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Edvardsen T, Aaberge L, Geiran O, Simonsen S, Kjekshus J, Platou E, Smiseth OA. Kolbjørn Forfang. Tidsskriftet 2022. [DOI: 10.4045/tidsskr.22.0225] [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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Edvardsen T, Skulstad H, Smiseth OA, Fosse E, Simonsen S, Geiran O. Halfdan Ihlen. Tidsskriftet 2022. [DOI: 10.4045/tidsskr.22.0182] [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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3
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Bendz B, Gude E, Ragnarsson A, Endresen K, Aaberge L, Geiran O, Simonsen S. Intra-aortic balloon pump in acute chest pain and cardiogenic shock - a long-term follow-up. SCAND CARDIOVASC J 2019; 53:337-341. [PMID: 31476881 DOI: 10.1080/14017431.2019.1657938] [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] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/26/2022]
Abstract
Objectives. Coronary revascularisation and intra-aortic balloon pump (IABP) has been considered the gold standard treatment of acute coronary syndrome with cardiogenic shock, recently challenged by the SHOCK II study. The aim of this non-randomised study was to investigate the long term prognosis after immediate IABP supported angiography, in patients with acute chest pain and cardiogenic shock, treated with percutaneous coronary intervention (PCI), cardiac surgery or optimal medical treatment. We assessed data from 281 consecutive patients admitted to our department from 2004 to 2010. Results. Mean (±SD) age was 63.8 ± 11.5 (range 30-84) years with a follow-up of 5.6 ± 4.4 (0-12.7) years. Acute myocardial infarction was the primary diagnosis in 93% of the patients, 4% presented with unstable angina pectoris and 3% cardiomyopathy or arrhythmias of non-ischemic aetiology. Systolic blood pressure at admittance was 85 ± 18 mmHg and diastolic 55 ± 18 mmHg. Thirty day, one- and five-year survival was 71.2%, 67.3% and 57.7%, respectively. PCI was performed immediately in 70%, surgery was done in 17%, and 13% were not eligible for any revascularisation. Independent variables predicting mortality were medical treatment vs revascularisation, out-of-hospital cardiac arrest, and advanced age. Three serious non-fatal complications occurred due to IABP treatment, i.e. 0.001 per treatment day. Conclusions. We report the use of IABP in patients with acute chest pain admitted for angiography. Long-term survival is acceptable and discriminating factors were no revascularisation, out-of-hospital cardiac arrest and age. IABP was safe and feasible and the complication rate was low.
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Affiliation(s)
- Bjørn Bendz
- Department of Cardiology.,Institute of Clinical Medicine, University of Oslo, Oslo, Norway
| | | | | | | | | | - Odd Geiran
- Department of Cardio-Thoracic Surgery, Heart-Lung Clinic, Oslo University Hospital, Rikshospitalet, Oslo, Norway.,Institute of Clinical Medicine, University of Oslo, Oslo, Norway
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Auråen H, Schultz HHL, Hämmäinen P, Riise GC, Larsson H, Hansson L, Dellgren G, Perch M, Geiran O, Fiane AE, Iversen M, Holm AM. Urgent lung allocation system in the Scandiatransplant countries. J Heart Lung Transplant 2018; 37:1403-1409. [PMID: 30241891 DOI: 10.1016/j.healun.2018.08.002] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.3] [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: 03/13/2018] [Revised: 06/26/2018] [Accepted: 08/01/2018] [Indexed: 11/28/2022] Open
Abstract
BACKGROUND Throughout the world, the scarcity of donor organs makes optimal allocation systems necessary. In the Scandiatransplant countries, organs for lung transplantation are allocated nationally. To ensure shorter wait time for critically ill patients, the Scandiatransplant urgent lung allocation system (ScULAS) was introduced in 2009, giving supranational priority to patients considered urgent. There were no pre-defined criteria for listing a patient as urgent, but each center was granted only 3 urgent calls per year. This study aims to explore the characteristics and outcome of patients listed as urgent, assess changes associated with the implementation of ScULAS, and describe how the system was utilized by the member centers. METHODS All patients listed for lung transplantation at the 5 Scandiatransplant centers 5 years before and after implementation of ScULAS were included. RESULTS After implementation, 8.3% of all listed patients received urgent status, of whom 81% were transplanted within 4 weeks. Patients listed as urgent were younger, more commonly had suppurative lung disease, and were more often on life support compared with patients without urgent status. For patients listed as urgent, post-transplant graft survival was inferior at 30 and 90 days. Although there were no pre-defined criteria for urgent listing, the system was not utilized at its maximum. CONCLUSIONS ScULAS rapidly allocated organs to patients considered urgent. These patients were younger and more often had suppurative lung disease. Patients with urgent status had inferior short-term outcome, plausibly due to the higher proportion on life support before transplantation.
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Affiliation(s)
- Henrik Auråen
- Department of Respiratory Medicine, Oslo University Hospital, Rikshospitalet, Oslo, Norway; Institute of Clinical Medicine, Faculty of Medicine, University of Oslo, Oslo, Norway
| | - Hans Henrik L Schultz
- Department of Cardiology, Section for Lung Transplantation, Copenhagen University Hospital, Rigshospitalet, Copenhagen, Denmark
| | - Pekka Hämmäinen
- Department of Cardiothoracic Surgery, Helsinki University Hospital, Helsinki, Finland
| | - Gerdt C Riise
- Department of Respiratory Medicine, Institute of Medicine, Sahlgrenska University Hospital, Gothenburg, Sweden
| | - Hillevi Larsson
- Division of Respiratory Medicine and Allergology, Department of Clinical Sciences, Lund University, Skåne University Hospital, Lund, Sweden
| | - Lennart Hansson
- Division of Respiratory Medicine and Allergology, Department of Clinical Sciences, Lund University, Skåne University Hospital, Lund, Sweden
| | - Göran Dellgren
- Department of Cardiothoracic Surgery and Transplant Institute, Sahlgrenska University Hospital, Gothenburg, Sweden
| | - Michael Perch
- Department of Cardiology, Section for Lung Transplantation, Copenhagen University Hospital, Rigshospitalet, Copenhagen, Denmark
| | - Odd Geiran
- Institute of Clinical Medicine, Faculty of Medicine, University of Oslo, Oslo, Norway; Department of Cardiothoracic Surgery, Oslo University Hospital Rikshospitalet, Oslo, Norway
| | - Arnt E Fiane
- Institute of Clinical Medicine, Faculty of Medicine, University of Oslo, Oslo, Norway; Department of Cardiothoracic Surgery, Oslo University Hospital Rikshospitalet, Oslo, Norway
| | - Martin Iversen
- Department of Cardiology, Section for Lung Transplantation, Copenhagen University Hospital, Rigshospitalet, Copenhagen, Denmark; Department of Clinical Medicine, University of Copenhagen, Copenhagen, Denmark
| | - Are Martin Holm
- Department of Respiratory Medicine, Oslo University Hospital, Rikshospitalet, Oslo, Norway; Institute of Clinical Medicine, Faculty of Medicine, University of Oslo, Oslo, Norway.
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Auråen H, Fiane A, Geiran O, Hämmäinen P, Perch M, Larsson H, Dellgren G, Durheim M, Holm A. A Nordic Multicenter Study on Size Mismatch in Bilateral Lung Transplantation. J Heart Lung Transplant 2018. [DOI: 10.1016/j.healun.2018.01.403] [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: 11/16/2022] Open
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6
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Holm AM, Auråen H, Durheim M, Fiane A, Geiran O, Schultz HHL, Iversen M. Survival and lung function in double lung transplant recipients with cystic fibrosis. Transplantation 2017. [DOI: 10.1183/1393003.congress-2017.pa1555] [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: 11/05/2022]
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7
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Fjeld NB, Fiane A, Geiran O, Lindberg H, Svennevig JL, Øvrum E. Gudmund Stenersen Semb. Tidsskriftet 2017; 137:17-0698. [DOI: 10.4045/tidsskr.17.0698] [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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Mishra V, Fiane AE, Winsnes BA, Geiran O, Sørensen G, Hagen TP, Gude E. Cardiac replacement therapies: outcomes and costs for heart transplantation versus circulatory assist. SCAND CARDIOVASC J 2016; 51:1-7. [PMID: 27248460 DOI: 10.1080/14017431.2016.1196826] [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] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/21/2022]
Abstract
OBJECTIVES Growing number of patients with terminal heart failure and a shortage of heart donors have increased use of short- and long-term mechanical circulatory support (MCS). Few studies have analyzed survival rates and healthcare costs for heart transplantation (HTx), with or without extracorporeal membrane oxygenation (ECMO) and left ventricular assist device (LVAD). DESIGN In a retrospective, single-center study, data were analyzed from patients listed for HTx who died on the waiting list (DWL, n = 12), underwent HTx (n = 206), had ECMO as bridge to HTx (ECHTx, n = 15), or received LVAD treatment, either isolated (LVAD, n = 19) or bridging to HTx (LVADHTx, n = 26) during 2005-2012. Survival and hospital costs were assessed. RESULTS One- and five-year survival rates were 96% and 83% for the LVADHTx group, 92% and 81% for HTx, 70% and 70% for ECHTx, 48% and 36% for LVAD and 0% for the DWL group (overall survival, p < 0.001). Total hospital cost at one year was $102,101 ± 202,604 for DWL, $151,685 ± 86,892 for HTx, $292,078 ± 101,915 for ECHTx, $427,337 ± 365,154 for LVAD, and $600,897 ± 198,109 for LVADHTx. CONCLUSION The LVADHTx and HTx groups showed excellent one- and five-year survival. The combined group of DWL and HTx patients had similar survival to the combined groups of MCS, but use of LVAD pre-transplant quadrupled the cost.
