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Association of increased arterial stiffness with diastolic dysfunction in ischemic stroke patients: the Norwegian Stroke in the Young Study.

https://arctichealth.org/en/permalink/ahliterature308176
Source
J Hypertens. 2020 03; 38(3):467-473
Publication Type
Journal Article
Date
03-2020
Author
Eigir Einarsen
Eva Gerdts
Ulrike Waje-Andreassen
Halvor Naess
Annette Fromm
Sahrai Saeed
Author Affiliation
Department of Clinical Science, University of Bergen.
Source
J Hypertens. 2020 03; 38(3):467-473
Date
03-2020
Language
English
Publication Type
Journal Article
Keywords
Adolescent
Adult
Brain Ischemia - epidemiology - physiopathology
Diastole - physiology
Humans
Hypertension
Middle Aged
Norway
Stroke - epidemiology - physiopathology
Vascular Stiffness - physiology
Young Adult
Abstract
Young and middle-aged ischemic stroke survivors have a high prevalence of hypertension, increased arterial stiffness and abnormal left ventricular (LV) geometry, which all are associated with the presence of LV diastolic dysfunction. However, the prevalence and covariates of diastolic dysfunction in these patients have not been reported.
To explore diastolic dysfunction in ischemic stroke patients aged 15-60 years included in the Norwegian Stroke in the Young Study.
Data from 260 patients with acute ischemic stroke was analyzed. Diastolic dysfunction was assessed by combining transmitral peak early flow (E), early diastolic mitral annular velocity (e'), E/e' ratio, left atrial volume index and peak tricuspid regurgitant jet velocity, following current European guidelines. Carotid-femoral pulse wave velocity at least 10?m/s by aplanation tonometry was defined as increased arterial stiffness.
Prevalent diastolic dysfunction was found in 20% of patients (13% with diastolic dysfunction grade 1 and 7% with diastolic dysfunction grades 2-3). Patients with diastolic dysfunction were older and more likely to have hypertension, overweight, increased arterial stiffness, higher LV mass and less percentage nightly reduction in mean blood pressure (BP) (all P?
PubMed ID
31725075 View in PubMed
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Atherosclerosis in Trial of Org 10172 in Acute Stroke Treatment Subtypes among Young and Middle-Aged Stroke Patients: The Norwegian Stroke in the Young Study.

https://arctichealth.org/en/permalink/ahliterature278382
Source
J Stroke Cerebrovasc Dis. 2016 Apr;25(4):825-30
Publication Type
Article
Date
Apr-2016
Author
Annette Fromm
Øystein Ariansen Haaland
Halvor Naess
Lars Thomassen
Ulrike Waje-Andreassen
Source
J Stroke Cerebrovasc Dis. 2016 Apr;25(4):825-30
Date
Apr-2016
Language
English
Publication Type
Article
Keywords
Adolescent
Adult
Age Factors
Carotid Artery Diseases - drug therapy - epidemiology - etiology
Carotid Intima-Media Thickness
Chondroitin Sulfates - therapeutic use
Dermatan Sulfate - therapeutic use
Female
Fibrinolytic Agents - therapeutic use
Heparitin Sulfate - therapeutic use
Humans
Longitudinal Studies
Male
Middle Aged
Neuroimaging
Norway - epidemiology
Stroke - classification - complications - diagnostic imaging
Young Adult
Abstract
Ischemic stroke patients subtyped as of undetermined cause (SUC) usually outnumber those with determined cause subtypes. Etiological stroke classifications may lead to neglect of parallel, noncausative findings. Atherosclerosis progresses over decades and is associated with high morbidity and mortality in young stroke patients in long-term follow-up studies. We compared the prevalence of carotid atherosclerosis in all TOAST subtypes among young patients with acute ischemic stroke.
We investigated 150 patients aged 15-60 years with documented acute ischemic stroke, and 84 controls free of cardiovascular disease. Stroke etiology was classified according to TOAST criteria. Carotid intima-media thickness (cIMT) measurements were obtained from 12 standardized multiangle measurements in the common carotid artery, carotid bifurcation, and internal carotid artery.
The causes of stroke were 5.3% large-artery atherosclerosis (LAA), 26.7% cardioembolism, 21.3% small-artery occlusion (SAO), 10% stroke of other determined cause, and 36.7% stroke of undetermined cause (SUC). cIMT was increased in patients with LAA (1.56?mm, P?=?.002), SAO (1.11?mm, P?=?.006), and SUC (1.10?mm, P?=?.004) compared to controls (cIMT 0.86?mm). Segmental cIMT distribution differed across stroke subtypes, age groups, and sexes.
Atherosclerotic disease is prevalent in the majority of young and middle-aged ischemic stroke patients, requiring determined investigation and aggressive treatment of modifiable risk factors.
PubMed ID
26796053 View in PubMed
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Cancer-Associated Stroke: The Bergen NORSTROKE Study.

