Oslo University Hospital (OUS)
Oslo University Hospital is a highly specialised hospital in charge of extensive regional and local hospital assignments and the provision of high quality services for the citizens of Oslo. The hospital also has a nationwide responsibility for a number of national and multi-regional assignments and has several national centres of competence.
A major part of the total medical research carried out at Norwegian medical centres is performed at Oslo University Hospital. This is the result of the hospital’s general research strategy and its extensive international and national network cooperation.
In this way, the medical centre complies with the requirements of its owner and patients relating to its role as national reference hospital, responsible for introducing and developing new medical examination methods, treatment methods and follow-ups. Research that supports prioritised areas of commitment will also safeguard the operation and development of national and multi-regional assignments, as well as the functions of the medical resource centres.
Procardio members in alphabetical order:
Eivind Westrum Aabel, MD, PhD fellow, Department of Cardiology, Oslo University Hospital, Rikshospitalet
Aabel's research is focused on arrhythmias and cardiomyopathies. Aabel won the prize for best abstract in the session for Cardiac function and imaging with his abstract presentation titled “Tricuspid annulus disjunction is a common finding in patients with mitral annulus disjunction" at the Annual Oslo Symposium on Heart Research in September 2021. The event was co-hosted by ProCardio.
Lars Aaberge, MD, PhD, Head of Section for Interventional Cardiology, Department of Cardiology, Oslo University Hospital, Rikshospitalet
The section performs catheter-based invasive diagnostics, treatment and controll of patients undergone a cardiac transplantation, pregnant women with heart disease, patientes suffering from severe heart failure and cardiomyopathies.
The staff at the section partakes in both national and international research collaboration.
Dr. Aaberge has authored several publications in internationally renowed peer-reviewed journals. His reaserach focuses on invasive cardiology and intensive coronary care.
Vibeke Marie Almaas, Consultant Cardiologist, MD, PhD, Department of Cardiology, Oslo University Hospital, Rikshospitalet
Her PhD focused on evaluation of new treatment methods (PTSMA and surgical myectomy) in patients with hypertrophic cardiomyopathy (HCM).
The aim of the project was to optimize the selection criterions for the therapy by evaluating myocardial function in HCM patients treated with either PTSMA or surgical myectomy.
Kristoffer Andresen, MD, PhD fellow
Reasearch focus on triplane speckle-tracking echocardiography of the right ventricle.
Ole-Gunnar Anfinsen, Consultant Cardiologist, MD, PhD, Section for Arrhythmia, Department of Cardiology, Oslo University Hospital, Rikshospitalet
Ole-Gunnar does research in internal medicine and cardiology, focusing on electrophysiology, catheter ablation and sleep apnea. He is supervising PhD fellow Tove Hunt, MD together with professor Kristina Haugaa. The projects Anfinsen is working on include "Sleep disordered breathing in patients with paroxysmal atrial fibrillation".
Jan Otto Beitnes, Consultant Cardiologist, MD, PhD, Department of Cardiology, Oslo University Hospital, Rikshospitalet
Beitnes has investigated the effect of different types of stem cell treatment after acute myocardial infarction. Mesenchymal stem cells (MSC) can be harvested from adipose tissue and muscle tissue, and when these cells are grown and then injected into the heart after a heart attack, a reduction in infarct size and improvement of cardiac function can be seen four weeks after the treatment. The injected cells do not appear to form heart muscle or vascular structures themselves, but affect the healing process after the infarction in another way. MSC are relevant cells for testing in further studies.
Bjørn Bendz, MD, PhD, Head of Division of Cardiovascular and Pulmonary Diseases, Department of Cardiology, Oslo University Hospital, Rikshospitalet
As a former head of section for interventional cardiology, Dr. Bendz has focused his research on invasive cardiology and intensive coronary care. He has authored several publications in internationally renowed peer-reviewed journals, among those the After Eighty study published in Lancet. Bjørn Bendz was elected the years' doctor of Oslo in 2018, and won the 12th semester students' educational award in 2015.
