genotype positive, phenotype negative (Genotype+ LVH−) and in phenotype positive (HCM LVH+). Methods: In this cross sectional study we included 187 subjects (age 49 ± 16 years, 89(48%) female, 121(65%) HCM LVH+ and 66 (35%) Genotype+ LVH-) who answered a questionnaire on physical activity history. Exercise ≥6 metabolic equivalents was defined as vigorous. Subjects with a history of vigorous exercise ≥4 h/week during ≥6 years were defined as athletes. All underwent echocardiography and Holter monitoring. VAs were defined as aborted cardiac arrest, sustained or non-sustained ventricular tachycardia. Results: In both Genotype+ LVH− and HCM LVH+, lifetime vigorous exercise correlated with larger left ventricular end-diastolic volume (rho 0.44 and 0.38 respectively, both p b 0.001). Lifetime vigorous exercise correlated with increased left ventricular mass in Genotype+ LVH− (rho 0.28, p = 0.03), but not in HCM LVH+ (p = 0.53). Left ventricular systolic function was similar between athletes and non-athletes in Genotype+ LVH− and HCM LVH+. HCM LVH+ athletes had lower E/e' (p = 0.03) and higher e' (p = 0.02) compared to non-athletes, while this difference was not observed in Genotype+ LVH−. Lifetime vigorous exercise was similar among HCM LVH+ with and without VAs (p = 0.89). Conclusions: Increased lifetime vigorous exercise was associated with larger left ventricular volumes in hypertrophic cardiomyopathy, but correlated to left ventricular mass only in Genotype+ LVH−. Vigorous exercise was associated with favorable diastolic function in HCM LVH+, and was not associated with VAs.

• Haugaa, Kristina; Basso, Cristina; Badano, Luigi P; Bucciarelli-Ducci, Chiara; Cardim, Nuno & Gaemperli, Oliver [Vis alle 14 forfattere av denne artikkelen] (2017). Comprehensive multi-modality imaging approach in arrhythmogenic cardiomyopathy - an expert consensus document of the European Association of Cardiovascular Imaging. European Heart Journal-Cardiovascular Imaging. ISSN 2047-2404. 18(3), s. 237–253. doi: 10.1093/ehjci/jew229. Fulltekst i vitenarkiv
• Lancellotti, Patrizio; Galderisi, Maurizio; Edvardsen, Thor; Donal, Erwan; Goliasch, Georg & Cardim, Nuno [Vis alle 25 forfattere av denne artikkelen] (2017). Echo-Doppler estimation of left ventricular filling pressure: Results of themulticentre EACVI Euro-Filling study. European Heart Journal-Cardiovascular Imaging. ISSN 2047-2404. 18(9), s. 961–968. doi: 10.1093/ehjci/jex067. Fulltekst i vitenarkiv
• Hetland, Sveinung Arild; Haugaa, Kristina; Vistnes, Maria; Liland, Kristian Hovde; Olseng, Margareth & Jacobsen, Morten [Vis alle 7 forfattere av denne artikkelen] (2017). A retrospective analysis of cardiovascular outcomes in patients treated with ASV. Scandinavian Cardiovascular Journal. ISSN 1401-7431. 51(2), s. 106–113. doi: 10.1080/14017431.2016.1262546. Fulltekst i vitenarkiv
• Broch, Kaspar; Leren, Ida Skrinde; Saberniak, Jørg; Ueland, Thor; Edvardsen, Thor & Gullestad, Lars [Vis alle 7 forfattere av denne artikkelen] (2017). Soluble ST2 is associated with disease severity in arrhythmogenic right ventricular cardiomyopathy. Biomarkers. ISSN 1354-750X. 22(3-4), s. 367–371. doi: 10.1080/1354750X.2016.1278266. Fulltekst i vitenarkiv
• Kvisvik, Brede Alexander; Mørkrid, Lars; Røsjø, Helge; Småstuen, Milada Cvancarova; Rowe, Alexander D. & Eek, Christian [Vis alle 9 forfattere av denne artikkelen] (2017). High-Sensitivity Troponin T vs I in Acute Coronary Syndrome: Prediction of Significant Coronary Lesions and Long-term Prognosis. Clinical Chemistry. ISSN 0009-9147. 63(2), s. 552–562. doi: 10.1373/clinchem.2016.261107. Fulltekst i vitenarkiv
• Steeds, RP; Garbi, M; Cardim, Nuno; Kasprzak, JD; Sade, E & Nihoyannapoulos, P [Vis alle 16 forfattere av denne artikkelen] (2017). EACVI appropriateness criteria for the use of transthoracic echocardiography in adults: a report of literature and current practice review. European Heart Journal-Cardiovascular Imaging. ISSN 2047-2404. 18(11), s. 1191–1204. doi: 10.1093/ehjci/jew333. Fulltekst i vitenarkiv
• Günther, Anne; Andersen, Rune; Gude, Einar; Jakobsen, Jarl Åsbjørn; Edvardsen, Thor & Sandvik, Leiv [Vis alle 9 forfattere av denne artikkelen] (2017). The predictive value of coronary artery calcium detected by computed tomography in a prospective study on cardiac allograft vasculopathy in heart transplant patients. Transplant International. ISSN 0934-0874. 31(1), s. 82–91. doi: 10.1111/tri.13057. Fulltekst i vitenarkiv
• Kvisvik, Brede Alexander; Mørkrid, Lars; Røsjø, Helge; Småstuen, Milada C; Rowe, Alexander D. & Eek, Christian [Vis alle 9 forfattere av denne artikkelen] (2017). Troponinas de alta sensibilidad T vs I en Sindrome Coronario Agudo: Prediccion de lesiones coronarias significativas y pronostico a largo plazo. Acta Bioquimica Clinica Latinoamericana. ISSN 0325-2957. 51(3), s. 395–407. Fulltekst i vitenarkiv
• Pedrosa, João; Queiros, Sandro; Bernard, Olivier; Engvall, Jan; Edvardsen, Thor & Nagel, Eike [Vis alle 7 forfattere av denne artikkelen] (2017). Fast and Fully Automatic Left Ventricular Segmentation and Tracking in Echocardiography Using Shape-Based B-Spline Explicit Active Surfaces. IEEE Transactions on Medical Imaging. ISSN 0278-0062. 36(11), s. 2287–2296. doi: 10.1109/TMI.2017.2734959. Fulltekst i vitenarkiv
• Håland, Trine Synnøve Fink; Hasselberg, Nina Eide; Almaas, Vibeke Marie; Dejgaard, Lars; Saberniak, Jørg & Leren, Ida Skrinde [Vis alle 9 forfattere av denne artikkelen] (2017). The systolic paradox in hypertrophic cardiomyopathy. Open heart. 4(1). doi: 10.1136/openhrt-2016-000571. Fulltekst i vitenarkiv
• Lie, Øyvind Haugen; Saberniak, Jørg; Dejgaard, Lars A.; Stokke, Mathis Korseberg; Hegbom, Finn & Anfinsen, Ole-Gunnar [Vis alle 8 forfattere av denne artikkelen] (2017). Lower than expected burden of premature ventricular contractions impairs myocardial function. ESC Heart Failure. 4(4), s. 585–594. doi: 10.1002/ehf2.12180. Fulltekst i vitenarkiv
• Galderisi, Maurizio; Cosyns, Bernard; Edvardsen, Thor; Cardim, Nuno; Delgado, Victoria & Salvo, Giovanni Di [Vis alle 19 forfattere av denne artikkelen] (2017). Standardization of adult transthoracic echocardiography reporting in agreement with recent chamber quantification, diastolic function, and heart valve disease recommendations: An expert consensus document of the European Association of Cardiovascular Imaging. European Heart Journal-Cardiovascular Imaging. ISSN 2047-2404. 18(12), s. 1301–1310. doi: 10.1093/ehjci/jex244. Fulltekst i vitenarkiv
• Dejgaard, Lars; Håland, Trine Synnøve Fink; Lie, Øyvind Haugen; Ribe, Margareth; Bjune, Thea & Leren, Ida Skrinde [Vis alle 9 forfattere av denne artikkelen] (2017). Data on exercise and cardiac imaging in a patient cohort with hypertrophic cardiomyopathy. Data in Brief. 15, s. 30–39. doi: 10.1016/j.dib.2017.08.018. Fulltekst i vitenarkiv
• Baumgartner, Helmut; Hung, Judy; Bermejo, Javier; Chambers, John B.; Edvardsen, Thor & Goldstein, Steven [Vis alle 10 forfattere av denne artikkelen] (2017). Recommendations on the echocardiographic assessment of aortic valve stenosis: A focused update from the European Association of Cardiovascular Imaging and the American Society of Echocardiography. European Heart Journal-Cardiovascular Imaging. ISSN 2047-2404. 18(3), s. 254–275. doi: 10.1093/ehjci/jew335. Fulltekst i vitenarkiv
• Almeida, Nuno; Papachristidis, Alexandros; Pearson, Peter; Sarvari, Sebastian Imre; Engvall, Jan & Edvardsen, Thor [Vis alle 10 forfattere av denne artikkelen] (2017). Left atrial volumetric assessment using a novel automated framework for 3D echocardiography: a multi-centre analysis. European Heart Journal-Cardiovascular Imaging. ISSN 2047-2404. 18(9), s. 1008–1015. doi: 10.1093/ehjci/jew166. Fulltekst i vitenarkiv
• Chambers, John B.; Garbi, Madalina; Nieman, Koen; Myerson, Saul; Piérard, Luc A. & Habib, Gilbert [Vis alle 9 forfattere av denne artikkelen] (2017). Appropriateness criteria for the use of cardiovascular imaging in heart valve disease in adults: A European Association of Cardiovascular Imaging report of literature review and current practice. European Heart Journal-Cardiovascular Imaging. ISSN 2047-2404. 18(5), s. 489–498. doi: 10.1093/ehjci/jew309. Fulltekst i vitenarkiv
• Hetland, Sveinung Arild; Lerum, Tøri Vigeland; Haugaa, Kristina & Edvardsen, Thor (2017). Patients with Cheyne-Stokes respiration and heart failure: patient tolerance after three-month discontinuation of treatment with adaptive servo-ventilation. Heart and Vessels. ISSN 0910-8327. Published ahead of print, s. 1–7. doi: 10.1007/s00380-017-0951-1. Fulltekst i vitenarkiv
• Lancellotti, Patrizio; Pellikka, Patricia A.; Budts, Werner; Chaudhry, Farrukh Abbas; Donal, Erwan & Dulgheru, Raluca [Vis alle 17 forfattere av denne artikkelen] (2017). The clinical use of stress echocardiography in non-ischaemic heart disease: recommendations from the European Association of Cardiovascular Imaging and the American Society of Echocardiography. Journal of the American Society of Echocardiography. ISSN 0894-7317. 30(2), s. 101–138. doi: 10.1016/j.echo.2016.10.016. Fulltekst i vitenarkiv
• Klæboe, Lars Gunnar; Håland, Trine Synnøve Fink; Leren, Ida Skrinde; Bekke, Rachel M. A. ter; Brekke, Pål Haugar & Røsjø, Helge [Vis alle 11 forfattere av denne artikkelen] (2017). Prognostic Value of Left Ventricular Deformation Parameters in Patients with Severe Aortic Stenosis: A Pilot Study of the Usefulness of Strain Echocardiography. Journal of the American Society of Echocardiography. ISSN 0894-7317. 30(8), s. 727–735.e1. doi: 10.1016/j.echo.2017.04.009. Fulltekst i vitenarkiv Vis sammendrag

