Papers by Reidar Bjørnerheim
Tidsskrift for Den norske legeforening
European heart journal. Acute cardiovascular care, 2017
Echocardiography is recommended for assessment of left ventricular systolic function in patients ... more Echocardiography is recommended for assessment of left ventricular systolic function in patients with acute heart failure but few randomised trials have validated techniques like tissue Doppler (TDI) and speckle tracking (STE) in patients with acute heart failure following ST-elevation myocardial infarction. This was a substudy from the LEAF (LEvosimendan in Acute heart Failure following myocardial infarction) trial (NCT00324766 ), which randomised 61 patients developing acute heart failure, including cardiogenic shock, within 48 hours after ST-elevation myocardial infarction, double-blind to a 25-hour infusion of levosimendan or placebo. TDI-derived systolic mitral annulus velocity (S'), STE-derived global longitudinal strain (S) and strain rate (SR) were measured at baseline, day 1, day 5 and after 42 days. Datasets rejected for analyses were 2% (TDI) and 17% (STE). S' increased by 23% in the levosimendan group versus 8% in the placebo group from baseline to day 1 ( p= 0.0...
Oxford Medicine Online, 2016
Modern digital echo laboratories are based on echo scanners working in a network with file server... more Modern digital echo laboratories are based on echo scanners working in a network with file server(s) and work-station computers for offline analysis and reporting. They may be based on vendor-specific software, but are preferably based on vendor-independent software solutions, being able to handle data from all brands of scanners. To enable analysis of advanced echocardiographic techniques, plug-ins for vendor-specific solutions should be integrated in the otherwise vendor-independent software. To obtain full efficiency, the system should be integrated with the hospital information system for patient demographics and scheduling, and the approved report should automatically be returned to the electronic patient record without the need for scanning or other handling by manpower. To obtain this, a variety of standards have been developed, most of them for medical imaging in general. Scanners of all major brands deliver data compatible with those standards, even if compatibility problem...
New England Journal of Medicine, 2016
Background Limited data are available on the long-term effects of contemporary drug-eluting stent... more Background Limited data are available on the long-term effects of contemporary drug-eluting stents versus contemporary bare-metal stents on rates of death, myocardial infarction, repeat revascularization, and stent thrombosis and on quality of life. Methods We randomly assigned 9013 patients who had stable or unstable coronary artery disease to undergo percutaneous coronary intervention (PCI) with the implantation of either contemporary drug-eluting stents or bare-metal stents. In the group receiving drug-eluting stents, 96% of the patients received either everolimus- or zotarolimus-eluting stents. The primary outcome was a composite of death from any cause and nonfatal spontaneous myocardial infarction after a median of 5 years of follow-up. Secondary outcomes included repeat revascularization, stent thrombosis, and quality of life. Results At 6 years, the rates of the primary outcome were 16.6% in the group receiving drug-eluting stents and 17.1% in the group receiving bare-metal stents (hazard ratio, 0.98; 95% confidence interval [CI], 0.88 to 1.09; P=0.66). There were no significant between-group differences in the components of the primary outcome. The 6-year rates of any repeat revascularization were 16.5% in the group receiving drug-eluting stents and 19.8% in the group receiving bare-metal stents (hazard ratio, 0.76; 95% CI, 0.69 to 0.85; P<0.001); the rates of definite stent thrombosis were 0.8% and 1.2%, respectively (P=0.0498). Quality-of-life measures did not differ significantly between the two groups. Conclusions In patients undergoing PCI, there were no significant differences between those receiving drug-eluting stents and those receiving bare-metal stents in the composite outcome of death from any cause and nonfatal spontaneous myocardial infarction. Rates of repeat revascularization were lower in the group receiving drug-eluting stents. (Funded by the Norwegian Research Council and others; NORSTENT ClinicalTrials.gov number, NCT00811772 .).
Scandinavian Journal of Clinical Laboratory Investigation, 1987
... Golf S, Bjornerheim R, Erichsen A, Hansson V. Relative selectivity of different @-adrenocepto... more ... Golf S, Bjornerheim R, Erichsen A, Hansson V. Relative selectivity of different @-adrenoceptor antagonists for human heart PI-and P2-receptor ... further submitted to iterated computer calcula-tions to determine the best fit according to different affinities for two separate binding ...
The Journal of Biological Chemistry, 2008
J Mol Cell Cardiol, 1986
The objective of the present study was to examine the effect of dietary ~3 fatty acids on fatty a... more The objective of the present study was to examine the effect of dietary ~3 fatty acids on fatty acid profile of porcine heart sarcol-mma and whether it caused changes in functional activities of the membrane. A concentration of 9% (W/w) mackerel oil or lard fat was added to a fatpoor diet of young pigs. After 8 weeks biopsies were taken from the left ventricle and homogenates and enriched sarcolemma fractions were prepared. Major changes were observed in 18:2~6, 20:4~6, 20:5~3 and 22:6~3 content with very little alterations of saturated fatty acids. Double bond indices were 1.28 and 1.85 in lard fat and mackerel oil fat fed animals, resp. Ca 2+ pumping ATPase and 5'-nucleotidase specific activities were significantly lower in the lard fat fed animals. No dietrelated differences were observed in the specific activity of the Na+/ Ca 2+ antiporter and its sensitivity to a K + diffusion potential. Adenylate cyclase in sarcolemma from mackerel oil fed pigs was more sensitive to stimulation by isoproterenol.