Pål H. Brekke, Consultant Cardiologist, MD, PhD, Department of Cardiology, Oslo University Hospital, Rikshospitalet
Brekke did his PhD fellowship at Akershus University Hospital (Ahus), focusing on markers of myocardial injury in patients with chronic obstructive pulmonary disease. Concurrently, he held a part time position at the University of Oslo, teaching research methodology and epidemiology. In recent years his research has focused on the development of new ultrasound technologies and methods. He has also been employed part time by the Norwegian Research Council funded BigMed project, in which big data analytics were being employed to improve sudden cardiac death prediction and prevention.
Kaspar Broch, Consultant Cardiologist, MD, PhD, Department of Cardiology, Oslo University Hospital, Rikshospitalet
Broch is the leader of the research group Clinical Cardiology, with main emphasis being on initiating and conducting proof-of-concept studies and testing ideas in well-controlled randomized studies.
The focus is heavily on the role of inflammatory and other active peptides in the development of heart disease, primarily related to the development of heart failure. The group also conducts testing of different biomarkers in blood to find their role in diagnosis, prognosis and therapeutic treatment of various cardiovascular diseases.
Lars Andreas Dejgaard, Cardiologist, MD, PhD, Department of Cardiology, Oslo University Hospital, Rikshospitalet
His PhD research focused on the use of different echocardiographic techniques for the assessment of the risk for sudden cardiac death in cardiomyopathies. He holds extensive knowledge in diagnosis and treatment of mitral annulus disjunction and mitral valve prolapse, and has published numerous articles in the field. His thesis was titled Cardiac diseases with risk of severe ventricular arrhythmias; risk stratification and impact of exercise and his dissertation even made it to forskning.no (news in Norwegian). Dejgaard won the best article prize for his paper The Mitral Annulus Disjunction Arrhythmic Syndrome in 2018. The selected articles are of especially high quality, and they present important finding on both-short and long-term scales. The works reflect the good quality and the interdisciplinarity that characterises several research environments at Oslo University Hospital. The research is a fundamental condition for the institution to maintain and strenghten the quality in the patient treatment.
Christian Eek, Consultant Cardiologist, MD, PhD, Department of Cardiology, Oslo University Hospital, Rikshospitalet
Eek's research is focusing on echocardiographic stratification of patients with acute coronary syndrome.
Thor Edvardsen, MD, PhD, FESC, FEACVI, the EACVI Past-President 2020-22
Head of Department of Cardiology, Oslo University Hospital, Rikshospitalet
Professor at the Institute of Clinical Medicine, University of Oslo
Edvardsen is the Dissemination Manager at ProCardio. He has published more than 300 international scientific publications in peer-reviewed journals, and more than 20 book chapters and books. Numerous of these articles are published in Circulation, Journal of the American College of Cardiology, European Heart Journal and other prestigious journals in cardiology. He has supervised and co-supervised 25 PhD candidates to complete their thesis, and is active in clinical and experimental research in the area of myocardial function. Edvardsen has extensive knowledge of cardiac ultrasound, CMR, CT and hemodynamics. Thor Edvardsen is also the chair of T2 on coronary syndromes.
Mette-Elise Estensen, Consultant Cardiologist, MD, PhD, Department of Cardiology, Oslo University Hospital, Rikshospitalet
In her PhD thesis Left ventricular function and systemic arterial properties in normal and preeclamptic pregnancy, Estensen concluded that women who have undergone preeclampsia have persistent cardiovascular changes that last up to three years after childbirth, which can help explain the increased incidence of cardiovascular disease in these women. Estensen found that during pregnancy women with preeclampsia have more rigid vessels compared to healthy women. Pregnancy is reffered to as life's stress to the heart. Preeclampsia occurs in 3-8% of all pregnancies and can have serious consequences for the mother and child. Research has shown that women who have undergone preeclampsia have a significantly increased risk of developing cardiovascular disease later in life.
Marianne Inngjerdingen Forså, MD, PhD fellow, Department of Cardiology, Oslo University Hospital, Rikshospitalet
Her research is focused on cardiac remodelling in children and adolescents. Forså won the best abstract in the Exercise, prevention and diagnostics -session with her abstract Cardiac remodelling in adolescent athletes – sex differences progress through adolescence at the 20th Annual Norwegian Symposium on Heart Research in 2022. The scientific program covered the latest news in cardiac research and invited lecturers represented the impressive field of cardiovascular research in Norway.