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Affiliation(s)
- Vinod Mishra
- a Department of Finance and Resource Management Unit , Oslo University Hospital , Oslo , Norway.,b Department of Health Management and Health Economics, Faculty of Medicine , University of Oslo , Oslo , Norway
| | - Arnt Eltvedt Fiane
- c Department of Cardiothoracic Surgery , Oslo University Hospital , Oslo , Norway.,d Faculty of Medicine , Institute of Clinical Medicine, University of Oslo , Oslo , Norway
| | - Benny Adam Winsnes
- a Department of Finance and Resource Management Unit , Oslo University Hospital , Oslo , Norway
| | - Odd Geiran
- c Department of Cardiothoracic Surgery , Oslo University Hospital , Oslo , Norway.,d Faculty of Medicine , Institute of Clinical Medicine, University of Oslo , Oslo , Norway
| | - Gro Sørensen
- c Department of Cardiothoracic Surgery , Oslo University Hospital , Oslo , Norway
| | - Terje Per Hagen
- b Department of Health Management and Health Economics, Faculty of Medicine , University of Oslo , Oslo , Norway
| | - Einar Gude
- e Department of Cardiology , Oslo University Hospital , Oslo , Norway
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Auråen H, Fiane A, Geiran O, Lyngstadaas V, Christen U, Leuckfeld I, Hans Henrik S, Iversen M, Andreas E, Holm A. Outcome in Age-Mismatched Lung Transplant Recipients. J Heart Lung Transplant 2016. [DOI: 10.1016/j.healun.2016.01.084] [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: 10/22/2022] Open
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10
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Tjeldhorn L, Amundsen SS, Barøy T, Rand-Hendriksen S, Geiran O, Frengen E, Paus B. Qualitative and quantitative analysis of FBN1 mRNA from 16 patients with Marfan Syndrome. BMC Med Genet 2015; 16:113. [PMID: 26684006 PMCID: PMC4683784 DOI: 10.1186/s12881-015-0260-4] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 08/31/2015] [Accepted: 12/10/2015] [Indexed: 11/17/2022]
Abstract
Background Pathogenic mutations in FBN1, encoding the glycoprotein, fibrillin-1, cause Marfan syndrome (MFS) and related connective tissue disorders. In the present study, qualitative and quantitative effects of 16 mutations, identified in FBN1 in MFS patients with systematically described phenotypes, were investigated in vitro. Methods Qualitative analysis was performed with reverse transcription-PCR (RT-PCR) and gel electrophoresis, and quantitative analysis to determine the FBN1 mRNA levels in fibroblasts from the 16 patients with MFS was performed with real-time PCR. Results Qualitative analysis documented that the mutations c.4817-2delA and c.A4925G led to aberrant FBN1 mRNA splicing leading to in frame deletion of exon 39 and in exon 39, respectively. No difference in the mean FBN1 mRNA level was observed between the entire group of cases and controls, nor between the group of patients with missense mutations and controls. The mean expression levels associated with premature termination codon (PTC) and splice site mutations were significantly lower than the levels in patients with missense mutations. A high level of FBN1 mRNA in the patient with the missense mutation c.G2447T did not segregate with the mutation in three of his first degree relatives. No association was indicated between the FBN1 transcript level and specific phenotypic manifestations. Conclusions Abnormal FBN1 transcripts were indicated in fibroblasts from patients with the splice site mutation c.4817-2delA and the missense mutation c.A4925G. While the mean FBN1 mRNA expression level in fibroblasts from patients with splice site and PTC mutations were lower than the mean level in patients with missense mutations and controls, inter-individual variability was high. The observation that high level of FBN1 mRNA in the patient with the missense mutation c.G2447T did not segregate with the mutation in the family suggests that variable expression of the normal FBN1 allele may contribute to explain the variability in FBN1 mRNA level. Electronic supplementary material The online version of this article (doi:10.1186/s12881-015-0260-4) contains supplementary material, which is available to authorized users.
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Affiliation(s)
- Lena Tjeldhorn
- Department of Medical Genetics, Oslo University Hospital, Box 4950, 0424, Oslo, Norway.
| | - Silja Svanstrøm Amundsen
- Department of Medical Genetics, Oslo University Hospital, Box 4950, 0424, Oslo, Norway. .,Institute of Clinical Medicine, Faculty of Medicine, University of Oslo, Oslo, Norway.
| | - Tuva Barøy
- Department of Medical Genetics, Oslo University Hospital, Box 4950, 0424, Oslo, Norway. .,Institute of Clinical Medicine, Faculty of Medicine, University of Oslo, Oslo, Norway.
| | - Svend Rand-Hendriksen
- TRS National Resource Centre for Rare Disorders, Sunnaas Rehabilitation Hospital, 1450 Nesoddtangen, Norway. .,Institute of Clinical Medicine, Faculty of Medicine, University of Oslo, Oslo, Norway.
| | - Odd Geiran
- Department of Cardiothoracic Surgery, Oslo University Hospital, Box 4950, 0424 Oslo, Norway. .,Institute of Clinical Medicine, Faculty of Medicine, University of Oslo, Oslo, Norway.
| | - Eirik Frengen
- Department of Medical Genetics, Oslo University Hospital, Box 4950, 0424, Oslo, Norway. .,Institute of Clinical Medicine, Faculty of Medicine, University of Oslo, Oslo, Norway.
| | - Benedicte Paus
- Department of Medical Genetics, Oslo University Hospital, Box 4950, 0424, Oslo, Norway. .,Institute of Clinical Medicine, Faculty of Medicine, University of Oslo, Oslo, Norway.
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11
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Fosshaug LE, Dahl CP, Risnes I, Bohov P, Berge RK, Nymo S, Geiran O, Yndestad A, Gullestad L, Aukrust P, Vinge LE, Øie E. Altered Levels of Fatty Acids and Inflammatory and Metabolic Mediators in Epicardial Adipose Tissue in Patients With Systolic Heart Failure. J Card Fail 2015; 21:916-23. [PMID: 26231517 DOI: 10.1016/j.cardfail.2015.07.014] [Citation(s) in RCA: 13] [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] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/17/2014] [Revised: 05/26/2015] [Accepted: 07/14/2015] [Indexed: 01/14/2023]
Abstract
BACKGROUND Adipose tissue has endocrine properties, secreting a wide range of mediators into the circulation, including factors involved in cardiovascular disease. However, little is known about the potential role of adipose tissue in heart failure (HF), and the aim of this study was to investigate epicardial (EAT) and subcutaneous (SAT) adipose tissue in HF patients. METHODS AND RESULTS Thirty patients with systolic HF and 30 patients with normal systolic function undergoing thoracic surgery were included in the study. Plasma was sampled and examined with the use of enzyme-linked immunosorbent assays, whereas SAT and EAT biopsies were collected and examined by means of reverse-transcription polymerase chain reaction and gas chromatography. Significantly higher expressions of mRNA encoding interleukin-6, adrenomedullin, peroxisome proliferator-activated receptor α, and fatty acid (FA)-binding protein 3, as well as higher levels of monounsaturated FA and palmitoleic acid, were seen in the EAT of HF patients, whereas the levels of docosahexaenoic acid were lower. Palmitoleic acid levels in EAT were correlated with 2 parameters of cardiac remodeling: increasing left ventricular end-diastolic diameter and N-terminal pro-B-type natriuretic peptide. CONCLUSIONS Our results demonstrate adipose tissue depot-specific alterations of synthesis of FA and inflammatory and metabolic mediators in systolic HF patients. EAT may be a source of increased circulatory and myocardial levels of these mediators through endocrine actions.