J Steroid Biochem Mol Biol, 1993
Intraprocedural Imaging of Cardiovascular Interventions, 2016
Tidsskrift For Den Norske Laegeforening, Sep 1, 2003
Scand J Clin Lab Invest, 1987
Tidsskrift For Den Norske Laegeforening, Dec 1, 2008
Ultrasound-based techniques are frequently used in cardiology, gynecology and radiology. Work-rel... more Ultrasound-based techniques are frequently used in cardiology, gynecology and radiology. Work-related symptoms are reported for ultrasound operators, but controlled studies have not been published. We wanted to map symptoms and clinical diagnoses in ultrasound operators, compare them to matched controls and evaluate a possible relation between symptoms and exposure. All ultrasound operators working at Rikshospitalet and Ullevaal University hospitals and matched controls who had other work at the hospitals were invited to participate. They answered questions about pain, well-being at the workplace, physical activity, smoking and validated function scores for the back (Oswestry Disability Index-ODI), shoulder and arm (Quick-DASH), and health- related quality of life (EQ-5D and EQ-VAS, as well as exposure time for ultrasound examinations. All participants underwent a blinded, systematic clinical examination. 81 persons participated (43 women, 38 men); 44 operators and 37 controls. The ultrasound operators reported significantly more work-related pain from the wrist, elbow and shoulder and scored significantly worse on Quick-DASH (difference 6.1 [95 % CI 2.0 to 10.2, p < 0.001) and health-related function (EQ-5D). There was no difference in health-related quality of life (EQ-VAS) or back function (ODI). The number of persons with one or more clinical diagnosis was significantly higher for ultrasound operators (26/44 [59 %]) than controls (7/37 [19 %]), odds ratio 5.2; 95 % CI 2,0 to 14.0, p < 0.001. For subacromial pain the numbers were 11/44 (25 %) and 2/37 (5 %), odds ratio 5,8; CI 1.2 to 28.3, p = 0.034. For the ultrasound operators there was a significant association between exposure > 1000 min/week and Quick-DASH, subacromial pain and lateral epicondylagia. Ultrasound operators reported significantly more shoulder and arm complaints and clinical diagnosis than controls.
European Journal of Echocardiography, 2007
Aims Hypertension is one of several risk factors of cardiovascular disease and is associated with... more Aims Hypertension is one of several risk factors of cardiovascular disease and is associated with left ventricular (LV) systolic and diastolic dysfunction. A method for reliably detecting the onset of LV dysfunction before transition to irreversible damage of the myocardium would be of crucial importance in subjects with essential hypertension. Methods and results Subjects with clear differences in BP level, development and duration of the hypertensive disease were examined at the age of 60 yrs: normotensives (n ¼ 17), new hypertensives who developed hypertension over a 20 year period (n ¼ 15) and hypertensives (n ¼ 19). Relationships between conventional echocardiographic and tissue velocities imaging (TVI) parameters compared to LV parameters, and TVI as an estimate of LV function were explored. E 0 Lat (TVI peak early diastolic velocity) (P ¼ 0.006) and E/E 0 Lat (P ¼ 0.002) demonstrated differences in diastolic function between the groups. There were no significant differences regarding systolic myocardial velocities. E 0 Lat correlated to S 0 Lat (TDI peak systolic velocity) (r ¼ 0.32, P ¼ 0.026) and was independently predicted by S 0 Lat (R 2 ¼ 0.24, P ¼ 0.025) in multivariate analysis. E 0 Lat correlated negatively to LV mass index (r ¼ 20.34, P ¼ 0.012), also in multivariate regression analysis (R 2 ¼ 0.12, P ¼ 0.032). Conclusions Myocardial diastolic velocities and mitral flow to annulus velocity ratio differentiated LV function between the hypertensive and normotensive groups. The parameters probably reflect changes in relaxation, recoil and contraction and parallel changes in LV mass index.
