More than 50 Norwegian researchers presented work at the world’s largest cardiovascular congress, the ESC Congress 2017 in Barcelona.
SATURDAY AUGUST 26
SYMPOSIUM
INGER-LISE AAMOT, Trondheim:
High intensity interval training at home
Home-based high intensity interval training is an effective, safe and feasible alternative to center-based cardiac rehabilitation, according to the presentation given by Aamot.
ADVANCES IN SCIENCE
TERJE PEDERSEN, Oslo:
State-of-the-art: Statin therapy
Professor Pedersen presented evidence for the effect of statins on cardiovascular morbidity and mortality. He also argued that low statin adherence due to muscular pain is a result of the nocebo effect.
METTE-ELISE ESTENSEN, Oslo:
Timing and mode of re-intervention in Tetralogy of Fallot
Tetralogy of Fallot is one of the most common types of congenital heart disease, and many patients need reoperation and re-intervention following primary surgical repair. Estensen’s presentation emphasized that continued efforts to develop the right time for the «ideal
valve» and implant methods are needed.
POSTERS
ELISABETH IVERSEN, Bergen:
Pulmonary vein stenosis after ablation treated by stent implantation – long term outcome
Stent implantation in symptomatic pulmonary vein stenosis after ablation demonstrates good clinical effect during long term follow up, and atrial fibrillation ablation can be performed in patients previously stented for pulmonary vein stenosis.
CHARLOTTE BJØRK INGUL, Trondheim:
Cardiac function in newborns of obese women and the effect of an exercise intervention during pregnancy
Newborns of obese women had reduced cardiac function compared to normal weight women. Exercise during pregnancy had no effect, maybe due to low adherence.
PETTER STORSTEN, Oslo
Relative downregulation of septal function and metabolism in TGA patients with atrial switch
Patients with transposition of the great arteries demonstrated markedly reduced septal function, which was accompanied by reduction in septal metabolism. The change in septal function and metabolism may be early markers of decompensation of the systemic ventricle.
SUNDAY AUGUST 27
CHAIR PERSONS
TERJE PEDERSEN, Oslo: DEBATE SESSION: Do we need PCSK9 inhibitors in post-MI patients?
OTTO SMISETH, Oslo: SYMPOSIUM: Echo for cardiac function: bread and butter for the clinician
EVA GERDTS, Bergen: ADVANCES IN SCIENCE: Hypertension damage – Under the radar
TONE MERETE NOREKVÅL, Bergen: ADVANCES IN SCIENCE: Heart and mind
TERJE KRISTIAN STEIGEN, Tromsø: ADVANCES IN SCIENCE: Chest pain in the emergency department: the “Biomarkers-Versus-Imaging-Dilemma”
MAIN SESSION
SIGRUN HALVORSEN, Oslo:
Primary PCI and fibrinolysis procedures
Professor Halvorsen presented the updated ESC guidelines for primary PCI and fibrinolysis procedures in patients with an acute STEMI.
STEFAN AGEWALL, Oslo:
Myocardial infarction with normal coronary arteries
During the same session in the main auditorium, professor Agewall presented the new guidelines regarding myocardial infarction with non-obstructive coronary arteries.
SATELLITE SYMPOSIA
DAN ATAR, Oslo:
Heart failure care – Where can things go wrong?
Vice-President of the ESC, Dan Atar, underlined that several things can go wrong in the continuum of care of heart failure patients. Important issues include the presence of an uptitraion plan and follow-up appointment scheduled at discharge, as well as securing adherence to therapies in the outpatient setting.
SIGRUN HALVORSEN, Oslo:
The patient in focus: the fragile atrial fibrillation (AF) patient
This talk focused on optimal clinical practices with non-vitamin K antagonist oral anticoagulants (NOACs) in stroke prevention in fragile patients with atrial fibrillation.
SYMPOSIA
KENNETH DICKSTEIN, Stavanger:
Should we abandon ejection fraction as indication for CRT?
In this talk, professor Dickstein pointed out that ejection fraction does not define underlying pathophysiology in heart failure, that it is an indicator of left ventricle volume rather than contractile function, and that there is consistent drug benefit across patients independent of ejection fraction.
TORBJØRN OMLAND, Oslo:
Population research in Circulation
Professor Omland is associate editor of Circulation, and presented an overview of what the new Circulation looks for in manuscripts on population research.