Nina Hasselberg, Consultant Cardiologist, MD, PhD, Department of Cardiology, Oslo University Hospital, Rikshospitalet
Her PhD work focused on myocardial function and prediction of arrhythmias in different cardiomyopathies, with emphasis on imaging modalities, especially echocardiography. She has worked as a postdoctoral fellow at University of Pittsburgh Medical Center, USA focusing on the project Peak Strain Dispersion and Clinical Outcomes in the EchoCRT trial. Hasselberg is currently leading the Cardiomyopathy work package at ProCardio. As a postdoctoral researcher, she will conduct research and supervise PhD students in the field of genetic cardiomyopathies and cardiac imaging. Hasselberg has several publications in peer-reviewed journals. She was an EACVI Education Committee member for 2021/22 and the former Norwegian ambassador of HIT (Heart Imagers of Tomorrow) during 2013-2019.
Kristina Hermann Haugaa, MD, PhD, FESC, Head of Outpatient Clinic and Genetic Cardiac Diseases, Department of Cardiology, Oslo University Hospital, Rikshospitalet
Associate professor at the Institute of Clinical Medicine, University of Oslo
Kristina Haugaa is the Center director at ProCardio Center for Innovation. Dr. Haugaa is a board certified specialist in Internal Medicine and Cardiology. Her research is focused on developing risk stratifying tools for life threatening ventricular arrhythmias and sudden cardiac death and management of genetic cardiac diseases. Dr. Haugaa has supervised and co-supervised over 15 PhD candidates to complete their thesis. She has twice been awarded the teacher of the year by medical students. She has over 200 international scientific publications in peer-reviewed journals. Dr. Haugaa was awarded with Oslo University Hospital's Early Career Award in June 2018 for her excellent research and leadership skills and with the Research prize from the Norwegian Society of Cardiology in 2020. Haugaa is the academic Secretary of the European Heart Rhythm Association (EHRA) and member of the EHRA executive board. Kristina Haugaa is also the chair of T1.2 on Mitral Annulus Disjunction.
Finn Hegbom, Consultant Cardiologist, MD, PhD, Section for Arrhythmia, Department of Cardiology, Oslo University Hospital, Rikshospitalet
Hegbom has been working with arrhythmic patients for 30 years, whereof the last 20 years with ablation procedures for the treatment of atrial fibrillation. Finn Hegbom is the co-author of the book (in Norwegian) Hjertearytmier; Klinikk, EKG og behandling.
Thomas Helle-Valle, Consultant Cardiologist, MD, PhD, Department of Cardiology, Oslo University Hospital, Rikshospitalet
In his PhD-thesis New non-invasive methods for quantification of myocardial function in the left ventricle, Helle-Valle introduced and validated new non-invasive methods for detailed assessment of myocardial function. His research demonstrated that new automated pattern recognition algorithms could be applied to echocardiography- or CT recordings to precisely quantify regional and global deformation of the left ventricle. Helle-Valle and colleagues used different models (mathematical simulation, animal experiments and clinical studies) to validate the new analytical methods and demonstrated that the percentage change in myocardial wall deformation (strain) and displacement (rotation) could be used to detect the extent of myocardial ischemia and understand the functional consequences.
Helle-Valle has extensive clinical experience in the use of various echocardiographic modalities and analyses, such as stress-, transesophageal- and intracardiac echocardiography, 4D-imaging and strainanalysis. He is involved in several research projects, particularly regarding atrial function and dyssynchrony, and has a particular responsibility regarding echocardiography during cardiac surgery and percutaneous procedures like MitralClip, TAVI, PTSMA and PFO/ASD/LAA-closure.
Torbjørn Holm, Consultant Cardiologist, MD, PhD, Department of Cardiology, Oslo University Hospital, Rikshospitalet
Holm has extensive experience in treatment of arrhythmia and heart failure. He has authored numerous scientific papers, and in one of the most recent ones Relationship between ablation index and myocardial biomarkers after radiofrequency catheter ablation for atrial fibrillation - PMC (nih.gov) he explores radiofrequency catheter ablation.
Radiofrequency (RF) catheter ablation aiming at electrical pulmonary vein (PV) isolation is an established treatment option for symptomatic drug-refractory atrial fibrillation (AF). Despite more than 20 years of scientific and technological advances, AF recurrence rates are significant, affecting up to 50% of patients after a single procedure. Reconnection of one or several PVs can be demonstrated in most patients experiencing AF recurrence. This is probably caused by inadequate lesions, reversible tissue injury and electrical reconduction. Unpredictable lesion formation has been a major limiting factor for RF catheter ablation. (Shared under creative commons CC BY-NC-ND license).
