(2/3) Levels of mid-regional pro-adrenomedullin and fibroblast growth factor 23 are higher on hospital admission in acute dyspnea patients with heart failure than in patients with acute dyspnea from other causes. However, the biomarkers’ diagnostic abilities are not as good as the traditional heart failure biomarker NT-proBNP.

More than 300 patients admitted to Akershus University Hospital with acute dyspnea were included in the studies. Nearly half of them had heart failure. Almost half of the patients with heart failure or COPD died during a follow-up period of median 2.5 years. Concentrations of mid-regional pro-adrenomedullin at admittance predicted mortality in heart failure but not COPD. Levels of fibroblast growth factor 23 were also associated with mortality in the heart failure patients, as well as in the full study population.

(4) Mid-regional pro-atrial natriuretic peptide and NT-proBNP are  equally strong diagnostic biomarkers for heart failure in patients admitted with acute dyspnea. Both biomarkers associate with mortality in patients with acute heart failure but only mid-regional pro-atrial natriuretic peptide predicts death also in patients with acute exacerbations of COPD.

(1) Included in the thesis is also a paper of the rationale and methology for the Akershus Cardiac Examination 1950 Study (ACE 1950). This study was performed between 2012 and 2015, and aims to investigate development and progression of cardiovascular disease and stroke in middle-aged men and women. The cohort study includes 3,706 women and men born in 1950 and living in Akershus County. Examinations include cardiac and carotid artery ultrasound, ECG, cognitive tests, blood and urine sampling, spirometry, blood pressure and body composition.

Almost 65 % of the eligible men and women participated, with an approximately even sex distribution. The participants will be followed up over several years, potentially through both questionnaires and national health registries.