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Abdullah R, Bjørnebekk A, Hauger LE, Hullstein IR, Edvardsen T, Haugaa KH, Almaas VM. Severe biventricular cardiomyopathy in both current and former long-term users of anabolic-androgenic steroids. Eur J Prev Cardiol 2023:zwad362. [PMID: 37992194 DOI: 10.1093/eurjpc/zwad362] [Citation(s) in RCA: 1] [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] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/08/2023] [Revised: 11/08/2023] [Accepted: 11/21/2023] [Indexed: 11/24/2023]
Abstract
AIMS Explore the cardiovascular effects of long-term anabolic-androgenic steroid (AAS)-use in both current and former weightlifting AAS-users, and estimate the occurrence of severe reduced myocardial function and the impact of duration and amount of AAS. METHODS In this cross-sectional study 101 weightlifting AAS-users with at least one year cumulative AAS-use (mean 11 ± 7 accumulated years of AAS-use) were compared to 71 non-using weightlifting controls (WLC) using clinical data and echocardiography. RESULTS Sixty-nine were current, 30 former (> 1 year since quitted), and 2 AAS-users were not available for this classification. AAS-users had higher left ventricular mass index (LVMI) (106 ± 26 versus 80 ± 15 g/m2, P < 0.001), worse LV ejection fraction (LVEF) (49 ± 7 versus 59 ± 5%, P < 0.001) and right ventricular global longitudinal strain (RVGLS) (-17.3 ± 3.5 versus -22.8 ± 2.0%, P < 0.001), and higher systolic blood pressure (SBP) (141 ± 17 vs. 133 ± 11 mmHg, p < 0.001) compared with WLC. In current users accumulated duration of AAS-use was 12 ± 7 years, and in former 9 ± 6 years (quitted 6 ± 6 years earlier). Compared to WLC, LVMI and LVEF were pathological in current and former users (p < 0.05) with equal distribution of severely reduced myocardial function (LVEF ≤40%) (11% vs. 10%, NS). In current users estimated life time AAS-dose correlated with reduced LVEF and LVGLS, p < 0.05, but not with LVMI, p = 0.12. Regression analyses of the total population showed that the strongest determinant of reduced LVEF were not coexisting strength training or hypertension, but history of AAS-use (β -0.53, P < 0.001). CONCLUSIONS Long-term AAS-users showed severely biventricular cardiomyopathy. The reduced systolic function was also found upon discountied use.
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Affiliation(s)
- Rang Abdullah
- University of Oslo, Oslo, Norway
- Anabolic Androgenic Steroid Research Group, Section for Clinical Addiction Research, Division of Mental Health and Addiction, Oslo University Hospital, Oslo, Norway
- ProCardio Center for Research Based Innovation, Department of Cardiology, Rikshospitalet, Oslo University Hospital, Aker, Oslo, Norway
| | - Astrid Bjørnebekk
- Anabolic Androgenic Steroid Research Group, Section for Clinical Addiction Research, Division of Mental Health and Addiction, Oslo University Hospital, Oslo, Norway
| | - Lisa E Hauger
- Anabolic Androgenic Steroid Research Group, Section for Clinical Addiction Research, Division of Mental Health and Addiction, Oslo University Hospital, Oslo, Norway
- National Centre for Epilepsy, Section for Clinical Psychology and Neuropsychology, Oslo University Hospital, Aker, Oslo, Norway
| | - Ingunn R Hullstein
- Norwegian Doping Control Laboratory, Department of Pharmacology, Oslo University Hospital, Aker, Oslo, Norway
| | - Thor Edvardsen
- University of Oslo, Oslo, Norway
- ProCardio Center for Research Based Innovation, Department of Cardiology, Rikshospitalet, Oslo University Hospital, Aker, Oslo, Norway
| | - Kristina H Haugaa
- University of Oslo, Oslo, Norway
- ProCardio Center for Research Based Innovation, Department of Cardiology, Rikshospitalet, Oslo University Hospital, Aker, Oslo, Norway
| | - Vibeke M Almaas
- ProCardio Center for Research Based Innovation, Department of Cardiology, Rikshospitalet, Oslo University Hospital, Aker, Oslo, Norway