Hunt's PhD research is focused on atrial fibrillation, sleep apnea and advanced treatment planning. Hunt is a co-author of the paper Effect of Continuous Positive Airway Pressure on Arrhythmia in Atrial Fibrillation and Sleep Apnea: A Randomized Controlled Trial - PubMed (nih.gov), in which the authors conclude that CPAP treatment does not seem to reduce or prevent paroxysmal AF.
Trine Håland, Consultant Cardiologist, MD, PhD, Department of Cardiology, Oslo University Hospital, Rikshospitalet
In her thesis Hypertrophic cardiomyopathy - Systolic function, differential diagnosis and risk stratification, Håland used cardiac ultrasound and modern methods of analysis to distinguish between hypertrophic cardiomyopathy HCM and the less frequent cardiac non-compaction cardiomyopathy. Together with the research team, she has also used cardiac ultrasound to assess cardiac muscle function in patients with HCM and their family members as a basis for assessing the risk of severe cardiac arrhythmias and death.
Patients with HCM and non-compaction cardiomyopathy have different cardiac structure, function and contraction patterns. This can be used to differentiate between the two heart muscle diseases, which is important because patients with non-compaction cardiomyopathy are at higher risk of severe cardiac arrhythmias. With standard examination techniques, the pump function is often considered normal in HCM.
Håland and co-workers exhibited how the use of newer and more sensitive methods of analysis can show that the pump function is still reduced. Seemingly healthy family members with the family's gene defects were investigated, and here too, subtle changes in cardiac structure and function were found despite no evidence of thickened heart muscle. Håland and co-workers could also show that uneven contraction of the heart muscle was a risk marker for severe cardiac arrhythmias in HCM, and that these changes were closely related to scarring in the heart muscle.
Esra Kaya, MD, PhD, Postdoctoral Researcher, Department of Cardiology, Oslo University Hospital, Rikshospitalet
After completing cardiology specialization in Turkey, she won Japanese Government Education Scholarship-MEXT and completed her PhD in Juntendo University, Tokyo, Japan. Her PhD focused on evaluation of primary mitral valve regurgitation by 3D echocardiography and early progression of tricuspid regurgitation after mitral valve repair. She found that early TR progression was 15% in patients who underwent mitral valve repair surgery for primary mitral regurgitation and age and BMI were independent predictors of early tricuspid regurgitation progression. She won EACVI Research Grant for the year 2020 with her project about left ventricular strain echocardiography and mechanical dispersion in TAVI candidates and began working in Oslo University Hospital, Rikshospitalet. Kaya won the best abstract prize in Norwegian Cardiology Society Spring Meeting 2022 with this project. She is currently working on functional echocardiographic imaging of aorta stenosis patients.
Erik Kongsgård, MD, PhD, Head of Section of Electrophysiology, Oslo University Hospital, Rikshospitalet
Kongsgård's research is focused on cardiac resynchronization therapy. He is the co-author of two research papers that have won the Oslo University Hospital award for best research article; Imaging predictors of response to cardiac resynchronization therapy: left ventricular work asymmetry by echocardiography and septal viability by cardiac magnetic resonance | European Heart Journal | Oxford Academic (oup.com) and Cardiac Mechanical Alterations and Genotype Specific Differences in Subjects With Long QT Syndrome - ScienceDirect.
Anette Borger Kvaslerud, MD, PhD, Department of Cardiology, Oslo University Hospital, Rikshospitalet
Degenerative aortic stenosis is the most prevalent valvular heart disease in Europe and North-America and a major burden for morbidity, mortality, and health care costs. In this thesis entitled Aortic stenosis – iron deficiency, diastolic dysfunction, and outcomes Anette Borger Kvaslerud and co-authors present the results of four studies that aim to investigate aspects of the management of severe aortic stenosis where there are still many unanswered questions. The first part of the thesis focuses on patients with severe aortic stenosis who are asymptomatic. In the first paper, they show that patients who were advised against valve intervention due to a lack of symptoms between 2002-2016 had a higher mortality rate than those who received aortic valve replacement. These results question the current management strategy of watchful waiting in this population. In paper two, 50 patients with asymptomatic severe aortic stenosis were examined with right heart catheterisation to assess the extent of exercise induced pulmonary hypertension due to left heart disease. They found that 45/50 patients had an abnormal hemodynamic response to exercise, suggesting that incipient heart failure is present in most of these patients.