https://arctichealth.org/en/permalink/ahliterature277024
Source
Cerebrovasc Dis Extra. 2015 Sep-Dec;5(3):107-13
Publication Type
Article
Author
Henriette Aurora Selvik
Lars Thomassen
Anna Therese Bjerkreim
Halvor Næss
Source
Cerebrovasc Dis Extra. 2015 Sep-Dec;5(3):107-13
Language
English
Publication Type
Article
Keywords
Aged
Aged, 80 and over
Brain Ischemia - blood - epidemiology
C-Reactive Protein - metabolism
Female
Fibrin Fibrinogen Degradation Products - metabolism
Follow-Up Studies
Humans
Inflammation - epidemiology
Male
Middle Aged
Neoplasms - blood - epidemiology
Norway - epidemiology
Prospective Studies
Registries
Risk factors
Severity of Illness Index
Stroke - blood - epidemiology
Thrombophilia - blood - epidemiology
Abstract
Underlying malignancy can cause ischemic stroke in some patients. Mechanisms include the affection of the coagulation cascade, tumor mucin secretion, infections and nonbacterial endocarditis. The release of necrotizing factor and interleukins may cause inflammation of the endothelial lining, creating a prothrombotic surface that triggers thromboembolic events, including stroke. The aims of this study were to assess the occurrence of cancer in patients who had recently suffered an ischemic stroke and to detect possible associations between stroke and cancer subtypes.
All ischemic stroke patients registered in the Norwegian Stroke Research Registry (NORSTROKE) as part of the ongoing Bergen NORSTROKE study were included. Blood samples were obtained on admission. Stroke etiology was determined by the Trial of Org 10172 in Acute Stroke Treatment (TOAST) criteria, and the severity of stroke was defined according to the National Institute of Health Stroke Scale score. Information about cancer disease after stroke was obtained from patient medical records and The Cancer Registry of Norway.
From a total of 1,282 ischemic stroke patients with no history of cancer, 55 (4.3%) patients were diagnosed with cancer after stroke. The median time from stroke onset to cancer diagnosis was 14.0 months (interquartile range 6.2-24.5). Twenty-three (41.8%) patients were diagnosed with cancer within 1 year and 13 (23.6%) within 6 months. The most common cancer type was lung cancer (19.0%). By Cox regression analysis, cancer after stroke was associated with elevated D-dimer levels on admittance (p
Notes
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PubMed ID
26648966 View in PubMed
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Causes and Predictors for Hospital Readmission after Ischemic Stroke.

