News
Dec 22, 2017

EuroEcho-Imaging 2017


 

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The annual EuroEcho-Imaging Congress took place in Lisbon, Portugal this year. Several center members presented their latest research.

This year was exceptional as two of the center PhD fellows also took home Young Investigator Awards.

“Negative crosstalk between the septum and left ventricular lateral wall in left bundle branch block: the lateral wall paradox” was selected for presentation in the Young Investigators Award – Basic Science session, where John Aalen, MD, PhD fellow, was named the winner.

Prof. J. Roelandt’s Young Investigator Award is awarded to the best original work in clinical science at the EuroEcho-Imaging congress. This year’s award was given to CCI PhD fellow Øyvind H. Lie, MD, in recognition of the work “Harmful effects of exercise intensity and exercise duration in patients with arrhythmogenic cardiomyopathy”.

Category: General
Posted by: Piritta

 

Rootwelt C, Lie ØH, Dejgaard LA, Edvardsen T, Haugaa KH
Imaging markers of ventricular arrhythmia in female arrhythmogenic cardiomyopathy patients

Christine Rootwelt presented her poster on sex differences in arrhythmogenic cardiomyopathy (AC) phenotypes. Disease penetrance is higher in men, and most studies are dominated by male subjects. Knowledge of markers of ventricular arrhythmia in female AC patients is lacking, and the aim of the study was to explore such potential markers. The study included 178 patients, of which 44% were female. Less females than males had experienced ventricular arrhythmia. There were several valid imaging markers of life threatening arrhythmia in females, and the strongest were right ventricular (RV) fractional area change (FAC), RV diameter (RVD) and RV longitudinal strain (RVLS). The optimal cut-off values for detecting ventricular arrhythmia were less pathologic in females than in males. We therefore suggest that sex-specific values should be considered when evaluating risk of life-threatening ventricular arrhythmia in patients with AC.

Bjerring AW, Landgraff HEW, Ansari HZ, Saberniak J, Murbræch K, Bruun H, Stokke TM, Haugaa KH, Hallen J, Edvardsen T, Sarvari SI
Early morphological changes in preadolescent athletes assessed by three-dimensional echocardiography


Bjerring AW, Landgraff HEW, Ansari HZ, Saberniak J, Murbræch K, Bruun H, Stokke TM, Haugaa KH, Hallen J, Edvardsen T, Sarvari SI
Early morphological changes and myocardial function assessed by strain echocardiography in preadolescent athlete's heart

Center PhD fellow Anders Wold Bjerring presented two abstracts on early morphological changes in preadolescent athletes assessed by either 3D echocardiography or strain.

 

Larsen CK, Aalen J, Kongsgård E, Fjeld JG, Smiseth OA, Hopp E
Increased diffuse fibrosis in the septum compared to the left ventricular lateral wall in patients with heart failure and left bundle branch block

Camilla Kjellstad Larsen presented the abstract on behalf of the research group. Left bundle branch block (LBBB) causes the left ventricle (LV) to contract dyssynchronously, with an early inefficient septal contraction and a more powerful contraction of the LV lateral wall later in systole. In this study we assessed regional diffuse fibrosis by T1 mapping cardiac magnetic resonance (CMR) with calculation of extracellular volume fraction (ECV). We found that average ECV in septum was significantly higher than in the LV lateral wall in non-ischaemic patients with reduced systolic function and LBBB. Average ECV was higher in females than in males. Interindividual ECV in septum and the lateral wall correlated strongly, but neither septal nor lateral wall ECV correlated to age, heart rate, blood pressure, QRS width, end diastolic or end systolic volume, ejection fraction, septal or lateral wall work.

Hence, we concluded that septum has a significantly higher level of diffuse fibrosis than the LV lateral wall in non-ischaemic patients with reduced systolic function and LBBB. Predictors and clinical implications remain to be found. We plan larger scale studies to explore these issues.