In the second part of the thesis, the prevalence and prognostic implications of iron deficiency in patients with severe aortic stenosis were assessed. In the third study, a prospective cohort study on 464 patients referred for aortic valve replacement, the prevalence of iron deficiency was 53 % (iron deficiency: ferritin < 100 µg/L or ferritin between 100 and 299 µg/L with transferrin saturation < 20 %). Although patients with iron deficiency had an overall worse clinical profile there was no association between iron deficiency and the risk of morbidity or mortality during follow-up. Finally, the fourth article presents the results of the IIISAS trial that randomised 149 patients with severe aortic stenosis and iron deficiency to intravenous ferric derisomaltose or placebo. Iron stores were restored in 76 % vs. 13 %, but no difference across study arms was found in the baseline-adjusted six-minute walk distance, which was the primary endpoint of the trial. Nor was there any difference in the secondary endpoints NYHA class, quality of life, and hand grip strength.
Øyvind Haugen Lie, Consultant Cardiologist, MD, PhD, Department of Cardiology, Oslo University Hospital, Rikshospitalet
Øyvind Haugen Lie successfully defended his PhD thesis "Risk stratification and management of patients with right ventricular arrhythmias" in December 2018. His supervisors were Associate Professor Kristina Hermann Haugaa, MD, PhD and Professor Thor Edvardsen, MD, PhD.
During his fellowship Lie was awarded with Prof. J. Roelandt's Young Investigator Award for best original work in clinical science at the 2017 EuroEcho-Imaging Congress. The award was given in recognition of the work “Harmful effects of exercise intensity and exercise duration in patients with arrhythmogenic cardiomyopathy".
Lie also won the best poster prize in the session for “Diagnostic and therapeutical strategies for cardiac disease" at the annual Center for Heart Failure Research Symposium two years in a row. He was give the prize in recognition of the work “How many are too many – Frequent premature ventricular contractions and left ventricular function" and "V-3 QRS-duration of premature ventricular contractions relates to ventricular tachycardia in patients with outflow tract arrhythmia", respectively.
Lie, together with his colleagues, discovered that the threshold ectopy burden associated with impaired left ventricular function was lower than previously assumed when accurate and sensitive echocardiographic tools were used. Patients with frequent premature ventricular contractions of right ventricular outflow tract origin may contract an ectopy-induced cardiomyopathy, those with more than 8000 premature ventricular contractions per 24 hours may benefit from antiarrhythmic therapy.
Higher exercise intensity is a strong and independent marker of adverse outcome in patients with arrhythmogenic cardiomyopathy, irrespective of longer exercise duration. Together with ECG-abnormalities and subtle left ventricular contraction abnormalities, information on exercise intensity at study entry yielded precise risk stratification that may be useful in the challenging selection of patients with arrhythmogenic cardiomyopathy who may benefit from a primary preventive implantable cardioverter-defibrillator.
Richard John Massey, Echo Technician, Engineer, PhD fellow, Department of Cardiology, Oslo University Hospital, Rikshospitalet
Massey is a member of the research group Clinical Cardiology, with main emphasis being on initiating and conducting proof-of-concept studies and testing ideas in well-controlled randomized studies. The focus is heavily on the role of inflammatory and other active peptides in the development of heart disease, primarily related to the development of heart failure. The group also conducts testing of different biomarkers in blood to find their role in diagnosis, prognosis and therapeutic treatment of various cardiovascular diseases.
Kari Melberg, Study Nurse, Department of Cardiology, Oslo University Hospital, Rikshospitalet
As a study nurse Melberg assists many researchers and doctors at Oslo University Hospital with clinical studies, including patient contact and recruitment.