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Strand ME, Vanhaverbeke M, Henkens MTHM, Sikking MA, Rypdal KB, Braathen B, Almaas VM, Tønnessen T, Christensen G, Heymans S, Lunde IG. Inflammation and Syndecan-4 Shedding from Cardiac Cells in Ischemic and Non-Ischemic Heart Disease. Biomedicines 2023; 11:biomedicines11041066. [PMID: 37189684 DOI: 10.3390/biomedicines11041066] [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] [Received: 03/04/2023] [Revised: 03/24/2023] [Accepted: 03/28/2023] [Indexed: 04/05/2023] Open
Abstract
Circulating biomarkers reflecting cardiac inflammation are needed to improve the diagnostics and guide the treatment of heart failure patients. The cardiac production and shedding of the transmembrane proteoglycan syndecan-4 is upregulated by innate immunity signaling pathways. Here, we investigated the potential of syndecan-4 as a blood biomarker of cardiac inflammation. Serum syndecan-4 was measured in patients with (i) non-ischemic, non-valvular dilated cardiomyopathy (DCM), with (n = 71) or without (n = 318) chronic inflammation; (ii) acute myocarditis (n = 15), acute pericarditis (n = 3) or acute perimyocarditis (23) and (iii) acute myocardial infarction (MI) at day 0, 3 and 30 (n = 119). Syndecan-4 was investigated in cultured cardiac myocytes and fibroblasts (n = 6–12) treated with the pro-inflammatory cytokines interleukin (IL)-1β and its inhibitor IL-1 receptor antagonist (IL-1Ra), or tumor necrosis factor (TNF)α and its specific inhibitor infliximab, an antibody used in treatment of autoimmune diseases. The levels of serum syndecan-4 were comparable in all subgroups of patients with chronic or acute cardiomyopathy, independent of inflammation. Post-MI, syndecan-4 levels were increased at day 3 and 30 vs. day 0. IL-1Ra attenuated IL-1β-induced syndecan-4 production and shedding in vitro, while infliximab had no effect. In conclusion, syndecan-4 shedding from cardiac myocytes and fibroblasts was attenuated by immunomodulatory therapy. Although its circulating levels were increased post-MI, syndecan-4 did not reflect cardiac inflammatory status in patients with heart disease.
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Affiliation(s)
- Mari E. Strand
- Institute for Experimental Medical Research, Oslo University Hospital and University of Oslo, 0450 Oslo, Norway
| | | | - Michiel T. H. M. Henkens
- Netherlands Heart Institute (NLHI), 3511 EP Utrecht, The Netherlands
- Department of Pathology, CARIM, Maastricht University Medical Centre, 6229 HX Maastricht, The Netherlands
- Department of Cardiology, CARIM, Maastricht University Medical Centre, 6229 HX Maastricht, The Netherlands
| | - Maurits A. Sikking
- Department of Cardiology, CARIM, Maastricht University Medical Centre, 6229 HX Maastricht, The Netherlands
| | - Karoline B. Rypdal
- Institute of Clinical Medicine, University of Oslo, 0315 Oslo, Norway
- K.G. Jebsen Center for Cardiac Biomarkers, University of Oslo, 0315 Oslo, Norway
- Division of Diagnostics and Technology, Akershus University Hospital, 1478 Lørenskog, Norway
| | - Bjørn Braathen
- Department of Cardiothoracic Surgery, Oslo University Hospital Ullevål, 0450 Oslo, Norway
| | - Vibeke M. Almaas
- Department of Cardiology, Oslo University Hospital Rikshospitalet, 0372 Oslo, Norway
| | - Theis Tønnessen
- Institute for Experimental Medical Research, Oslo University Hospital and University of Oslo, 0450 Oslo, Norway
- Department of Cardiothoracic Surgery, Oslo University Hospital Ullevål, 0450 Oslo, Norway
| | - Geir Christensen
- Institute for Experimental Medical Research, Oslo University Hospital and University of Oslo, 0450 Oslo, Norway
| | - Stephane Heymans
- Department of Cardiovascular Science, University of Leuven, 3000 Leuven, Belgium
| | - Ida G. Lunde
- Institute for Experimental Medical Research, Oslo University Hospital and University of Oslo, 0450 Oslo, Norway
- K.G. Jebsen Center for Cardiac Biomarkers, University of Oslo, 0315 Oslo, Norway