  Background: In patients with aortic stenosis, subtle alterations in myocardial mechanics can be detected by speckle-tracking echocardiography before reduction of left ventricular ejection fraction (LVEF). Methods: In this prospective study, 162 patients with aortic stenosis with an average aortic valve area of 0.7 ± 0.2 cm2 and a mean LVEF of 60 ± 11% were included. Global longitudinal strain (GLS) and mechanical dispersion (SD of time from Q/R on the electrocardiogram to peak strain in 16 left ventricular segments) were assessed using echocardiography, and all-cause mortality (n = 37) was recorded during 37 ± 13 months of follow-up. Results: Overall, nonsurvivors had more pronounced mechanical dispersion and worse GLS compared with survivors (74 ± 24 vs 61 ± 18 msec [P < .01] and −14.5 ± 4.4% vs −16.7 ± 3.6% [P < .01], respectively). In the 42 conservatively treated patients without surgical aortic valve replacement, a similar pattern was observed in nonsurvivors versus survivors (mechanical dispersion, 80 ± 24 vs 57 ± 14 msec [P < .01]; GLS, −14.0 ± 4.9% vs −17.1 ± 3.8% [P = .04], respectively). Mechanical dispersion was significantly associated with mortality (hazard ratio per 10-msec increase, 1.23; 95% CI, 1.07–1.42; P < .01) in a Cox model adjusted for LVEF and with aortic valve replacement treatment as a time-dependent covariate. Continuous net reclassification improvement showed that mechanical dispersion was incremental to LVEF, GLS, and valvulo-arterial impedance when adjusting for aortic valve replacement treatment in the total population. Conclusion: Increased mechanical dispersion may be a risk marker providing novel prognostic information in patients with aortic stenosis.

• Baumgartner, Helmut; Hung, Judy; Bermejo, Javier; Chambers, John B.; Edvardsen, Thor & Goldstein, Steven [Vis alle 10 forfattere av denne artikkelen] (2017). Recommendations on the Echocardiographic Assessment of Aortic Valve Stenosis: A Focused Update from the European Association of Cardiovascular Imaging and the American Society of Echocardiography. Journal of the American Society of Echocardiography. ISSN 0894-7317. 30(4), s. 372–392. doi: 10.1016/j.echo.2017.02.009. Fulltekst i vitenarkiv
• Senior, Roxy; Becher, Harald; Monaghan, Mark; Agati, Luciano; Zamorano, Jose & Vanoverschelde, Jean Louis [Vis alle 9 forfattere av denne artikkelen] (2017). Clinical practice of contrast echocardiography: Recommendation by the European Association of Cardiovascular Imaging (EACVI) 2017. European Heart Journal-Cardiovascular Imaging. ISSN 2047-2404. 18:1205(11), s. 1–33. doi: 10.1093/ehjci/jex182. Fulltekst i vitenarkiv
• Ruddox, Vidar; Sandven, Irene; Munkhaugen, John; Skattebu, Julie; Edvardsen, Thor & Otterstad, Jan Erik (2017). Atrial fibrillation and the risk for myocardial infarction, all-cause mortality and heart failure: A systematic review and meta-analysis. European Journal of Preventive Cardiology (EJPC). ISSN 2047-4873. 24(14), s. 1555–1566. doi: 10.1177/2047487317715769. Fulltekst i vitenarkiv
• Slart, Riemer H.J.A.; Glaudemans, Andor W.J.M.; Lancellotti, Patrizio; Hyafil, Fabien; Blankstein, Ron & Schwartz, Ronald G. [Vis alle 17 forfattere av denne artikkelen] (2017). A joint procedural position statement on imaging in cardiac sarcoidosis: From the Cardiovascular and Inflammation & Infection Committees of the European Association of Nuclear Medicine, the European Association of Cardiovascular Imaging, and the American Society of Nuclear Cardiology. European Heart Journal-Cardiovascular Imaging. ISSN 2047-2404. 18(10), s. 1073–1089. doi: 10.1093/ehjci/jex146. Fulltekst i vitenarkiv
• Stokke, Thomas Muri; Hasselberg, Nina Eide; Smedsrud, Marit Kristine; Sarvari, Sebastian Imre; Haugaa, Kristina & Smiseth, Otto A. [Vis alle 8 forfattere av denne artikkelen] (2017). Geometry as a Confounder When Assessing Ventricular Systolic Function: Comparison Between Ejection Fraction and Strain. Journal of the American College of Cardiology. ISSN 0735-1097. 70(8), s. 942–954. doi: 10.1016/j.jacc.2017.06.046. Fulltekst i vitenarkiv
• Nestaas, Eirik; Shih, Jhih-Yuan; Smedsrud, Marit Kristine; Gjesdal, Ola; Hopp, Einar & Haugaa, Kristina [Vis alle 7 forfattere av denne artikkelen] (2017). Comparison of Electrocardiography Markers and Speckle Tracking Echocardiography for Assessment of Left Ventricular Myocardial Scar Burden in Patients With Previous Myocardial Infarction. American Journal of Cardiology. ISSN 0002-9149. 119(9), s. 1307–1312. doi: 10.1016/j.amjcard.2017.01.020. Fulltekst i vitenarkiv Vis sammendrag

  Myocardial scar burden is an important prognostic factor after myocardial infarction. This cohort study compared assessment of left ventricle scar burden between pathological Q waves on electrocardiography (ECG), Selvester multiparametric ECG scoring system for scar burden, and global longitudinal strain (GLS) by speckle-tracking echocardiography 6 months after myocardial infarction. The scar burden was defined by late gadolinium enhancement cardiac magnetic resonance as fraction of total left ventricle tissue. ECG measures were presence of pathologic Q waves and Selvester scores. GLS was the average of peak strain from 16 left ventricle segments. In 34 patients aged 58 ± 10 years (mean ± SD), the scar burden was 19% (9, 26) (median [quartiles]) and 79% had scar burden >5%. Patients with scar burden >5% more frequently had pathologic Q waves (63% vs 14%) and had worse Selvester scores (5 [3, 7] vs 0 [0, 1]) and worse GLS (−16.6 ± 2.4% vs −19.9 ± 1.1%). Pathologic Q waves, Selvester scores, ejection fraction, and GLS related to scar burden in univariable analyses. Sensitivity and specificity for detecting scar burden >5% was 63% and 86% (pathologic Q waves), 89% and 86% (Selvester score), 81% and 86% (ejection fraction), 89% and 86% (GLS), and 96% and 71% (combination of Q waves, Selvester score, and GLS). In conclusion, Selvester score and GLS related to scars 6 months after myocardial infarction, and pathologic Q waves were only weakly associated with scar and GLS was associated with scar independently of ECG markers.