https://arctichealth.org/en/permalink/ahliterature273383
Source
J Stroke Cerebrovasc Dis. 2015 Sep;24(9):2095-101
Publication Type
Article
Date
Sep-2015
Author
Anna T Bjerkreim
Lars Thomassen
Jan Brøgger
Ulrike Waje-Andreassen
Halvor Næss
Source
J Stroke Cerebrovasc Dis. 2015 Sep;24(9):2095-101
Date
Sep-2015
Language
English
Publication Type
Article
Keywords
Aged
Aged, 80 and over
Brain Ischemia - complications
Female
Hospitalization
Humans
Length of Stay - statistics & numerical data
Logistic Models
Male
Middle Aged
Norway
Patient Discharge
Patient Readmission - statistics & numerical data
Retrospective Studies
Risk factors
Statistics, nonparametric
Stroke - epidemiology - etiology - therapy
Abstract
Readmission after stroke is frequent, but limited data are available in Europe. This study aimed at assessing frequencies, causes, and factors associated with early and late unplanned readmissions within 1 year after discharge from ischemic stroke hospitalization.
All surviving ischemic stroke patients admitted to the Department of Neurology, Haukeland University Hospital, Norway, between July 1, 2007, and June 30, 2012, were followed from discharge until August 1, 2012. Information on readmissions was collected by medical chart reviews. Logistic regression was performed to assess factors associated with early (=90 days) and late (91-365 days) readmission.
Of 1175 patients discharged alive, 18.8% were readmitted within 90 days, and 24.5% were readmitted between day 91 and 365. Most frequent causes were infections, recurrent ischemic stroke, other cardiovascular events, and events related to index stroke. Early readmission was associated with older age, impaired physical function, atherosclerotic etiology of index stroke, and a higher risk factor burden. Late readmission was associated with older age and prior myocardial infarction. Early readmitted patients had shorter length of index admission, poorer physical function and higher frequencies of atherosclerotic etiology of index stroke, atrial fibrillation, and complications with infection during the index admission compared to patients readmitted late.
Readmission after ischemic stroke is frequent, especially in the early period after discharge. Diagnoses and predictors varied according to time point for readmission, reflecting different underlying mechanisms for causes of readmission. Causes of early readmission may include a prothrombotic state and disposition for recurrent infections.
PubMed ID
26142260 View in PubMed
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Chronic fatigue syndrome after Giardia enteritis: clinical characteristics, disability and long-term sickness absence.

https://arctichealth.org/en/permalink/ahliterature127200
Source
BMC Gastroenterol. 2012;12:13
Publication Type
Article
Date
2012
Author
Halvor Naess
Morten Nyland
Trygve Hausken
Inghild Follestad
Harald I Nyland
Author Affiliation
Institute of Clinical Medicine, Department of Neurology, and Unit for Gastroenterology, Department for Medicine, Haukeland University Hospital, Bergen, Norway. halvor.naess@haukeland.no
Source
BMC Gastroenterol. 2012;12:13
Date
2012
Language
English
Publication Type
Article
Keywords
Absenteeism
Adult
Anxiety - epidemiology - psychology
Depression - epidemiology - psychology
Disability Evaluation
Enteritis - complications - parasitology
Fatigue Syndrome, Chronic - epidemiology - psychology
Female
Giardia - isolation & purification
Giardiasis - complications
Humans
Incidence
Male
Norway
Retrospective Studies
Severity of Illness Index
Time Factors
Abstract
A waterborne outbreak of Giardia lamblia gastroenteritis led to a high prevalance of long-lasting fatigue and abdominal symptoms. The aim was to describe the clinical characteristics, disability and employmentloss in a case series of patients with Chronic Fatigue Syndrome (CFS) after the infection.
Patients who reported persistent fatigue, lowered functional capacity and sickness leave or delayed education after a large community outbreak of giardiasis enteritis in the city of Bergen, Norway were evaluated with the established Centers for Disease Control and Prevention criteria for CFS. Fatigue was self-rated by the Fatigue Severity Scale (FSS). Physical and mental health status and functional impairment was measured by the Medical Outcome Severity Scale-short Form-36 (SF-36). The Hospital Anxiety and Depression Scale (HADS) was used to measure co-morbid anxiety and depression. Inability to work or study because of fatigue was determined by sickness absence certified by a doctor.
A total of 58 (60%) out of 96 patients with long-lasting post-infectious fatigue after laboratory confirmed giardiasis were diagnosed with CFS. In all, 1262 patients had laboratory confirmed giardiasis. At the time of referral (mean illness duration 2.7 years) 16% reported improvement, 28% reported no change, and 57% reported progressive course with gradual worsening. Mean FSS score was 6.6. A distinctive pattern of impairment was documented with the SF-36. The physical functioning, vitality (energy/fatigue) and social functioning were especially reduced. Long-term sickness absence from studies and work was noted in all patients.
After giardiasis enteritis at least 5% developed clinical characteristics and functional impairment comparable to previously described post-infectious fatigue syndrome.
Notes
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PubMed ID
22316329 View in PubMed
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Comparing patients with spinal cord infarction and cerebral infarction: clinical characteristics, and short-term outcome.

