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Havig SM, Berg-Pedersen RM, Krabseth HM, Müller LD, Haugaa K, Zare HK, Gjesdal K, Krajci P, Opdal MS. Effect on QTc interval by switching from methadone to equipotent R-methadone dose in methadone maintenance treatment patients. Basic Clin Pharmacol Toxicol 2024; 134:519-530. [PMID: 38308508 DOI: 10.1111/bcpt.13982] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/10/2023] [Revised: 01/11/2024] [Accepted: 01/11/2024] [Indexed: 02/04/2024]
Abstract
Methadone (R,S-methadone) can prolong the QT interval. R-methadone inhibits cardiac potassium channel function less than S-methadone. We tested if switching from methadone to R-methadone would reduce corrected QT (QTc) intervals in methadone maintenance treatment (MMT) patients. Nine patients, with automatically read QTc intervals ≥450 ms, were required to detect a 20 ms (clinically relevant) reduction in QTc intervals with 15 ms standard deviation (SD) and 90% power. Nine stabilized MMT patients, using median (range) 70 (40-120) mg methadone, were included. Data (ECG recordings, serum samples, and withdrawal symptoms) were collected both before drug intake (Cmin ) and at 3 h after drug intake (Cmax ), and were collected on the day before the switch from methadone to equipotent R-methadone dose and at 14 and 28 days after the switch. A cardiologist calculated QTc intervals retrospectively. Serum electrolytes and methadone concentrations were measured. Mean QTc intervals at Cmin were 472 ms and 422 ms on methadone (automatically and manually read) and 414 ms on R-methadone (manually read). Mean (SD) change in QTc intervals was -8 (10) ms (p = 0.047) at Cmin but non-significant at Cmax . R-methadone showed a concentration-dependent relationship with QTc intervals. Switching to R-methadone reduced QTc intervals, but far less than the 20 ms considered clinically relevant.
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Affiliation(s)
| | | | | | | | - Kristina Haugaa
- Department of Cardiology, Oslo University Hospital, Oslo, Norway
- Institute of Clinical Medicine, University of Oslo, Oslo, Norway
| | | | - Knut Gjesdal
- Institute of Clinical Medicine, University of Oslo, Oslo, Norway
| | - Peter Krajci
- Department of Substance Use Disorder Treatment, Oslo University Hospital, Oslo, Norway
| | - Mimi Stokke Opdal
- Department of Pharmacology, Oslo University Hospital, Oslo, Norway
- Institute of Clinical Medicine, University of Oslo, Oslo, Norway
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2
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Fyksen TS, Vanberg P, Gjesdal K, von Lueder TG, Bjørnerheim R, Steine K, Atar D, Halvorsen S. Cardiovascular phenotype of long-term anabolic-androgenic steroid abusers compared with strength-trained athletes. Scand J Med Sci Sports 2022; 32:1170-1181. [PMID: 35460300 PMCID: PMC9540672 DOI: 10.1111/sms.14172] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/23/2021] [Revised: 04/12/2022] [Accepted: 04/18/2022] [Indexed: 12/04/2022]
Abstract
Introduction Abuse of anabolic‐androgenic steroids (AAS) has been linked to a variety of different cardiovascular (CV) side effects, but still the clinical effects of AAS abuse on CV risk are not clear. The aim of this study was to assess the CV phenotype of a large cohort of men with long‐term AAS use compared with strength‐trained athletes without AAS use. Methods Fifty one strength‐trained men with ≥3 years of AAS use was compared with twenty one strength‐trained competing athletes. We verified substance abuse and non‐abuse by blood and urine analyses. The participants underwent comprehensive CV evaluation including laboratory analyses, 12‐lead ECG with measurement of QT dispersion, exercise ECG, 24 h ECG with analyses of heart rate variability, signal averaged ECG, basic transthoracic echocardiography, and coronary computed tomography angiography (CCTA). Results Hemoglobin levels and hematocrit were higher among the AAS users compared with non‐users (16.8 vs. 15.0 g/dl, and 0.50% vs. 0.44%, respectively, both p < 0.01) and HDL cholesterol significantly lower (0.69 vs. 1.25 mmol/L, p < 0.01). Maximal exercise capacity was 270 and 280 W in the AAS and the non‐user group, respectively (p = 0.04). Echocardiography showed thicker intraventricular septum and left ventricular (LV) posterior wall among AAS users (p < 0.01 for both), while LV ejection fraction was lower (50 vs. 54%, p = 0.02). Seven AAS users (17%) had evidence of coronary artery disease on CCTA. There were no differences in ECG measures between the groups. Conclusions A divergent CV phenotype dominated by increased CV risk, accelerated coronary artery disease, and concentric myocardial hypertrophy was revealed among the AAS users.
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Affiliation(s)
- Tea Saetereng Fyksen
- Institute of Clinical Medicine, University of Oslo, Oslo, Norway.,Department of Cardiology, Oslo University Hospital Ullevål, Oslo, Norway
| | - Paul Vanberg
- Department of Cardiology, Oslo University Hospital Ullevål, Oslo, Norway
| | - Knut Gjesdal
- Institute of Clinical Medicine, University of Oslo, Oslo, Norway.,Department of Cardiology, Oslo University Hospital Ullevål, Oslo, Norway
| | | | - Reidar Bjørnerheim
- Department of Cardiology, Oslo University Hospital Ullevål, Oslo, Norway
| | - Kjetil Steine
- Institute of Clinical Medicine, University of Oslo, Oslo, Norway.,Department of Cardiology, Akershus University Hospital, Lørenskog, Norway
| | - Dan Atar
- Institute of Clinical Medicine, University of Oslo, Oslo, Norway.,Department of Cardiology, Oslo University Hospital Ullevål, Oslo, Norway
| | - Sigrun Halvorsen
- Institute of Clinical Medicine, University of Oslo, Oslo, Norway.,Department of Cardiology, Oslo University Hospital Ullevål, Oslo, Norway
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3
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Sagberg K, Eskild A, Sommerfelt S, Gjesdal K, Higgins L, Borthne A, Hillestad V. 441. Placental volume in gestational week 27 measured by three dimensional (3d) ultrasound and magnetic resonance imaging (mri). Eur J Obstet Gynecol Reprod Biol 2022. [DOI: 10.1016/j.ejogrb.2021.11.170] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/24/2022]
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4
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Falk RS, Mariampillai JE, Prestgaard EE, Heir T, Bodegård J, Robsahm TE, Grundvold I, Skretteberg PT, Engeseth K, Bjornholt JV, Stavem K, Liestøl K, Sandvik L, Thaulow E, Erikssen G, Kjeldsen SE, Gjesdal K, Erikssen JE. The Oslo Ischaemia Study: cohort profile. BMJ Open 2021; 11:e049111. [PMID: 34645662 PMCID: PMC8515426 DOI: 10.1136/bmjopen-2021-049111] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/17/2022] Open
Abstract
PURPOSE The Oslo Ischaemia Study was designed to investigate the prevalence and predictors of silent coronary disease in Norwegian middle-aged men, specifically validating exercise electrocardiography (ECG) findings compared with angiography. The study has been important in investigating long-term predictors of cardiovascular morbidity and mortality, as well as investigating a broad spectrum of epidemiological and public health perspectives. PARTICIPANTS In 1972-1975, 2014 healthy men, 40-59 years old, were enrolled in the study. Comprehensive clinical examination included an ECG-monitored exercise test at baseline and follow-ups. The cohort has been re-examined four times during 20 years. Linkage to health records and national health registries has ensured complete endpoint registration of morbidity until the end of 2006, and cancer and mortality until the end of 2017. FINDINGS TO DATE The early study results provided new evidence, as many participants with a positive exercise ECG, but no chest pain ('silent ischaemia'), did not have significant coronary artery stenosis after all. Still, they were over-represented with coronary disease after years of follow-up. Furthermore, participants with the highest physical fitness had lower risk of cardiovascular disease, and the magnitude of blood pressure responses to moderate exercise was shown to influence the risk of cardiovascular disease and mortality. With time, follow-up data allowed the scope of research to expand into other fields of medicine, with the aim of investigating predictors and the importance of lifestyle and risk factors. FUTURE PLANS Recently, the Oslo Ischaemia Study has been found worthy, as the first scientific study, to be preserved by The National Archives of Norway. All the study material will be digitised, free to use and accessible for all. In 2030, the Oslo Ischaemia Study will be linked to the Norwegian Cause of Death Registry to obtain complete follow-up to death. Thus, a broad spectrum of additional opportunities opens.
