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Echocardiographic indices of cardiac function: Normal values and associations with cardiac risk factors in a population free from cardiovascular disease, hypertension and diabetes: the HUNT 3 Study
Norwegian University of Science and Technology, Faculty of Medicine, Department of Circulation and Medical Imaging. (Nord-Trøndelag Health Trust, Levanger Hospital, Department of Medicine)
2010 (English)Doctoral thesis, comprehensive summary (Other academic)Alternative title
Ekkokardiografiske mål pa hjertefunksjon: Normalverdier og assosiasjon medrisikofaktorer hos personer uten hjertesykdom, høyt blodtrykk og diabetes. Data fra HUNT 3. (Norwegian)
Abstract [no]

Ultralydundersøkelse av hjertet (ekkokardiografi) er den undersøkelsen som samlet sett gir mest informasjon om hjertets struktur og funksjon. Undersøkelsen er en hjørnestein i utredning og diagnostikk av hjertesykdom. Vevsdoppler- (hastighetsdata fra hjertemuskelen) og deformasjonsanalyser (grad av forkortning av hjertemuskelen og hastigheten det skjer med) er nye ekkokardiografiske metoder som har vist seg følsomme for påvisning av redusert hjertefunksjon.

Forutsetningen for at legene mest nøyaktig skal kunne påvise svekket hjertefunksjon relatert til sykdom er at man har god kjennskap til hva som er normalt. Hovedmålet for studiene var derfor a etablere normalverdier for spesifikke metoder for kvantitering (måling) av hjertefunksjonen og a belyse hvordan hjertefunksjonen hos friske personer er assosiert med ulike risikofaktorer for hjertesykdom.

I forbindelse med Helseundersøkelsen i Nord-Trondelag (HUNT 3) ble i alt 1.296 personer undersøkt med ultralyd av hjertet (ekkokardiografi) pa Steinkjer og i Namsos. Deltakerne i studiene ble tilfeldig trukket ut blant deltakere i HUNT 3 som var hjertefriske og ikke hadde forhøyet blodtrykk eller sukkersyke.

Arbeidet bestar av fire delstudier. I studie 1 ble repeterbarheten av de ulike hjertefunksjonsmalene studert. Alle metodene hadde akseptabel repeterbarhet og de fleste hadde utmerket repeterbarhet. Gjennom studie 2 og 3 ble normalverdier for ulike nye hjertefunksjonsmal bade for venstre og hoyre hjertekammer publisert. Malt med de nye metodene fant man at hjertefunksjonen avtok med alder og var forskjellige mellom kvinner og menn. Normalverdiene ble derfor utarbeidet i forhold til alder og kjønn. I studie 4 ble de ulike hjertefunksjonsmalene til deltakerne studert mot nivået av ulike risikofaktorer for hjertesykdom. Studien viste at overvekt, høyt blodtrykk, høyt niva av det ugunstige kolesterolet og røyking var assosiert med darligere hjertefunksjon (malt med de beskrevne metodene) selv hos friske personer. Høyere niva av det gunstige kolesterolet var assosiert med bedre hjertefunksjon. Studien konkluderte med at risikofaktorene svekker hjertefunksjonen allerede for man kan påvise sykdom.

Place, publisher, year, edition, pages
2010.
Series
Doctoral theses at NTNU, ISSN 1503-8181 ; 2010:257Dissertations at the Faculty of Medicine, ISSN 0805-7680 ; 259
Identifiers
URN: urn:nbn:no:ntnu:diva-12556ISBN: 978-82-471-2514-4OAI: oai:DiVA.org:ntnu-12556DiVA: diva2:415045
Public defence
2010-12-13, 00:00
Available from: 2011-05-05 Created: 2011-05-05 Last updated: 2011-09-28Bibliographically approved
List of papers
1. Reproducibility in echocardiographic assessment of the left ventricular global and regional function, the HUNT study.
Open this publication in new window or tab >>Reproducibility in echocardiographic assessment of the left ventricular global and regional function, the HUNT study.
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2010 (English)In: European Journal of Echocardiography, ISSN 1525-2167, E-ISSN 1532-2114, Vol. 11, no 2, 149-56 p.Article in journal (Refereed) Published
Abstract [en]

Systolic M-mode annulus excursion showed better inter-observer reproducibility than other traditional and newer measurements of LV systolic and diastolic function. Repeated analyses of the same recordings underestimate the more clinically relevant inter-observer reproducibility by approximately 40% for most measurements of LV function.