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Affiliation(s)
- Linn E Fosshaug
- Department of Internal Medicine, Diakonhjemmet Hospital, Oslo, Norway; Research Institute of Internal Medicine, Oslo University Hospital Rikshospitalet, Oslo, Norway; Center for Heart Failure Research, University of Oslo, Oslo, Norway; Faculty of Medicine, University of Oslo, Oslo, Norway.
| | - Christen P Dahl
- Research Institute of Internal Medicine, Oslo University Hospital Rikshospitalet, Oslo, Norway; Center for Heart Failure Research, University of Oslo, Oslo, Norway; Faculty of Medicine, University of Oslo, Oslo, Norway; Department of Cardiology, Oslo University Hospital Rikshospitalet, Oslo, Norway; K. G. Jebsen Inflammatory Research Center, University of Oslo, Oslo, Norway
| | - Ivar Risnes
- Department of Thoracic and Cardiovascular Surgery, Oslo University Hospital Rikshospitalet, Oslo, Norway
| | - Pavol Bohov
- Department of Clinical Science, University of Bergen, Bergen, Norway
| | - Rolf K Berge
- Department of Clinical Science, University of Bergen, Bergen, Norway; Department of Heart Disease, Haukeland University Hospital, Bergen, Norway
| | - Ståle Nymo
- Research Institute of Internal Medicine, Oslo University Hospital Rikshospitalet, Oslo, Norway; Center for Heart Failure Research, University of Oslo, Oslo, Norway; Faculty of Medicine, University of Oslo, Oslo, Norway
| | - Odd Geiran
- K. G. Jebsen Inflammatory Research Center, University of Oslo, Oslo, Norway; Department of Thoracic and Cardiovascular Surgery, Oslo University Hospital Rikshospitalet, Oslo, Norway
| | - Arne Yndestad
- Research Institute of Internal Medicine, Oslo University Hospital Rikshospitalet, Oslo, Norway; Center for Heart Failure Research, University of Oslo, Oslo, Norway; Faculty of Medicine, University of Oslo, Oslo, Norway; K. G. Jebsen Inflammatory Research Center, University of Oslo, Oslo, Norway
| | - Lars Gullestad
- Center for Heart Failure Research, University of Oslo, Oslo, Norway; Faculty of Medicine, University of Oslo, Oslo, Norway; Department of Cardiology, Oslo University Hospital Rikshospitalet, Oslo, Norway
| | - Pål Aukrust
- Research Institute of Internal Medicine, Oslo University Hospital Rikshospitalet, Oslo, Norway; Faculty of Medicine, University of Oslo, Oslo, Norway; K. G. Jebsen Inflammatory Research Center, University of Oslo, Oslo, Norway; Section of Clinical Immunology and Infectious Diseases, Oslo University Hospital Rikshospitalet, Oslo, Norway
| | - Leif E Vinge
- Department of Internal Medicine, Diakonhjemmet Hospital, Oslo, Norway; Research Institute of Internal Medicine, Oslo University Hospital Rikshospitalet, Oslo, Norway; Center for Heart Failure Research, University of Oslo, Oslo, Norway; Department of Cardiology, Oslo University Hospital Rikshospitalet, Oslo, Norway
| | - Erik Øie
- Department of Internal Medicine, Diakonhjemmet Hospital, Oslo, Norway; Research Institute of Internal Medicine, Oslo University Hospital Rikshospitalet, Oslo, Norway; Center for Heart Failure Research, University of Oslo, Oslo, Norway; Department of Cardiology, Oslo University Hospital Rikshospitalet, Oslo, Norway
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12
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Morken NH, Diaz-Garcia C, Reisaeter AV, Foss A, Leivestad T, Geiran O, Hervás D, Brännström M. Obstetric and neonatal outcome of pregnancies fathered by males on immunosuppression after solid organ transplantation. Am J Transplant 2015; 15:1666-73. [PMID: 25868657 DOI: 10.1111/ajt.13159] [Citation(s) in RCA: 27] [Impact Index Per Article: 3.0] [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: 03/18/2014] [Revised: 12/03/2014] [Accepted: 12/14/2014] [Indexed: 01/25/2023]
Abstract
Immunosuppressive drugs may influence spermatogenesis, but little is known about outcome of pregnancies fathered by transplanted males. We estimated risk of adverse outcomes in pregnancies (with data after the first trimester) fathered by males that had undergone organ transplantation and were treated with immunosuppression. A population-based study, linking data from the Norwegian transplant registry and the Medical Birth Registry of Norway during 1967-2009 was designed. All Norwegian men undergoing solid organ transplantation were included. Odds ratios for major malformations, preeclampsia, preterm delivery (<37 weeks) and small-for-gestational-age were obtained using logistic regression. A total of 2463 transplanted males, fathering babies of 4614 deliveries before and 474 deliveries after transplantation were identified. The risk of preeclampsia was increased (AOR: 7.4, 95% CI: 1.1-51.4,) after transplantation compared to prior to transplantation. No increased risk was found for congenital malformations or other outcomes when compared with pregnancies before transplantation or with the general population (2 511 506 births). Our results indicate an increased risk of preeclampsia mediated through the transplanted and immunosuppressed father. Importantly, no increased risk was found for other adverse obstetric outcomes or malformations, which may reassure male transplant recipients planning to father children.
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Affiliation(s)
- N-H Morken
- Department of Clinical Sciences, University of Bergen, Norway.,Department of Global Public Health and Primary Care, University of Bergen, Norway.,Department of Obstetrics and Gynecology, Haukeland University Hospital, Bergen, Norway
| | - C Diaz-Garcia
- Department of Gynecology and Obstetrics, La Fe University Hospital and Instituto de Investigación Sanitaria La Fe, University of Valencia, Spain
| | | | - A Foss
- Department of Transplantation Medicine, Rikshospitalet, Oslo University Hospital, Norway
| | | | - O Geiran
- Institute of Clinical Medicine, University of Oslo, Norway.,Department of Cardio-Thoracic Surgery, Rikshospitalet, Oslo University Hospital, Norway
| | - D Hervás
- Biostatistics Unit, Instituto de Investigación Sanitaria La Fe, University of Valencia, Spain
| | - M Brännström
- Department of Obstetrics & Gynecology, Sahlgrenska Academy, University of Gothenburg, Sweden
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Hommerstad A, Hall KS, Bjerkehagen B, Eskild TH, Geiran O, Øie E. [A woman in her 50s with heavy breathing and hypotension]. Tidsskr Nor Laegeforen 2014; 134:1758-61. [PMID: 25273250 DOI: 10.4045/tidsskr.13.1110] [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] [Subscribe] [Scholar Register] [Indexed: 11/02/2022] Open
Affiliation(s)
- Anders Hommerstad
- Medisinsk avdeling Diakonhjemmet Sykehus * Nåværende adresse: Medisinsk avdeling Oslo universitetssykehus, Ullevål
| | | | | | | | - Odd Geiran
- Thoraxkirurgisk avdeling, Oslo universitetssykehus, Rikshospitalet
| | - Erik Øie
- Medisinsk avdeling, Diakonhjemmet Sykehus
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14
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Auråen H, Fiane A, Bjørtuft Ø, Christen U, Geiran O, Kongerud J, Holm A. Effects of Organ Donor Factors on Lung Transplant Recipient Outcome at One-Year Follow-Up. J Heart Lung Transplant 2014. [DOI: 10.1016/j.healun.2014.01.714] [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: 10/25/2022] Open
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15
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Dellgren G, Geiran O, Lemström K, Gustafsson F, Eiskjaer H, Koul B, Hagerman I, Selimovic N. Three decades of heart transplantation in Scandinavia: long-term follow-up. Eur J Heart Fail 2014; 15:308-15. [DOI: 10.1093/eurjhf/hfs160] [Citation(s) in RCA: 32] [Impact Index Per Article: 3.2] [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)
- Göran Dellgren
- Transplant Institute and Department of Cardiothoracic Surgery; Sahlgrenska University Hospital, University of Gothenburg; SE-413 45 Gothenburg Sweden
| | - Odd Geiran
- Department of Cardiothoracic Surgery; Oslo University Hospital, University of Oslo; Oslo Norway
| | - Karl Lemström
- Department of Cardiothoracic Surgery; Helsinki University Hospital; Helsinki Finland
| | - Finn Gustafsson
- Department of Cardiology; Rigshospitalet; Copenhagen Denmark
| | - Hans Eiskjaer
- Department of Cardiology; Århus University Hospital; Århus Denmark
| | - Bansi Koul
- Department of Cardiothoracic Surgery; Lund University Hospital; Lund Sweden
| | - Inger Hagerman
- Department of Cardiology; Karolinska University Hospital; Stockholm Sweden
| | - Nedim Selimovic
- Department of Cardiology; Sahlgrenska University Hospital; Gothenburg Sweden
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Andreassen AK, Ragnarsson A, Gude E, Geiran O, Andersen R. Balloon pulmonary angioplasty in patients with inoperable chronic thromboembolic pulmonary hypertension. Heart 2013; 99:1415-20. [PMID: 23846611 DOI: 10.1136/heartjnl-2012-303549] [Citation(s) in RCA: 184] [Impact Index Per Article: 16.7] [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: 12/21/2022] Open
Abstract
OBJECTIVE To examine the effect of balloon pulmonary angioplasty (BPA) on chronic thromboembolic pulmonary hypertension (CTEPH) in patients with inoperable disease or persistent pulmonary hypertension after pulmonary endarterectomy. DESIGN Observational cohort study. SETTING Referred patients with inoperable or persistent CTEPH. PATIENTS Twenty consecutive CTEPH patients (10 females), aged 60±10 years. INTERVENTIONS BPA MAIN OUTCOME MEASURES Right heart catheterisation, functional capacity (cardiopulmonary exercise testing (CPET) and NYHA class) and blood sampled biomarkers N-terminal pro-brain natriuretic peptide (NT-proBNP) and troponin T examined at the time of diagnosis and repeated in all patients 3 months after the last BPA. RESULTS Seventy-three catheterisations were performed with 18.6±6.1 BPAs per patient on segmental and subsegmental arteries. Two deaths occurred following the first BPA, with an overall 10% periprocedural death rate. Reperfusion oedema complicated seven procedures. Comparisons before and after BPA showed significant haemodynamic improvements, including decreased mean pulmonary artery pressure (mPAP) (45±11 mm Hg vs 33±10 mm Hg; p<0.001) and increased cardiac output (4.9±1.6 L/min vs 5.4±1.9 L/min; p=0.011). Reduced right ventricular strain was indicated by significantly lower plasma levels of NT-proBNP and troponin T. Significant improvement in functional capacity was evident as assessed by NYHA class (3.0±0.5 vs 2.0±0.5; p<0.001) and CPET (13.6±5.6 mL/kg/min vs 17.0±6.5 mL/kg/min; p<0.001). Seventeen patients (85%) were alive after 51±30 months of follow-up. CONCLUSIONS BPA may offer an alternative form of treatment in selected CTEPH patients. While prognostic markers such as haemodynamics, functional capacity and biomarkers improve, significant periprocedural complications must be recognised. Randomised trials are warranted.