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Affiliation(s)
- Ragnhild Sørum Falk
- Oslo Centre for Biostatistics and Epidemiology, Oslo University Hospital, Oslo, Norway
| | | | | | - Trond Heir
- Institute of Clinical Medicine, University of Oslo, Oslo, Norway
| | - Johan Bodegård
- Department of Cardiology, Oslo University Hospital, Oslo, Norway
| | | | - Irene Grundvold
- Department of Cardiology, Akershus University Hospital, Lorenskog, Lørenskog, Norway
| | | | - Kristian Engeseth
- Department of Cardiology, Akershus University Hospital, Lorenskog, Lørenskog, Norway
| | - Jorgen Vildershoj Bjornholt
- Institute of Clinical Medicine, University of Oslo, Oslo, Norway
- Department of Microbiology, Oslo University Hospital, Oslo, Norway
| | - Knut Stavem
- Department of Pulmonary Medicine, Akershus University Hospital, Lørenskog, Norway
- Institute of Clinical Medicine, University of Oslo, Lørenskog, Norway
| | - Knut Liestøl
- Institute of Informatics, University of Oslo, Oslo, Norway
| | - Leiv Sandvik
- Oslo Centre for Biostatistics and Epidemiology, Oslo University Hospital, Oslo, Norway
| | - Erik Thaulow
- Institute of Clinical Medicine, University of Oslo, Oslo, Norway
- Department of Paediatric Cardiology, Oslo University Hospital, Oslo, Norway
| | - Gunnar Erikssen
- Department of Cardiology, Oslo University Hospital, Oslo, Norway
| | - Sverre E Kjeldsen
- Department of Cardiology, Oslo University Hospital, Oslo, Norway
- Institute of Clinical Medicine, University of Oslo, Oslo, Norway
- Department of Nephrology, Oslo University Hospital, Oslo, Norway
| | - Knut Gjesdal
- Department of Cardiology, Oslo University Hospital, Oslo, Norway
| | - Jan E Erikssen
- Institute of Clinical Medicine, University of Oslo, Oslo, Norway
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Brunström M, Kjeldsen SE, Kreutz R, Gjesdal K, Narkiewicz K, Burnier M, Oparil S, Mancia G. Missing Verification of Source Data in Hypertension Research: The HYGIA PROJECT in Perspective. Hypertension 2021; 78:555-558. [PMID: 34232677 PMCID: PMC8260337 DOI: 10.1161/hypertensionaha.121.17356] [Citation(s) in RCA: 18] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
Affiliation(s)
- Mattias Brunström
- Department of Public Health and Clinical Medicine, Umeå University, Sweden (M. Brunström)
| | - Sverre E Kjeldsen
- Department of Cardiology, University of Oslo, Ullevaal Hospital, Norway (S.E.K., K.G.)
| | - Reinhold Kreutz
- Department of Clinical Pharmacology and Toxicology, Charité Medical University, Berlin, Germany (R.K.)
| | - Knut Gjesdal
- Department of Cardiology, University of Oslo, Ullevaal Hospital, Norway (S.E.K., K.G.)
| | - Krzysztof Narkiewicz
- Department of Hypertension and Diabetology, Medical University of Gdansk, Poland (K.N.)
| | - Michel Burnier
- Service of Nephrology and Hypertension, Centre Hospitalier Universitaire Vaudois, Lausanne, Switzerland (M. Burnier)
| | - Suzanne Oparil
- Vascular Biology and Hypertension Program, Department of Medicine, University of Alabama, Birmingham (S.O.)
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Ariansen I, Degerud E, Gjesdal K, Tell GS, Næss Ø. Examining the lower range of the association between alcohol intake and risk of incident hospitalization with atrial fibrillation. Int J Cardiol Heart Vasc 2020; 31:100679. [PMID: 34095445 PMCID: PMC8164130 DOI: 10.1016/j.ijcha.2020.100679] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/16/2020] [Revised: 11/05/2020] [Accepted: 11/13/2020] [Indexed: 01/19/2023]
Abstract
Background Evidence is sparse on the association between alcohol intakes in the lower range and risk of atrial fibrillation (AF). We aimed to investigate self-reported low and moderate alcohol intakes and subsequent risk of incident AF among current drinkers. Methods Norwegian population-based health examination surveys assessing self-reported daily alcohol intake (mean grams per day) were linked to health and population registers. Hazard ratios (HR) (95% confidence interval) for time to incident (first) hospitalization with AF by alcohol intake level were assessed by Cox regression, with adjustment for educational level and cardiovascular risk factors except blood pressure. Results The study population included 234,392 participants (49% men). Incident hospitalization with AF was identified in 5043 (2.2%) persons during a mean follow-up of 9 years. Compared to a very low alcohol intake of <1 unit weekly, a moderate consumption in the range of 1 to <2 units daily increased the risk of incident AF by 18% (HR 1.18 [1.06-1.32]). The average risk of incident AF increased by 9% per daily alcohol unit of 12 g (HR 1.09 [1.03, 1.14]). In sex-stratified analyses significant associations were found in men only. Conclusions We found that less than two alcohol units/day significantly increased the risk of incident AF, however, in men only. Reduction of even a moderate alcohol intake may thus reduce the risk of AF at the population level.
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Affiliation(s)
- Inger Ariansen
- Division of Mental and Physical Health, Norwegian Institute of Public Health, Oslo, Norway
| | - Eirik Degerud
- Division of Mental and Physical Health, Norwegian Institute of Public Health, Oslo, Norway.,Department of Occupational Health Surveillance, National Institute of Occupational Health, Oslo, Norway
| | - Knut Gjesdal
- Department of Cardiology, Oslo University Hospital Ullevål, Oslo, Norway.,Institute of Clinical Medicine, Oslo University, Oslo, Norway
| | - Grethe S Tell
- Department of Global Public Health and Primary Care, University of Bergen, Norway.,Division of Mental and Physical Health, Norwegian Institute of Public Health, Oslo, Norway
| | - Øyvind Næss
- Department of Community Medicine and Global Health, Institute of Health and Society, Faculty of Medicine, University of Oslo, Oslo, Norway.,Division of Mental and Physical Health, Norwegian Institute of Public Health, Oslo, Norway
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7
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Barzenje AD, Gjesdal K, Winsvold BS, Småstuen MC, Stovner LJ, Gravdahl GB, Nilsen KB. Clinical and vascular responses to propranolol and candesartan in migraine patients: A randomized controlled clinical trial. Cephalalgia Reports 2020. [DOI: 10.1177/2515816320946491] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022] Open
Abstract
Background: Both propranolol and candesartan are prophylactic drugs for migraine, but with unknown mechanisms of action. The objectives of the present study were to investigate these drugs’ effects on arterial wall dynamics and the potential relation between their vascular and clinical effect. Methods: The study was based on data from a previously published randomized, placebo-controlled, triple-blinded, double crossover clinical trial comparing the prophylactic effects of candesartan and propranolol in 72 patients. Finapres noninvasive blood pressure curves were analyzed. On the descending limb of the pulse curve, a notch is produced by pulse wave reflection, and its relative height compared to the top of the curve (the notch ratio) was used as a marker of arterial wall stiffness. Results: Candesartan decreased the notch ratio from baseline ( p = 0.005), reflecting more compliant arteries and vasodilation, whereas propranolol increased the notch ratio ( p = 0.005), reflecting less compliant arteries and vasoconstriction. There was no difference in baseline notch ratio between clinical responders and nonresponders. Conclusion: The drugs are both efficient prophylactic medications, yet they have opposite effects on arterial wall dynamics. This suggests that drug effects other than those on arterial compliance must be responsible for their prophylactic effect in migraine.
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Affiliation(s)
| | - Knut Gjesdal
- Institute of Clinical Medicine, University of Oslo, Oslo, Norway
- Department of Cardiology, Oslo University Hospital Ullevål, Oslo, Norway
| | - Bendik Slagsvold Winsvold
- Department of Research, Innovation and Education, Division of Clinical Neuroscience, Oslo University Hospital, Oslo, Norway
| | | | - Lars Jacob Stovner
- Department of Neuromedicine and Movement Science, Norwegian University of Science and Technology, Trondheim, Norway
- National Advisory Unit on Headaches, St. Olavs Hospital, Trondheim, Norway
| | | | - Kristian Bernhard Nilsen
- Department of Research, Innovation and Education, Division of Clinical Neuroscience, Oslo University Hospital, Oslo, Norway
- Department of Neuromedicine and Movement Science, Norwegian University of Science and Technology, Trondheim, Norway
- Section for Clinical Neurophysiology, Department of Neurology, Division of Cinical Neuroscience, Oslo University Hospital, Norway
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8
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Mirza Y, Prestgaard EE, Selmer R, Liestøl K, Grundvold I, Erikssen JE, Kjeldsen SE, Gjesdal K. Ten-year prediction of cardiovascular disease in healthy Norwegian men, based on NORRISK-2. Tidsskr Nor Laegeforen 2020; 140:20-0089. [PMID: 32900157 DOI: 10.4045/tidsskr.20.0089] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/02/2022] Open
Abstract
BACKGROUND Norwegian guidelines for primary prevention of cardiovascular disease recommend the use of the NORRISK-2 risk model, with some additions. We wished to investigate whether NORRISK-2 could predict cardiovascular disease in healthy Norwegian men who took part in the Oslo Ischaemia Study. MATERIAL NORRISK-2 scores were calculated for 2 014 men in the age group 40-60 years who were included in the Oslo Ischaemia Study in 1972-75. Cox regression analyses were used to calculate the hazard ratio for death and cardiovascular disease within ten years of the participants' initial assessment. RESULTS No participant was lost to follow-up of the 2 014 men, 125 died in the first ten years after inclusion, 61 of whom died from cardiovascular disease. Those who died were older than those who survived, with a larger proportion of daily smokers, and they had higher systolic blood pressure and resting pulse, increased total cholesterol and lower physical fitness. The majority of those who died from acute myocardial infarction and ischaemic stroke within ten years were classified in the high-risk group in NORRISK-2. INTERPRETATION NORRISK-2 satisfactorily identified the high-risk persons in this cohort of healthy, middle-aged Norwegian men. This supports use of the Norwegian guidelines in the decision on possible primary protection against cardiovascular disease.