ADVANCES IN SCIENCE
FADL EL MULA MOHAMED FADL EL MULA, Oslo:
Sham or no-sham control in trials of renal denervation for treatment resistant hypertension: a systematic meta-analysis
This analysis does not support the use of sham control in studies of renal denervation in resistant hypertension. Pooled effects of nine randomized and controlled studies of renal denervation showed no significant effect on blood pressure.
RAPID FIRE ABSTRACT
ERIK PRESTGAARD, Oslo:
7-year change in physical fitness in healthy middle-aged men predicts stroke during 28 years follow-up
Temporal change in physical fitness in middle-aged healthy men predicts stroke during long-term follow-up and into old ages.
MODERATED POSTER
MARIA JOAO PINJO, Trondheim
Modeling of cardiac ischaemia and reperfusion injury: a human-based in vitro model using iPS-derived cardiomyocytes
The data presented in this study lend support to the use of human induced pluripotent stem derived cardiomyocytes as a relevant model system to investigate ischemia/reperfusion injury.
POSTERS
KRISTIN ANGEL, Oslo:
Maternal cardiovascular status after pregnancies complicated by preeclampsia or diabetes
Multiple significant structural and functional cardiovascular abnormalities are found in women one year after pregnancy complicated by preeclampsia.
ERIKA NERDRUM AAGÅRD, Oslo
Left ventricular mechanical dispersion, a novel marker for ventricular arrhythmic events, is increased in conditions with enhanced risk for cardiovascular disease. Data from the ACE 1950 study
Increased left ventricle mechanical dispersion is frequently present in subjects with clinical conditions at risk of cardiovascular disease. This may indicate that these individuals are more prone to ventricular events.
DANIELA MELICHOVA, Arendal:
Mechanical dispersion predicts survival after ST-segment elevation myocardial infarction in patients treated with thrombolysis or percutaneous coronary intervention
STEMI patients treated with thrombolysis had increased risk of ventricular arrhythmia and death compared to patients treated with primary PCI. Mechanical dispersion predicted adverse clinical events, which indicates that increased heterogenous myocardial deformation after STEMI may affect outcome.
STINE FOSSUM, Oslo:
Cardiovascular risk profile at the age of 40 in women with previous hyperemesis gravidarum or hypertensive disorders in pregnancy
Women with previous hypertensive disorders in pregnancy had increased levels of most cardiovascular risk factors at the age of 40, but there was no consistent evidence of increased cardiovascular risk among women who suffered from hyperemesis gravidarum.
LARS ANDREAS DEJGAARD, Oslo:
Exercise and gender differences in hypertrophic cardiomyopathy
Exercise was associated with larger left ventricular volumes only in females with hypertrophic cardiomyopathy. Maximal wall thickness was smaller in phenotype positive female athletes than in phenotype positive female non-athletes. No such association was seen in males or in females with genotype positive, phenotype negative hypertrophic cardiomyopathy.
CECILIE BENEDICTE ISERN, Oslo:
Value of blood pressure measurements in both arms in olympic and paralympic athletes
Elevated blood pressure can easily be missed if measured in one arm only: One quarter of Olympic and Paralympic athletes had high or high-normal blood pressure, and one third had a blood pressure difference of more than 5 mmHg between arms.
HILDE MOSEBYE BERGE, Oslo:
Cardiovascular incidents, including sudden cardiac arrests, in professional male football players with negative preparticipation cardiac screening results: 8-year follow-up
A comprehensive protocol including echocardiography and ECG was not sufficient to detect cardiovascular disease at an early stage in male football players i Norway. Thus, routine pre-participation cardiac screening should not be recommended.
GARD FRODAHL TVEITEVÅG SVINGEN, Bergen:
Plasma trimethylamine-N-oxide is associated with atrial fibrillation
Among patients with suspected stable angina pectoris, plasma TMAO was associated with previous and incident atrial fibrillation, and improved risk prediction of the latter. The findings suggest that higher plasma TMAO reflects metabolic alterations predisposing for atrial fibrillation.