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Affiliation(s)
- Arne K Andreassen
- Department of Cardiology, Oslo University Hospital Rikshospitalet, Oslo, Norway.
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Auråen H, Mollnes TE, Bjørtuft Ø, Bakkan PA, Geiran O, Kongerud J, Fiane A, Holm AM. Multiorgan procurement increases systemic inflammation in brain dead donors. Clin Transplant 2013; 27:613-8. [DOI: 10.1111/ctr.12175] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 05/21/2013] [Indexed: 12/15/2022]
Affiliation(s)
| | | | - Øystein Bjørtuft
- Department of Respiratory Medicine; Oslo University Hospital Rikshospitalet; Oslo; Norway
| | - Per A. Bakkan
- Department of Transplantation; Oslo University Hospital Rikshospitalet; Oslo; Norway
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Rustad LA, Nytroen K, Andreassen A, Geiran O, Endresen K, Gullestad L, Aakhus S, Amundsen BH. Heart transplant systolic and diastolic function is impaired by prolonged pretransplant graft ischaemic time and high donor age: an echocardiographic study. Eur J Cardiothorac Surg 2013; 44:e97-104. [DOI: 10.1093/ejcts/ezt233] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
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Mishra V, Fiane AE, Geiran O, Sørensen G, Khushi I, Hagen TP. Hospital costs fell as numbers of LVADs were increasing: experiences from Oslo University Hospital. J Cardiothorac Surg 2012; 7:76. [PMID: 22925716 PMCID: PMC3515474 DOI: 10.1186/1749-8090-7-76] [Citation(s) in RCA: 10] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/20/2012] [Accepted: 08/13/2012] [Indexed: 11/29/2022] Open
Abstract
Background The current study was undertaken to examine total hospital costs per patient of a consecutive implantation series of two 3rd generation Left Ventricle Assist Devices (LVAD). Further we analyzed if increased clinical experience would reduce total hospital costs and the gap between costs and the diagnosis related grouped (DRG)-reimbursement. Method Cost data of 20 LVAD implantations (VentrAssist™) from 2005-2009 (period 1) were analyzed together with costs from nine patients using another LVAD (HeartWare™) from 2009-June 2011 (period 2). For each patient, total costs were calculated for three phases - the pre-LVAD implantation phase, the LVAD implantation phase and the post LVAD implant phase. Patient specific costs were obtained prospectively from patient records and included personnel resources, medication, blood products, blood chemistry and microbiology, imaging and procedure costs including operating room costs. Overhead costs were registered retrospectively and allocated to the specific patient by predefined allocation keys. Finally, patient specific costs and overhead costs were aggregated into total hospital costs for each patient. All costs were calculated in 2011-prices. We used regression analyses to analyze cost variations over time and between the different devices. Results The average total hospital cost per patient for the pre-LVAD, LVAD and post-LVAD for period 1 was $ 585, 513 (range 132, 640- 1 247, 299), and the corresponding DRG- reimbursement (2009) was $ 143, 192 . The mean LOS was 54 days (range 12- 127). For period 2 the total hospital cost per patient was $ 413, 185 (range 314, 540- 622, 664) and the corresponding DRG- reimbursement (2010) was $ 136, 963. The mean LOS was 49 days (range 31- 93). The estimates from the regression analysis showed that the total hospital costs, excluding device costs, per patient were falling as the number of treated patients increased. The estimate from the trend variable was -14, 096 US$ (CI -3, 842 to -24, 349, p < 0.01). Conclusion There were significant reductions in total hospital costs per patient as the numbers of patients were increasing. This can possibly be explained by a learning effect including better logistics, selection and management of patients.
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Affiliation(s)
- Vinod Mishra
- Department of Finance and Resource Management Unit, Oslo University Hospital, Oslo, Norway.
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Auråen H, Mollnes T, Kongerud J, Bjørtuft Ø, Geiran O, Fiane A, Holm A. 637 Procedure for Solid Organ Recovery Leads to Systemic Inflammatory Response. J Heart Lung Transplant 2012. [DOI: 10.1016/j.healun.2012.01.651] [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: 10/28/2022] Open
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Gjersvik P, Hansen S, Møller B, Leivestad T, Geiran O, Simonsen S, Pfeffer P, Fauchald P. Are heart transplant recipients more likely to develop skin cancer than kidney transplant recipients? Transpl Int 2011. [DOI: 10.1111/j.1432-2277.2000.tb02065.x] [Citation(s) in RCA: 20] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
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Åbyholm F, Støren G, Geiran O. Spontaneous Pneumothorax. Acta Radiol 2010. [DOI: 10.3109/00016924809133048] [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: 11/13/2022]
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Arora S, Gunther A, Wennerblom B, Ueland T, Andreassen AK, Gude E, Endresen K, Geiran O, Wilhelmsen N, Andersen R, Aukrust P, Gullestad L. Systemic markers of inflammation are associated with cardiac allograft vasculopathy and an increased intimal inflammatory component. Am J Transplant 2010; 10:1428-36. [PMID: 20486911 DOI: 10.1111/j.1600-6143.2010.03118.x] [Citation(s) in RCA: 17] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/25/2023]
Abstract
We evaluated an extensive profile of clinical variables and immune markers to assess the inflammatory milieu associated with cardiac allograft vasculopathy (CAV) assessed by intravascular ultrasound (IVUS) and virtual histology (VH). In total, 101 heart transplant (HTx) recipients were included and underwent IVUS/VH examination and measurement of plasma C-reactive protein (CRP), soluble tumor necrosis factor receptor-1, interleukin-6, osteoprotegerin, soluble gp130, von Willebrand factor, vascular cell adhesion molecule-1 (VCAM-1) and neopterin. Mean Maximal Intimal Thickness (MIT) was 0.61 +/- 0.19 mm and mean fibrotic, fibrofatty, dense calcified and necrotic core components were 55 +/- 15, 14 +/- 10, 15 +/- 13 and 17 +/- 9%, respectively. In multivariate analysis, CRP > 1.5 mg/L (OR 4.6, p < 0.01), VCAM-1 > 391 ng/mL (adjusted OR 3.2, p = 0.04) and neopterin > 7.7 nmol/L (OR 3.8, p = 0.02) were independently associated with MIT > 0.5 mm. Similarly, CRP > 1.5 mg/L (OR 3.7, p < 0.01) and VCAM-1 > 391 (OR 2.7, p = 0.04) were independently associated with an increased intimal inflammatory component (dense calcified/necrotic core component > 30%). Advanced CAV is associated with elevated CRP, VCAM-1 and neopterin and the two former biomarkers are also associated with an increased intimal inflammatory component. Forthcoming studies should clarify if routine measurements of these markers can accurately identify HTx recipients at risk of developing advanced CAV and vulnerable lesions.