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Abstract
Background The goal of this literature review was to assess sex differences in the quality of life (QoL) in patients with atrial fibrillation ( AF ) and, if possible, to determine if these are due to AF . Methods and Results The electronic database PubMed was searched on January 23, 2018, using the search terms "QoL", gender differences, " AF " female, and gender to find potential articles that assessed sex differences in QoL in AF patients. In all, 851 articles were identified, from which 25 original studies were eligible for this systematic review. Female AF patients were found to have poorer QoL and more symptoms than male AF patients. They scored lower, predominantly on the physical component score of the Medical Outcomes Study Short-Form 36 Health Survey. Conclusions The available literature consistently describes poorer QoL in female AF patients but does not clearly address whether this is a reflection of sex differences seen in the general population or is related to AF per se. It is also questionable whether the relatively poorer QoL in women is large enough to be of clinical importance.
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Affiliation(s)
| | - Helene Ree
- 1 Faculty of Medicine Oslo University Oslo Norway
| | - Knut Gjesdal
- 2 Institute of Clinical Medicine Oslo University Oslo Norway.,3 Department of Cardiology Oslo University Hospital Ullevål Oslo Norway
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10
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Bjørkavoll-Bergseth M, Kleiven Ø, Auestad B, Eftestøl T, Oskal K, Nygård M, Skadberg Ø, Aakre KM, Melberg T, Gjesdal K, Ørn S. Duration of Elevated Heart Rate Is an Important Predictor of Exercise-Induced Troponin Elevation. J Am Heart Assoc 2020; 9:e014408. [PMID: 32065043 PMCID: PMC7070191 DOI: 10.1161/jaha.119.014408] [Citation(s) in RCA: 13] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
Background The precise mechanisms causing cardiac troponin (cTn) increase after exercise remain to be determined. The aim of this study was to investigate the impact of heart rate (HR) on exercise-induced cTn increase by using sports watch data from a large bicycle competition. Methods and Results Participants were recruited from NEEDED (North Sea Race Endurance Exercise Study). All completed a 91-km recreational mountain bike race (North Sea Race). Clinical status, ECG, blood pressure, and blood samples were obtained 24 hours before and 3 and 24 hours after the race. Participants (n=177) were, on average, 44 years old; 31 (18%) were women. Both cTnI and cTnT increased in all individuals, reaching the highest level (of the 3 time points assessed) at 3 hours after the race (P<0.001). In multiple regression models, the duration of exercise with an HR >150 beats per minute was a significant predictor of both cTnI and cTnT, at both 3 and 24 hours after exercise. Neither mean HR nor mean HR in percentage of maximum HR was a significant predictor of the cTn response at 3 and 24 hours after exercise. Conclusions The duration of elevated HR is an important predictor of physiological exercise-induced cTn elevation. Clinical Trial Registration URL: https://www.clinicaltrials.gov/. Unique identifier: NCT02166216.
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Affiliation(s)
- Magnus Bjørkavoll-Bergseth
- Department of Cardiology Stavanger University Hospital Stavanger Norway.,Department of Clinical Science University of Bergen Norway
| | - Øyunn Kleiven
- Department of Cardiology Stavanger University Hospital Stavanger Norway
| | - Bjørn Auestad
- Department of Research Stavanger University Hospital Stavanger Norway.,Department of Mathematics and Physics University of Stavanger Norway
| | - Trygve Eftestøl
- Department of Electrical Engineering and Computer Science University of Stavanger Norway
| | - Kay Oskal
- Department of Electrical Engineering and Computer Science University of Stavanger Norway
| | - Martin Nygård
- Department of Electrical Engineering and Computer Science University of Stavanger Norway
| | - Øyvind Skadberg
- Department of Clinical Biochemistry Stavanger University Hospital Stavanger Norway
| | - Kristin Moberg Aakre
- Department of Medical Biochemistry and Pharmacology Haukeland University Hospital Bergen Norway.,Department of Clinical Science University of Bergen Norway
| | - Tor Melberg
- Department of Cardiology Stavanger University Hospital Stavanger Norway
| | - Knut Gjesdal
- Department of Cardiology Oslo University Hospital Ullevål, and Institute of Clinical Medicine Oslo University Oslo Norway
| | - Stein Ørn
- Department of Cardiology Stavanger University Hospital Stavanger Norway.,Department of Electrical Engineering and Computer Science University of Stavanger Norway
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Gjesdal K. Langtids EKG: Riktig bruk er viktig. Tidsskriftet 2020; 140:20-0200. [DOI: 10.4045/tidsskr.20.0200] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/02/2022] Open
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Mariampillai JE, Liestøl K, Kjeldsen SE, Prestgaard EE, Engeseth K, Bodegard J, Berge E, Gjesdal K, Erikssen J, Grundvold I, Skretteberg PT. Exercise Systolic Blood Pressure at Moderate Workload Is Linearly Associated With Coronary Disease Risk in Healthy Men. Hypertension 2019; 75:44-50. [PMID: 31735088 DOI: 10.1161/hypertensionaha.119.13528] [Citation(s) in RCA: 22] [Impact Index Per Article: 4.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/19/2022]
Abstract
There is no consensus on the definition of an exaggerated increase in systolic blood pressure (SBP) during exercise. The aim was to explore a potential threshold for exercise SBP associated with increased risk of coronary heart disease in healthy men using repeated exercise testing. Two thousand fourteen healthy white male employees were recruited into the Oslo Ischemia Study during early 1970s. At follow-up 7 years later, 1392 men were still considered healthy. A bicycle exercise test at 100 W workload was performed at both visits. Cox regression analyses were performed with increasing cutoff levels of peak exercise SBP at 100 W workload (SBP100W) from 160 mm Hg to 200 mm Hg, adjusted for cardiovascular risk factors and physical fitness. Participants with SBP100W below cutoff level at both baseline and first follow-up were compared with participants with SBP100W equal to or above cutoff level at both visits. Compared with participants with SBP100W below all cutoff levels between 165 and 195 mm Hg, coronary heart disease risk was increased among participants with SBP100W equal to or above cutoff at all levels. There was no evidence of a distinct threshold level for coronary heart disease risk, and the relation between SBP100W and coronary heart disease appears linear. When investigating exercise SBP at moderate workload measured at 2 exercise tests in healthy middle-aged white men, there is increasing risk of coronary heart disease with increasing exercise SBP independent of SBP at rest. The association is linear from the low range of exercise SBP, and there is no sign of a distinct threshold level for increased coronary disease risk.
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Affiliation(s)
- Julian E Mariampillai
- From the Department of Cardiology, Oslo University Hospital, Ullevaal, Norway (J.E.M., S.E.K., E.E.P., K.E., J.B., E.B., I.G., P.T.S.)
| | - Knut Liestøl
- Institute of Informatics (K.L.), University of Oslo, Norway
| | - Sverre E Kjeldsen
- From the Department of Cardiology, Oslo University Hospital, Ullevaal, Norway (J.E.M., S.E.K., E.E.P., K.E., J.B., E.B., I.G., P.T.S.).,Institute of Clinical Medicine (S.E.K., E.E.P., K.E., K.G., J.E.), University of Oslo, Norway
| | - Erik E Prestgaard
- From the Department of Cardiology, Oslo University Hospital, Ullevaal, Norway (J.E.M., S.E.K., E.E.P., K.E., J.B., E.B., I.G., P.T.S.).,Institute of Clinical Medicine (S.E.K., E.E.P., K.E., K.G., J.E.), University of Oslo, Norway
| | - Kristian Engeseth
- From the Department of Cardiology, Oslo University Hospital, Ullevaal, Norway (J.E.M., S.E.K., E.E.P., K.E., J.B., E.B., I.G., P.T.S.).,Institute of Clinical Medicine (S.E.K., E.E.P., K.E., K.G., J.E.), University of Oslo, Norway
| | - Johan Bodegard
- From the Department of Cardiology, Oslo University Hospital, Ullevaal, Norway (J.E.M., S.E.K., E.E.P., K.E., J.B., E.B., I.G., P.T.S.)
| | - Eivind Berge
- From the Department of Cardiology, Oslo University Hospital, Ullevaal, Norway (J.E.M., S.E.K., E.E.P., K.E., J.B., E.B., I.G., P.T.S.).,Institute of Clinical Medicine; University of Tromsø, Norway (E.B.)
| | - Knut Gjesdal
- Institute of Clinical Medicine (S.E.K., E.E.P., K.E., K.G., J.E.), University of Oslo, Norway
| | - Jan Erikssen
- Institute of Clinical Medicine (S.E.K., E.E.P., K.E., K.G., J.E.), University of Oslo, Norway
| | - Irene Grundvold
- From the Department of Cardiology, Oslo University Hospital, Ullevaal, Norway (J.E.M., S.E.K., E.E.P., K.E., J.B., E.B., I.G., P.T.S.)
| | - Per T Skretteberg
- From the Department of Cardiology, Oslo University Hospital, Ullevaal, Norway (J.E.M., S.E.K., E.E.P., K.E., J.B., E.B., I.G., P.T.S.)