• Ross, Stian Balnagown; Odland, Hans Henrik; Aranda, Alfonso; Edvardsen, Thor; Gammelsrud, Lars Ove & Håland, Trine Synnøve Fink [Vis alle 9 forfattere av denne artikkelen] (2017). Cardiac resynchronization therapy when no lateral pacing option exists: vectorcardiographic guided non-lateral left ventricular lead placement predicts acute hemodynamic response. Europace. ISSN 1099-5129. 20(8), s. 1294–1302. doi: 10.1093/europace/eux249. Fulltekst i vitenarkiv
• Donal, Erwan; Delgado, Victoria; Magne, Julien; Bucciarelli-Ducci, Chiara; Leclercq, Christophe & Cosyns, Bernard [Vis alle 20 forfattere av denne artikkelen] (2017). Rational and design of EuroCRT: An international observational study on multi-modality imaging and cardiac resynchronization therapy. European Heart Journal-Cardiovascular Imaging. ISSN 2047-2404. 18(10), s. 1120–1127. doi: 10.1093/ehjci/jex021. Fulltekst i vitenarkiv
• Edvardsen, Thor; Donal, Erwan; Bucciarelli-Ducci, Chiara; Maurovich-Horvat, Pál; Maurer, Gerald & Popescu, Bogdan A. (2017). The years 2015-2016 in the European Heart Journal - Cardiovascular Imaging. Part I. European Heart Journal-Cardiovascular Imaging. ISSN 2047-2404. 18(10), s. 1092–1098. doi: 10.1093/ehjci/jex192. Fulltekst i vitenarkiv
• Habib, Gilbert; Bucciarelli-Ducci, Chiara; Caforio, Alida L.P.; Cardim, Nuno; Charron, Philippe & Cosyns, Bernard [Vis alle 31 forfattere av denne artikkelen] (2017). Multimodality imaging in restrictive cardiomyopathies: An EACVI expert consensus document in collaboration with the "Working Group on myocardial and pericardial diseases" of the European Society of Cardiology Endorsed by The Indian Academy of Echocardiography. European Heart Journal-Cardiovascular Imaging. ISSN 2047-2404. 18(10), s. 1090–1091. doi: 10.1093/ehjci/jex034. Fulltekst i vitenarkiv
• Ruddox, Vidar; Norum, Ingvild Billehaug; Stokke, Thomas Muri; Edvardsen, Thor & Otterstad, Jan Erik (2017). Focused cardiac ultrasound by unselected residents-the challenges. BMC Medical Imaging. 17(22), s. 1–8. doi: 10.1186/s12880-017-0191-y. Fulltekst i vitenarkiv Vis sammendrag

  Background Focus Cardiac Ultrasound (FoCUS) performed by internal medicine residents on call with 2 h of training can provide a means for ruling out cardiac disease, but with poor sensitivity. The purpose of the present study was to evaluate diagnostic usefulness as well as diagnostic accuracy of FoCUS following 4 h of training. Methods All residents on call were given a 4-h training course with an additional one-hour training course after 6 months. They were asked to provide a pre- and post-FoCUS diagnosis, with the final diagnosis at discharge as reference. Results During a 7 month period 113 FoCUS examinations were reported; after 53 were excluded this left 60 for evaluation with a standard echocardiogram performed on average 11.5 h after FoCUS. Examinations were performed on the basis of chest pain and dyspnoea/edema. The best sensitivity was found in terms of the detection of reduced left ventricular (LV) ejection fraction (EF) (92%), LV dilatation (85%) and pericardial effusion (100%). High values were noted for negative predictive values, although false positives were seen. A kappa > 0.6 was observed for reduced LVEF, right ventricular area fraction and dilatation of LV and left atrium. In 48% of patients pre- and post-FoCUS diagnoses were identical and concordant with the final diagnosis. Importantly, in 30% examinations FoCUS correctly changed the pre-FoCUS diagnosis. Conclusions A FoCUS protocol with a 4-h training program gained clinical usefulness in one third of examinations. False positive findings represented the major challenge.

• Sarvari, Sebastian Imre; Sitges, Marta; Sanz, Maria; Viu, Jose Maria Tolosana; Edvardsen, Thor & Stokke, Thomas Muri [Vis alle 8 forfattere av denne artikkelen] (2017). Left ventricular dysfunction is related to the presence and extent of a septal flash in patients with right ventricular pacing. Europace. ISSN 1099-5129. 19(2), s. 289–296. doi: 10.1093/europace/euw020. Fulltekst i vitenarkiv
• Edvardsen, Thor; Gerber, Bernhard; Donal, Erwan; Maurovich-Horvat, Pál; Maurer, Gerald & Popescu, Bogdan Alexandru (2017). The year 2015-16 in the European Heart Journal - Cardiovascular Imaging. Part II. European Heart Journal-Cardiovascular Imaging. ISSN 2047-2404. 18(12), s. 1322–1330. doi: 10.1093/ehjci/jex237. Fulltekst i vitenarkiv
• Lancellotti, Patrizio; Galderisi, Maurizio; Donal, Erwan; Edvardsen, Thor; Popescu, Bogdan A. & Farmakis, Dimitrios [Vis alle 14 forfattere av denne artikkelen] (2017). Protocol update and preliminary results of EACVI/HFA Cardiac Oncology Toxicity (COT) Registry of the European Society of Cardiology. ESC Heart Failure. 4(3), s. 312–318. doi: 10.1002/ehf2.12162. Fulltekst i vitenarkiv
• Håland, Trine Synnøve Fink; Saberniak, Jørg; Leren, Ida Skrinde; Edvardsen, Thor & Haugaa, Kristina (2017). Echocardiographic comparison between left ventricular non-compaction and hypertrophic cardiomyopathy. International Journal of Cardiology. ISSN 0167-5273. 228, s. 900–905. doi: 10.1016/j.ijcard.2016.11.162. Fulltekst i vitenarkiv Vis sammendrag

  Background: Modern imaging technology has improved detection of left ventricular non-compaction cardiomyopathy (LVNC). Hypertrophic cardiomyopathy (HCM) shares morphological features with LVNC, but prognosis and treatment strategies differ between LVNC and HCM. Methods and results: Weaimed to compare global and regional LV myocardial function in LVNC and HCM.We hypothesized that apical function is reduced in LVNC due to the embryonic reduced compaction of the apex. We studied 25 patients with LVNC (47 ± 14 years) according to current criteria, 50 with HCM (47 ± 14 years) and 50 healthy individuals (49 ± 19 years). By echocardiography, we assessed maximal wall thickness (MWT) and LV ejection fraction (EF). Numbers of trabeculations were counted from 3 apical views. Global longitudinal strain by speckle tracking echocardiography was calculated froma 16 LV segments model. LV basal (6 segments) and apical (4 segments) longitudinal strainswere averaged.MWTwas thinner, EF lower and trabeculationswere more pronounced in LVNC compared to HCM(all p b 0.001) butwith no significantly differences in LV global longitudinal strain (−15.1± 6.1 vs.−16.8±3.7, p=0.14). Function by longitudinal strain increased significantly frombase to apex in HCM(−14.9±4.3% vs.−19.5±4.7%, p b 0.001) and in healthy controls (−20.0±1.9% vs. −21.8 ± 2.9%, p b 0.001), but not in LVNC (−14.7 ± 6.4% vs. −15.7 ± 7.2%, p = 0.35). Conclusions: Increased number of trabeculations, thinnerMWT and lower EF were characteristics of LVNC. Myocardial function was homogeneously reduced in LVNC,while an apical to basal gradient with relatively preserved apical function was present in HCM. These characteristics may help to discriminate between LVNC and HCM.

• Leren, Ida Skrinde; Saberniak, Jørg; Håland, Trine Synnøve Fink; Edvardsen, Thor & Haugaa, Kristina (2017). Combination of ECG and Echocardiography for Identification of Arrhythmic Events in Early ARVC. JACC Cardiovascular Imaging. ISSN 1936-878X. 10(5), s. 503–513. doi: 10.1016/j.jcmg.2016.06.011. Fulltekst i vitenarkiv Vis sammendrag

  OBJECTIVES: The aim of this study was to investigate early markers of arrhythmic events (AEs) and improve risk stratification in early arrhythmogenic right ventricular cardiomyopathy (ARVC). BACKGROUND: AEs are frequent in patients with ARVC, but risk stratification in subjects with early ARVC is challenging. METHODS: Early ARVC disease was defined as possible or borderline ARVC diagnosis according to the ARVC Task Force Criteria 2010. We performed resting and signal averaged electrocardiogram (ECG). Using echocardiography, we assessed right ventricular (RV) outflow tract diameter and right ventricular basal diameter (RV diameter). Global longitudinal strain and mechanical dispersion (MD) from strain echocardiography were assessed in both the right and left ventricle. AEs were defined as documented ventricular tachycardia, cardiac syncope, or aborted cardiac arrest. RESULTS: Of 162 included subjects with ARVC (41 ± 16 years of age, 47% female), 73 had early ARVC, including mutation positive family members not fulfilling definite ARVC diagnosis. AEs occurred in 15 (21%) subjects with early ARVC. Those with AEs in early disease had larger RV diameter (40 ± 4 mm vs. 37 ± 5 mm), more pronounced RVMD (39 ± 15 ms vs. 26 ± 11 ms), and more pathological signal averaged ECGs compared with those without AEs (all p ≤ 0.05). Adding measurements of RV diameter and RVMD to electrical parameters improved identification of subjects with AEs compared with electrical parameters alone (p = 0.05). CONCLUSIONS: ECG parameters, RV diameter, and RVMD were markers of previous arrhythmic events in patients with early ARVC. A combination of electrical and echocardiographic parameters improved identification of subjects with AEs in early ARVC disease. Copyright © 2017 American College of Cardiology Foundation. Published by Elsevier Inc. All rights reserved. KEYWORDS: arrhythmic risk; arrhythmogenic right ventricular cardiomyopathy; echocardiography; signal averaged ECG; ventricular arrhythmias

• Saberniak, Jørg; Leren, Ida Skrinde; Håland, Trine Synnøve Fink; Beitnes, Jan Otto; Hopp, Einar & Borgquist, Rasmus [Vis alle 8 forfattere av denne artikkelen] (2016). Comparison of patients with early-phase arrhythmogenic right ventricular cardiomyopathy and right ventricular outflow tract ventricular tachycardia. European Heart Journal-Cardiovascular Imaging. ISSN 2047-2404. 18(1), s. 62–69. doi: 10.1093/ehjci/jew014. Fulltekst i vitenarkiv Vis sammendrag

  Aims: Differentiation between early-phase arrhythmogenic right ventricular cardiomyopathy (ARVC) and right ventricular outflow tract (RVOT)-ventricular tachycardia (VT) can be challenging, and correct diagnosis is important. We compared electrocardiogram (ECG) parameters and morphological right ventricular (RV) abnormalities and investigated if ECG and cardiac imaging can help to discriminate early-phase ARVC from RVOT-VT patients. Methods and results: We included 44 consecutive RVOT-VT (47+14 years) and 121 ARVC patients (42+17 years). Of the ARVC patients, 77 had definite ARVC and 44 had early-phase ARVC disease. All underwent clinical examination, ECG, and Holter monitoring. Frequency of premature ventricular complexes (PVC) was expressed as percent per total beats/24 h (%PVC), and PVC configuration was recorded. By echocardiography, we assessed indexed RV basal diameter (RVD), indexed RVOT diameter, and RV and left ventricular (LV) function. RV mechanical dispersion (RVMD), reflecting RV contraction heterogeneity, was assessed by speckle-tracking strain echocardiography. RV ejection fraction (RVEF) was assessed by cardiac magnetic resonance imaging (CMR). Patients with early-phase ARVC had lower %PVC by Holter and PVC more frequently originated from the RV lateral free wall (both P , 0.001). RVD was larger (21+3 vs. 19+2 mm, P , 0.01), RVMD was more pronounced (22+15 vs. 15+13 ms, P ¼ 0.03), and RVEF by CMR was decreased (41+8 vs. 49+4%, P , 0.001) in early-phase ARVC vs. RVOT-VT patients. Conclusion: Patients with early-phase ARVC had structural abnormalities with lower RVEF, increased RVD, and pronounced RVMD in addition to lower %PVC by Holter compared with RVOT-VT patients. These parameters can help correct diagnosis in patients with unclear phenotypes.