- Division of Diagnostics and Technology, Akershus University Hospital, 1478 Lørenskog, Norway
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Castrini AI, Skjølsvik E, Estensen ME, Almaas VM, Skulstad H, Lyseggen E, Edvardsen T, Lie ØH, Picard KCI, Lakdawala NK, Haugaa KH. Pregnancy and Progression of Cardiomyopathy in Women With LMNA Genotype‐Positive. J Am Heart Assoc 2022; 11:e024960. [PMID: 35434999 PMCID: PMC9238471 DOI: 10.1161/jaha.121.024960] [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] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
Background We aimed to assess the association between number of pregnancies and long‐term progression of cardiac dysfunction, arrhythmias, and event‐free survival in women with pathogenic or likely pathogenic variants of gene encoding for Lamin A/C proteins ( LMNA+). Methods and Results We retrospectively included consecutive women with LMNA+ and recorded pregnancy data. We collected echocardiographic data, occurrence of atrial fibrillation, atrioventricular block, sustained ventricular arrhythmias, and implantation of cardiac electronic devices (implantable cardioverter defibrillator/cardiac resynchronization therapy defibrillator). We analyzed retrospectively complications during pregnancy and the peripartum period. We included 89 women with LMNA+ (28% probands, age 41±16 years), of which 60 had experienced pregnancy. Follow‐up time was 5 [interquartile range, 3–9] years. We analyzed 452 repeated echocardiographic examinations. Number of pregnancies was not associated with increased long‐term risk of atrial fibrillation, atrioventricular block, sustained ventricular arrhythmias, or implantable cardioverter defibrillator/cardiac resynchronization therapy defibrillator implantation. Women with previous pregnancy and nulliparous women had a similar annual deterioration of left ventricular ejection fraction (−0.5/year versus −0.3/year, P=0.37) and similar increase of left ventricular end‐diastolic diameter (0.1/year versus 0.2/year, P=0.09). Number of pregnancies did not decrease survival free from death, left ventricular assist device, or need for cardiac transplantation. Arrhythmias occurred during 9% of pregnancies. No increase in maternal and fetal complications was observed. Conclusions In our cohort of women with LMNA+, pregnancy did not seem associated with long‐term adverse disease progression or event‐free survival. Likewise, women with LMNA+ generally well‐tolerated pregnancy, with a small proportion of patients experiencing arrhythmias.
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Affiliation(s)
- Anna I. Castrini
- Institute of Clinical Medicine Faculty of Medicine University of Oslo Norway
- ProCardio Center for Innovation Department of Cardiology Oslo University Hospital Rikshospitalet Norway
| | - Eystein Skjølsvik
- ProCardio Center for Innovation Department of Cardiology Oslo University Hospital Rikshospitalet Norway
| | - Mette E. Estensen
- ProCardio Center for Innovation Department of Cardiology Oslo University Hospital Rikshospitalet Norway
| | - Vibeke M. Almaas
- ProCardio Center for Innovation Department of Cardiology Oslo University Hospital Rikshospitalet Norway
| | - Helge Skulstad
- Institute of Clinical Medicine Faculty of Medicine University of Oslo Norway
- ProCardio Center for Innovation Department of Cardiology Oslo University Hospital Rikshospitalet Norway
| | - Erik Lyseggen
- ProCardio Center for Innovation Department of Cardiology Oslo University Hospital Rikshospitalet Norway
| | - Thor Edvardsen
- Institute of Clinical Medicine Faculty of Medicine University of Oslo Norway
- ProCardio Center for Innovation Department of Cardiology Oslo University Hospital Rikshospitalet Norway
| | - Øyvind H. Lie
- ProCardio Center for Innovation Department of Cardiology Oslo University Hospital Rikshospitalet Norway
| | | | | | - Kristina H. Haugaa