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Affiliation(s)
- S Arora
- Department of Cardiology, Oslo University Hospital, Rikshospitalet, Oslo, Norway.
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Leuckfeld I, Olsen I, Geiran O, Bjørtuft Ø, Paster BJ. Subgingival microflora in chronic obstructive pulmonary disease. Microbial Ecology in Health and Disease 2009. [DOI: 10.3109/08910600903194412] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 01/08/2023]
Affiliation(s)
- Inga Leuckfeld
- Institute of Oral Biology, Faculty of Dentistry, University of Oslo
- Division of Cardiac and Respiratory Medicine and Surgery, Oslo University Hospital-Rikshospitalet
| | - Ingar Olsen
- Institute of Oral Biology, Faculty of Dentistry, University of Oslo
| | - Odd Geiran
- Division of Cardiac and Respiratory Medicine and Surgery, Oslo University Hospital-Rikshospitalet
- Faculty Division Rikshospitalet, University of Oslo, Oslo, Norway
| | - Øystein Bjørtuft
- Division of Cardiac and Respiratory Medicine and Surgery, Oslo University Hospital-Rikshospitalet
- Faculty Division Rikshospitalet, University of Oslo, Oslo, Norway
| | - Bruce J. Paster
- Department of Molecular Genetics, Forsyth Institute
- Department of Oral Medicine, Infection and Immunity, Harvard School of Dental Medicine, Boston, MA, USA
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Leuckfeld I, Olsen I, Geiran O, Bjørtuft Ø, Paster BJ. Subgingival microflora in chronic obstructive pulmonary disease. Microbial Ecology in Health & Disease 2009. [DOI: 10.3402/mehd.v21i3-4.7498] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/14/2022]
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Rand-Hendriksen S, Lundby R, Tjeldhorn L, Andersen K, Offstad J, Semb SO, Smith HJ, Paus B, Geiran O. Erratum: Prevalence data on all Ghent features in a cross-sectional study of 87 adults with proven Marfan syndrome. Eur J Hum Genet 2009. [DOI: 10.1038/ejhg.2009.65] [Citation(s) in RCA: 2] [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: 11/09/2022] Open
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Arora S, Aukrust P, Ueland T, Broch K, Simonsen S, Gude E, Fiane AE, Geiran O, Wergeland R, Andreassen AK, Gullestad L. Elevated serum uric acid levels following heart transplantation predict all-cause and cardiac mortality. Eur J Heart Fail 2009; 11:1005-13. [PMID: 19737803 DOI: 10.1093/eurjhf/hfp115] [Citation(s) in RCA: 10] [Impact Index Per Article: 0.7] [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: 01/30/2023] Open
Abstract
AIMS We evaluated the relationship between elevated serum uric acid (SUA) and mortality as well as cardiac allograft vasculopathy (CAV) among 184 heart transplant (HTx) recipients. We also measured inflammatory, neurohormonal, and oxidative stress markers to explore pathophysiological mechanisms. METHODS AND RESULTS There were 28 (15%) deaths, patients with SUA > or = 502 micromol/L (upper quartile) at 1 year post-HTx had an increased risk of total mortality (adjusted HR 2.21, P = 0.03) and cardiac mortality (adjusted HR 4.38, P = 0.03). Elevated SUA was a significant risk factor for development of moderate/severe angiographic CAV (adjusted HR 4.79, P = 0.01). A smaller decline in SUA (<97 micromol/L) during the first year post-HTx was also associated with an increased risk of mortality (P = 0.02). Patients with elevated SUA had significantly higher levels of high-sensitivity C-reactive protein (P = 0.008) and N-terminal probrain natriuretic peptide (P = 0.022), but there was no significant difference in oxidative stress parameters. CONCLUSION Elevated SUA at 1 year post-HTx, or a modest rather than a marked decline in SUA levels during the first year post-HTx, is associated with an increased risk of mortality. Although the pathophysiological mechanism is unclear, our data indicate a potential relationship between SUA and inflammation which should be explored further.
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Affiliation(s)
- Satish Arora
- Department of Cardiology, Rikshospitalet Medical Centre, N-0027 Oslo, Norway.
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Arora S, Aukrust P, Andreassen A, Simonsen S, Gude E, Grov I, Geiran O, Fiane A, Gullestad L. The prognostic importance of modifiable risk factors after heart transplantation. Am Heart J 2009; 158:431-6. [PMID: 19699867 DOI: 10.1016/j.ahj.2009.05.036] [Citation(s) in RCA: 27] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/15/2008] [Accepted: 05/25/2009] [Indexed: 11/25/2022]
Abstract
BACKGROUND It is well established that the treatment of modifiable risk factors can reduce cardiovascular mortality in the general population. However, there is limited data evaluating the importance of modifiable risk factors for survival following heart transplantation (HTx). Hence, we evaluated the prognostic importance of smoking, obesity, hyperglycemia and hyperlipidemia at 1 year after HTx for all-cause and cardiac mortality. METHODS We evaluated 381 patients attending their first annual visit post-HTx. Data regarding modifiable risk factors was collected together with other clinical variables. Median follow-up time was 7.4 years. RESULTS In total, there were 122 (32%) deaths and smoking and elevated total cholesterol were independent risk factors for all-cause mortality (adjusted HR 1.6 [P = .02] and 1.8 [P = .003], respectively). A significantly higher incidence of cardiac death was noted amongst smokers and patients with elevated total cholesterol. Elevated body mass index and hemoglobin A(1c) did not affect prognosis and elevated total cholesterol was not a risk factor once statin therapy commenced at the time of HTx was instituted as protocol. CONCLUSIONS Smoking is a risk factor for all-cause and cardiac mortality, but elevated total cholesterol is a risk factor only in the absence of statin therapy being commenced at the time of HTx.
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Affiliation(s)
| | - Odd Geiran
- Department of Thoracic and Cardiovascular Surgery, National Hospital, Oslo, Norway
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Thiara APS, Høyland V, Norum H, Aasmundstad TA, Karlsen HM, Fiane AE, Geiran O. Extracorporeal membrane oxygenation support for 59 days without changing the ECMO circuit: a case of Legionella pneumonia. Perfusion 2009; 24:45-7. [DOI: 10.1177/0267659109106297] [Citation(s) in RCA: 18] [Impact Index Per Article: 1.2] [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
We report the successful use of veno-venous extracorporeal membrane oxygenation (ECMO) in a 53-year-old patient with Legionella pneumonia and acute respiratory distress syndrome (ARDS) with severe barotraumas. The patient was supported for 59 days without any changes in the ECMO circuit. This is probably the longest support ever reported using the same oxygenator.
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Affiliation(s)
- APS Thiara
- Department of Thoracic and Cardiovascular Surgery, Oslo University Hospital, Oslo, Norway
| | - V Høyland
- Department of Thoracic and Cardiovascular Surgery, Oslo University Hospital, Oslo, Norway
| | - H Norum
- Department Anaesthesia and Intensive Care, Oslo University Hospital, Oslo, Norway
| | - TA Aasmundstad
- Department Anaesthesia and Intensive Care, Oslo University Hospital, Oslo, Norway
| | - HM Karlsen
- Department of Thoracic and Cardiovascular Surgery, Oslo University Hospital, Oslo, Norway
| | - AE Fiane
- Faculty Division Rikshospitalet, University of Oslo, Oslo, Norway
| | - O Geiran
- Faculty Division Rikshospitalet, University of Oslo, Oslo, Norway
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Lundby R, Rand-Hendriksen S, Hald JK, Lilleås FG, Pripp AH, Skaar S, Paus B, Geiran O, Smith HJ. Dural ectasia in Marfan syndrome: a case control study. AJNR Am J Neuroradiol 2009; 30:1534-40. [PMID: 19461064 DOI: 10.3174/ajnr.a1620] [Citation(s) in RCA: 40] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/07/2022]
Abstract
BACKGROUND AND PURPOSE Dural ectasia (DE) is one of the major criteria of Marfan syndrome (MFS). Our aim was to establish the prevalence of DE in an adult population fulfilling the Ghent criteria for MFS and to assess definitions of DE. MATERIALS AND METHODS One hundred five adults with suspected MFS were included. MR imaging at 1.5T was performed unless contraindicated; then CT was obtained. Lumbosacral anteroposterior vertebral body diameters (VBD) and dural sac diameters (DSD) were measured. Dural sac ratios (DSR = DSD/VBD) at levels L3 through S1 were calculated. Anterior meningoceles, herniations of nerve root sleeves, and scalloping were characterized. One hundred one sex- and age-matched patients were included as controls. RESULTS We identified 3 patient groups: 1) fulfilling Ghent criteria independent of DE (n = 73), 2); fulfilling Ghent criteria dependent on DE (n = 14), and 3); and suspected MFS, not fulfilling Ghent criteria (n = 18). DE was found in 86% of group 1. At levels L4-S1, mean DSRs were significantly higher in group 1 than in group 3 and controls (P < .001). Herniations of the nerve root sleeves were present in 73% in group 1 versus 1% in controls. Anterior meningoceles were found in 37% and 14% in groups 1 and 2, respectively, but not in group 3 or controls. CONCLUSIONS The diagnosis of DE on MR imaging or CT should be based on the presence of at least 1 of the following criteria: anterior meningoceles or nerve root sleeve herniation, DSD at S1 or below larger than DSD at L4, and DSR at S1 >0.59.