MONDAY AUGUST 28
CHAIR PERSONS
MAJA-LISA LØCHEN, Tromsø: SYMPOSIUM: Cholesterol in prevention guidelines: differing views across the oceans
TONE MERETE NOREKVÅL, Bergen: SYMPOSIUM: Taking care of patients with grown-up congenital heart disease
STEFAN AGEWALL, Oslo: SYMPOSIUM: The use of oral anticoagulants in special situations
OLE CHRISTIAN MJØLSTAD, Trondheim: ADVANCES IN SCIENCE: ICD indications in 2017
SYMPOSIA
DAN ATAR, Oslo:
Oral anticoagulation in patients after STEMI – Old data, new trials and clinical advice
Professor Atar prestented information from new trials that could shed new light on the role of oral anticoagulants in coronary heart
disease, and may lead to new recommendations post STEMI.
SVERRE ERIK KJELDSEN, Oslo:
Managing hypertension in the elderly – When to start and how low to go?
In this talk, Professor Kjeldsen presented updated information on recommended blood pressure lowering strategies in people older than 65 years of age.
SIGRUN HALVORSEN, Oslo:
“Plaque but no obstructive coronary disease” – Primary or secondary prevention?
Non-obstructive coronary artery disease is generally not recognized as a high-risk condition with need of secondary prevention. However, Halvorsen argued that secondary prevention with statins should be prescribed to most of these patients, in addition to risk factor modification.
ADVANCES IN SCIENCE
EVA GERDTS, Bergen:
Sex difference in cardiovascular risk is offset by presence of left ventricular hypertrophy
In hypertension, presence of left ventricular hypertension attenuates the sex difference in cardiovascular risk.
RAPID FIRE ABSTRACT
JON AALEN, Oslo:
Patients with left bundle branch block are hypersensitive to afterload: moderate elevation of systolic pressure caused marked depression of left ventricular function
Moderate elevation of afterload in patients with left bundle branch block caused marked depression of left ventricular systolic function. This was attributed to aggravation of septal function.
MODERATED POSTER
KARL-ANDREAS DUMONT, Oslo:
Validation of a novel 3D holographic display for non-invasive quantification of mitral annular dynamics
A new and non-invasive three-dimensional virtual semi-automatic, semi-transparent method for quantification of mitral annular dynamics may represent a new powerful tool for quantifying mitral annular dynamics. The method correlates well with sonomicrometry over a wide range of loading conditions.
BEST POSTER
ØYUNN KLEIVEN, Stavanger:
Prolonged release of cardiac troponin I after endurance exercise could indicate silent coronary artery disease in recreational athletes: the NEEDED study 2014
Subjects with coronary artery disease had significantly higher cardiac troponin I values 24 hours after endurance exercise. This finding suggests that the subjects with highly increased cardiac troponin I values after prolonged exercise should be further investigated even in the absence of symptoms or significant ECG changes.
POSTERS
KRISTINA FLADSETH, Tromsø:
Differences in mortality between patients referred to coronary angiography with stable angina or unstable angina
There was no difference in mortality between patients referred to coronary angiography for unstable and stable angina. A better identification of acute angina patients who safely can be referred to elective coronary angiography is warranted.
JAHN FREDERIK GRUE, Trondheim:
Automatic measurements of tissue doppler indices to detect left ventricular dysfunction
Automatic measurements of mitral annular motion were helpful in detection of left ventricular dysfunction. MAPSE and S’ were the best among the indices that were assessed.
VEGARD VAVIK, Bergen:
Systemic cardiac troponin T is associated with incident atrial fibrillation among patients with suspected stable angina
In a large and well-defined cohort of patients undergoing elective coronary angiography, higher levels of high sensitive cardiac troponin T predicted increased risk of incident atrial fibrillation independent of traditional risk factors.
LARS MOLGAARD SAXHAUG, Levanger:
Feasibility, accuracy and clinical influence of pocket-sized imaging by experts of the carotid arteries in patients with stroke and transitory ischemic attack
Point-of-care examinations of the carotid arteries by experts using a pocket-sized imaging device were feasible, accurate and could significantly reduce the need for high-end ultrasound examination in stroke and TIA patients.
STEFAN AGEWALL, Oslo:
Heart rate prediction of outcome in heart failure following myocardial infarction depend on heart rhythm status
In patients with reduced systolic function and/or heart failure after myocardial infarction, higher heart rate predicts increased major cardiovascular events during the first year in patients without atrial fibrillation. This association is markedly attenuated in subjects with atrial fibrillation.