- Institute of Clinical Medicine Faculty of Medicine University of Oslo Norway
- ProCardio Center for Innovation Department of Cardiology Oslo University Hospital Rikshospitalet Norway
- Faculty of Medicine Karolinska Institutet AND Cardiovascular Division Karolinska University Hospital Stockholm Sweden
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Rootwelt-Norberg C, Lie ØH, Chivulescu M, Castrini AI, Sarvari SI, Lyseggen E, Almaas VM, Bogsrud MP, Edvardsen T, Haugaa KH. Sex differences in disease progression and arrhythmic risk in patients with arrhythmogenic cardiomyopathy. Europace 2021; 23:1084-1091. [PMID: 33829244 PMCID: PMC8286854 DOI: 10.1093/europace/euab077] [Citation(s) in RCA: 4] [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] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/27/2020] [Accepted: 03/17/2021] [Indexed: 11/14/2022] Open
Abstract
AIMS We aimed to assess sex-specific phenotypes and disease progression, and their relation to exercise, in arrhythmogenic cardiomyopathy (AC) patients. METHODS AND RESULTS In this longitudinal cohort study, we included consecutive patients with AC from a referral centre. We performed echocardiography at baseline and repeatedly during follow-up. Patients' exercise dose at inclusion was expressed as metabolic equivalents of task (MET)-h/week. Ventricular arrhythmia (VA) was defined as aborted cardiac arrest, sustained ventricular tachycardia, or appropriate therapy by implantable cardioverter-defibrillator. We included 190 AC patients (45% female, 51% probands, age 41 ± 17 years). Ventricular arrhythmia had occurred at inclusion or occurred during follow-up in 85 patients (33% of females vs. 55% of males, P = 0.002). Exercise doses were higher in males compared with females [25 (interquartile range, IQR 14-51) vs. 12 (IQR 7-22) MET-h/week, P < 0.001]. Male sex was a marker of proband status [odds ratio (OR) 2.6, 95% confidence interval (CI) 1.4-5.0, P = 0.003] and a marker of VA (OR 2.6, 95% CI 1.4-5.0, P = 0.003), but not when adjusted for exercise dose and age (adjusted OR 1.8, 95% CI 0.9-3.6, P = 0.12 and 1.5, 95% CI 0.7-3.1, P = 0.30, by 5 MET-h/week increments). In all, 167 (88%) patients had ≥2 echocardiographic examinations during 6.9 (IQR 4.7-9.8) years of follow-up. We observed no sex differences in deterioration of right or left ventricular dimensions and functions. CONCLUSION Male AC patients were more often probands and had higher prevalence of VA than female patients, but not when adjusting for exercise dose. Importantly, disease progression was similar between male and female patients.
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Affiliation(s)
- Christine Rootwelt-Norberg
- Institute of Clinical Medicine, Faculty of Medicine, University of Oslo, PO Box 4950 Nydalen, 0424 Oslo, Norway.,ProCardio Center for Innovation, Department of Cardiology, Oslo University Hospital, Rikshospitalet, Oslo, Norway
| | - Øyvind H Lie
- Institute of Clinical Medicine, Faculty of Medicine, University of Oslo, PO Box 4950 Nydalen, 0424 Oslo, Norway.,ProCardio Center for Innovation, Department of Cardiology, Oslo University Hospital, Rikshospitalet, Oslo, Norway
| | - Monica Chivulescu
- Institute of Clinical Medicine, Faculty of Medicine, University of Oslo, PO Box 4950 Nydalen, 0424 Oslo, Norway.,ProCardio Center for Innovation, Department of Cardiology, Oslo University Hospital, Rikshospitalet, Oslo, Norway
| | - Anna I Castrini
- Institute of Clinical Medicine, Faculty of Medicine, University of Oslo, PO Box 4950 Nydalen, 0424 Oslo, Norway.,ProCardio Center for Innovation, Department of Cardiology, Oslo University Hospital, Rikshospitalet, Oslo, Norway
| | - Sebastian I Sarvari
- ProCardio Center for Innovation, Department of Cardiology, Oslo University Hospital, Rikshospitalet, Oslo, Norway
| | - Erik Lyseggen
- ProCardio Center for Innovation, Department of Cardiology, Oslo University Hospital, Rikshospitalet, Oslo, Norway