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Bakke K, Meltzer S, Grøvik E, Negård A, Stein Harald H, Hansen Ree A, Gjesdal K, Røe Redalen K. OC-0402 Tumour blood perfusion from baseline contrast-based MRI predicts radiation outcome in rectal cancer. Radiother Oncol 2019. [DOI: 10.1016/s0167-8140(19)30822-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/26/2022]
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Piira A, Lannem A, Sørensen M, Glott T, Knutsen R, Jørgensen L, Gjesdal K, Hjeltnes N, Knutsen S. Robot-assisted locomotor training did not improve walking function in patients with chronic incomplete spinal cord injury: A randomized clinical trial. J Rehabil Med 2019; 51:385-389. [DOI: 10.2340/16501977-2547] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022] Open
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15
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Prestgaard E, Mariampillai J, Engeseth K, Erikssen J, Bodegård J, Liestøl K, Gjesdal K, Kjeldsen S, Grundvold I, Berge E. Change in Cardiorespiratory Fitness and Risk of Stroke and Death: Long-Term Follow-Up of Healthy Middle-Aged Men. Stroke 2019; 50:155-161. [PMID: 30580727 DOI: 10.1161/strokeaha.118.021798] [Citation(s) in RCA: 24] [Impact Index Per Article: 4.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/29/2023]
Abstract
Background and Purpose- Low cardiorespiratory fitness is associated with increased risk of cardiovascular disease. The present study aims to assess whether change of fitness over time has any impact on long-term risk of stroke and death. Methods- We recruited healthy men aged 40 to 59 years in 1972 to 1975, and followed them until 2007. Physical fitness was assessed with a bicycle ECG test at baseline and again at 7 years, by dividing the total exercise work by body weight. Participants were categorized as remained fit, became unfit, remained unfit, or became fit, depending on whether fitness remained or crossed the median values from baseline to the 7-year visit. Outcome data were collected up to 35 years, from study visits, hospital records, and the National Cause of Death Registry. Risks of stroke and death were estimated by Cox regression analyses and expressed as hazard ratios (HRs) with 95% CIs. Results- Of 2014 participants, 1403 were assessed both at baseline and again at 7 years, and were followed for a mean of 23.6 years. Compared with the became unfit group, risk of stroke was 0.85 (0.54-1.36) for the remained unfit, 0.43 (0.28-0.67) for the remained fit, and 0.34 (0.17-0.67) for the became fit group. For all-cause death, risks were 0.99 (0.76-1.29), 0.57 (0.45-0.74), and 0.65 (0.46-0.90), respectively. Among those with high fitness at baseline, the became unfit group had a significantly higher risk of stroke (HR, 2.35; CI, 1.49-3.63) and death (HR, 1.74; CI, 1.35-2.23) than those who remained fit. Among those who had low fitness at baseline, the became fit group had a significantly lower risk of stroke (HR, 0.40; CI, 0.21-0.72) and death (HR, 0.66; CI, 0.50-0.85) than participants in the remained unfit group. Conclusions- Cardiorespiratory fitness at baseline and change in fitness was associated with large changes in long-term risk of stroke and death. These findings support the encouragement of regular exercise as a stroke prevention strategy.
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Affiliation(s)
- Erik Prestgaard
- From the Institute of Clinical Medicine (E.P., K.E., J.E., K.G., S.K.), University of Oslo, Norway
- Department of Cardiology, Oslo University Hospital, Ullevål, Norway (E.P., J.M., K.E., J.B., K.G., S.K., I.G., E.B.)
| | - Julian Mariampillai
- Department of Cardiology, Oslo University Hospital, Ullevål, Norway (E.P., J.M., K.E., J.B., K.G., S.K., I.G., E.B.)
| | - Kristian Engeseth
- From the Institute of Clinical Medicine (E.P., K.E., J.E., K.G., S.K.), University of Oslo, Norway
- Department of Cardiology, Oslo University Hospital, Ullevål, Norway (E.P., J.M., K.E., J.B., K.G., S.K., I.G., E.B.)
| | - Jan Erikssen
- From the Institute of Clinical Medicine (E.P., K.E., J.E., K.G., S.K.), University of Oslo, Norway
| | - Johan Bodegård
- Department of Cardiology, Oslo University Hospital, Ullevål, Norway (E.P., J.M., K.E., J.B., K.G., S.K., I.G., E.B.)
| | - Knut Liestøl
- Department of Informatics (K.L.), University of Oslo, Norway
| | - Knut Gjesdal
- From the Institute of Clinical Medicine (E.P., K.E., J.E., K.G., S.K.), University of Oslo, Norway
- Department of Cardiology, Oslo University Hospital, Ullevål, Norway (E.P., J.M., K.E., J.B., K.G., S.K., I.G., E.B.)
| | - Sverre Kjeldsen
- From the Institute of Clinical Medicine (E.P., K.E., J.E., K.G., S.K.), University of Oslo, Norway
- Department of Cardiology, Oslo University Hospital, Ullevål, Norway (E.P., J.M., K.E., J.B., K.G., S.K., I.G., E.B.)
| | - Irene Grundvold
- Department of Cardiology, Oslo University Hospital, Ullevål, Norway (E.P., J.M., K.E., J.B., K.G., S.K., I.G., E.B.)
| | - Eivind Berge
- Department of Cardiology, Oslo University Hospital, Ullevål, Norway (E.P., J.M., K.E., J.B., K.G., S.K., I.G., E.B.)
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16
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Piira A, Lannem A, Sørensen M, Glott T, Knutsen R, Jørgensen L, Gjesdal K, Hjeltnes N, Knutsen S. Manually assisted body-weight supported locomotor training does not re-establish walking in non-walking subjects with chronic incomplete spinal cord injury: A randomized clinical trial. J Rehabil Med 2019; 51:113-119. [DOI: 10.2340/16501977-2508] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022] Open
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17
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Engeseth K, Prestgaard EE, Mariampillai JE, Grundvold I, Liestol K, Kjeldsen SE, Bodegard J, Erikssen JE, Gjesdal K, Skretteberg PT. Physical fitness is a modifiable predictor of early cardiovascular death: A 35-year follow-up study of 2014 healthy middle-aged men. Eur J Prev Cardiol 2018; 25:1655-1663. [DOI: 10.1177/2047487318793459] [Citation(s) in RCA: 24] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/31/2022]
Abstract
Background Physical fitness has been shown to predict cardiovascular death during long-term follow-up. In the present study we aimed to investigate how physical fitness and other cardiovascular risk factors at middle-age influenced the risk of cardiovascular death during the early (0–11 years), intermediate (12–23 years) and late (24–35 years) parts of a 35-year observation period. Methods and results Age-adjusted physical fitness was calculated in 2014 apparently healthy, middle-aged men after maximal bicycle electrocardiogram-tests in 1972–1975 (Survey 1) and 1979–1982 (Survey 2). The men were assessed through 35 years after Survey 1, and 28 years after Survey 2 by Cox proportional hazards models. Low Survey 1 physical fitness was independently associated with increased risks of early and intermediate, but not late, cardiovascular death. Survey 1 to Survey 2 change in physical fitness, age, smoking status, systolic blood pressure and cholesterol impacted cardiovascular death risks in all periods. Family history of coronary heart disease impacted early and intermediate, but not late, cardiovascular death. Conclusions Most classical cardiovascular risk factors were strong predictors of early, intermediate and late cardiovascular death. Physical fitness measured at median age 50 years was independently associated with risk of early cardiovascular death, but the association weakened as time progressed. Change in physical fitness during middle-age impacted cardiovascular death risk in a full lifetime perspective. Thus, our data suggest that physical fitness is a modifiable cardiovascular risk factor with limited duration in contrast to the sustained impact of smoking, blood pressure and cholesterol on cardiovascular mortality.