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Affiliation(s)
- R Lundby
- Department of Radiology, Rikshospitalet, Sognsvannsveien 20, Oslo, Norway.
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Haerem JW, Siebke JC, Ulstrup J, Geiran O, Helle I. HBsAG transmission from a cardiac surgeon incubating hepatitis B resulting in chronic antigenemia in four patients. Acta Med Scand 2009; 210:389-92. [PMID: 7336996 DOI: 10.1111/j.0954-6820.1981.tb09836.x] [Citation(s) in RCA: 21] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 01/24/2023]
Abstract
A cardiac surgeon experienced an uneventful course of acute hepatitis B. HBsAg was transmitted to 11 persons: 5 of 72 patients operated on during his incubation of hepatitis B, three relatives of the infected patients, one laboratory technician, and two of the surgeon's family members. Two years later, 4 of the 5 operated patients are still infectious, whereas the 7 non-operated persons have cleared their antigenemia. This study demonstrates the significant risk of hepatitis B transmission from a cardiac surgeon incubating the disease. Furthermore, it indicates that patients who have been infected during open heart surgery and cardiopulmonary bypass run a particular risk of becoming chronic HBs antigen carriers.
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Rand-Hendriksen S, Lundby R, Tjeldhorn L, Andersen K, Offstad J, Semb SO, Smith HJ, Paus B, Geiran O. Prevalence data on all Ghent features in a cross-sectional study of 87 adults with proven Marfan syndrome. Eur J Hum Genet 2009; 17:1222-30. [PMID: 19293838 DOI: 10.1038/ejhg.2009.30] [Citation(s) in RCA: 32] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/19/2023] Open
Abstract
The prevalence of each single feature in the Ghent criteria in patients with Marfan syndrome (MFS) is not known. To elucidate this, a cross-sectional study of 105 adults with presumed MFS was carried out. All patients were examined by the same group of investigators with standardized and complete assessment of all features in the Ghent criteria. Eighty-seven (83%) fulfilled the criteria in 56 different variants. The most prevalent major criterion in Ghent-positive persons was dural ectasia (91%), followed by major genetic criterion (89%) and ectopic lenses (62 %). In 14 persons (16%), the diagnosis was dependent on the dural findings. In all, 79% fulfilled both major dural and major genetic (positive family history and/or FBN1 mutation) criteria, suggesting that most patients with MFS might be identified by investigating these criteria. A history or finding of ascending aortic disease was present in 46 patients (53%). This low prevalence might partly reflect a high number of diagnosed patients encompassing the whole spectrum of the syndrome. The study confirms the need to examine for the complete set of features in the Ghent criteria to identify all patients with MFS. The majority of persons with MFS might be identified by the combined assessment of dura mater and family history, supplemented with DNA analysis in family-negative cases. The low prevalence of ascending aortic disease might indicate better future prospects in an adult population than those traditionally considered.
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Affiliation(s)
- Svend Rand-Hendriksen
- TRS National Resource Centre for Rare Disorders, Sunnaas Rehabilitation Hospital, Nesoddtangen, Norway.
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Arora S, Aukrust P, Gude E, Andreassen A, Grov I, Skaardal R, Ueland T, Geiran O, Gullestad L. 62: C-Reactive Protein, Vascular Cell Adhesion Molecule and Neopterin Are Markers of Advanced Cardiac Allograft Vasculopathy Determined by Intravascular Ultrasound. J Heart Lung Transplant 2009. [DOI: 10.1016/j.healun.2008.11.739] [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: 11/30/2022] Open
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Leuckfeld I, Olsen I, Geiran O, Bjørtuft Ø, Paster B. Subgingival microflora in chronic obstructive pulmonary disease. Microbial Ecol in Hlth & Disease 2009. [DOI: 10.1080/08910600903194412] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
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Abstract
OBJECTIVE The main objective of this study was to analyze direct hospital cost and to compare cost with existing DRG reimbursement for open repair of thoracic and thoraco-abdominal aortic disease. STUDY SAMPLE AND METHODOLOGY: Between January 2003 and September 2003, the cost of treatment for 24 surgical procedures on ascending aorta and arch, descending or thoraco-abdominal aortic disease were examined prospectively. Seven patients had urgent or emergency surgeries. Ten had sternotomies for disease of the ascending aorta and aortic arch; two had left thoracotomies and three thoraco-laparotomy incisions with procedures performed on x-corporeal circulation. Nine other patients had more distal thoraco-abdominal aortic operations with a clamp-and-sew technique. Micro-cost analysis was performed on each hospital stay, in addition overhead hospital costs were allocated to each procedure. RESULTS The patients were grouped by discharge diagnosis (ICD-10) and surgical procedure performed (NCSP) into Norwegian DRG code. Patient with surgery on ascending aorta & aortic arch were allocated to DRG 108 (n=9) or 483 (tracheostomy, n=1) while patient with surgery on descending or thoraco-abdominal aorta were allocated to DRG 108 (n=3), 110 (n=4), 111 (n=4) or 483 (tracheostomy, n=3). The mean EuroSCORE for patients with proximal aortic disease was 11 (5-18), and the length of stay was 5 days (range 3-8 days), spending 2 days (range 1-7 days) in thoracic intensive care unit. For patients with distal aortic disease the mean Euroscore was 7 (2-14), and the mean length of stay 10 days (range 4-23 days) with a mean 4 days (range 1-13 days) in intensive care unit. Eight patients developed medical problems requiring new surgical procedures or prolonged ICU stay. The average direct hospital cost for proximal aortic surgery was USD 15,877 (USD 1=NOK 7.5) while the respective 100% DRG reimbursement including one patient needing a tracheostomy, was 19 803 USD. For patients with distal aortic disease, average direct hospital cost was 23 005 USD and DRG reimbursement including patients needing a tracheostomy was 31543 USD. CONCLUSION Our results underscore previous findings that these patients are resource intensive. This study shows that Norwegian 100% DRG reimbursement did over-compensate observed total hospital costs in this cohort. Detailed analysis showed that this was due to the higher DRG reimbursement for patients needing prolonged ventilatory support. Thus the actual DRG reimbursement seems to be relevant to the tertiary hospital actual costs when these complicated patients are considered as a group. It remains however unclear whether this reimbursement is sufficient to support the scientific infrastructure for new knowledge and skills needed for the further refinement of treatment.
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Affiliation(s)
- Vinod Mishra
- Health Professional Support Department, Rikshospitalet Radiumhospitalet Medical Center, and Faculty Division Rikshospitalet, University of Oslo, Oslo, Norway.