| | - Vibeke M Almaas
- ProCardio Center for Innovation, Department of Cardiology, Oslo University Hospital, Rikshospitalet, Oslo, Norway
| | - Martin P Bogsrud
- Unit for Cardiac and Cardiovascular Genetics, Department of Medical Genetics, Oslo University Hospital, Ullevål, Oslo, Norway
| | - Thor Edvardsen
- Institute of Clinical Medicine, Faculty of Medicine, University of Oslo, PO Box 4950 Nydalen, 0424 Oslo, Norway.,ProCardio Center for Innovation, Department of Cardiology, Oslo University Hospital, Rikshospitalet, Oslo, Norway
| | - Kristina H Haugaa
- Institute of Clinical Medicine, Faculty of Medicine, University of Oslo, PO Box 4950 Nydalen, 0424 Oslo, Norway.,ProCardio Center for Innovation, Department of Cardiology, Oslo University Hospital, Rikshospitalet, Oslo, Norway
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Peltenburg P, Kallas D, van der Werf C, Lieve KV, Franciosi S, Roston TM, Denjoy I, Martijn Bos J, Sorensen KB, Perez G, Wada Y, Noguer FR, Almaas VM, Yap SC, Khan H, Maltret A, LaPage MJ, Giudicessi JR, Barker Clur SA, Blom NA, Tanck M, Davis AM, Behr E, Rudic B, Brugada GS, Kannankeril PJ, Sacher F, Skinner J, Tfelt-Hansen J, Tavacova T, Baban A, Robyns T, Semsarian C, Schwartz PJ, Van Den Berg MP, Roberts JD, Grima EZ, Swan H, Kammeraad JA, Krahn AD, Haugaa KH, Shimizu W, Till J, Horie M, Probst V, Brugada R, Ackerman MJ, Sanatani S, Leenhardt A, Wilde AA. B-PO04-026 NON-SELECTIVE VERSUS Β1-SELECTIVE BETA-BLOCKERS IN THE TREATMENT OF SYMPTOMATIC CHILDREN WITH CATECHOLAMINERGIC POLYMORPHIC VENTRICULAR TACHYCARDIA. Heart Rhythm 2021. [DOI: 10.1016/j.hrthm.2021.06.722] [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: 12/01/2022]
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Lorén CE, Dahl CP, Do L, Almaas VM, Geiran OR, Mörner S, Hellman U. Low Molecular Mass Myocardial Hyaluronan in Human Hypertrophic Cardiomyopathy. Cells 2019; 8:cells8020097. [PMID: 30699940 PMCID: PMC6406527 DOI: 10.3390/cells8020097] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.4] [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] [Subscribe] [Scholar Register] [Received: 12/13/2018] [Revised: 01/11/2019] [Accepted: 01/23/2019] [Indexed: 12/23/2022] Open
Abstract
During the development of hypertrophic cardiomyopathy, the heart returns to fetal energy metabolism where cells utilize more glucose instead of fatty acids as a source of energy. Metabolism of glucose can increase synthesis of the extracellular glycosaminoglycan hyaluronan, which has been shown to be involved in the development of cardiac hypertrophy and fibrosis. The aim of this study was to investigate hyaluronan metabolism in cardiac tissue from patients with hypertrophic cardiomyopathy in relation to cardiac growth. NMR and qRT-PCR analysis of human cardiac tissue from hypertrophic cardiomyopathy patients and healthy control hearts showed dysregulated glucose and hyaluronan metabolism in the patients. Gas phase electrophoresis revealed a higher amount of low molecular mass hyaluronan and larger cardiomyocytes in cardiac tissue from patients with hypertrophic cardiomyopathy. Histochemistry showed high concentrations of hyaluronan around individual cardiomyocytes in hearts from hypertrophic cardiomyopathy patients. Experimentally, we could also observe accumulation of low molecular mass hyaluronan in cardiac hypertrophy in a rat model. In conclusion, the development of hypertrophic cardiomyopathy with increased glucose metabolism affected both hyaluronan molecular mass and amount. The process of regulating cardiomyocyte size seems to involve fragmentation of hyaluronan.
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Affiliation(s)
- Christina E Lorén
- Cardiology, Heart Centre, Department of Public Health and Clinical Medicine, Umeå University, 901 85 Umeå, Sweden.
| | - Christen P Dahl
- Department of Cardiology, Oslo University Hospital Rikshospitalet, 0424 Oslo, Norway.