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Affiliation(s)
- Kristian Engeseth
- Institute of Clinical Medicine, University of Oslo, Norway
- Department of Cardiology, Oslo University Hospital, Norway
| | - Erik E Prestgaard
- Institute of Clinical Medicine, University of Oslo, Norway
- Department of Cardiology, Oslo University Hospital, Norway
| | | | | | - Knut Liestol
- Department of Informatics, University of Oslo, Norway
| | - Sverre E Kjeldsen
- Institute of Clinical Medicine, University of Oslo, Norway
- Department of Cardiology, Oslo University Hospital, Norway
| | - Johan Bodegard
- Department of Cardiology, Oslo University Hospital, Norway
| | | | - Knut Gjesdal
- Institute of Clinical Medicine, University of Oslo, Norway
- Department of Cardiology, Oslo University Hospital, Norway
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18
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Prestgaard E, Mariampillai J, Engeseth K, Bodegard J, Erikssen J, Gjesdal K, Liestol K, Kjeldsen S, Grundvold I, Berge E. 3137Body mass index and cardiorespiratory fitness improve stroke prediction beyond classical cardiovascular risk factors. Eur Heart J 2018. [DOI: 10.1093/eurheartj/ehy563.3137] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Affiliation(s)
- E Prestgaard
- Oslo University Hospital, Cardiology, Oslo, Norway
| | | | - K Engeseth
- Oslo University Hospital, Cardiology, Oslo, Norway
| | - J Bodegard
- Oslo University Hospital, Cardiology, Oslo, Norway
| | - J Erikssen
- University of Oslo, Medicine, Oslo, Norway
| | - K Gjesdal
- University of Oslo, Medicine, Oslo, Norway
| | - K Liestol
- University of Oslo, Informatics, Oslo, Norway
| | - S Kjeldsen
- Oslo University Hospital, Cardiology, Oslo, Norway
| | - I Grundvold
- Oslo University Hospital, Cardiology, Oslo, Norway
| | - E Berge
- Oslo University Hospital, Cardiology, Oslo, Norway
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19
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Abstract
SummaryAt the end of a diagnostic right heart catheterization ten patients received an intravenous infusion of l-adrenaline which gradually increased the arterial plasma adrenaline concentration from resting physiological values to high values as seen during myocardial infarction, pheochromocytoma and hypoglycemia. Blood was sampled from the brachial artery, femoral vein and hepatic vein. During the adrenaline infusion venous beta-thromboglobulin concentrations increased 23% from 61 ± 5 to 80 ± 7 μg/l (mean ± SE), arterial platelet counts 20% from 212 ± 17 to 253 ± 25 × 109/l and arterial platelet volume 4% from 7.25 ± 0.20 to 7.56 ± 0.21 femtoliter. All changes were significant at the 5% level. Thus, acute increments of arterial plasma adrenaline significantly stimulated the blood platelet parameters studied.
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Affiliation(s)
- K Lande
- The Department of Medicine and Department of Clinical Physiology, Ullevål Hospital, University of Oslo, Oslo, Norway
| | - K Gjesdal
- The Department of Medicine and Department of Clinical Physiology, Ullevål Hospital, University of Oslo, Oslo, Norway
| | - E Fønstelien
- The Department of Medicine and Department of Clinical Physiology, Ullevål Hospital, University of Oslo, Oslo, Norway
| | - S E Kjeldsen
- The Department of Medicine and Department of Clinical Physiology, Ullevål Hospital, University of Oslo, Oslo, Norway
| | - I Eide
- The Department of Medicine and Department of Clinical Physiology, Ullevål Hospital, University of Oslo, Oslo, Norway
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Lande K, Gjesdal K, Os I, Kjeldsen SE, Eide I, Westheim A, Hjermann I. Does Arterial Rather than Venous Plasma Beta-Thromboglobulin Better Reflect In Vivo Platelet Release Reaction? Thromb Haemost 2018. [DOI: 10.1055/s-0038-1657894] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/28/2022]
Affiliation(s)
- K Lande
- Department of Medicine, Department of Clinical Physiology and Medical Outpatient Clinic, Ullevål Hospital, University of Oslo, N-0407 Oslo 4, Norway
| | - K Gjesdal
- Department of Medicine, Department of Clinical Physiology and Medical Outpatient Clinic, Ullevål Hospital, University of Oslo, N-0407 Oslo 4, Norway
| | - I Os
- Department of Medicine, Department of Clinical Physiology and Medical Outpatient Clinic, Ullevål Hospital, University of Oslo, N-0407 Oslo 4, Norway
| | - S E Kjeldsen
- Department of Medicine, Department of Clinical Physiology and Medical Outpatient Clinic, Ullevål Hospital, University of Oslo, N-0407 Oslo 4, Norway
| | - I Eide
- Department of Medicine, Department of Clinical Physiology and Medical Outpatient Clinic, Ullevål Hospital, University of Oslo, N-0407 Oslo 4, Norway
| | - A Westheim
- Department of Medicine, Department of Clinical Physiology and Medical Outpatient Clinic, Ullevål Hospital, University of Oslo, N-0407 Oslo 4, Norway
| | - I Hjermann
- Department of Medicine, Department of Clinical Physiology and Medical Outpatient Clinic, Ullevål Hospital, University of Oslo, N-0407 Oslo 4, Norway
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Abstract
SummaryHuman platelet factor 4 (PF-4) showed a reaction of complete identity with PF-4 from Macaca mulatta when tested against rabbit anti-human-PF-4. Such immunoglobulin was used for quantitative precipitation of in vivo labelled PF-4 in monkey serum. The results suggest that the active protein had an intra-platelet half-life of about 21 hours. In vitro 125I-labelled human PF-4 was injected intravenously into two monkeys and isolated by immuno-precipita-tion from platelet-poor plasma and from platelets disrupted after gel-filtration. Plasma PF-4 was found to have a half-life of 7 to 11 hours. Some of the labelled PF-4 was associated with platelets and this fraction had a rapid initial disappearance rate and a subsequent half-life close to that of plasma PF-4. The results are compatible with the hypothesis that granular PF-4 belongs to a separate compartment, whereas membrane-bound PF-4 and plasma PF-4 may interchange.
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22
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Gjesdal K, Nordøy A, Wang H, Berntsen H, Mjøs OD. Effects of Fasting on Plasma and Platelet-Free Fatty Acids and Platelet Function in Healthy Males. Thromb Haemost 2018. [DOI: 10.1055/s-0038-1648048] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/28/2022]
Abstract
Summary10 healthy male volunteers fasted for 72 hours. Their plasma concentration of free fatty acid increased more than two-fold, to 1.8 mmol/1. The number of reversible venous “in vivo” platelet aggregates increased significantly (p <0.01); this figure correlated with the concentration of long-chain saturated free fatty acid in plasma (p <0.02). The correlation with the amount of long-chain saturated free fatty acid plus oleic acid (18:1) was even better (p <0.01). Plasma PF-4 concentration increased, suggesting increased platelet release reaction. In spite of the plasma increase, total platelet FFA concentration was reduced and there was a change in the distribution of platelet free fatty acid which correlated with the degree of aggregation.
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23
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Nordøy A, Gjesdal K, Jaeger S, Berntsen H. The Effect of Noradrenalin Infusion on Plasma and Platelet Lipids and Platelet Function in Man. Thromb Haemost 2018. [DOI: 10.1055/s-0038-1647884] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/28/2022]
Abstract
SummaryNoradrenalin was given as an intravenous infusion in a dosage of 0.1 μg/kg/h over a period of 30 minutes to 5 healthy male subjects. Blood samples were collected before, at the end of and 24 hours after the infusion. A significant increase in the number of circulating platelets and a marked increase of plasma FFA, reflecting an increase of all the main components of the FFA fraction were observed. No significant changes were observed in the similar lipid fraction in platelets and except for a moderate increase in platelet factor 3 activity, no significant changes in other platelet function tests were present.
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24
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Abstract
SummaryThe present study aimed at testing the hypothesis of a link between mental stress and blood platelet function. Twenty-nine 19-year-old men were recruited from the 98th percentile of mean blood pressure (116 mmHg) at a routine medical screening. They were not informed about their elevated blood pressures at the time of the screening. One year later they were randomized into two groups. Group 1 (n = 16) was exposed to mental stress by a letter informing them about their high blood pressure, while group 2 (n = 13) was sent a neutral letter. At an examination 2 weeks later, heart rate (p <0.05) and plasma adrenaline (p <0.05) responses to a cold pressor test were exaggerated in the informed group. The plasma beta-thromoglobulin (pTG) concentration was elevated in the informed group (p <0.05) as was mean blood pressure (p <0.05). (3TG correlated positively with hematocrit (r = 0.59, p <0.005) and mean blood pressure (r = 0.43, p <0.05), and negatively with plasma HDL (r = −0.61, p = 0.001). The study shows that awareness of hypertension induces a hyperadrenergic state which is associated with the platelet release reaction. Under these circumstances platelet release seems to be correlated to established coronary heart disease risk factors.