• Haugaa, Kristina; Håland, Trine Synnøve Fink; Leren, Ida Skrinde; Saberniak, Jørg & Edvardsen, Thor (2016). Arrhythmogenic right ventricular cardiomyopathy, clinical manifestations, and diagnosis. Europace. ISSN 1099-5129. 18(7), s. 965–972. doi: 10.1093/europace/euv340. Fulltekst i vitenarkiv
• Sarvari, Sebastian Imre; Haugaa, Kristina; Stokke, Thomas Muri; Ansari, Hamza; Leren, Ida Skrinde & Hegbom, Finn [Vis alle 8 forfattere av denne artikkelen] (2016). Strain echocardiographic assessment of left atrial function predicts recurrence of atrial fibrillation. European Heart Journal-Cardiovascular Imaging. ISSN 2047-2404. 17(6), s. 660–667. doi: 10.1093/ehjci/jev185. Fulltekst i vitenarkiv
• Cardim, Nuno; Galderisi, Maurizio; Edvardsen, Thor; Plein, Sven; Popescu, Bogdan A. & D'Andrea, Antonello [Vis alle 16 forfattere av denne artikkelen] (2016). Hipertrofik kardiyomiyopatili hastalarda "çok yöntemli" kardiyak göröntölemenin rolö: Suudi Kalp Birliǧince Desteklenen Avrupa Kardiyovasköler Göröntöleme Birliǧi Uzman Göröşö [Role of multimodality cardiac imaging in the management of patients with hypertrophic cardiomyopathy: An expert consensus of the European Association of Cardiovascular Imaging Endorsed by the Saudi Heart Association]. Turk Kardiyoloji Dernegi Arsivi. ISSN 1016-5169. 44, s. 81–115. Fulltekst i vitenarkiv
• Galderisi, Maurizio; Cardim, Nuno; D'Andrea, Antonello; Bruder, Oliver; Cosyns, Bernard & Davin, Laurent [Vis alle 17 forfattere av denne artikkelen] (2016). Atlet kalbine çoklu modaliteli kardiyak görüntuleme yaklaşimi: Avrupa Kardiyovasküler Görüntuleme Derneǧi Uzman Uzlaşisi [Themulti-modality cardiac imaging approach to the Athletés heart: An expert consensus of the European Association of Cardiovascular Imaging]. Turk Kardiyoloji Dernegi Arsivi. ISSN 1016-5169. 44, s. 1–21. doi: 10.1093/ehjci/jeu323. Fulltekst i vitenarkiv
• Lancellotti, Patrizio; Price, Susanna; Edvardsen, Thor; Cosyns, Bernard; Neskovic, Aleksandar N. & Dulgheru, Raluca [Vis alle 18 forfattere av denne artikkelen] (2016). Akut kardiyovasköler bakimda ekokardiyografinin kullanimi: Avrupa Kardiyovasköler Göröntöleme Birliǧi ile Akut Kardiyovasköler Bakim Birliǧi'nin önerileri. Turk Kardiyoloji Dernegi Arsivi. ISSN 1016-5169. 44, s. 53–80. doi: 10.1093/ehjci/jeu210. Fulltekst i vitenarkiv
• Lancellotti, Patrizio; Pellikka, Patricia A; Budts, Werner; Chaudry, Farooq A; Donal, Erwan & Raluca, Dulgheru [Vis alle 17 forfattere av denne artikkelen] (2016). The clinical use of stress echocardiography in non-ischaemic heart disease: recommendations from the European Association of Cardiovascular Imaging and the American Society of Echocardiography. European Heart Journal-Cardiovascular Imaging. ISSN 2047-2404. 17(11), s. 1191–1229. doi: 10.1093/ehjci/jew190. Fulltekst i vitenarkiv
• Pedrosa, Joao; Heyde, Brecht; Heeren, Laurens; Engvall, Jan; Zamorano, Jose & Papachristidis, Alexandros [Vis alle 9 forfattere av denne artikkelen] (2016). Automatic short axis orientation of the left ventricle in 3D ultrasound recordings. Progress in Biomedical Optics and Imaging. ISSN 1605-7422. 9790. doi: 10.1117/12.2214106. Fulltekst i vitenarkiv
• Nagueh, Sherif F.; Smiseth, Otto Armin; Appleton, Christopher P.; Byrd, Benjamin F.; Dokainish, Hisham & Edvardsen, Thor [Vis alle 14 forfattere av denne artikkelen] (2016). Recommendations for the evaluation of left ventricular diastolic function by echocardiography: An update from the American society of echocardiography and the European association of cardiovascular imaging. European Heart Journal-Cardiovascular Imaging. ISSN 2047-2404. 17(12), s. 1321–1360. doi: 10.1093/ehjci/jew082. Fulltekst i vitenarkiv
• Barros, Marcio V.L.; Leren, Ida Skrinde; Edvardsen, Thor; Haugaa, Kristina; Carmo, Andre A.L. & Lage, Thais A.R. [Vis alle 9 forfattere av denne artikkelen] (2016). Mechanical dispersion assessed by strain echocardiography is associated with malignant arrhythmias in chagas cardiomyopathy. Journal of the American Society of Echocardiography. ISSN 0894-7317. 29(4), s. 368–374. doi: 10.1016/j.echo.2015.12.008. Fulltekst i vitenarkiv Vis sammendrag

  Background Sudden death is one of the characteristics of Chagas disease (ChD). With the development of strategies for the prevention of malignant arrhythmias, especially with implantable cardioverter-defibrillators (ICDs), there is interest in developing strategies to predict sudden cardiac death. The aim of this study was to test the hypothesis that global longitudinal strain (GLS) and mechanical dispersion (MD) may be associated with malignant ventricular arrhythmias in patients with ChD. Methods A cross-sectional study was conducted including 62 patients with ChD who were separated into two groups according to ICD implantation status. Group 0 consisted of 34 patients with ChD without ICDs, and group 1 comprised 28 patients with ICDs. Complete echocardiographic studies, including GLS and MD measurements, were performed in all patients. Results Chamber dimensions, ejection fraction, and diastolic function showed no significant differences between patients with and those without ICDs. GLS was reduced in patients with ChD with ICDs compared with those without (P = .02). By receiver operating characteristic curve analyses, GLS identified patients with ChD with ICDs with sensitivity of 67% and specificity of 69%. MD was more pronounced in patients with ChD with ICDs compared with those without (P < .001), with a C statistic of 0.83 (95% CI, 0.71–0.91). MD > 57 msec detected ICD presence with sensitivity of 79% and specificity of 71% and was superior to GLS and ejection fraction (P < .05). In multivariate analysis, New York Heart Association functional class (odds ratio, 3.02; 95% CI, 1.09–8.39; P = .03), MD (odds ratio, 1.11; 95% CI, 1.04–1.19; P = .001), and GLS (odds ratio, 0.72; 95% CI, 0.54–0.96; P = .026) were significant and independently associated with malignant arrhythmic events. Conclusions GLS and MD may add important information in the risk stratification of patients with ChD. The use of MD by strain echocardiography could be an attractive tool in the decision making for ICD placement as primary prevention for sudden cardiac death in patients with ChD.