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Arora S, Jenum P, Aukrust P, Rollag H, Andreassen A, Simonsen S, Gude E, Fiane A, Geiran O, Gullestad L. 349: Pretransplant Toxoplasma gondii Seropositivity amongst Heart Transplant Recipients Is Associated with an Increased Risk of All-Cause and Cardiac Mortality. J Heart Lung Transplant 2008. [DOI: 10.1016/j.healun.2007.11.359] [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: 11/28/2022] Open
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Arora S, Andreassen A, Simonsen S, Gude E, Fiane A, Geiran O, Gullestad L. 175: Traditional Modifiable Risk Factors: What Is Their Significance Following Heart Transplantation? J Heart Lung Transplant 2008. [DOI: 10.1016/j.healun.2007.11.182] [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: 10/22/2022] Open
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Leuckfeld I, Obregon-Whittle MV, Lund MB, Geiran O, Bjørtuft Ø, Olsen I. Severe chronic obstructive pulmonary disease: association with marginal bone loss in periodontitis. Respir Med 2008; 102:488-94. [PMID: 18191392 DOI: 10.1016/j.rmed.2007.12.001] [Citation(s) in RCA: 54] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/17/2007] [Revised: 11/30/2007] [Accepted: 12/04/2007] [Indexed: 11/19/2022]
Abstract
An association between chronic marginal periodontitis and chronic obstructive pulmonary disease (COPD) has been suggested. The aim of this study was to investigate whether chronic marginal periodontitis is more prevalent in very severe COPD than in other very severe respiratory diseases, and whether periodontitis in COPD is related to risk factors for periodontitis that are often present in COPD subjects. Orthopantomograms were collected from 130 patients with COPD and 50 patients with non-COPD evaluated for lung transplantation. Chronic marginal periodontitis was defined as a general marginal bone level > or = 4 mm. The prevalence of periodontitis was 44% in the COPD group vs. 7.3% in the non-COPD group. All oral measurements differed significantly between the groups. The difference in mean marginal bone level remained statistically significant when adjusting for age, gender and pack years smoked. In logistic regression analysis mean marginal bone level > or = 4 mm was identified as a factor significantly associated with severe COPD. This study demonstrates that chronic marginal periodontitis is common in patients with severe COPD. The high prevalence of periodontitis in COPD patients appears to be independent of possible risk factors for periodontitis such as age, pack years smoked, body mass index, use of corticosteroids and bone mineral density.
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Affiliation(s)
- I Leuckfeld
- Institute of Oral Biology, University of Oslo, Oslo, Norway.
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Sivertsen B, Relbo A, Gullestad L, Hellesvik M, Grov I, Andreassen A, Simonsen S, Geiran O, Havik OE. [Self-assessed health and psychological symptoms after heart transplantation]. Tidsskr Nor Laegeforen 2007; 127:3198-3201. [PMID: 18084359] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/25/2023] Open
Abstract
BACKGROUND The purpose of this study was to assess quality of life (QoL, self-reported health) and psychological adjustment in a sample of heart transplanted patients. MATERIAL AND METHODS The sample comprised 147 (117 men) Norwegian heart transplanted patients (operated 1983 - 1999). Data on QoL and psychological adjustment were collected during annual routine follow-up controls between 1998 and 2000. The Short Form 36 (SF-36), the Symptom Checklist 90-Revised (SCL-90-R), and Beck Depression Inventory (BDI) were used. RESULTS On average, heart transplant recipients reported significantly reduced QoL and increased levels of psychological symptoms compared to a normative population. Recently operated patients reported a generally good QoL compared to the norms, while there was a worsening after 3 years of both the patients' psychological symptoms and QoL, compared to patients who were transplanted less than 3 years ago. The clinical significance was underscored by the BDI; 30 % of the patients were classified as suffering from mild depression (BDI >/= 10) if transplanted more than 3 years ago, compared to 16 % in patients operated less than 3 years ago (p < .05). 62 % of the patients never returned to work and became/remained permanent disability pensioners. INTERPRETATION This study demonstrates that heart transplanted patients have a reduced QoL and psychological problems after the transplantation and this seems to worsen with time. Detection and early intervention of psychological symptoms may assist heart transplant survivors in their return to everyday life. The cross-sectional nature of the study makes it difficult to infer causality from these results.
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Affiliation(s)
- Børge Sivertsen
- Institutt for klinisk psykologi Universitetet i Bergen 5015 Bergen.
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42
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Arora S, Jenum PA, Aukrust P, Rollag H, Andreassen AK, Simonsen S, Gude E, Fiane AE, Geiran O, Gullestad L. Pre-Transplant Toxoplasma gondiiSeropositivity Among Heart Transplant Recipients Is Associated With an Increased Risk of All-Cause and Cardiac Mortality. J Am Coll Cardiol 2007; 50:1967-72. [DOI: 10.1016/j.jacc.2007.07.068] [Citation(s) in RCA: 20] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/10/2007] [Revised: 06/22/2007] [Accepted: 07/30/2007] [Indexed: 11/26/2022]
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Rand-Hendriksen S, Tjeldhorn L, Lundby R, Semb SO, Offstad J, Andersen K, Geiran O, Paus B. Search for correlations between FBN1 genotype and complete Ghent phenotype in 44 unrelated Norwegian patients with Marfan syndrome. Am J Med Genet A 2007; 143A:1968-77. [PMID: 17663468 DOI: 10.1002/ajmg.a.31759] [Citation(s) in RCA: 28] [Impact Index Per Article: 1.6] [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: 11/07/2022]
Abstract
In monogenic disorders, correlation between genotype and phenotype is a premise for predicting prognosis in affected patients. Predictive genetic testing may enable prophylaxis and promote clinical follow-up. Although Marfan syndrome (MFS) is known as a monogenic disorder, according to the present diagnostic criteria a mutation in the gene FBN1 is not sufficient for the diagnosis, which also depends on the presence of a number of clinical, radiological, and other findings. The fact that MFS patient cohorts only infrequently have been examined for all relevant phenotypic manifestations may have contributed to inconsistent reports of genotype-phenotype correlations. In the Norwegian Study of Marfan syndrome, all participants were examined for all findings contained in the Ghent nosology by the same investigators. Mutation identification was carried out by robot-assisted direct sequencing of the entire FBN1 coding sequence and MLPA analysis. A total of 46 mutations were identified in 44 unrelated patients, all fulfilling Ghent criteria. Although no statistically significant correlation could be obtained, the data indicate associations between missense or splice site mutations and ocular manifestations. While mutations in TGF-domains were associated with the fulfillment of few major criteria, severe affection was indicated in two cases with C-terminal mutations. Intrafamilial phenotypic variation among carriers of the same mutation, suggesting the influence of epigenetic facors, complicates genetic counseling. The usefulness of predictive genetic testing in FBN1 mutations requires further investigation.
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Affiliation(s)
- Svend Rand-Hendriksen
- TRS National Resource Centre for Rare Disorders, Sunnaas Rehabilitation Hospital, Nesoddtangen, Norway
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Arora S, Andreassen A, Simonsen S, Gude E, Dahl C, Skaardal R, Hoel I, Geiran O, Gullestad L. Prognostic Importance of Renal Function 1 Year After Heart Transplantation for All-Cause and Cardiac Mortality and Development of Allograft Vasculopathy. Transplantation 2007; 84:149-54. [PMID: 17667805 DOI: 10.1097/01.tp.0000268810.61393.2c] [Citation(s) in RCA: 44] [Impact Index Per Article: 2.6] [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: 10/23/2022]
Abstract
BACKGROUND Impaired renal function is associated with increased mortality among heart failure patients. Although a significant proportion of heart transplant (HTx) recipients have reduced renal function at 1 year post-HTx, no previous study has evaluated the associated risk for both all-cause and cardiac mortality. Hence, we assessed the relationship between glomerular filtration rate (GFR) at 1 year post-HTx and all-cause and cardiac mortality and development of cardiac allograft vasculopathy (CAV). METHODS We evaluated 381 patients with a minimum survival of 1 year post-HTx and the Modification of Diet in Renal Disease Study formula was used to calculate estimated GFR. Mortality and angiographic CAV were defined as separate endpoints, and median follow-up was 7.4 and 4.0 years, respectively. RESULTS During the follow-up period, 122 patients died and 154 patients developed CAV. Reduced GFR pre-HTx was not a risk factor for either endpoint. Overall, 193 (51%) patients had GFR <60 ml/min/1.73 m at one year post-HTx and this was an independent predictor of all-cause mortality with an adjusted hazard ratio of 1.7 (P=0.01) for a GFR between 30-60 and 3.2 (P=0.006) for GFR <30 ml/min/1.73 m. GFR <60 ml/min/1.73 m at 1 year post-HTx was also associated with a higher risk of cardiac mortality (HR=1.9; P=0.04) but did not predict the development of CAV. CONCLUSIONS Renal impairment is evident in a majority of HTx recipients at 1 year post-HTx. It is an important risk factor for both all-cause and cardiac mortality but does not predict the development of angiographic CAV.
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Affiliation(s)
- Satish Arora
- Department of Cardiology, Rikshospitalet-Radiumhospitalet Medical Center, Oslo, Norway.