- Department of Clinical Medicine, UiT, the Arctic University of Norway, 9019 Tromsø, Norway.
- Research Institute of Internal Medicine, Oslo University Hospital Rikshospitalet, 0372 Oslo, Norway.
| | - Lan Do
- Cardiology, Heart Centre, Department of Public Health and Clinical Medicine, Umeå University, 901 85 Umeå, Sweden.
| | - Vibeke M Almaas
- Department of Cardiology, Oslo University Hospital Rikshospitalet, 0424 Oslo, Norway.
| | - Odd R Geiran
- Faculty of Medicine, University of Oslo, 0318 Oslo, Norway.
- Department of Thoracic and Cardiovascular Surgery, Oslo University Hospital Rikshospitalet, 0424 Oslo, Norway.
| | - Stellan Mörner
- Cardiology, Heart Centre, Department of Public Health and Clinical Medicine, Umeå University, 901 85 Umeå, Sweden.
| | - Urban Hellman
- Cardiology, Heart Centre, Department of Public Health and Clinical Medicine, Umeå University, 901 85 Umeå, Sweden.
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Haland TF, Almaas VM, Hasselberg NE, Saberniak J, Leren IS, Hopp E, Edvardsen T, Haugaa KH. Strain echocardiography is related to fibrosis and ventricular arrhythmias in hypertrophic cardiomyopathy. Eur Heart J Cardiovasc Imaging 2016; 17:613-21. [PMID: 26873460 PMCID: PMC4871235 DOI: 10.1093/ehjci/jew005] [Citation(s) in RCA: 177] [Impact Index Per Article: 22.1] [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] [Received: 09/09/2015] [Accepted: 01/04/2016] [Indexed: 12/25/2022] Open
Abstract
Aims Hypertrophic cardiomyopathy (HCM) patients are at risk of ventricular arrhythmias (VAs). We aimed to explore whether systolic function by strain echocardiography is related to VAs and to the extent of fibrosis by cardiac magnetic resonance imaging (CMR). Methods and results We included 150 HCM patients and 50 healthy individuals. VAs were defined as non-sustained and sustained ventricular tachycardia and aborted cardiac arrest. Left ventricular function was assessed by ejection fraction (EF) and by global longitudinal strain (GLS) assessed by speckle tracking echocardiography. Mechanical dispersion was calculated as standard deviation (SD) of time from Q/R on ECG to peak longitudinal strain in 16 left ventricular segments. Late gadolinium enhancement (LGE) was assessed by CMR. HCM patients had similar EF (61 ± 5% vs. 61 ± 8%, P = 0.77), but worse GLS (−15.7 ± 3.6% vs. −21.1 ± 1.9%, P < 0.001) and more pronounced mechanical dispersion (64 ± 22 vs. 36 ± 13 ms, P < 0.001) compared with healthy individuals. VAs were documented in 37 (25%) HCM patients. Patients with VAs had worse GLS (−14.1 ± 3.6% vs. −16.3 ± 3.4%, P < 0.01), more pronounced mechanical dispersion (79 ± 27 vs. 59 ± 16 ms, P < 0.001), and higher %LGE (6.1 ± 7.8% vs. 0.5 ± 1.4%, P < 0.001) than patients without VAs. Mechanical dispersion correlated with %LGE (R = 0.52, P < 0.001) and was independently associated with VAs (OR 1.6, 95% CI 1.1–2.3, P = 0.02) and improved risk stratification for VAs. Conclusion GLS, mechanical dispersion, and LGE were markers of VAs in HCM patients. Mechanical dispersion was a strong independent predictor of VAs and related to the extent of fibrosis. Strain echocardiography may improve risk stratification of VAs in HCM.