Christine Rootwelt – Norberg, MD, PhD, Department of Cardiology, Oslo University Hospital, Rikshospitalet
Arrhythmogenic cardiomyopathy is a genetic cardiac disease associated with high risk of life-threatening arrhythmias and sudden cardiac death, and many arrhythmogenic cardiomyopathy patients end up with an implantable cardioverter defibrillator. However, the selection of patients to receive a defibrillator is highly challenging. After introduction of genetic testing in Norway, more arrhythmogenic cardiomyopathy patients are identified before they experience life-threatening arrhythmias. During 4 years follow-up in patients without previous life-threatening events, precise risk prediction was achieved by applying a risk prediction model including exercise history, T-wave inversions on ECG and cardiac dysfunction by echocardiographic strain imaging. Male patients showed more penetrant disease and worse phenotype than females, but this difference was confounded by sex differences in exercise habits. After implementation of exercise restrictions, disease progression was similar between the sexes.
The studies of this thesis improve the understanding of disease manifestations of arrhythmogenic cardiomyopathy and provide new data relevant to risk stratification in clinical practice.
EuroEcho is an annual conference in cardiology organised by the European Society of Cardiology. Each year, the Young Investigator Award is given to a young researcher who participates at the conference. In December 2021, PhD fellow Christine Rootwelt-Norberg received the award for her presentation of the study Disease progression rate is a strong predictor of ventricular arrhythmias in patients with cardiac laminopathies - a primary prevention cohort study.
Thuy Mi Tran Nguyen, MD, PhD fellow, Department of Cardiology, Oslo University Hospital, Rikshospitalet
Nguyen is partaking in the large IMPROVE study together with Daniela Melichova. The purpose of The Improve Study is to study whether global strain is better than left ventricular ejection fraction (LVEF) as a prognostic parameter. The study includes a large number of patients that have undergone a heart attack and/or are suffering from heart failure. The goal is to show whether the method can be implemented on a daily basis in clinical practice, rather than the current use of LVEF, with the purpose of optimal selection criteria for individual and tailored treatment. An additional investigation is whether measuring mechanical dispersion gives a better assessment of who is prone to arrhythmic events and thereby improve the selection criteria for an implantable cardioverter-defibrillator (ICD). The study has been mentioned in Norwegian news a few times; De er «gift» med forskningen sin - fvn.no, De har gitt Europa en ny og bedre hjertebehandling - agderposten.no.
Njord Nordstrand, Consultant Cardiologist, MD, PhD, Department of Cardiology, Oslo University Hospital, Rikshospitalet
Doctor and researcher Njord Nordstrand has shown in his doctoral work Arterial stiffness and nocturnal hypertension in morbidly obese individuals - clinical characteristics and the effects of various weight loss strategies that the main artery becomes softer and behaves like it was five years younger after just 7 weeks of healthy eating habits and exercise. Furthermore, Nordstrand and colleagues show that weight reduction reduces daily blood pressure.
Weight reduction is the cornerstone treatment to counteract obesity and obesity-related diseases. Nordstrand and colleagues show that it is very important not only to focus on fewer calories, but also on healthy eating habits and increased physical activity. Physical inactivity and unhealthy food increase the risk factor for cardiovascular disease regardless of weight. A person who eats less, but still unhealthy, will lose weight. This will naturally reduce some of the risk of disease, but this risk can, as Nordstrand and his colleagues show, be further reduced by changing the diet and increasing physical activity.
Margareth Ribe, Study Nurse, Department of Cardiology, Oslo University Hospital, Rikshospitalet
Margareth Ribe has been working at the Division of Cardiovascular and Pulmonary Diseases since 2001. Ribe coordinates studies and assist in research activities. She specializes on analysis of MRI tagging.
Darijan Ribic, MD, PhD fellow, Department of Cardiology, Oslo University Hospital, Rikshospitalet
Ribic is a member of the research group Clinical Cardiology, with main emphasis being on initiating and conducting proof-of-concept studies and testing ideas in well-controlled randomized studies. The focus is heavily on the role of inflammatory and other active peptides in the development of heart disease, primarily related to the development of heart failure. The group also conducts testing of different biomarkers in blood to find their role in diagnosis, prognosis and therapeutic treatment of various cardiovascular diseases.
Stian Ross, Consultant Cardiologist, MD, PhD, Department of Cardiology, Oslo University Hospital, Rikshospitalet
Heart failure patients need individualized therapy and are recommended treatment with a biventricular pacemaker if prolonged QRS duration co-exists. However, one third will not benefit from this treatment called cardiac resynchronization therapy (CRT). Response is normally validated after 6 months. The overall aim of the thesis Cardiac resynchronization therapy - Acute response parameters was to investigate feasibility and predictive capability of novel acute CRT response parameters.