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Havik OE, Sivertsen B, Relbo A, Hellesvik M, Grov I, Geiran O, Andreassen AK, Simonsen S, Gullestad L. Depressive Symptoms and All-Cause Mortality After Heart Transplantation. Transplantation 2007; 84:97-103. [PMID: 17627244 DOI: 10.1097/01.tp.0000268816.90672.a0] [Citation(s) in RCA: 51] [Impact Index Per Article: 3.0] [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: 01/07/2023]
Abstract
BACKGROUND Several studies indicate that heart transplantation (HTx) is associated with depression and reduced quality of life. However, the impact of depression on the prognosis for HTx-patients has not yet been sufficiently established. The aim of the present study was to prospectively investigate the influence of depression on mortality in patients with HTx, adjusting for other known risk factors. METHODS In a prospective, cross-sectional study with minimum 5-year follow-up, symptoms of depression were assessed in 147 HTx-patients using the Beck Depression Inventory (BDI). RESULTS Mild to severe depressive symptoms (BDI > or =10) were observed in 36 patients (24.5%). Depressive symptoms on inclusion increased the risk of mortality during the follow-up period. The risk remained significant after adjusting for several somatic and lifestyle risk factors, and the adjusted relative risk associated with depression (risk ratio: 2.32; 95% CI: 1.13-4.79; P=0.02) was comparable to the adjusted relative risk associated with time since HTx. CONCLUSIONS Symptoms of depression predict mortality independently of somatic and lifestyle risk factors in HTx patients, and this group of patients should be screened for depressive symptoms.
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Affiliation(s)
- Odd E Havik
- Department of Clinical Psychology, University of Bergen, Bergen, Norway.
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Arora S, Gullestad L, Wergeland R, Simonsen S, Holm T, Hognestad A, Ueland T, Geiran O, Andreassen A. Probrain Natriuretic Peptide and C-Reactive Protein as Markers of Acute Rejection, Allograft Vasculopathy, and Mortality in Heart Transplantation. Transplantation 2007; 83:1308-15. [PMID: 17519779 DOI: 10.1097/01.tp.0000263338.39555.21] [Citation(s) in RCA: 35] [Impact Index Per Article: 2.1] [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 N-terminal probrain natriuretic peptide (NT-proBNP) and C-reactive protein (CRP) are useful in risk stratification of patients with congestive heart failure. They could also be markers of distinctly altered hormonal and immunological milieus, but the combined prognostic value of these biomarkers in heart transplant (HTx) recipients has not been assessed previously. METHODS We sought to assess the individual and combined value of NT-proBNP and CRP as markers of acute rejection, cardiac allograft vasculopathy (CAV) and all-cause mortality in HTx recipients. We evaluated 101 patients for acute rejection and 210 patients for CAV and all-cause mortality. Patients evaluated for rejection had serial endomyocardial biopsies and plasma sampling performed during the first year postHTx. All other patients had plasma samples taken upon inclusion at an annual visit. Median follow-up for CAV and all-cause mortality was 2.2 years and 5.4 years, respectively. RESULTS Altogether, 1131 biopsy procedures were performed, and increased NT-proBNP and CRP levels were not useful markers of acute cellular rejection. In total, 78 (37%) patients developed CAV, and 39 (19%) patients died. Neither biomarker was a predictor of CAV, but both were independent predictors of mortality. When combining both biomarkers, elevated levels of both NT-proBNP and CRP identified patients at highest risk for CAV (HR 2.10, P=0.01) and all-cause mortality (HR 3.14, P=0.01). CONCLUSIONS In HTx recipients, NT-proBNP and CRP are not useful as markers of acute cellular rejection during the first year postHTx, but combined analysis adds significantly to their predictive value for development of CAV and all-cause mortality.
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Affiliation(s)
- Satish Arora
- Department of Cardiology, Rikshospitalet-Radiumhospitalet Medical Center, Oslo, Norway.
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Tjeldhorn L, Rand-Hendriksen S, Gervin K, Brandal K, Inderhaug E, Geiran O, Paus B. Rapid and efficient FBN1 mutation detection using automated sample preparation and direct sequencing as the primary strategy. ACTA ACUST UNITED AC 2007; 10:258-64. [PMID: 17253931 DOI: 10.1089/gte.2006.258-264] [Citation(s) in RCA: 18] [Impact Index Per Article: 1.1] [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: 11/12/2022]
Abstract
Mutations in the fibrillin-1 (FBN1) gene cause Marfan syndrome (MFS) and the other type-1 fibrillinopathies. Finding these mutations is a major challenge considering that the FBN1 gene has a coding region of 8,600 base pairs divided into 65 exons. Most of the more than 600 known mutations have been identified using a mutation scanning method prior to sequencing of fragments with a suspected mutation. However, it is not obvious that these screening methods are ideal, considering cost, efficiency, and sensitivity. We have sequenced the entire FBN1 coding sequence and flanking intronic sequences in samples from 105 patients with suspected MFS, taking advantage of robotic devices, which reduce the cost of supplies and the quantity of manual work. In addition, automation avoids many tedious steps, thus reducing the opportunity for human error. Automated assembling of PCR, purification of PCR products, and assembly of sequencing reactions resulted in completion of the FBN1 sequence in half of the time needed for the manual protocol. Mutations were identified in 69 individuals. The mutation detection rate (76%), types, and genetic distribution of mutations resemble the findings in other MFS populations. We conclude that automated sequencing using the robotic systems is well suited as a primary strategy for diagnostic mutation identification in FBN1.
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Affiliation(s)
- Lena Tjeldhorn
- Department of Medical Genetics, Ulleval University Hospital, Oslo, Norway
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Arora S, Gullestad L, Wergeland R, Holm T, Hognestad A, Geiran O, Andreassen A. 168: Combined analysis of NT-proBNP and C-reactive protein improves their predictive value for development of cardiac allograft vasculopathy and all-cause mortality but not acute cellular rejection in heart transplant recipients. J Heart Lung Transplant 2007. [DOI: 10.1016/j.healun.2006.11.185] [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: 11/16/2022] Open
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Gude E, Arora S, Simonsen S, Gullestad L, Geiran O, Andreassen A. 40: The prognostic value of pre- and within one year postoperative right heart hemodynamics in heart transplant recipients. J Heart Lung Transplant 2007. [DOI: 10.1016/j.healun.2006.11.054] [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: 11/30/2022] Open
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Marques da Silva R, Caugant DA, Eribe ERK, Aas JA, Lingaas PS, Geiran O, Tronstad L, Olsen I. Bacterial diversity in aortic aneurysms determined by 16S ribosomal RNA gene analysis. J Vasc Surg 2006; 44:1055-60. [PMID: 17098542 DOI: 10.1016/j.jvs.2006.07.021] [Citation(s) in RCA: 69] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/25/2006] [Accepted: 07/06/2006] [Indexed: 10/23/2022]
Abstract
BACKGROUND Aortic aneurysms are common vascular conditions that cause considerable morbidity and mortality. Understanding of the mechanisms involved in the pathogenesis of the condition remains limited. Recently, infection has been suggested as possible contributor in the development of the disease. The aim of the present study was to examine aortic aneurysms for the presence of bacterial DNA using polymerase chain reaction (PCR) targeting the 16S ribosomal RNA (rRNA) gene, followed by cloning and sequencing. METHODS Universal eubacterial primers were used to amplify 16S rRNA bacterial genes in 10 specimens from arterial walls of aortic aneurysms. Subsequently, PCR amplicons were cloned into Escherichia coli and sequencing of the cloned inserts was used to determine species identity or closest relatives by comparison with known sequences in GenBank. RESULTS Sequences of Stenotrophomonas spp., including S. maltophilia (formerly Pseudomonas homology group V) were detected in six aneurysm samples. Propionibacterium acnes was identified in five samples, and Brevundimonas diminuta (formerly P. diminuta) in four samples. Other species previously assigned to the Pseudomonas genus such as Comamonas testosteroni, Delftia acidovorans, Burkholderia cepacia, Herbaspirillum sp., and Acidovorax sp. were also detected. Some clones fell into other environmental species, including Methylobacterium sp. and Bradyrhizobium elkanii, and others represented bacteria that have not yet been cultivated. DNA sequences from oral bacteria, including Streptococcus sanguinis, Tannerella forsythia, and Leptotrichia buccalis were detected. Sequences from Prevotella melaninogenica and Lactobacillus delbrueckii, which are commonly found in both mouth and gastrointestinal tract, were also detected. Additional species included Dermacoccus spp. and Corynebacterium vitaeruminis. CONCLUSIONS A wide variety of bacteria, including oral bacteria, was found to colonize aortic aneurysms and may play a role in their development. Several of these microorganisms have not yet been cultivated. CLINICAL RELEVANCE Although Chlamydophila pneumoniae has been detected in aneurysmal walls, its exact role in the condition remains inconclusive. Overall, there is scarce information about the role of microorganisms in aneurysmal disease. In the present study, we used molecular genetics to detect a diversity of bacteria in arterial walls of aortic aneurysms. The presence of multiple microorganisms in aneurysmal disease may have implications for chemoprophylaxis and antibiotic treatment if directed only at C.pneumoniae.
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