• Håland, Trine Synnøve Fink; Almaas, Vibeke Marie; Hasselberg, Nina Eide; Saberniak, Jørg; Leren, Ida Skrinde & Hopp, Einar [Vis alle 8 forfattere av denne artikkelen] (2016). Strain echocardiography is related to fibrosis and ventricular arrhythmias in hypertrophic cardiomyopathy. European Heart Journal-Cardiovascular Imaging. ISSN 2047-2404. 17(6), s. 613–621. doi: 10.1093/ehjci/jew005. Fulltekst i vitenarkiv Vis sammendrag

  Aims Hypertrophic cardiomyopathy (HCM) patients are at risk of ventricular arrhythmias (VAs). We aimed to explore whether systolic function by strain echocardiography is related to VAs and to the extent of fibrosis by cardiac magnetic resonance imaging (CMR). Methods and results We included 150 HCM patients and 50 healthy individuals. VAs were defined as non-sustained and sustained ventricular tachycardia and aborted cardiac arrest. Left ventricular function was assessed by ejection fraction (EF) and by global longitudinal strain (GLS) assessed by speckle tracking echocardiography. Mechanical dispersion was calculated as standard deviation (SD) of time from Q/R on ECG to peak longitudinal strain in 16 left ventricular segments. Late gadolinium enhancement (LGE) was assessed by CMR. HCM patients had similar EF (61 ± 5% vs. 61 ± 8%, P = 0.77), but worse GLS (−15.7 ± 3.6% vs. −21.1 ± 1.9%, P < 0.001) and more pronounced mechanical dispersion (64 ± 22 vs. 36 ± 13 ms, P < 0.001) compared with healthy individuals. VAs were documented in 37 (25%) HCM patients. Patients with VAs had worse GLS (−14.1 ± 3.6% vs. −16.3 ± 3.4%, P < 0.01), more pronounced mechanical dispersion (79 ± 27 vs. 59 ± 16 ms, P < 0.001), and higher %LGE (6.1 ± 7.8% vs. 0.5 ± 1.4%, P < 0.001) than patients without VAs. Mechanical dispersion correlated with %LGE (R = 0.52, P < 0.001) and was independently associated with VAs (OR 1.6, 95% CI 1.1–2.3, P = 0.02) and improved risk stratification for VAs. Conclusion GLS, mechanical dispersion, and LGE were markers of VAs in HCM patients. Mechanical dispersion was a strong independent predictor of VAs and related to the extent of fibrosis. Strain echocardiography may improve risk stratification of VAs in HCM.

• Leren, Ida Skrinde; Saberniak, Jørg; Håland, Trine Synnøve Fink; Majid, Eman; Edvardsen, Thor & Haugaa, Kristina (2016). Nadolol decreases the incidence and severity of ventricular arrhythmias during exercise stress testing compared with β&lt;sub&gt;1&lt;/sub&gt;-selective β-blockers in patients with catecholaminergic polymorphic ventricular tachycardia. Heart Rhythm. ISSN 1547-5271. 13(2), s. 432–440. doi: 10.1016/j.hrthm.2015.09.029. Fulltekst i vitenarkiv
• Hasselberg, Nina Eide; Haugaa, Kristina; Bernard, Anne; Ribe, Margareth; Kongsgård, Erik & Donal, Erwan [Vis alle 7 forfattere av denne artikkelen] (2016). Left ventricular markers of mortality and ventricular arrhythmias in heart failure patients with cardiac resynchronization therapy. European Heart Journal-Cardiovascular Imaging. ISSN 2047-2404. 17(3), s. 343–350. doi: 10.1093/ehjci/jev173. Fulltekst i vitenarkiv
• Garbi, Madalina; Edvardsen, Thor; Bax, Jeroen; Petersen, Steffen E.; McDonagh, Theresa & Filippatos, Gerasimos [Vis alle 7 forfattere av denne artikkelen] (2016). EACVI appropriateness criteria for the use of cardiovascular imaging in heart failure derived from European National Imaging Societies voting. European Heart Journal-Cardiovascular Imaging. ISSN 2047-2404. 17(7), s. 711–721. doi: 10.1093/ehjci/jew081. Fulltekst i vitenarkiv
• Edvardsen, Thor; Sarvari, Sebastian Imre & Haugaa, Kristina (2016). Strain imaging–from Scandinavian research to global deployment. Scandinavian Cardiovascular Journal. ISSN 1401-7431. 50(5-6), s. 266–275. doi: 10.1080/14017431.2016.1239836. Fulltekst i vitenarkiv
• Nagueh, Sherif F.; Smiseth, Otto A.; Appleton, Christopher P.; Byrd, Benjamin F; Dokainish, Hisham & Edvardsen, Thor [Vis alle 14 forfattere av denne artikkelen] (2016). Recommendations for the Evaluation of Left Ventricular Diastolic Function by Echocardiography: An Update from the American Society of Echocardiography and the European Association of Cardiovascular Imaging. Journal of the American Society of Echocardiography. ISSN 0894-7317. 29(4), s. 277–314. doi: 10.1016/j.echo.2016.01.011. Fulltekst i vitenarkiv
• Donal, Erwan; Lip, Gregory Y.H.; Galderisi, Maurizio; Goette, Andreas; Shah, Dipen & Marwan, Mohamed [Vis alle 23 forfattere av denne artikkelen] (2016). EACVI/EHRA Expert Consensus Document on the role of multi-modality imaging for the evaluation of patients with atrial fibrillation. European Heart Journal-Cardiovascular Imaging. ISSN 2047-2404. 17(4), s. 355–383. doi: 10.1093/ehjci/jev354. Fulltekst i vitenarkiv
• Edvardsen, Thor; Cardim, Nuno; Cosyns, Bernard; Delgado, Victoria; Donal, Erwan & Dulgheru, Raluca [Vis alle 16 forfattere av denne artikkelen] (2016). Criteria for recommendation and expert consensus papers: From the European Association of Cardiovascular Imaging Scientific Documents Committee. European Heart Journal-Cardiovascular Imaging. ISSN 2047-2404. 17(10), s. 1098–1100. doi: 10.1093/ehjci/jew157. Fulltekst i vitenarkiv
• Gerber, Bernhard L.; Edvardsen, Thor; Piérard, Luc A.; Saraste, Antti; Knuuti, Juhani & Maurer, Gerald [Vis alle 8 forfattere av denne artikkelen] (2015). The year 2014 in the European Heart Journal-Cardiovascular Imaging: Part II. European Heart Journal-Cardiovascular Imaging. ISSN 2047-2404. 16(11), s. 1180–1184. doi: 10.1093/ehjci/jev223. Fulltekst i vitenarkiv
• Cardim, Nuno; Galderisi, Maurizio; Edvardsen, Thor; Plein, Sven; Popescu, Bogdan A. & D'Andrea, Antonello [Vis alle 16 forfattere av denne artikkelen] (2015). Role of multimodality cardiac imaging in the management of patients with hypertrophic cardiomyopathy: An expert consensus of the European Association of Cardiovascular Imaging Endorsed by the Saudi Heart Association. European Heart Journal-Cardiovascular Imaging. ISSN 2047-2404. 16(3), s. 280–280hh. doi: 10.1093/ehjci/jeu291. Fulltekst i vitenarkiv
• Lancellotti, Patrizio; Płońska-Gościniak, Edyta; Garbi, Madalina; Bucciarelli-Ducci, Chiara; Cosyns, Bernard & Cardim, Nuno [Vis alle 16 forfattere av denne artikkelen] (2015). Cardiovascular imaging practice in Europe: A report from the European Association of Cardiovascular Imaging. European Heart Journal-Cardiovascular Imaging. ISSN 2047-2404. 16(7), s. 697–702. doi: 10.1093/ehjci/jev116. Fulltekst i vitenarkiv
• Lancellotti, Patrizio; Anker, Stefan D.; Donal, Erwan; Edvardsen, Thor; Popescu, Bogdan A. & Farmakis, Dimitrios [Vis alle 11 forfattere av denne artikkelen] (2015). EACVI/HFA Cardiac Oncology Toxicity Registry in breast cancer patients: Rationale, study design, and methodology (EACVI/HFACOT Registry) - EURObservational Research Program of the European Society of Cardiology. European Heart Journal-Cardiovascular Imaging. ISSN 2047-2404. 16(5), s. 466–470. doi: 10.1093/ehjci/jev024. Fulltekst i vitenarkiv
• Leren, Ida Skrinde; Hasselberg, Nina Eide; Saberniak, Jørg; Håland, Trine Synnøve Fink; Kongsgård, Erik & Smiseth, Otto A. [Vis alle 8 forfattere av denne artikkelen] (2015). Cardiac mechanical alterations and genotype specific differences in subjects with long QT Syndrome. JACC Cardiovascular Imaging. ISSN 1936-878X. 8(5), s. 501–510. doi: 10.1016/j.jcmg.2014.12.023. Fulltekst i vitenarkiv

Se alle arbeider i NVA

• Edvardsen, Thor (2026). Norske eksperter krever strengere hjertescreening for idrettsutøvere. [Radio]. Dagbladet. Fulltekst i vitenarkiv Vis sammendrag

  Etter Olaf Tuftes plutselige død, oppfordrer norske hjertespesialister til en mer målrettet hjertescreening av toppidrettsutøvere for å forhindre hjertestans.

• Edvardsen, Thor (2026). Bedømmelse av venstre ventrikkels systolisk funksjon. Fulltekst i vitenarkiv
• Edvardsen, Thor (2026). Vevsdoppler og deformasjonsekkokardiografi. Fulltekst i vitenarkiv
• Edvardsen, Thor (2026). Shear wave velocities in healthy adults. Myocardial Velocity and Deformation Imaging. Fulltekst i vitenarkiv
• Edvardsen, Thor (2026). Role of Echocardiography in Risk Stratification of HCM. Fulltekst i vitenarkiv
• Edvardsen, Thor (2026). Valvular heart disease: highlights. Moderate aortic stenosis. Fulltekst i vitenarkiv
• Edvardsen, Thor (2026). EACVI documents in clinical practice. Strain echocardiography. Fulltekst i vitenarkiv
• Sverre, Elise Christine Bjørkholen; Madssen, Erik; Kristensen, A M D; Nyen, J E; Bakken, Arnhild & Holmager, T [Vis alle 12 forfattere av denne artikkelen] (2026). Effect of long-term beta-blocker therapy on physical activity after myocardial infarction: a post hoc analysis of the BETAMI trial. European Journal of Preventive Cardiology (EJPC). ISSN 2047-4873. 33(Supplement_2). doi: 10.1093/eurjpc/zwag249.065. Fulltekst i vitenarkiv Vis sammendrag