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Affiliation(s)
- Morten Rostrup
- The Department of Internal Medicine, Ullevål Hospital, University of Oslo Medical School, Norway
| | - Håvard Holth Mundal
- The Department of Internal Medicine, Ullevål Hospital, University of Oslo Medical School, Norway
| | - Sverre Erik Kjeldsen
- The Department of Internal Medicine, Ullevål Hospital, University of Oslo Medical School, Norway
| | - Knut Gjesdal
- The Department of Internal Medicine, Ullevål Hospital, University of Oslo Medical School, Norway
| | - Ivar Eide
- The Department of Internal Medicine, Ullevål Hospital, University of Oslo Medical School, Norway
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25
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Kjeldsen SE, Gjesdal K, Leren P, Eide IK. Decreased Platelet-Free Dopamine and Unchanged Noradrenaline and Adrenaline in Essential Hypertension. Thromb Haemost 2018. [DOI: 10.1055/s-0038-1647040] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/28/2022]
Abstract
SummaryThe content of free-catecholamines in blood platelets is much higher than in plasma and platelet catecholamines must be taken up from plasma, since platelets lack the enzymes for catecholamine synthesis. There is some evidence that platelet catecholamine content under certain circumstances may be an integrated measure of plasma catecholamine concentrations over time. Platelet-free catecholamines were therefore assayed in 18 untreated patients with essential hypertension and in 16 normotensive control subjects. Mean platelet-free dopamine in the hypertensive group was 3.7 ± 0.4 pg/mg platelet weight, i.e. significantly less than the 6.5 ± 0.9 pg/mg found in the normotensive (p <0.005). Platelet contents of noradrenaline and adrenaline did not differ. Decreased platelet-free dopamine and unchanged platelet noradrenaline and adrenaline persisted after adjustment for increased body weight in the hypertensive group. Although the reasons for decreased platelet-free dopamine in the hypertensive group remain unknown, this finding may add to previous result showing facilitated release of granular contents from blood platelets in patients with essential hypertension. Our data do not support platelet levels of free-catecholamines to be a marker of increased sympathetic tone in essential hypertension.
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Affiliation(s)
- S E Kjeldsen
- The Department of Internal Medicine, Oslo University Medical School, Ullevaal Hospital, Oslo, Norway
| | - K Gjesdal
- The Department of Internal Medicine, Oslo University Medical School, Ullevaal Hospital, Oslo, Norway
| | - P Leren
- The Department of Internal Medicine, Oslo University Medical School, Ullevaal Hospital, Oslo, Norway
| | - I K Eide
- The Department of Internal Medicine, Oslo University Medical School, Ullevaal Hospital, Oslo, Norway
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26
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Gjesdal K. Hjertemedisin på Rikshospitalet – historikk og historier. Tidsskriftet 2018. [DOI: 10.4045/tidsskr.18.0136] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/02/2022] Open
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Gjesdal K. Hjertehelse og hjertesykdom. Tidsskriftet 2018. [DOI: 10.4045/tidsskr.18.0780] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/02/2022] Open
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28
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Prestgaard E, Hodnesdal C, Engeseth K, Erikssen J, Bodegård J, Liestøl K, Gjesdal K, Kjeldsen SE, Grundvold I, Berge E. Long-term predictors of stroke in healthy middle-aged men. Int J Stroke 2017; 13:292-300. [DOI: 10.1177/1747493017730760] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
Background There are few data on risk factors for stroke during long-term follow-up of healthy individuals. Aims We aimed to investigate the long-term predictive impact on stroke risk of baseline variables including hemodynamic variables measured at rest and during exercise in middle-aged, healthy men. Methods We performed a prospective cohort study of 2014 healthy Norwegian men aged 40–59 years, recruited during the period 1972–1975 and followed until 2007. Participants underwent a comprehensive clinical assessment at baseline, including a bicycle exercise test. Data on stroke, transient ischemic attack, and death were collected on all participants from follow-up visits, medical records, and the National Cause of Death Registry. We used Cox regression for analysis and estimated hazard ratios with 95% confidence intervals, adjusting for traditional risk factors and hemodynamic variables measured at rest and during exercise. Results During 35 years’ follow-up, 316 participants (16%) had stroke, of which 287 (91%) were ischemic and 29 (9%) were hemorrhagic. Age (hazard ratio 2.70 per increase in one standard deviation, 95% confidence interval 2.13–3.43), resting systolic blood pressure (hazard ratio 1.24, 95% confidence interval 1.11–1.39), body mass index (hazard ratio 1.14, 95% confidence interval 1.02–1.29), and atrioventricular conduction time (hazard ratio 1.11, 95% confidence interval 1.03–1.19) were significantly associated with long-term risk of stroke, as were maximal systolic blood pressure and heart rate during exercise (hazard ratio 1.28, 95% confidence interval 1.13–1.46, and hazard ratio 0.86, 95% confidence interval 0.74–0.99, respectively). Conclusions Hemodynamic variables at rest and during exercise testing add to the predictive value of clinical variables in healthy, middle-aged men, and should be included in the assessment of long-term risk of stroke, when available.
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Affiliation(s)
- Erik Prestgaard
- Institute of Clinical Medicine, University of Oslo, Oslo, Norway
- Department of Cardiology, Oslo University Hospital, Ullevål, Norway
| | | | - Kristian Engeseth
- Institute of Clinical Medicine, University of Oslo, Oslo, Norway
- Department of Cardiology, Oslo University Hospital, Ullevål, Norway
| | - Jan Erikssen
- Institute of Clinical Medicine, University of Oslo, Oslo, Norway
| | - Johan Bodegård
- Department of Cardiology, Oslo University Hospital, Ullevål, Norway
| | - Knut Liestøl
- Department of Informatics, University of Oslo, Oslo, Norway
| | - Knut Gjesdal
- Institute of Clinical Medicine, University of Oslo, Oslo, Norway
- Department of Cardiology, Oslo University Hospital, Ullevål, Norway
| | - Sverre E. Kjeldsen
- Institute of Clinical Medicine, University of Oslo, Oslo, Norway
- Department of Cardiology, Oslo University Hospital, Ullevål, Norway
| | - Irene Grundvold
- Department of Cardiology, Oslo University Hospital, Ullevål, Norway
| | - Eivind Berge
- Department of Cardiology, Oslo University Hospital, Ullevål, Norway
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29
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Mariampillai J, Engeseth K, Kjeldsen S, Prestgaard E, Gjesdal K, Liestøl K, Erikssen J, Bodegard J, Grundvold I, Skretteberg P. [OP.3C.02] EXERCISE SYSTOLIC BLOOD PRESSURE AT MODERATE WORKLOAD. J Hypertens 2017. [DOI: 10.1097/01.hjh.0000523057.28806.64] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
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30
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Prestgaard E, Mariampillai J, Engeseth K, Gjesdal K, Liestol K, Erikssen J, Bodegard J, Kjeldsen S, Berge E, Grundvold I. 11947-year change in physical fitness in healthy middle-aged men predicts stroke during 28 years follow-up. Eur Heart J 2017. [DOI: 10.1093/eurheartj/ehx502.1194] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
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31
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Larssen MS, Steine K, Hilde JM, Skjørten I, Hodnesdal C, Liestøl K, Gjesdal K. Mechanisms of ECG signs in chronic obstructive pulmonary disease. Open Heart 2017; 4:e000552. [PMID: 28533915 PMCID: PMC5437720 DOI: 10.1136/openhrt-2016-000552] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/21/2016] [Revised: 12/29/2016] [Accepted: 01/03/2017] [Indexed: 02/06/2023] Open
Abstract
OBJECTIVE Patients with chronic obstructive pulmonary disease (COPD) often have abnormal ECGs. Our aim was to separate the effects on ECG by airway obstruction, emphysema and right ventricular (RV) afterload in patients with COPD. METHODS A cross-sectional study was performed on 101 patients with COPD without left heart disease and 32 healthy age-matched controls. Body mass index (BMI) was measured, and pulmonary function tests, ECG, echocardiography and right heart catheterisation (only patients) were performed. Variables were grouped into (1) airway obstruction by FEV% (percentage of forced expiratory volume)_predicted, (2) emphysema by residual volume/total lung capacity and residual volume (percent of predicted) and (3) RV afterload by mean pulmonary pressure, artery compliance, vascular resistance and RV wall thickness. RESULTS In multivariate regression analysis, emphysema correlated negatively to R+S amplitudes in horizontal and frontal leads, RV/left ventricle (LV) end-diastolic volume ratio to horizontal amplitudes and BMI negatively to frontal amplitudes. Increased airway obstruction, RV afterload and BMI correlated with horizontal QRS-axis clockwise rotation. Airway obstruction, RV afterload, RV/LV end-diastolic volume ratio and BMI correlated to the Sokolow-Lyon Index for RV, and RV afterload negatively to Sokolow-LyonIndex for LV. Several classical ECG changes could, however, not be ascribed to specific mechanisms. CONCLUSIONS In COPD, the various pathophysiological mechanisms modify the ECG differently. Increased airway obstruction and RV afterload mainly increase the Sokolow-Lyon Index for RV mass and associate with clockwise rotation of the horizontal QRS-axis, whereas emphysema reduces the QRS amplitudes. BMI is an equally important determinant for the majority of the ECG changes.