Identifiers
urn:nbn:no:ntnu:diva-13268 (URN)10.1093/ejechocard/jep188 (DOI)19959533 (PubMedID)
Available from: 2011-08-24 Created: 2011-08-24 Last updated: 2013-01-25Bibliographically approved
2. Reference values and distribution of conventional echocardiographic Doppler measures and longitudinal tissue Doppler velocities in a population free from cardiovascular disease.
Open this publication in new window or tab >>Reference values and distribution of conventional echocardiographic Doppler measures and longitudinal tissue Doppler velocities in a population free from cardiovascular disease.
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2010 (English)In: Circulation. Cardiovascular imaging, ISSN 1942-0080, Vol. 3, no 5, 614-22 p.Article in journal (Refereed) Published
Abstract [en]

BACKGROUND: This study aimed to investigate the distribution of conventional Doppler measurements, pulsed wave tissue Doppler imaging (pwTDI)- and color tissue Doppler imaging-derived velocities, by age and sex in a healthy population. METHODS AND RESULTS: Longitudinal tissue Doppler velocities were determined in 1266 healthy individuals from standard apical 4- and 2-chamber views. By the pwTDI method, mean ± SD systolic mitral annular velocities were 8.2 ± 1.3 cm/s in women and 8.6 ± 1.4 cm/s in men, and by color tissue Doppler, they were 6.6 ± 1.1 cm/s in women and 6.9 ± 1.3 cm/s in men. With pwTDI, diastolic early mitral annular velocities were 11.8 ± 3.2 cm/s in women and 10.8 ± 3.0 cm/s in men, with corresponding ratios between mitral early flow velocity and early diastolic tissue velocity of 6.7 ± 0.8 in women and 6.4 ± 0.8 in men. By pwTDI, tricuspid annular systolic and early diastolic velocities were 12.5 ± 1.9 and 13.3 ± 3.0, respectively, in women and 12.8 ± 2.2 and 12.5 ± 3.3, respectively, in men. There was a significant decrease in left and right ventricular function with increasing age. Conclusions- The longitudinal mitral and tricuspid annular velocities from this population study are widely applicable as reference values. Reference values for annular velocities should be specified by sex and age. The average of inferoseptal and anterolateral wall velocities may be the preferred index of left ventricular performance.

Identifiers
urn:nbn:no:ntnu:diva-13269 (URN)10.1161/CIRCIMAGING.109.926022 (DOI)20581050 (PubMedID)
Available from: 2011-08-24 Created: 2011-08-24 Last updated: 2011-08-24Bibliographically approved
3. Segmental and global longitudinal strain and strain rate based on echocardiography of 1266 healthy individuals: the HUNT study in Norway.
Open this publication in new window or tab >>Segmental and global longitudinal strain and strain rate based on echocardiography of 1266 healthy individuals: the HUNT study in Norway.
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2010 (English)In: European Journal of Echocardiography, ISSN 1525-2167, E-ISSN 1532-2114, Vol. 11, no 2, 176-83 p.Article in journal (Refereed) Published
Abstract [en]

The reference values for global and segmental longitudinal strain and SR obtained from this population study are applicable for use in a wide clinical setting.

Identifiers
urn:nbn:no:ntnu:diva-13271 (URN)10.1093/ejechocard/jep194 (DOI)19946115 (PubMedID)
Available from: 2011-08-24 Created: 2011-08-24 Last updated: 2011-08-24Bibliographically approved
4. Cardiovascular risk factors and systolic and diastolic cardiac function: a tissue Doppler and speckle tracking echocardiographic study.
Open this publication in new window or tab >>Cardiovascular risk factors and systolic and diastolic cardiac function: a tissue Doppler and speckle tracking echocardiographic study.
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2011 (English)In: Journal of the American Society of Echocardiography, ISSN 0894-7317, E-ISSN 1097-6795, Vol. 24, no 3, 322-32.e6 p.Article in journal (Refereed) Published
Abstract [en]

These findings suggest that conventional risk factors may predict cardiac function many years before clinical disease. The J-shaped associations related to diastolic blood pressure and BMI may suggest that in some individuals, low levels of these factors may indicate underlying but unknown disease.

Identifiers
urn:nbn:no:ntnu:diva-13270 (URN)10.1016/j.echo.2010.12.010 (DOI)21247733 (PubMedID)
Available from: 2011-08-24 Created: 2011-08-24 Last updated: 2011-09-28Bibliographically approved

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