  Abstract Introduction The BETAMI-DANBLOCK trial recently found that beta-blockers reduced the risk of all-cause death or major adverse cardiovascular events in patients with a recent myocardial infarction (MI) without heart failure symptoms and left ventricular ejection fraction ≥40%. Some observational data and small intervention studies indicate a possible negative relationship between beta-blocker therapy and physical activity (PA) levels. However, it is still unclear how beta-blocker treatment influences PA after an acute MI. Purpose To investigate the effect of long-term beta-blocker therapy on PA level after MI in patients without heart failure. Method In this post-hoc analysis of the multicentre, randomized, open-label BETAMI trial with blinded endpoint evaluation, patients hospitalized with a MI and without heart failure were assigned to beta-blocker therapy within seven days after the event or no beta-blocker therapy. PA levels were assessed prior to randomization and at 1-, 6-, 12- and 18-months follow-up by self-reported questionnaires. The main endpoints were between-group changes in hours/week of light- (e.g., walking, dancing, cycling) and vigorous PA (e.g., brisk uphill walking, running) from baseline to 18 months, estimated by linear mixed models. Additionally, we assessed between-group differences in the proportion with guideline-recommended PA level (≥30 minutes of moderate activity on ≥5 days/week) and the participation rates in cardiac rehabilitation or organized PA programs. Results Of the 2867 patients, 2148 (75%) responded to the questions regarding PA in the follow-up period. Median age was 62 (IQR 55-70) years, and 19.6% were women. The median beta-blocker dose in the intervention arm was equivalent to metoprolol depot 50 mg/day. No differences in mean hours of light and vigorous physical activity were reported between the beta-blocker and non-beta-blocker groups at baseline, and these remained comparable throughout the 18 months follow-up (Figure 1). At baseline 31.2% met the guideline-recommended level of PA. This proportion increased to 39.2% at 6 months, with no significant differences between treatment arms at any time point (Figure 2). We found no effect of beta-blocker dose on the PA level. Participation in cardiac rehabilitation or organized PA at 12 months follow-up was 43.6% in the beta-blocker group and 42.3% in the non-beta-blocker group. Conclusions Beta-blocker therapy did not affect the PA level in post-MI patients without heart failure during 18 months follow-up.For image description, please refer to the figure legend and surrounding text.  For image description, please refer to the figure legend and surrounding text.

• Tveten, Ingrid Elisabeth; Nyberg, John; Grue, Jahn Frederik; Helland, Ragnhild Holden; Melichova, Daniela & Nguyen, Thuy Mi [Vis alle 13 forfattere av denne artikkelen] (2026). Deep learning segmentation and quantification of the left ventricle from the parasternal short axis view. European Heart Journal-Cardiovascular Imaging. ISSN 2047-2404. 27(Supplement_1). doi: 10.1093/ehjci/jeaf367.131. Fulltekst i vitenarkiv Vis sammendrag

  Background: Although parasternal short-axis (PSAX) images are routinely acquired during echocardiographic examinations, they remain under-utilized for quantitative analysis of the left ventricle (LV) morphology and function. This is even though PSAX offers a complete cross-sectional view of the LV myocardium, providing complementary information to apical views. The limited use of quantitative PSAX measurements is largely due to time-consuming manual workflows and inter-observer variability. Automated methods could help overcome these barriers and facilitate broader use of PSAX-based measurements in clinical practice. Purpose: To develop and evaluate a fully automated deep learning (DL) method for quantification of LV morphology and function from PSAX images. Methods: Two clinicians manually annotated the LV lumen and myocardium in PSAX images from 384 subjects for model development and 47 subjects for evaluation. A segmentation model based on nnU-Net was trained to delineate the LV lumen and myocardium. Model performance was assessed using Dice coefficients and the 95th percentile Hausdorff distance (HD95). Based on the segmentations, we calculated the cross-sectional lumen area and mean wall thickness (MWT) at end-diastole (ED) and end-systole (ES), LV fractional area change (LVFAC), and global circumferential strain (GCS). Agreement between DL-based and clinician-derived measurements was assessed and compared to inter-observer variability. We compared MWT at ED between subjects with hypertension (systolic blood pressure ≥ 160 mmHg or use of antihypertensive medication) and those without hypertension. Results: The nnU-Net model achieved Dice coefficients of 0.94±0.03 and 0.86±0.07, and HD95s of 3.0±1.6 mm and 3.3±1.5 mm, for the lumen and myocardium, respectively. The nnU-Net outperformed inter-observer Dice (0.93±0.04 and 0.82±0.07) and HD95 (3.7±1.5 mm and 4.2±1.4 mm). Feasibility of the measurement pipeline was 90%. Agreement between DL-based measurements and observers was similar for GCS. For all other measurements, DL−observer agreement exceeded inter-observer agreement. For MWT ED the agreement with the mean of two observers (bias -0.4 mm and limits of agreement (LoA) -1.8 to 1.0 mm) was in line with the inter-observer comparison (bias 1.7 mm and LoA -0.2 to 3.5 mm). MWT at ED was significantly higher in subjects with hypertension than in those without (p < 0.001). Conclusion: The proposed DL-based measurement pipeline for PSAX enables automatic measurements of LV cross-sectional area, wall thickness and subsequent functional measurements. Agreement with manual measurements was high, and the method was able to detect structural differences associated with hypertension. These results highlight the potential of DL to unlock the value of PSAX analysis in comprehensive LV assessment.|