JARLE JORTVEIT, Lillesand:
Bystander cardiopulmonary resuscitation after out-of- hospital cardiac arrest in children with congenital heart defects
The rate of bystander cardiopulmonary resuscitation after out-of-hospital cardiac arrest among children with congenital heart defects was high in Norway between 1994 and 2012. The survival was comparable to the reported rate in the general child population.
DAN ATAR, Oslo:
Differences in two-year outcomes according to type of atrial fibrillation: results from the GARFIELD-AF registry
Persistent and permanent atrial fibrillation were associated with higher mortality risk than paroxysmal atrial fibrillation, but had similar adjusted risks of stroke/systemic embolism and major bleeding in two years of follow-up.
TUESDAY AUGUST 29
CHAIR PERSONS
STEFAN AGEWALL, Oslo: SYMPOSIUM: Pharmacological treatment of Takotsubo cardiomyopathy
THOR EDVARDSEN, Oslo: SYMPOSIUM. Role of imaging in common clinical scenarios – Update on practice recommendations
DAN ATAR, Oslo: ADVANCES IN SCIENCE: How to make oral anticoagulation safe
THOR EDVARDSEN, Oslo: RAPID FIRE ABSTRACT: Deformation imaging and outcome
GUIDELINES IN DAILY PRACTICE
TRYGVE SUNDBY HALL, Oslo:
Gastrointestinal bleeding in an atrial fibrillation patient
Sundby Hall presented the treatment of a female patient with atrial fibrillation and gastrointestinal bleeding.
SYMPOSIA
MARIUS TRØSEID, Oslo:
The gut and the heart
In a session focusing on how cardiovascular disease can be prevented with a healthy diet, Trøseid presented the latest update on the relation between diet, gut microbiota and cardiovascular risk. He concluded that if the gut microbiome should be clinically relevant, a personalized approach is probably necessary.
ERIK EKKER SOLBERG, Oslo:
Sports cardiology highlights
Ekker Solberg is chair-elect of the Society of Cardiology’s working group on sports cardiology, and presented the last year’s scientific highlights within the field.
CASE-BASED SYMPOSIUM
SARA REINVIK ULIMOEN, Rud:
70 year old female with pancreatic cancer and syncope
In this session on cardiovascular challenges of anticancer therapy, Reinvik Ulimoen presented a patient case with with pancreatic cancer and syncope.
CARDIOLOGY @BREAKFAST
MAJA-LISA LØCHEN, Tromsø:
Choosing the right pharmacologic agent for smoking cessation
Professor Løchen summed up her talk concluding that a health professional should never stop assisting with smoking cessation, and that nicotine replacement therapy, bupropion and varenicline are effective therapies.
CLINICAL TRIAL UPDATES
TERJE PEDERSEN, Oslo:
Further Cardiovascular Outcomes Research with PCSK9 Inhibition in Subjects With Elevated Risk
The FOURIER study investigates if additional LDL cholesterol lowering with evolocumab is well tolerated and decreases the risk of major cardiovascular events in subjects with clinically evident cardiovascular disease. Professor Pedersen presented the latest updates from this double-blind, randomized, placebo-controlled, multicenter study, where data collection for the primary outcome measure was completed in 2016,
ADVANCES IN SCIENCE
EVA GERDTS, Bergen:
Sex difference in cardiovascular risk is offset by presence of left ventricular hypertrophy
In hypertension, presence of left ventricular hypertension attenuates the sex difference in cardiovascular risk.
RAPID FIRE ABSTRACTS:
ØYVIND HAUGEN LIE, Oslo:
Exercise dose and threshold for adverse outcome in arrhythmogenic cardiomyopathy
Higher exercise doses were associated with adverse outcome in patients with arrhythmogenic cardiomyopathy. More than 2.5 hours of moderate intensity exercise each week was the threshold for ventricular arrhythmia and right ventricular dilation, and double the exercise dose was the threshold for right and left ventricular dysfunction.
KJETIL HALVORSEN LØLAND, Bergen:
Presentation, detection and treatment of Lotus valve thrombosis
Thrombosis of the Lotus valve is not uncommon and associated with significant valvular dysfunction and morbidity. Multidetector computed tomography is crucial in both detection and monitoring of therapeutic intervention.