Both electrical and mechanical parameters were assessed in this project and compared to the acute hemodynamic response to CRT under device implantation. We observed that a premature septal contraction pattern assessed using echocardiography might be an excellent marker of acute hemodynamic response to CRT.
In a standard CRT implantation, a lateral position of the left ventricular lead is recommended. This region may, however, not always be accessible. We found that pacing induced changes in a 3D ECG had good predictive capability of the acute CRT response in patients with a non-lateral left ventricular position.
The pacemaker leads positions move when the heart contracts and we hypothesized that the motion of the pacemaker leads could provide mechanical information used to estimate contractility. We extracted contractile surrogates from a 3D continuous interlead distance between the right and left ventricular lead. The results were disappointing, and non of the contractile surrogates were able to predict acute CRT response.
Kristoffer Engh Russell, Consultant Cardiologist, MD, PhD, FESC, Department of Cardiology, Oslo University Hospital, Rikshospitalet
Doctor and researcher Kristoffer Russell has found new methods to assess heart function in patients with heart failure, which will be able to guide the best possible treatment.
The number of patients with heart failure increases every year worldwide, despite the fact that several new medicines have been introduced in recent years. It is therefore important to be able to assess the degree of heart failure as well as the underlying cause in each individual patient in order to provide the correct treatment. Patients with heart failure often have an uneven contraction of the heart, which means that much of the "pumping work" done by the heart does not agree to carry blood out into the body, but is wasted. This energy loss is due to parts of the heart muscle being stretched while other parts contract. Quantification of such lost work as well as assessment of the underlying cause is important because this is work that can potentially increase heart function if performed synchronously (at the same time) using a new type of pacemaker treatment. Assessing work done by the heart is also important to assess the extent of damage to the heart muscle after a heart attack and to assess response to treatment.
In his thesis Novel methods for assessing left ventricular dyssynchrony and myocardial function, Kristoffer Russell and his colleagues have shown that with the help of ultrasound of the heart and information about the pressure in the heart chamber, you can distinguish between different causes of uneven contraction of the heart. The new method also makes it possible to assess regional differences in work carried out in the heart and therefore gives the opportunity to quantify how large a proportion of the work the heart does that does not agree to pump blood and is therefore considered wasted. The aim of the new method is to help the doctor implement the right treatment for patients with heart failure, such as pacemaker treatment, which will improve quality of life and longevity.
Siri Rostoft, Professor, MD, PhD, Geriatric Department, Oslo University Hospital, Rikshospitalet
Rostoft's focus area is on treatment of elderly cancer patients. She was recently awarded with the Paul Calabresi prize, a very prestigious award for showcasing leadership in the field of expertice.
Camilla Lien Sandnes, Team Leader, Senior Adviser, Research Administration, Research Support Services, Oslo University Hospital, Rikshospitalet
Sandnes works with external funding and reporting.
Sebastian Sarvari, Consultant Cardiologist, Cardio-Oncologist, MD, PhD, Department of Cardiology, Oslo University Hospital, Rikshospitalet
Sebastian Imre Sarvari is the leader for the Cardio-oncology work package at ProCardio.
His main research focus is on cardiac imaging, cardio-oncology and sports cardiology.
In his PhD thesis Detection of subtle myocardial alterations by echocardiographic techniques for improved prognostic information in patients with heart disease Sarvari showed that new ultrasound methods can detect cardiac function at a very early stage in different patient groups.
Sudden cardiac death due to arrhythmia is one of the most common causes of death in the Western world and in younger is often caused by hereditary heart disease. A new ultrasound method can predict which patients are going to get serious heart rhythm abnormalities. The thesis examined patients with arrhythmogenic right ventricular cardiomyopathy. The disease is one of the most common hereditary disorders that lead to sudden cardiac death. The study shows that irregular cardiac contractility measured by the new method is a risk marker of cardiovascular arrhythmia. The method improves the selection of patients with high risk of death so that these can be fitted with a defibrillator.
Eystein Skjølsvik, Consultant Cardiologist, MD, PhD, Department of Cardiology, Oslo University Hospital, Rikshospitalet
In his PhD thesis Natural progression and arrhythmic risk in patients with cardiomyopathies Skjøsvik looked at the correlation of arrhythmia with Lamin A/C cardiomyopathy and mitral valve prolaps.