• Sverre, Elise Christine Bjørkholen; Madssen, Erik; Nyen, Johanne; Bakken, Arnhild; Holmager, Therese & Jortveit, Jarle [Vis alle 11 forfattere av denne artikkelen] (2026). Effect of long-term beta-blocker therapy on physical activity after myocardial infarction: a post hoc analysis of the BETAMI trial. doi: https:/esc365.escardio.org/preventive-cardiology/sessions/18492-behaviour-and-awareness-in-risk-development-and-successful-risk-management. Fulltekst i vitenarkiv
• Munkhaugen, John; Bakken, Arnhild; Kristiansen, Anna Meta Dyrvig; Edvardsen, Thor; Wiseth, Rune & Steigen, Terje [Vis alle 12 forfattere av denne artikkelen] (2026). Sekundærforebygging med betablokkere etter hjerteinfarkt. 146. doi: 10.4045/tidsskr.25.0735. Fulltekst i vitenarkiv
• Edvardsen, Thor (2025). Course director EchoNaples. Fulltekst i vitenarkiv
• Edvardsen, Thor (2025). Co-chair Norwegian Cardiology Spring meeting. Fulltekst i vitenarkiv
• Edvardsen, Thor & Selmer, Lisa Marie (2025). Shear wave elastography in cardiac imaging: promise and questions ahead. European Heart Journal-Cardiovascular Imaging. ISSN 2047-2404. 26(9), s. 1548–1548. doi: 10.1093/ehjci/jeaf208. Fulltekst i vitenarkiv
• Edvardsen, Thor (2025). Prognosis and management of moderate aortic stenosis. Fulltekst i vitenarkiv
• Edvardsen, Thor (2025). Assessment of asymptomatic patients at risk of cardiomyopathy and arrhythmias. Fulltekst i vitenarkiv
• Edvardsen, Thor (2025). Athletes heart. Fulltekst i vitenarkiv
• Edvardsen, Thor (2025). Where are the cardio-oncology patients? Fulltekst i vitenarkiv
• Edvardsen, Thor (2025). Infiltrativ CMP. Fulltekst i vitenarkiv
• Edvardsen, Thor (2025). HCM: clues to echo diagnosis and assessment. Fulltekst i vitenarkiv
• Edvardsen, Thor (2025). Hvilke ekko funn bør initiere henvisning til MR ? Fulltekst i vitenarkiv
• Edvardsen, Thor & Klæboe, Lars Gunnar (2025). Assessment of Diastolic Function: Is It Time to Relax? Rethinking Echocardiographic Approaches. Journal of the American Society of Echocardiography. ISSN 0894-7317. 38(5), s. 378–379. doi: 10.1016/j.echo.2025.02.004. Fulltekst i vitenarkiv
• Solberg, Erik Ekker; Ingul, Charlotte Ingeborg Björk; Edvardsen, Thor; Grimsmo, Jostein; Haugaa, Kristina Ingrid Helena Hermann & Loennechen, Jan Pål [Vis alle 11 forfattere av denne artikkelen] (2025). Målrettet hjertescreening av idrettsutøvere. 145(7). doi: 10.4045/tidsskr.25.0127. Fulltekst i vitenarkiv
• Edvardsen, Thor (2024). Role of Echocardiography in Risk Stratification of HCM. Fulltekst i vitenarkiv
• Edvardsen, Thor (2024). Arrhythmogenic mitral valve prolapse. Cardiac imaging in clinical practice. Fulltekst i vitenarkiv
• Edvardsen, Thor (2024). Multimodality Imaging in Arrhythmogenic Cardiomyopathies. Cardiac imaging in clinical practice. Fulltekst i vitenarkiv
• Edvardsen, Thor (2024). Echocardiographic risk prediction in ventricular arrhythmias - the role of mechanical dispersion. Fulltekst i vitenarkiv
• Edvardsen, Thor (2024). Echocardiographic workup for HCM – making the diagnosis and evaluation of cardiac function. Fulltekst i vitenarkiv
• Edvardsen, Thor (2024). Longitudinal strain: how to better understand LV performance. Fulltekst i vitenarkiv
• Nguyen, ​Thuy Mi Tran; Melichova, Daniela; Gjertsen, Erik; Heggelund, Geir; Kleiven, Øyunn & Brunvand, Harald [Vis alle 8 forfattere av denne artikkelen] (2024). All-cause mortality and incidence of appropriate therapy from a primary preventive implantable cardioverter defibrillator in patients with non-ischemic dilated cardiomyopathy. European Heart Journal, Supplement. ISSN 1520-765X. 45. doi: 10.1093/eurheartj/ehae666.717. Fulltekst i vitenarkiv
• Muraru, Denisa; Pontone, Gianluca; Jurcut, Ruxandra; Magne, Julien; Donal, Erwan & Stankovic, Ivan [Vis alle 28 forfattere av denne artikkelen] (2024). How to conduct clinical research in cardiovascular imaging: a primer for clinical cardiologists and researchers-a statement of the European Association of Cardiovascular Imaging (EACVI) of the ESC. European Heart Journal-Cardiovascular Imaging. ISSN 2047-2404. 26(1), s. 4–21. doi: 10.1093/ehjci/jeae238. Fulltekst i vitenarkiv
• Nyberg, John; Østvik, Andreas; Salte, Ivar Mjåland; Olaisen, Sindre Hellum; Karlsen, Sigve & Dahlslett, Thomas [Vis alle 14 forfattere av denne artikkelen] (2024). Improved reproducibility of regional longitudinal strain in echocardiography by deep learning. Fulltekst i vitenarkiv
• Almaas, Vibeke Marie; Abdullah, Rang; Edvardsen, Thor; Haugaa, Kristina Ingrid Helena Hermann & Bjørnebekk, Astrid Kristine (2024). Comment on 'Anabolic-androgenic steroids and cardiac function. European Journal of Preventive Cardiology (EJPC). ISSN 2047-4873. 31(13), s. e97–e98. doi: 10.1093/eurjpc/zwae183. Fulltekst i vitenarkiv
• Salte, Ivar Mjåland; Østvik, Andreas; Olaisen, Sindre Hellum; Karlsen, Sigve; Dahlslett, Thomas & Smistad, Erik [Vis alle 13 forfattere av denne artikkelen] (2023). Response to “Minimal Detectable Change and Reproducibility of Echocardiographic Strain: Implications for Clinical Practice”. Journal of the American Society of Echocardiography. ISSN 0894-7317. doi: 10.1016/j.echo.2023.08.017. Fulltekst i vitenarkiv
• Gregersen, Ida; Ueland, Thor; Holter, Jan Cato; Olsen, Maria Belland; Michelsen, Annika Elisabet & Murphy, Sarah L [Vis alle 22 forfattere av denne artikkelen] (2022). CXCL16 associates with adverse outcome and cardiac involvement in hospitalized patients with Covid-19. Journal of Infection. ISSN 0163-4453. 85(6), s. 735–738. doi: 10.1016/j.jinf.2022.09.029. Fulltekst i vitenarkiv
• Edvardsen, Thor; Asch, Federico M.; Davidson, Brian; Delgado, Victoria; DeMaria, Anthony & Dilsizian, Vasken [Vis alle 20 forfattere av denne artikkelen] (2022). Non-Invasive Imaging in Coronary Syndromes: Recommendations of The European Association of Cardiovascular Imaging and the American Society of Echocardiography, in Collaboration with The American Society of Nuclear Cardiology, Society of Cardiovascular Computed Tomography, and Society for Cardiovascular Magnetic Resonance. Journal of the American Society of Echocardiography. ISSN 0894-7317. 35(4), s. 329–354. doi: 10.1016/j.echo.2021.12.012. Fulltekst i vitenarkiv
• Edvardsen, Thor; Asch, Federico M.; Davidson, Brian; Delgado, Victoria; DeMaria, Anthony & Dilsizian, Vasken [Vis alle 20 forfattere av denne artikkelen] (2022). Non-Invasive Imaging in Coronary Syndromes: Recommendations of The European Association of Cardiovascular Imaging and the American Society of Echocardiography, in Collaboration with The American Society of Nuclear Cardiology, Society of Cardiovascular Computed Tomography, and Society for Cardiovascular Magnetic Resonance. Journal of cardiovascular computed tomography. ISSN 1934-5925. 16(4), s. 362–383. doi: 10.1016/j.jcct.2022.05.006. Fulltekst i vitenarkiv
• Aabel, Eivind Westrum; Chivulescu, Ana Monica; Lie, Øyvind Haugen; Hopp, Einar; Gjertsen, Erik & Ribe, Margareth [Vis alle 11 forfattere av denne artikkelen] (2022). High incidence of ventricular arrhythmia in arrhythmic mitral valve syndrome - an implantable loop recorder study. Fulltekst i vitenarkiv
• Aabel, Eivind Westrum; Chivulescu, Ana Monica; Lie, Øyvind Haugen; Rootwelt-Norberg, Christine; Ribe, Margareth & Gjertsen, Erik [Vis alle 12 forfattere av denne artikkelen] (2022). Predictors of ventricular arrhythmias in arrhythmic mitral valve syndrome - a study using implantable loop recorders. Fulltekst i vitenarkiv
• Bardan, Sara; Kvaslerud, Anette Borger; Andresen, Kristoffer; Kløve, Sophie Foss; Edvardsen, Thor & Gullestad, Lars [Vis alle 7 forfattere av denne artikkelen] (2022). Intravenous ferric derisomaltose in iron-deficient patients undergoing transcatheter aortic valve implantation due to severe aortic stenosis: study protocol of the randomised controlled IIISAS trial. BMJ Open. 12(9). doi: 10.1136/bmjopen-2021-059546. Fulltekst i vitenarkiv Vis sammendrag

  Abstract Introduction Iron deficiency is a prevalent comorbidity in patients with severe aortic stenosis and may be associated with procedural and clinical outcomes after transcatheter aortic valve implantation (TAVI). In the Intravenous Iron Supplement for Iron Deficiency in Patients with Severe Aortic Stenosis (IIISAS) trial, we aim to examine whether a single administration of ferric derisomaltose can improve physical capacity after TAVI. Methods and analysis This randomised, double-blind, placebo-controlled trial aims to enrol 150 patients with iron deficiency who are scheduled for TAVI due to severe aortic stenosis. The study drug and matching placebo are administered approximately 3 months prior to TAVI, and the patients are followed for 3 months after TAVI. Inclusion criteria are iron deficiency, defined as serum ferritin<100 µg/L or ferritin between 100 and 300 µg/L in combination with a transferrin saturation<20% and written informed consent. Exclusion criteria include haemoglobin<10 g/dL, red blood cell disorders, end-stage kidney failure, intolerance to ferric derisomaltose, and ongoing infections. The primary endpoint is the baseline-adjusted distance walked on a 6 min walk test (6MWT) 3 months after TAVI. Secondary end points include quality of life, New York Heart Association functional class (NYHA functional class), and skeletal muscle strength. Ethics and dissemination Ethical approval was obtained from the Regional Committee for Medical and Health Research of South-Eastern Norway and The Norwegian Medicines Agency. Enrolment has begun, and results are expected in 2022. The results of the IIISAS trial will be disseminated by presentations at international and national conferences and by publications in peer-reviewed journals.

• Tangen, Jorun; Aukrust, Pål; Barrat-Due, A; Trøseid, Marius; Olsen, Inge Christoffer & Nezvalova-Henriksen, Katerina [Vis alle 15 forfattere av denne artikkelen] (2021). Cardiac function is normal in most patients recovered from COVID-19. Fulltekst i vitenarkiv
• Stokke, Mathis K.; Castrini, Anna I.; Aneq, Meriam Åström; Jensen, Henrik K.; Madsen, Trine & Hansen, Jim [Vis alle 12 forfattere av denne artikkelen] (2021). Reply to: TFC ECG in arrhythmogenic cardiomyopathy: Inadequate mixture of criteria? International Journal of Cardiology. ISSN 0167-5273. 323, s. 203–203. doi: 10.1016/j.ijcard.2020.08.050. Fulltekst i vitenarkiv
• Chivulescu, Ana Monica; Krogh-Sørensen, Kirsten; Scheirlynck, Esther; Lindberg, Beate Rikken; Dejgaard, Lars & Lie, Øyvind Haugen [Vis alle 14 forfattere av denne artikkelen] (2020). Mitral annulus disjunction is highly prevalent in patients with Marfan syndrome and Loyes-Dietz syndrome. Fulltekst i vitenarkiv
• Edvardsen, Thor; Klæboe, Lars Gunnar & Haugaa, Kristina Ingrid Helena Hermann (2020). The infarcted myocardium and mechanical dispersion: Another brick in the wall. European Heart Journal-Cardiovascular Imaging. ISSN 2047-2404. 21(11), s. 1235–1236. doi: 10.1093/ehjci/jeaa209. Fulltekst i vitenarkiv
• Čelutkienė, Jelena; Pudil, Radek; López-Fernández, Teresa; Grapsa, Julia; Nihoyannopoulos, Petros & Bergler-Klein, Jutta [Vis alle 47 forfattere av denne artikkelen] (2020). Role of cardiovascular imaging in cancer patients receiving cardiotoxic therapies: a position statement on behalf of the Heart Failure Association (HFA), the European Association of Cardiovascular Imaging (EACVI) and the Cardio-Oncology Council of the European Society of Cardiology (ESC). 22(9), s. 1504–1524. doi: 10.1002/ejhf.1957. Fulltekst i vitenarkiv
• Edvardsen, Thor; Cosyns, Bernard; Popescu, Bogdan A. & Maurer, Gerald (2020). Maurizio Galderisi (31 August 1954-27 March 2020). European Heart Journal. ISSN 0195-668X. 41(25), s. 2350–2351. doi: 10.1093/eurheartj/ehaa268. Fulltekst i vitenarkiv
• Edvardsen, Thor; Cosyns, Bernard; Popescu, Bogdan A. & Maurer, Gerald (2020). Maurizio Galderisi (31 August 1954-27 March 2020). European Heart Journal-Cardiovascular Imaging. ISSN 2047-2404. 21(6), s. 591–591. doi: 10.1093/ehjci/jeaa077. Fulltekst i vitenarkiv
• Edvardsen, Thor (2019). Focused cardiac ultrasound examination is ready for use as a diagnostic tool of acute aortic syndromes in the emergency room. European Heart Journal. ISSN 0195-668X. 40(24), s. 1961–1962. doi: 10.1093/eurheartj/ehz356. Fulltekst i vitenarkiv
• Donal, Erwan; Delgado, Victoria; Bucciarelli-Ducci, Chiara; Galli, Elena; Haugaa, Kristina & Charron, Philippe [Vis alle 19 forfattere av denne artikkelen] (2019). Multimodality imaging in the diagnosis, risk stratification, and management of patients with dilated cardiomyopathies: An expert consensus document from the European Association of Cardiovascular Imaging. European Heart Journal-Cardiovascular Imaging. ISSN 2047-2404. 20(10), s. 1075–1093. doi: 10.1093/ehjci/jez178. Fulltekst i vitenarkiv
• Edvardsen, Thor & Haugaa, Kristina (2019). Stretch and Rebound in the Search for Cardiac Resynchronization Therapy Candidates. JACC Cardiovascular Imaging. ISSN 1936-878X. 12(9), s. 1753–1754. doi: 10.1016/j.jcmg.2018.08.008. Fulltekst i vitenarkiv
• Gonzalez, Alba; Aurlien, Dag; Larsson, Pål Gunnar; Olsen, Ketil Berg; Dahl, Iselin Teresa & Edvardsen, Thor [Vis alle 8 forfattere av denne artikkelen] (2019). Corrigendum to “Seizure-like episodes and EEG abnormalities in patients with long QT syndrome” (Seizure: European Journal of Epilepsy (2018) 61 (214–220), (S1059131118303662), (10.1016/j.seizure.2018.08.020)). Seizure. ISSN 1059-1311. 69, s. 304–304. doi: 10.1016/j.seizure.2018.12.002. Fulltekst i vitenarkiv
• Fox, Kevin; Achenbach, Stephan; Bax, Jeroen; Cosyns, Bernard; Delgado, Victoria & Dweck, Mark R. [Vis alle 17 forfattere av denne artikkelen] (2019). Multimodality imaging in cardiology: a statement on behalf of the Task Force on Multimodality Imaging of the European Association of Cardiovascular Imaging. European Heart Journal. ISSN 0195-668X. 40(6), s. 553–558. doi: 10.1093/eurheartj/ehy669. Fulltekst i vitenarkiv
• Cardim, Nuno; Dalen, Håvard; Voigt, Jens-Uwe; Ionescu, Adrian; Price, Susanna & Neskovic, Aleksandar N [Vis alle 14 forfattere av denne artikkelen] (2019). The use of handheld ultrasound devices: a position statement of the European Association of Cardiovascular Imaging (2018 update). European Heart Journal-Cardiovascular Imaging. ISSN 2047-2404. 20(3), s. 245–252. doi: 10.1093/ehjci/jey145. Fulltekst i vitenarkiv Vis sammendrag