Nestaas E, Gjesdal O, Sarvari SI, Hopp E, Smith HJ, Haugaa KH, Edvardsen T
Late occurring post systolic shortening is a marker of myocardial scar

Nestaas E, Gjesdal O, Sarvari SI, Hopp E, Smith HJ, Haugaa KH, Edvardsen T
The association between segmental scar burden and late occurrence of post-systolic strain

Eirik Nestaas presented two posters on timing of post-systolic strain and scars, “The association between segmental scar burden and late occurrence of post-systolic strain” and “Late occurring post systolic shortening is a marker of myocardial scar.”

This project shows that the timing of the post-systolic shortening is a strong marker for myocardial scars. Identification of myocardial scars by echocardiography is highly warranted because of the poor prognosis associated with high scar burden. That severely scarred segments exhibits post-systolic shortening with peaks late in diastole could have impact on the placement of the left ventricle lead in cardiac resynchronization therapy.

Aalen J, Hisdal J, Storsten P, Remme EW, Larsen CK, Sirnes PA, Gjesdal O, Skulstad H, Smiseth OA
Pressure-strain loops in the evaluation of left bundle branch block: septal function is aggravated by increased afterload

Aalen J, Larsen CK, Hopp E, Andersen OS, Krogh MR, Odland HH, Kongsgard E, Skulstad H, Remme EW, Smiseth OA
Negative crosstalk between left ventricular lateral wall and septum in left bundle branch block: "the lateral wall paradox"


John Aalen presented two abstracts at the congress. “Negative crosstalk between the septum and left ventricular lateral wall in left bundle branch block: the lateral wall paradox” was selected for presentation in the Young Investigator Award – Basic Science session, where Aalen was named the winner. This study shows how septal function in left bundle branch block is highly affected by contractility in the left ventricular lateral wall. Aalen also gave an oral presentation of the abstract “Pressure-strain loops in the evaluation of left bundle branch block: septal function is aggravated by increased afterload” in one of the rapid-fire sessions.

Lie ØH, Rootwelt C, Dejgaard LA, Leren IS, Edvardsen T, Haugaa KH
Echocardiography in prediction of life-threatening ventricular arrhythmia in patients with arrhythmogenic cardiomyopathy

Lie ØH, Dejgaard LA, Saberniak J, Rootwelt, Stokke MK, Edvardsen T, Haugaa KH
Harmful effects of exercise intensity and exercise duration in arrhythmogenic cardiomyopathy

 

Prof. J. Roelandt’s Young Investigator Award is awarded to the best original work in clinical science at the EuroEcho Imaging congress. This year’s award was given to CCI PhD fellow Øyvind H. Lie, MD, in recognition of the work “Harmful effects of exercise intensity and exercise duration in patients with arrhythmogenic cardiomyopathy”. Lie and co-workers discovered that high intensity exercise was strongly associated with life-threatening arrhythmia, right ventricular dysfunction and left ventricular dysfunction in 173 patients with the disease, independently of exercise duration. Long duration exercise was on the other hand only associated with right ventricular dilation. Low intensity exercise, even for longer durations, may be advised as a less harmful alternative to patients who wish to remain physically active. Lie will give his award-winning lecture during the Japanese Society of Echocardiography meeting in April 2018.

Øyvind H. Lie also gave a rapid fire oral presentation of the abstract “Echocardiography in prediction of life-threatening arrhythmia in patients with arrhythmogenic cardiomyopathy; a prospective cohort study”. In this study, patients presenting with life-threatening arrhythmia were excluded, and the value of the first echocardiography in predicting the first life-threatening arrhythmia was assessed. One hundred-seventeen patients were included, and life-threatening arrhythmia occurred in 18 during 4.2 years of follow-up. Right ventricular longitudinal strain and left ventricular mechanical dispersion were the strongest predictors of dangerous arrhythmia, and combining these two markers had incremental predictive value. The findings underline that any evidence of myocardial affection is associated with increased risk, and that both ventricles should be assessed for optimal risk prediction in patients with arrhythmogenic cardiomyopathy.