https://arctichealth.org/en/permalink/ahliterature131324
Source
Vasc Health Risk Manag. 2011;7:497-502
Publication Type
Article
Date
2011
Author
Halvor Naess
Fredrik Romi
Author Affiliation
Department of Neurology, Haukeland University Hospital, N-5021 Bergen, Norway. haln@haukeland.no
Source
Vasc Health Risk Manag. 2011;7:497-502
Date
2011
Language
English
Publication Type
Article
Keywords
Adult
Aged
Aged, 80 and over
Cerebral Infarction - diagnosis - etiology - physiopathology - rehabilitation
Disability Evaluation
Female
Humans
Infarction - diagnosis - etiology - physiopathology - rehabilitation
Linear Models
Logistic Models
Male
Middle Aged
Norway
Odds Ratio
Patient Discharge
Prognosis
Recovery of Function
Retrospective Studies
Risk assessment
Risk factors
Spinal Cord - blood supply
Time Factors
Abstract
To compare the clinical characteristics, and short-term outcome of spinal cord infarction and cerebral infarction.
Risk factors, concomitant diseases, neurological deficits on admission, and short-term outcome were registered among 28 patients with spinal cord infarction and 1075 patients with cerebral infarction admitted to the Department of Neurology, Haukeland University Hospital, Bergen, Norway. Multivariate analyses were performed with location of stroke (cord or brain), neurological deficits on admission, and short-term outcome (both Barthel Index [BI] 1 week after symptom onset and discharge home or to other institution) as dependent variables.
Multivariate analysis showed that patients with spinal cord infarction were younger, more often female, and less afflicted by hypertension and cardiac disease than patients with cerebral infarction. Functional score (BI) was lower among patients with spinal cord infarctions 1 week after onset of symptoms (P
Notes
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PubMed ID
21915166 View in PubMed
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Comparing withdrawal and non-withdrawal of life-sustaining treatment among patients who died from stroke.

https://arctichealth.org/en/permalink/ahliterature273165
Source
Vasc Health Risk Manag. 2015;11:507-10
Publication Type
Article
Date
2015
Author
Eirik Helvig
Lars Thomassen
Ulrike Waje-Andreassen
Halvor Naess
Source
Vasc Health Risk Manag. 2015;11:507-10
Date
2015
Language
English
Publication Type
Article
Keywords
Age Factors
Aged
Aged, 80 and over
Biomarkers - blood
Brain Ischemia - blood - diagnosis - mortality - therapy
C-Reactive Protein - analysis
Cause of Death
Hospital Mortality
Hospitals, University
Humans
Intracranial Hemorrhages - blood - diagnosis - mortality - therapy
Kaplan-Meier Estimate
Life Support Care
Norway - epidemiology
Proportional Hazards Models
Registries
Retrospective Studies
Risk assessment
Risk factors
Severity of Illness Index
Sex Factors
Stroke - blood - diagnosis - mortality - therapy
Time Factors
Treatment Outcome
Withholding Treatment
Abstract
In severe stroke, a decision to withdraw life-sustaining treatment is sometimes made in cooperation with the family. The aim of this study was to study the time from withdrawing life-sustaining treatment to death in patients with severe ischemic or hemorrhagic stroke.
In total, 2,506 patients with stroke admitted to Haukeland University Hospital between 2006 and 2011 were prospectively registered in the Bergen NORSTROKE database. Risk factors, stroke severity, etiology, and blood analyses were registered. Retrospectively, the patients' records were examined to determine the number of days from withdrawing all life-sustaining treatment to death in patients who died from severe stroke during the hospital stay.
Life-sustaining treatment was withheld in 50 patients with severe stroke. Median time to death after withdrawing life-sustaining treatment was 4 days, and a quarter lived at least 1 week (range =1-11 days). Cox regression analyses showed that short time from withdrawing life-sustaining treatment to death was associated with high age (Hazard ratio [HR] =1.05, P=0.07), male sex (HR =2.9, P=0.01), high C-reactive protein on admission (HR =1.01, P=0.001), and hemorrhagic stroke (versus ischemic stroke, HR =1.5, P=0.03).
One week after withdrawing life-sustaining treatment, a quarter of our patients with severe stroke remained alive. Short time to death was associated with high age, male sex, hemorrhagic stroke, and high C-reactive protein on admittance.
Notes
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PubMed ID
26366088 View in PubMed
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Covariables and types of abnormal left ventricular geometry in nonelderly ischemic stroke survivors: the Norwegian Stroke in the Young Study.