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Affiliation(s)
- Marte Strømsnes Larssen
- Faculty of Medicine, University of Oslo, Oslo, Norway.,Department of Cardiology Ullevål, Oslo University Hospital, Oslo, Norway
| | - Kjetil Steine
- Faculty of Medicine, University of Oslo, Oslo, Norway.,Department of Cardiology, Akershus University Hospital, Oslo, Norway
| | | | | | - Christian Hodnesdal
- Faculty of Medicine, University of Oslo, Oslo, Norway.,Department of Cardiology Ullevål, Oslo University Hospital, Oslo, Norway
| | - Knut Liestøl
- Faculty of Mathematics and Natural Sciences, University of Oslo, Oslo, Norway
| | - Knut Gjesdal
- Faculty of Medicine, University of Oslo, Oslo, Norway.,Department of Cardiology Ullevål, Oslo University Hospital, Oslo, Norway
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Gjesdal K. Winston Churchill – livlegens beretning. Tidsskriftet 2017; 137:17-0193. [DOI: 10.4045/tidsskr.17.0193] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/02/2022] Open
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Engeseth K, Hodnesdal C, Grundvold I, Liestøl K, Gjesdal K, Kjeldsen SE, Erikssen JE, Bodegard J, Skretteberg PT. Temporal Reduction in Chronotropic Index Predicts Risk of Cardiovascular Death Among Healthy Middle-Aged Men: a 28-Year Follow-Up Study. J Am Heart Assoc 2016; 5:e004555. [PMID: 27881424 PMCID: PMC5210440 DOI: 10.1161/jaha.116.004555] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/23/2016] [Accepted: 10/24/2016] [Indexed: 11/16/2022]
Abstract
BACKGROUND Chronotropic index is a standardized measure of heart rate (HR) increment during exercise that reflects the combined effects of age, resting HR, and physical fitness. Low chronotropic index has been reported to predict disease and death. We tested whether temporal change in chronotropic index over 7 years influenced risk of cardiovascular death through up to 28 years. METHODS AND RESULTS Chronotropic index was calculated ([achieved maximal HR-resting HR]/[age-predicted maximal HR-resting HR]) after a symptom-limited bicycle ECG exercise test in 1420 healthy men at 2 examinations 7 years apart, in 1972 and 1979. Events of cardiovascular death were registered by manual scrutiny of all participants' hospital charts and the Norwegian Cause of Death Registry. The participants were divided into quartiles of temporal change in chronotropic index, with quartile one having the most negative value. Cox proportional hazard regression models were used to estimate risks and adjusted for classical cardiovascular risk factors. Incidence of cardiovascular death was 310 (22%) during median of 21 years of follow-up. After multivariable adjustment, and comparison with quartile four (mean +0.11), quartiles one (-0.16), two (-0.04), and three (+0.02) were associated with hazard ratios 1.50 (95% CI 1.10-2.05), 1.10 (0.79-1.53), and 1.04 (0.74-1.45) for cardiovascular death. Results remained robust also after exclusion of 31 participants with exercise ECG-induced signs of coronary ischemia. CONCLUSIONS Temporal reduction in chronotropic index was associated with increased long-term risk of cardiovascular death and might be a clinically important predictor when assessing risk in healthy individuals over a longer time.
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Affiliation(s)
- Kristian Engeseth
- Department of Cardiology, Oslo University Hospital, Ullevaal, Oslo, Norway
- Faculty of Medicine, University of Oslo, Norway
| | - Christian Hodnesdal
- Department of Cardiology, Oslo University Hospital, Ullevaal, Oslo, Norway
- Faculty of Medicine, University of Oslo, Norway
| | - Irene Grundvold
- Department of Cardiology, Oslo University Hospital, Ullevaal, Oslo, Norway
- Centre for Clinical Heart Research, Oslo University Hospital, Oslo, Norway
| | - Knut Liestøl
- Department of Informatics, University of Oslo, Norway
| | - Knut Gjesdal
- Department of Cardiology, Oslo University Hospital, Ullevaal, Oslo, Norway
- Faculty of Medicine, University of Oslo, Norway
| | - Sverre E Kjeldsen
- Department of Cardiology, Oslo University Hospital, Ullevaal, Oslo, Norway
- Faculty of Medicine, University of Oslo, Norway
| | | | - Johan Bodegard
- Department of Cardiology, Oslo University Hospital, Ullevaal, Oslo, Norway
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Gjesdal K. Scandinavian Cardiovascular Journal - 50 years anniversary. SCAND CARDIOVASC J 2016; 50:251-252. [PMID: 27735190 DOI: 10.1080/14017431.2016.1249021] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
Affiliation(s)
- Knut Gjesdal
- a Cardiology Department , Oslo University Hospital Ullevål, Institute of Clinical Medicine, Oslo University , Oslo , Norway
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Bodegard J, Erikssen G, Bjørnholt JV, Gjesdal K, Thelle D, Erikssen J. Symptom-limited exercise testing, ST depressions and long-term coronary heart disease mortality in apparently healthy middle-aged men. ACTA ACUST UNITED AC 2016; 11:320-7. [PMID: 15292766 DOI: 10.1097/01.hjr.0000136460.57921.46] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
BACKGROUND Previous studies have shown that ST depressions > or =1.0 mm during or post-exercise increase long-term risk of dying from coronary heart disease (CHD), the need for coronary artery bypass grafting (CABG) or the development of acute myocardial infarction (AMI) in healthy men. In the present prospective cohort study we investigate whether less marked ST depressions may influence CHD mortality, incidence of AMI, the need for a CABG or having a non-fatal stroke. METHODS During 1972-75, 2014 men aged 40-59 years, free from somatic diseases and not using any drugs, underwent an examination programme including case history, clinical examination, various blood tests and a symptom-limited exercise ECG-test. ECG was registered during exercise and at 30 s, 1, 2, 3 and 5 min post-exercise. The possible prognostic impact of ST-changes of 0.50-0.99 mm and > or =1.00 mm compared with normal ST-segments were studied separately and combined. Horizontal, down-sloping and slowly up-sloping ST-segment patterns were combined. RESULTS After adjustment for age, smoking, blood pressure, cholesterol, maximal heart rate, left ventricular hypertrophy and physical fitness ST depressions > or =0.50 mm--during and/or post-exercise--were associated with a 1.47-fold [95% confidence interval (CI) 1.10-1.95], and 1.54-fold (95% CI of 1.17-2.04) increased 26 years risk of CHD-mortality, respectively. The same ST-changes also increased 22 years risk of developing non-fatal AMI or needing CABG but not developing non-fatal stroke. CONCLUSIONS Even an ST depression > or =0.50 mm during and/or after exercise increases the long-term risk of CHD-death, developing an AMI or needing CABG. No association was found between ST-changes and incidence of non-fatal strokes.
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Affiliation(s)
- Johan Bodegard
- The Department of Clinical Epidemiology, University of Oslo, Norway.
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Gjesdal K. K. Gjesdal svarer:. Tidsskriftet 2016; 136:1185. [DOI: 10.4045/tidsskr.16.0580] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/02/2022] Open
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Gjesdal K. Indremedisin og kirurgi i kompakt blanding. Tidsskriftet 2016. [DOI: 10.4045/tidsskr.16.0139] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/02/2022] Open
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Barth Z, Nomeland Witczak B, Schwartz T, Gjesdal K, Flatø B, Koller A, Sanner H, Sjaastad I. In juvenile dermatomyositis, heart rate variability is reduced, and associated with both cardiac dysfunction and markers of inflammation: a cross-sectional study median 13.5 years after symptom onset. Rheumatology (Oxford) 2015; 55:535-43. [DOI: 10.1093/rheumatology/kev376] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/23/2015] [Indexed: 01/24/2023] Open
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Barth Z, Witczak B, Schwartz T, Gjesdal K, Flatø B, Koller Ά, Sjaastad I, Sanner H. FRI0535 Evaluation of the Heart Rate Variability and it's Relationship with the Cardiac Function and Inflammation in Juvenile Dermatomyositis. Ann Rheum Dis 2015. [DOI: 10.1136/annrheumdis-2015-eular.1467] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/03/2022]
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Opdal MS, Arnesen M, Müller LD, Hullstein I, Sayed K, Brørs O, Kringen M, Sagedal S, Gjesdal K, Krajci P. Effects of Hemodialysis on Methadone Pharmacokinetics and QTc. Clin Ther 2015; 37:1594-9. [PMID: 25963997 DOI: 10.1016/j.clinthera.2015.04.009] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/31/2015] [Revised: 03/12/2015] [Accepted: 04/15/2015] [Indexed: 11/26/2022]
Abstract
PURPOSE Effects of hemodialysis on pharmacokinetic properties and QTc were studied in 4 patients taking daily methadone dose of 100 mg (range, 60-120 mg). METHODS Methadone in serum, dialysate, and urine were measured by LC-MS/MS. QTc was calculated with Bazett's formula. FINDINGS The serum Cmin methadone level was 1124 nmol/L (range, 547-1581 nmol/L). Methadone dialysate clearance was 17.1 mL/min (range, 13.7-20.6 mL/min). Total loss in dialysate was 2.30% (range, 1,25-3,70%) of daily methadone intake. QTc increased from 391 msec (range, 369-406 msec) to 445 msec (range, 407-479 msec), independently of serum methadone level, which may be explained by normalization of serum electrolytes. IMPLICATIONS Methadone dose adjustment is not needed because of hemodialysis.