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Affiliation(s)
- Trine F Haland
- Department of Cardiology, Oslo University Hospital, Rikshospitalet, PO Box 4950 Nydalen, N-0424 Oslo, Norway Center for Cardiological Innovation, Oslo University Hospital, Oslo, Norway University of Oslo, Oslo, Norway Institute for Surgical Research, Oslo University Hospital, Rikshospitalet, Oslo, Norway
| | - Vibeke M Almaas
- Department of Cardiology, Oslo University Hospital, Rikshospitalet, PO Box 4950 Nydalen, N-0424 Oslo, Norway Center for Cardiological Innovation, Oslo University Hospital, Oslo, Norway University of Oslo, Oslo, Norway
| | - Nina E Hasselberg
- Department of Cardiology, Oslo University Hospital, Rikshospitalet, PO Box 4950 Nydalen, N-0424 Oslo, Norway Center for Cardiological Innovation, Oslo University Hospital, Oslo, Norway University of Oslo, Oslo, Norway Institute for Surgical Research, Oslo University Hospital, Rikshospitalet, Oslo, Norway
| | - Jørg Saberniak
- Department of Cardiology, Oslo University Hospital, Rikshospitalet, PO Box 4950 Nydalen, N-0424 Oslo, Norway Center for Cardiological Innovation, Oslo University Hospital, Oslo, Norway University of Oslo, Oslo, Norway Institute for Surgical Research, Oslo University Hospital, Rikshospitalet, Oslo, Norway
| | - Ida S Leren
- Department of Cardiology, Oslo University Hospital, Rikshospitalet, PO Box 4950 Nydalen, N-0424 Oslo, Norway Center for Cardiological Innovation, Oslo University Hospital, Oslo, Norway University of Oslo, Oslo, Norway Institute for Surgical Research, Oslo University Hospital, Rikshospitalet, Oslo, Norway
| | - Einar Hopp
- Center for Cardiological Innovation, Oslo University Hospital, Oslo, Norway University of Oslo, Oslo, Norway Department of Radiology and Nuclear Medicine, Oslo University Hospital, Rikshospitalet, Oslo, Norway
| | - Thor Edvardsen
- Department of Cardiology, Oslo University Hospital, Rikshospitalet, PO Box 4950 Nydalen, N-0424 Oslo, Norway Center for Cardiological Innovation, Oslo University Hospital, Oslo, Norway University of Oslo, Oslo, Norway Institute for Surgical Research, Oslo University Hospital, Rikshospitalet, Oslo, Norway
| | - Kristina H Haugaa
- Department of Cardiology, Oslo University Hospital, Rikshospitalet, PO Box 4950 Nydalen, N-0424 Oslo, Norway Center for Cardiological Innovation, Oslo University Hospital, Oslo, Norway University of Oslo, Oslo, Norway Institute for Surgical Research, Oslo University Hospital, Rikshospitalet, Oslo, Norway
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Haland T, Neglia L, Mas-Stachurska A, Malanin D, Baruteau AE, Pontnau F, Capotosto L, Hristova K, Sevilla T, Wojtkowska A, Almaas VM, Hasselberg NE, Saberniak J, Leren IS, Hopp E, Edvardsen T, Haugaa KH, Piazza R, Doronzo A, Leonelli V, Morosin M, Leiballi E, Pecoraro R, Lutman C, Dragos A, Cassin M, Sitges M, Meirelles T, Hernandez V, Egea G, Bijnens B, Poggio D, Ferrazzi P, Spirito P, Specchia G, Grillo M, Amigoni P, Bersano C, Pisani M, Chioffi M, Hascoet S, Piot D, Lambert V, Petit J, Ladouceur M, Ferreira A, Iserin L, Mousseaux E, D'angeli I, Conde Y, Ashurov R, Miraldi F, Vitarelli A, Dasheva A, Marinov R, Lasarov S, Mitev I, Mitev P, Konstantinov G, Kaneva A, Katova TZ, Revilla-Orodea A, Uruena-Martinez N, Fuertes-Alija JJ, Rodriguez-Velasco M, Gomez-Salvador I, San Roman-Calvar JA, Tomaszewski A, Czekajska-Chehab E, Wysokinski A, Adamczyk P, Siek E, Zakoscielna M. Moderated Posters session: advanced echo techniques in congenital heart diseaseP526Systolic function by strain echocardiography is related to cardiac fibrosis and arrhythmias in hypertrophic cardiomyopathyP527Natural history of bicuspid aortic valve valvulo-aortopathy in affected patients followed in a single centerP528Postsystolic thickening as a likely sign of altered deformation due to pressure overload in a Marfan murine model.P529Strain rate echocardiography in patients with hypertrophic cardiomyopathy undergoing surgical myectomy.P530Transthoracic echocardiography is a safe alternative for assessment and guidance of