Mohammad Osman Pervez has assessed the potential of three novel biomarkers for cardiovascular disease in patients with acute dyspnea.


  1. Mid-regional pro-adrenomedullin, fibroblast growth factor 23 and mid-regional pro-atrial natriuretic peptide all predict early death in patients hospitalized with acute heart failure.
  2. None of the three biomarkers are better than NT-proBNP in diagnosing heart failure in patients admitted with acute dyspnea.


Thesis: Novel biomarkers in patients with acute dyspnea
Candidate: Mohammad Osman Pervez
Time: September 10, 2020 at 12:15
Place: Online-based solution, due to the covid-19 situation
Link to university website


(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.


(1) Berge, T., Vigen, T., Pervez, M. O., Ihle-Hansen, H., Lyngbakken, M. N., Omland, T., Smith, P., Steine, K., Røsjø, H., Tveit, A., & ACE 1950 Study Group. (2015). Heart and brain interactions–the Akershus Cardiac Examination (ACE) 1950 Study design. Scandinavian Cardiovascular Journal49(6), 308-315.

(2) Pervez, M. O., Lyngbakken, M. N., Myhre, P. L., Brynildsen, J., Langsjøen, E. C., Høiseth, A. D., Christensen, G., Omland, T., & Røsjø, H. (2017). Mid-regional pro-adrenomedullin in patients with acute dyspnea: Data from the Akershus Cardiac Examination (ACE) 2 Study. Clinical biochemistry50(7-8), 394-400.

(3) Lyngbakken, M. N., Pervez, M. O., Brynildsen, J., Pedersen, M. H., Sølvernes, J., Christensen, G., Høiseth, A. D., Omland, T., & Røsjø, H. (2018). Fibroblast growth factor 23 in patients with acute dyspnea: data from the Akershus Cardiac Examination (ACE) 2 Study. Clinical biochemistry52, 41-47.

(4) Pervez, M. O., Winther, J. A., Brynildsen, J., Strand, H., Christensen, G., Høiseth, A. D., Myhre, P. L., Røysland, R., Lyngbakken, M. N., Omland, T., & Røsjø, H. (2018). Prognostic and diagnostic significance of mid-regional pro-atrial natriuretic peptide in acute exacerbation of chronic obstructive pulmonary disease and acute heart failure: data from the ACE 2 Study. Biomarkers23(7), 654-663.

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