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Affiliation(s)
- Mimi Stokke Opdal
- Institute of Clinical Medicine, Oslo University, Oslo, Norway; Department of Pharmacology, Oslo University Hospital, Oslo, Norway.
| | - Margrete Arnesen
- Department of Substance Use Disorder Treatment, Oslo University Hospital, Oslo, Norway
| | | | - Ingunn Hullstein
- Department of Pharmacology, Oslo University Hospital, Oslo, Norway; Norwegian Doping Control Laboratory, Oslo University Hospital, Oslo, Norway
| | | | - Odd Brørs
- Institute of Clinical Medicine, Oslo University, Oslo, Norway
| | - Marianne Kringen
- Department of Pharmacology, Oslo University Hospital, Oslo, Norway
| | - Solbjørg Sagedal
- Department of Nephrology, Oslo University Hospital, Oslo, Norway
| | - Knut Gjesdal
- Institute of Clinical Medicine, Oslo University, Oslo, Norway; Department of Cardiology, Oslo University Hospital, Oslo, Norway
| | - Peter Krajci
- Department of Substance Use Disorder Treatment, Oslo University Hospital, Oslo, Norway
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Kvittingen EV, Gjelsvik B, Gjesdal K. EKG i allmennpraksis – kvaliteten kan forbedres. Tidsskriftet 2015; 135:746. [DOI: 10.4045/tidsskr.15.0310] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/02/2022] Open
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Engeseth K, Hodnesdal C, Grundvold I, Liestøl K, Gjesdal K, Erikssen G, Kjeldsen SE, Erikssen JE, Bodegard J, Skretteberg PT. Heart rate reserve predicts cardiovascular death among physically unfit but otherwise healthy middle-aged men: a 35-year follow-up study. Eur J Prev Cardiol 2014; 23:59-66. [DOI: 10.1177/2047487314553202] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/11/2014] [Accepted: 09/08/2014] [Indexed: 11/16/2022]
Affiliation(s)
- Kristian Engeseth
- Department of Cardiology, Oslo University Hospital, Ullevaal, Norway
- Faculty of Medicine, University of Oslo, Norway
| | - Christian Hodnesdal
- Department of Cardiology, Oslo University Hospital, Ullevaal, Norway
- Faculty of Medicine, University of Oslo, Norway
| | - Irene Grundvold
- Department of Cardiology, Oslo University Hospital, Ullevaal, Norway
- Faculty of Medicine, University of Oslo, Norway
- Centre for Clinical Heart Research, Oslo University Hospital, Norway
| | - Knut Liestøl
- Department of Informatics, University of Oslo, Norway
| | - Knut Gjesdal
- Department of Cardiology, Oslo University Hospital, Ullevaal, Norway
- Faculty of Medicine, University of Oslo, Norway
| | | | - Sverre E Kjeldsen
- Department of Cardiology, Oslo University Hospital, Ullevaal, Norway
- Faculty of Medicine, University of Oslo, Norway
| | | | - Johan Bodegard
- Department of Cardiology, Oslo University Hospital, Ullevaal, Norway
| | - Per Torger Skretteberg
- Department of Cardiology, Oslo University Hospital, Ullevaal, Norway
- Faculty of Medicine, University of Oslo, Norway
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Berge HM, Gjesdal K, Andersen TE, Solberg EE, Steine K. Prevalence of abnormal ECGs in male soccer players decreases with the Seattle criteria, but is still high. Scand J Med Sci Sports 2014; 25:501-8. [DOI: 10.1111/sms.12274] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 05/22/2014] [Indexed: 01/21/2023]
Affiliation(s)
- H. M. Berge
- Oslo Sports Trauma Research Center; Norwegian School of Sport Sciences; Oslo Norway
| | - K. Gjesdal
- Cardiology Department; Oslo University Hospital; Oslo Norway
- Institute of Clinical Medicine; University of Oslo; Oslo Norway
| | - T. E. Andersen
- Oslo Sports Trauma Research Center; Norwegian School of Sport Sciences; Oslo Norway
| | - E. E. Solberg
- Department of Internal Medicine; Diakonhjemmet Hospital; Oslo Norway
| | - K. Steine
- Institute of Clinical Medicine; University of Oslo; Oslo Norway
- Cardiology Department; Akershus University Hospital; Lørenskog Norway
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Ulimoen SR, Enger S, Norseth J, Pripp AH, Abdelnoor M, Arnesen H, Gjesdal K, Tveit A. Improved rate control reduces cardiac troponin T levels in permanent atrial fibrillation. Clin Cardiol 2014; 37:422-7. [PMID: 24700386 DOI: 10.1002/clc.22281] [Citation(s) in RCA: 19] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/26/2014] [Revised: 03/06/2014] [Indexed: 11/06/2022] Open
Abstract
BACKGROUND Detectable levels of troponins are often found in serum of patients with atrial fibrillation (AF), and recent reports suggest that Tn concentrations are independently related to patient prognosis. HYPOTHESIS We hypothesized that treatment with common rate-reducing drugs might lower the levels of cardiac troponin T (TnT) in patients with permanent AF. We also wanted to investigate whether the different drugs would impact the Tn levels differently. METHODS Sixty patients were included (mean age 71 ± 9 years, 18 women) in this randomized crossover study. All patients had stable, permanent AF without ischemic heart disease or congestive heart failure. Diltiazem 360 mg, verapamil 240 mg, metoprolol 100 mg, and carvedilol 25 mg were administered once daily for 3 weeks, in a randomized sequence. At baseline and on the last day of each treatment period, TnT concentrations were measured at rest and after a maximal exercise test. RESULTS TnT was detectable in all patients. In 22% of the patients, TnT concentrations were above the threshold normally used for diagnosing myocardial infarction. All drugs reduced the levels of TnT significantly compared with baseline (P < 0.001 for all), but there were no significant differences between the treatments. Levels of TnT increased significantly in response to exercise testing (P < 0.001 for all). CONCLUSIONS Elevated TnT was demonstrated in a large proportion of stable patients with permanent AF without ischemic heart disease. A moderate reduction of heart rate by the study drugs was associated with a significant reduction in levels of TnT.
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Affiliation(s)
- Sara R Ulimoen
- Department of Medical Research, Vestre Viken Hospital Trust, Baerum Hospital, Rud, Norway; Faculty of Medicine, University of Oslo, Oslo, Norway
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Berge HM, Steine K, Andersen TE, Solberg EE, Gjesdal K. MEASUREMENT METHOD IS IMPORTANT FOR INTERPRETATION OF ATHLETES' ECG. Br J Sports Med 2014. [DOI: 10.1136/bjsports-2014-093494.22] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022]
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Abstract
BACKGROUND ECG is recommended for preparticipation health examination in athletes. Owing to a lack of consensus on how to read and interpret athletes' ECGs, different criteria for abnormality are used. AIMS To compare the prevalence of abnormal ECGs and test the correlation between visual and computer-based measurements. METHODS In a preparticipation cardiac screening examination of 595 male professional soccer players aged 18-38 years, ECGs were categorised according to the European Society of Cardiology's (ESC) recommendations and the Seattle criteria, respectively. Visual measurements were conducted with callipers on-screen on the averaged PQRST complex in each lead, calculated by the trimmed mean. Computer-based measurements were derived from the medium beat. Heart rhythm and conduction were scored visually by a cardiologist. Categorical variables were compared by κ statistics (K) and continuous variables by intraclass correlation. RESULTS ECGs of good quality were available from 579 players. According to the ESC's recommendations and Seattle criteria, respectively, ECGs were categorised as abnormal in 171 (29.5%) vs 64 (11.1%) players after visual assessment, and in 293 (50.6%; K=0.395) vs 127 (21.9%; K=0.564) after computer-based measurements. Intraclass correlation was very good for measurements of R and S wave amplitudes and moderate to very good for intervals. K was very good for pathological Q wave amplitudes and moderate for T wave inversions. CONCLUSIONS Abnormal ECGs were more than twice as common after computer-based than after visual measurements. Such a difference will markedly influence the number of athletes who need further examinations. Reference values may need adjustments dependent on measurement methods.
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Affiliation(s)
- H M Berge
- Oslo Sports Trauma Research Center, The Norwegian School of Sport Sciences, , Oslo, Norway
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