Dejgaard LA, Lie ØH, Håland TF, Ribe M, Edvardsen T, Haugaa KH
Favorable diastolic function and increased left ventricular volumes in hypertrophic cardiomyopathy patients engaging in vigorous exercise

Lars Dejgaard presented the abstract on behalf of the research group. Competitive sports are discouraged in patients with hypertrophic cardiomyopathy, due to possible risk of malignant cardiac arrhythmias. In this study we demonstrated potentially beneficial cardiac changes, such as larger left ventricular volumes, thinner left ventricular walls and better diastolic left ventricular function in hypertrophic cardiomyopathy patients engaging in vigorous exercise. Additionally we found no difference in prevalence of ventricular arrhythmias between the sedate and the exercisers.

Hence, we concluded that ongoing vigorous exercise was associated with favorable cardiac morphology and function and not increased occurrence of ventricular arrhythmias.

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POSTERS AT EUROECHO-IMAGING CONGRESS IN LISBON, PORTUGAL

Aalen J, Hisdal J, Storsten P, Remme EW, Larsen CK, Sirnes PA, Gjesdal O, Skulstad H, Smiseth OA
Pressure-strain loops in the evaluation of left bundle branch block: septal function is aggravated by increased afterload

Aalen J, Larsen CK, Hopp E, Andersen OS, Krogh MR, Odland HH, Kongsgard E, Skulstad H, Remme EW, Smiseth OA
Negative crosstalk between left ventricular lateral wall and septum in left bundle branch block: "the lateral wall paradox"

Andersen OS, Remme EW, Broch K, Andreassen AK, Skulstad H, Gude E, Smiseth OA
Improved estimate of left ventricular filling pressure by left atrial and left ventricular strain imaging

Bjerring AW, Landgraff HEW, Ansari HZ, Saberniak J, Murbræch K, Bruun H, Stokke TM, Haugaa KH, Hallen J, Edvardsen T, Sarvari SI
Early morphological changes in preadolescent athletes assessed by three-dimensional echocardiography

Bjerring AW, Landgraff HEW, Ansari HZ, Saberniak J, Murbræch K, Bruun H, Stokke TM, Haugaa KH, Hallen J, Edvardsen T, Sarvari SI
Early morphological changes and myocardial function assessed by strain echocardiography in preadolescent athlete's heart

Dejgaard LA, Lie OH, Haland TF, Ribe M, Edvardsen T, Haugaa KH
Favorable diastolic function and increased left ventricular volumes in hypertrophic cardiomyopathy patients engaging in vigorous exercise

Klæboe LG, Lie ØH, Dejgaard LA, Haugaa KH, Edvardsen T
Echocardiography can differentiate between athlete’s heart and hypertrophic cardiomyopathy genotype positive with mild phenotype

Larsen CK, Aalen J, Kongsgård E, Fjeld JG, Smiseth OA, Hopp E
Increased diffuse interstitial fibrosis in the septum compared to the left ventricular lateral wall in patients with heart failure and left bundle branch block

Lie ØH, Rootwelt C, Dejgaard LA, Leren IS, Edvardsen T, Haugaa KH
Echocardiography in prediction of life-threatening ventricular arrhythmia in patients with arrhythmogenic cardiomyopathy

Lie ØH, Dejgaard LA, Saberniak J, Rootwelt, Stokke MK, Edvardsen T, Haugaa KH
Harmful effects of exercise intensity and exercise duration in arrhythmogenic cardiomyopathy

Nestaas E, Gjesdal O, Sarvari SI, Hopp E, Smith HJ, Haugaa KH, Edvardsen T
Late occurring post systolic shortening is a marker of myocardial scar

Nestaas E, Gjesdal O, Sarvari SI, Hopp E, Smith HJ, Haugaa KH, Edvardsen T
The association between segmental scar burden and late occurrence of post-systolic strain

Remme EW, Stokke TM, Haugaa KH, Smiseth OA, Edvardsen T
Subendocardial speckle tracking overestimates myocardial shortening and may falsely indicate preserved systolic function in hypertrophic cardiomyopathy patients

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