Thrombosis Journal, 2015
Introduction: Platelet activation, thrombin generation and fibrin formation play important roles ... more Introduction: Platelet activation, thrombin generation and fibrin formation play important roles in intracoronary thrombus formation, which may lead to acute myocardial infarction. We investigated whether the prothrombotic markers D-dimer, pro-thrombin fragment 1 + 2 (F1 + 2) and endogenous thrombin potential (ETP) are associated with myocardial necrosis assessed by Troponin T (TnT), and left ventricular impairment assessed by left ventricular ejection fraction (LVEF) and N-terminal pro b-type natriuretic peptide (NT-proBNP). Materials/Methods: Patients (n = 987) with ST-elevation mycardial infarction (STEMI) were included. Blood samples were drawn at a median time of 24 h after onset of symptoms. Results: Statistically significant correlations were found between both peak TnT and D-dimer (p < 0.001) and F1 + 2 (p < 0.001), and between NT-proBNP and D-dimer (p = 0.001) and F1 + 2 (p < 0.001). When dividing TnT and NT-proBNP levels into quartiles there were significant trends for increased levels of both markers across quartiles (all p < 0.001) D-dimer remained significantly associated with NT-proBNP after adjustments for covariates (p = 0.001) whereas the association between NTproBNP and F1 + 2 was no longer statistically significant (p = 0.324). A significant inverse correlation was found between LVEF and D-dimer (p < 0.001) and F1 + 2 (p = 0.013). When dichotomizing LVEF levels at 40 %, we observed significantly higher levels of both D-dimer (p < 0.001) and F1 + 2 (p = 0.016) in the group with low EF (n = 147). Summary/conclusion: In our cohort of STEMI patients we demonstrated that levels of D-dimer and F1 + 2 were significantly associated with myocardial necrosis as assessed by peak TnT. High levels of these coagulation markers in patients with low LVEF and high NTproBNP may indicate a hypercoagulable state in patients with impaired myocardial function.
Scandinavian Journal of Clinical and Laboratory Investigation
The affinity constants of inhibition (Ki values) for both beta 1- and beta 2-receptor subtypes we... more The affinity constants of inhibition (Ki values) for both beta 1- and beta 2-receptor subtypes were determined for four different beta-adrenoceptor antagonists by a radioligand binding technique in a human myocardial membrane preparation. The radioligand was the high affinity antagonist [125I]-(-)-iodocyanopindolol (ICYP), and the drugs tested were atenolol, metoprolol, ICI 141,292 and ICI 118,551. Different concentrations of the drugs at test were allowed to compete with a constant concentration of ICYP for the specific binding sites (beta-receptors). Ki values for beta 1- and beta 2-receptors for each beta-adrenoceptor antagonist were developed from these data by computer calculations. Atenolol and metoprolol were found to differ slightly regarding potency (absolute Ki values) and to be practically equal regarding relative selectivity (approx. 40; i.e. ratio between high and low Ki values), while ICI 141,292 was found to have slightly higher relative selectivity (approx. 60) and much higher potency. All these drugs exhibited highest affinity for the beta 1-receptor population. In contrast, ICI 118,551 exhibited a very high relative selectivity (approx. 300) with highest affinity for the beta 2-receptor subtype. The method represents a good supplement to physiological and clinical examinations of selectivity of beta-blockers, and offers several advantages regarding simplicity, specificity and accuracy.
Cardiovascular Research
The aim of this study was to investigate the relative numbers of myocardial beta 1 and beta 2 rec... more The aim of this study was to investigate the relative numbers of myocardial beta 1 and beta 2 receptors in pigs. Membrane particles from left ventricular porcine and mixed ventricular rat myocardium were examined for subtypes of beta adrenergic receptors with a radioligand binding technique using [125I]-cyanopindolol (ICYP) as trace, and the new highly beta 1 selective antagonist Sandoz 204 545 and the beta 2 selective antagonist ICI 118 551 for displacement. Radioligand displacement experiments were also performed using propranolol, isoprenaline and terbutaline. The displacement curves obtained with the subtype selective antagonists and agonist revealed biphasic inhibition of specific ICYP binding in rat preparations, indicating a beta 1/beta 2 ratio of approximately 2/1. In porcine preparations displacement of specific ICYP binding with all agents resulted in monophasic curves, thus sharply contrasting the rat preparations. Affinity constants of displacing drugs derived from these monophasic curves indicated that the specific binding site was a beta 1 receptor. No displacement compatible with beta 2 affinity was found. In the same rat preparations we found that adenylate cyclase activation and inhibition by beta receptor subtype specific agonists and antagonists were mediated by two receptor subtypes, whereas in the pig, adenylate cyclase activation and its inhibition seemed to occur via only one receptor subtype, the beta 1 adrenoceptor.
Tidsskrift for Den norske legeforening
Despite an increase in the number of education positions for cardiologists in Norway in the late ... more Despite an increase in the number of education positions for cardiologists in Norway in the late 1980s, there is felt to be a marked lack of sub-specialists in cardiology in most types of hospitals. A working group under the Norwegian Society of Cardiology has used a questionnaire in 1993, membership data from the Norwegian Society of Cardiology in 1994, a telephone query to all hospitals in the country, and data from the Norwegian Medical Association in 1995 to examine this apparent lack of specialists and the potentials for educating them. We were able to confirm a current lack of approximately 60 cardiologists. In addition, the capacity for education has been reduced and will not compensate for the predicted retirement of specialists from approximately year 2000. The capacity for educating cardiologists must be increased.
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Papers by Reidar Bjørnerheim