The most common familial dilated cardiomyopathy is due to lamin A/C gene mutations. Lamin A/C cardiomyopathy is a highly penetrant, and age dependent disease with a dismal prognosis. Competitive sports may worsen the prognosis, but evidence is limited and the effect of exercise is still unknown. The progression lamin A/C disease related to age is still unclear. We hypothesized that exercise worsen lamin A/C cardiomyopathy. By cardiac imaging we studied how disease progression relates to exercise exposure and end stage heart failure. We observed that lamin A/C patients with greater exercise exposure had worse cardiac function and more atrial fibrillation than those with less. Lamin A/C disease starts at young age with electrical disease. Structural heart disease occurs from middle age. Right ventricular dysfunction and tricuspid regurgitation were associated with imminent end stage heart failure. Our findings may imply exercise restriction in lamin A/C disease. Assessment of right ventricular function and tricuspid regurgitation may be prognostic in lamin A/C disease.
Mitral valve prolapse (MVP) is common, and the prognosis is good. However in autopsy materials of sudden death in the young, MVP is disproportionally common. Mitral annulus disjunction (MAD) is a pathological atrial displacement of the mitral leaflet hinge-point. MAD may exist alone, but it's commonly associated with MVP and sudden death. We aimed to describe the clinical characteristics of MAD, explore the anatomy and its relation to MVP and severe ventricular arrhythmia. Palpitations were the most common symptom in MAD. MAD is easily recognizable by echocardiography and exists in varying degree along the posterior mitral-leaflet. Severe ventricular arrhythmias are related to younger age, scarring in the papillary muscle and the existence of MAD without concomitant MVP. The finding of MAD by echocardiograpy may be of prognostic significance.
Marit Kristine Smedsrud, Consultant Pediatric Cardiologist, MD, PhD, Department of Pediatric Cardiology, Oslo University Hospital, Rikshospitalet
Smedsrud's PhD thesis Assessment of incipient global myocardial dysfunction by speckle tracking echocardiography. Clinical studies with emphasis on patients with stable coronary artery disease and patients with chronic aortic regurgitation. focused on the identification of patients with viable dysfunctional myocardium with the potential for recovery of function. A viable dysfunctional myocardium has important implications regarding the selection of patients for myocardial revascularization. Smedsrud's research interests are myocardial dysfunction, coronary artery disease, left ventricular function, strain, speckle tracking and echocardiography. She was recently the first author of Highly malignant disease in childhood-onset arrhythmogenic right ventricular cardiomyopathy - Oslo universitetssykehus (oslo-universitetssykehus.no), a research paper published in European Heart Journal.
Helge Skulstad, MD, PhD, FESC, Head of Section of Cardiac Ultrasound, Department of Cardiology, Oslo University Hospital, Rikshospitalet
Associate Professor at Institute of Clinical Medicine, University of Oslo and Associated Editor in Scandinavian Cardiovascular Journal
Helge Skulstad is group leader of T1, Valvular disease, at ProCardio. His main interest in ProCardio is to develop automatic detection of severe valvular heart disease to improve diagnosis and treatment of these patients.
Skulstad has extensive knowledge in Doppler echocardiography, transesophageal echocardiography and cardiac imaging, as well as in experimental research and clinical studies. The main topics of his research are regional myocardial function and deformation echocardiography.
In addition to supervising several PhD fellows at the Integrated CardioVascular Function research group, Skulstad is also a senior researcher in the group for clinical and experimental cardiovascular monitoring at the Intervention Centre at Oslo University Hospital, where one of his projects is focusing on effects of epinephrine and betablockers on systolic and diastolic left ventricular function during therapeutic hypothermia.
Skulstad has numerous publications in peer-reviewed journals of high impact and is sited several times.
Jorun Tangen, Cardiologist, MD, PhD, Department of Cardiology, Oslo University Hospital, Rikshospitalet
Tangen has examined patients with echocardiography and studied their ventricular function 3 months after a Covid-infection. Tangen is currently working with patients with coronary artery disease. Her main research focus areas are on left atrial volume index and its predictive value on mortality in patients with acute myocardial infarction (AMI), and AI and strain curve pattern in patients with AMI.