ODD ERIK JOHANSEN, Asker:
Effects of empagliflozin on cardiac and vascular hemodynamic markers by subgroups of age, sex and hypertension in patients with T2DM and high CV risk: EMPA-reg outcome
Empagliflozin consistently improved systolic blood pressure and cardiac and vascular hemodynamic markers, irrespective of age, sex, or baseline systolic blood pressure.
NAIYEREH MOHAMMADZADEH, Oslo:
Lack of the extracellular matrix proteoglycan lumican in mice exacerbates left ventricular dilatation and contractile dysfunction upon pressure overload
Lumican seems to play an important role during development and cardiac remodeling in response to pressure overload, with exacerbated dilatation and contractile dysfunction as the most important phenotype.
MODERATED POSTERS
AYODEJI AWOYEMI, Oslo:
Markers of gut leakage are associated with cardiovascular events in a high-risk population
The significant association found between markers of gut leakage and clinical outcome in individuals at high risk of cardiovascular disease indicate that gut-related endotoxemia is of importance.
CHRISTIAN SHETELIG, Oslo:
Circulating interleukin-8 levels are associated with myocardial injury, left ventricular function and future clinical adverse events in patients with ST-elevation myocardial infarction
High circulating interleukin-8 levels in STEMI patients were associated with large infarct size, impaired recovery of left ventricular function and adverse clinical outcome.
SAHRAID SAEED, Bergen:
Hypertension is associated with subclinical left ventricular dysfunction in ischemic stroke survivors (the NOR-SYS study)
Hypertensive stroke survivors had greater burden of cardiovascular disease risk factors and markedly reduced peak systolic global longitudinal strain, reflecting subclinical left ventricular dysfunction. The prevalent subclinical left ventricular dysfunction may contribute to the observed higher cardiovascular event rate in stroke survivors.
RAGNA ELISE GOVATSMARK, Trondheim:
Completeness and correctness of myocardial infarction diagnoses in a medical quality register and an administrative health register
The Norwegian Myocardial Infarction Register and the Norwegian Patient Register showed high degree of completeness and correctness. Both registries may be used for administrative purposes, disease surveillance, quality assessment, and research.
POSTERS
ANDERS HOMMERSTAD, Oslo:
Worst lead residual ST-deviation 60 minutes after primary PCI for STEMI is associated with infarct size and myocardial salvage on cardiac magnetic resonance imaging
Significant associations were detected between worst lead residual ST-deviation measured 60 minutes after revascularisation of a first time STEMI and infarct size, myocardial salvage and microvascular obstruction.
ANNE PERNILLE OFSTAD, Oslo:
Concomitant heart failure (HF) and type 2 diabetes (T2D) – a deadly duo
In vulnerable patients with type 2 diabetes and concomitant heart failure, guideline recommended heart failure drugs are effective. When choosing glucose lowering therapy, outcomes from available cardiovascular outcome trials should be considered.
NATHAN SCRIMGOUR, Trondheim:
MicroRNA-451a regulate expression and activity of matrix metalloproteinases 2 and 9 in human cardiomyocytes
MicroRNA-451a seems to have an important role on regulating MMP2 and 9 in human cardiac cells. Increasing low expressed microRNA-451a in patients with heart failure after myocardial infarction may have a potential for further verification as targeted treatment of heart failure.
JACOB THALAMUS, Skien:
Pitfalls in automated QTc measurements. Experience from a manual review
Agreement between manually and automated QTc measurement was 88% in ECGs in sinus rhythm and with adequate technical quality indicating reliable automated QTc in absence of atrial fibrillation and other rhythm disturbances.
HELGA MIDTBØ, Bergen:
Abnormal left ventricular geometry in ankylosing spondylitis
Patients with ankylosing spondylitis have higher prevalence of left ventricular hypertrophy, in particular eccentric left ventricular hypertrophy, which may contribute to the reported increased risk of cardiovascular events in patients with ankylosing spondylitis.
DANA CRAMARIUC, Bergen:
Sex-specific covariates of aortic valve calcification by echocardiography: relation to outcome in aortic stenosis
Aortic valve calcification scored by echocardiography has sex-specific characteristics in aortic stenosis. Moderate/severe aortic valve calcification is associated with higher cardiovascular morbidity in both sexes, and with higher all-cause mortality in men.