transcatheter closure of secundum atrial septal defect in childrenP531Aortic root dilatation and stiffness assessed by magnetic resonance imaging in adults with repaired tetralogy of FallotP532Assessment of biventricular and vascular function using three-dimensional speckle tracking echocardiography in adult patients with surgical repair of tetralogy of FallotP533A study of functional anatomy of aortic-mitral valve coupling using 3D echocardiography in patients with double orifice mitral valveP534Evaluation of bicuspid aortic valve and its repercussion in the left ventricle with cardiovascular magnetic resonanceP535Echocardiographic assessment of anomalous pulmonary venous connection. Eur Heart J Cardiovasc Imaging 2015. [DOI: 10.1093/ehjci/jev252] [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: 11/14/2022] Open
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Apelland T, Gude E, Strøm EH, Gullestad L, Eiklid KL, Månsson JE, Reinholt FP, Houge G, Dahl CP, Almaas VM, Heiberg A. Familial globotriaosylceramide-associated cardiomyopathy mimicking Fabry disease. Heart 2014; 100:1793-8. [DOI: 10.1136/heartjnl-2014-305616] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/03/2022] Open
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Almaas VM, Haugaa KH, Strøm EH, Scott H, Smith HJ, Dahl CP, Geiran OR, Endresen K, Aakhus S, Amlie JP, Edvardsen T. Noninvasive assessment of myocardial fibrosis in patients with obstructive hypertrophic cardiomyopathy. Heart 2013; 100:631-8. [DOI: 10.1136/heartjnl-2013-304923] [Citation(s) in RCA: 68] [Impact Index Per Article: 6.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/03/2022] Open
Abstract
ObjectiveLate gadolinium enhancement cardiac magnetic resonance (LGE-CMR) imaging is the reference standard for non-invasive assessment of fibrosis. In hypertrophic cardiomyopathy (HCM) patients the histological substrate for LGE is still unknown. The aim of this study was to assess the ability of LGE and strain echocardiography to detect type and extent of myocardial fibrosis in obstructive HCM patients undergoing septal myectomy.MethodsThirty-two HCM patients (age 60±10) were included in this cross-sectional study and preoperatively examined by speckle-tracking strain echocardiography and LGE-CMR (n=21). Histological fibrosis was classified as interstitial, replacement and total.ResultsHistological fibrosis was present in 31 patients. The percentage of total, interstitial and replacement fibrosis was 15(7, 31)%, 11(5, 24)% and 3(1, 6)%, respectively. Reduced longitudinal septal strain correlated with total (r=0.50, p=0.01) and interstitial (r=0.40, p=0.03), but not with replacement fibrosis (r=0.28, p=0.14). Septal LGE was detected in 13/21 (62%), but percentage LGE did not correlate with total fibrosis (r=0.25, p=0.28). Extent of fibrosis did not differ between patients with and without septal LGE (20(9, 58)% versus 14(5, 19)% p=0.41). Patients with ventricular arrhythmias (n=8) had lower septal longitudinal strain and increased extent total and interstitial fibrosis in myectomy specimens, but no differences were demonstrated in LGE. Reduced longitudinal septal strain and increased extent of interstitial fibrosis predicted ventricular arrhythmias independently of age and gender.ConclusionsIn myectomised HCM patients, reduced longitudinal septal strain correlated better with interstitial and total fibrosis in myectomy specimens, and was a more powerful tool to predict arrhythmias than LGE.
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Almaas VM, Haugaa KH, Strøm EH, Scott H, Dahl CP, Leren TP, Geiran OR, Endresen K, Edvardsen T, Aakhus S, Amlie JP. Increased amount of interstitial fibrosis predicts ventricular arrhythmias, and is associated with reduced myocardial septal function in patients with obstructive hypertrophic cardiomyopathy. ACTA ACUST UNITED AC 2013; 15:1319-27. [DOI: 10.1093/europace/eut028] [Citation(s) in RCA: 39] [Impact Index Per Article: 3.5] [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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