  Recent technological advances in echocardiography, with progressive miniaturization of ultrasound machines, have led to the development of handheld ultrasound devices (HUD). These devices, no larger than some mobile phones, can be used to perform partial, focused exams as an extension to the physical examination. The European Association of Cardiovascular Imaging (EACVI) acknowledges that the dissemination of appropriate HUD use is inevitable and desirable, because of its potential impact on patient management. However, as a scientific society of cardiac imaging, our role is to provide guidance in order to optimize patient benefit and minimize drawbacks from inappropriate use of this technology. This document provides updated recommendations for the use of HUD, including nomenclature, appropriateness, indications, operators, clinical environments, data management and storage, educational needs and training of potential users. It also adresses gaps in evidence, controversial issues and future technological developments.

• Magne, Julien; Bucciarelli-Ducci, Chiara; Dahl, Jordi S.; Gimelli, Alessia; Haugaa, Kristina & Miller, Owen [Vis alle 10 forfattere av denne artikkelen] (2018). EuroEcho-imaging 2017: Highlights. European Heart Journal-Cardiovascular Imaging. ISSN 2047-2404. 19(5), s. 482–489. doi: 10.1093/ehjci/jey037. Fulltekst i vitenarkiv
• Edvardsen, Thor & Haugaa, Kristina Ingrid Helena Hermann (2018). Strain Echocardiography: From Variability to Predictability ∗. JACC Cardiovascular Imaging. ISSN 1936-878X. 11(1), s. 35–37. doi: 10.1016/j.jcmg.2017.03.012. Fulltekst i vitenarkiv
• Edvardsen, Thor & Smiseth, Otto A. (2018). Evaluation of diastolic function by echocardiography: important progression, but issues to be resolved. European Heart Journal-Cardiovascular Imaging. ISSN 2047-2404. 19, s. 387–388. doi: 10.1093/ehjci/jex319. Fulltekst i vitenarkiv
• Edvardsen, Thor & Opdahl, Anders (2018). Yet another echocardiographic index: do we need more? European Heart Journal. ISSN 0195-668X. 0, s. 1–3. doi: 10.1093/eurheartj/ehy270. Fulltekst i vitenarkiv
• Haugaa, Kristina; Edvardsen, Thor & Smiseth, Otto A. (2017). Mechanical dyssynchrony - Resurrected as a flashing and rocking parameter to predict prognosis after cardiac resynchronization therapy. European Heart Journal-Cardiovascular Imaging. ISSN 2047-2404. 18(10), s. 1118–1119. doi: 10.1093/ehjci/jex198. Fulltekst i vitenarkiv
• Kolias, Theodore J. & Edvardsen, Thor (2016). Beyond ejection fraction: adding strain to the Armamentarium. JACC Cardiovascular Imaging. ISSN 1936-878X. 9(8), s. 922–923. doi: 10.1016/j.jcmg.2015.10.029. Fulltekst i vitenarkiv
• Marchlinski, Francis E. & Edvardsen, Thor (2016). Arrhythmogenic Right Ventricular Cardiomyopathy: Better Tools for Detecting Early Disease and Progression. Journal of the American College of Cardiology. ISSN 0735-1097. 68(20), s. 2198–2200. doi: 10.1016/j.jacc.2016.09.916. Fulltekst i vitenarkiv
• Nestaas, Eirik; Sarvari, Sebastian Imre; Hopp, Einar; Gjesdal, Ola; Smedsrud, Marit Kristine & Haugaa, Kristina [Vis alle 7 forfattere av denne artikkelen] (2016). The timing of the post systolic shortening in prediction of scarred myocardium. Fulltekst i vitenarkiv
• Lancellotti, Patrizio; Pibarot, Philippe; Chambers, John; Edvardsen, Thor; Delgado, Victoria & Dulgheru, Raluca [Vis alle 22 forfattere av denne artikkelen] (2016). Recommendations for the imaging assessment of prosthetic heart valves: A report from the European Association of Cardiovascular Imaging endorsed by the Chinese Society of Echocardiography, the Inter-American Society of Echocardiography, and the Brazilian Department of Cardiovascular Imaging. European Heart Journal-Cardiovascular Imaging. ISSN 2047-2404. 17(6), s. 589–590. doi: 10.1093/ehjci/jew025. Fulltekst i vitenarkiv
• Haugaa, Kristina & Edvardsen, Thor (2016). Global longitudinal strain: the best biomarker for predicting prognosis in heart failure? European Journal of Heart Failure. ISSN 1388-9842. 18(11), s. 1340–1341. doi: 10.1002/ejhf.632. Fulltekst i vitenarkiv
• Manotheepan, Ravinea; Danielsen, Tore Kristian; Saberniak, Jorg; Sadredini, Mani; Anderson, Mark e. & Carlson, Cathrine Rein [Vis alle 11 forfattere av denne artikkelen] (2016). Exercise training as anti-arrhythmic therapy in cathecholaminergic polymorphic ventricular tachycardia type 1. Fulltekst i vitenarkiv
• Forså, Marianne Inngjerdingen; Edvardsen, Thor; Haugaa, Kristina Ingrid Helena Hermann & Smedsrud, Marit Kristine (2026). The growing heart – from normal to pathology. Impact of exercise and genetics. Universitetet i Oslo. ISSN 9788234808258. Fulltekst i vitenarkiv Vis sammendrag

  Athlete’s heart is a physiological cardiac adaptation to exercise, characterized by increased wall thickness and chamber size. These changes may overlap with early signs of hypertrophic cardiomyopathy, a genetic disease associated with ventricular arrhythmias and sudden cardiac death. Distinguishing between the two conditions is crucial, yet data on paediatric athletes remain limited. Similarly, arrhythmogenic right ventricular cardiomyopathy has mainly been studied in adults, leaving paediatric patients underrepresented. In the thesis The growing heart – from normal to pathology. Impact of exercise and genetics, Marianne Inngjerdingen Forså and co-authors investigate cardiac development in adolescent athletes and paediatric cardiomyopathy patients. The work is based on three longitudinal cohort studies. The authors describe signs of athlete’s heart in both males and females from age 12, with increasing sex differences during adolescence. Athletes of both sexes displayed wall thickness beyond upper reference values, suggesting a potential grey zone of left ventricular hypertrophy. Compared with age- and sex-matched genotype-positive hypertrophic cardiomyopathy patients, the athletes showed symmetrical cardiac growth and relative normalization of wall thickness as body size increased. In contrast, genotype-positive hypertrophic cardiomyopathy patients showed increasingly asymmetrical wall thickness. Two cases of cardiac arrest occurred after rapid disease progression. The thesis further examines arrhythmogenic right ventricular cardiomyopathy in children and adolescents. Previous guidelines recommended cardiac evaluation of genotype-positive children from age 10–12 years. Forså and co-authors found high disease penetrance and a malignant phenotype before age 12, with progression to heart failure in early-onset disease. Arrhythmias were more frequent in adolescence. The thesis highlights the limitations of extrapolating findings from adults to paediatric populations.

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