https://arctichealth.org/en/permalink/ahliterature301349
Source
J Hypertens. 2018 09; 36(9):1858-1864
Publication Type
Journal Article
Research Support, Non-U.S. Gov't
Date
09-2018
Author
Anja Linde
Eva Gerdts
Ulrike Waje-Andreassen
Nadia Pristaj
Halvor Naess
Annette Fromm
Sahrai Saeed
Author Affiliation
Department of Heart Disease, Haukeland University Hospital.
Source
J Hypertens. 2018 09; 36(9):1858-1864
Date
09-2018
Language
English
Publication Type
Journal Article
Research Support, Non-U.S. Gov't
Keywords
Adolescent
Adult
Arteries - diagnostic imaging - physiopathology
Brain Ischemia - complications
Carotid Intima-Media Thickness
Echocardiography
Female
Heart Ventricles
Humans
Hypertension - complications - diagnostic imaging - epidemiology - physiopathology
Hypertrophy, Left Ventricular - diagnostic imaging - epidemiology
Male
Middle Aged
Norway - epidemiology
Prevalence
Prospective Studies
Pulse Wave Analysis
Stroke - complications - diagnostic imaging
Survivors
Ventricular Remodeling
Young Adult
Abstract
Abnormal left ventricular (LV) geometry types, like LV hypertrophy (LVH) and concentric remodelling, are independently associated with impaired prognosis in hypertension. Little is known about the prevalence and covariables of abnormal LV geometry types in younger ischemic stroke patients.
We used clinical and echocardiographic data from 280 patients aged 15-60 years included in the Norwegian Stroke in the Young Study. LVH was defined as LV mass index greater than 46.7?g/m in women and greater than 49.2?g/m in men. Concentric remodelling was considered present if posterior wall thickness/LV internal diameter ratio at least 0.43 in the absence of LVH. Arterial damage was assessed by mean common carotid intima-media thickness (IMT) and carotid-femoral pulse wave velocity (PWV).
Abnormal LV geometry was found in 37% of patients. Concentric remodelling was the most prevalent abnormal LV geometry type, found in 21%, whereas LVH was found in 16%. In multivariable logistic regression analyses, LVH was associated with increased PWV, higher BMI and creatinine, and presence of diabetes and hypertension (all P?
PubMed ID
29794558 View in PubMed
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C-reactive protein and homocysteine predict long-term mortality in young ischemic stroke patients.

https://arctichealth.org/en/permalink/ahliterature261478
Source
J Stroke Cerebrovasc Dis. 2013 Nov;22(8):e435-40
Publication Type
Article
Date
Nov-2013
Author
Halvor Naess
Harald Nyland
Titto Idicula
Ulrike Waje-Andreassen
Source
J Stroke Cerebrovasc Dis. 2013 Nov;22(8):e435-40
Date
Nov-2013
Language
English
Publication Type
Article
Keywords
Adolescent
Adult
Age Factors
Biological Markers - blood
Brain Ischemia - blood - diagnosis - mortality
C-Reactive Protein - metabolism
Cause of Death
Comorbidity
Disability Evaluation
Female
Homocysteine - blood
Humans
Kaplan-Meier Estimate
Linear Models
Male
Middle Aged
Norway - epidemiology
Prognosis
Proportional Hazards Models
Registries
Retrospective Studies
Risk factors
Stroke - blood - diagnosis - mortality
Time Factors
Young Adult
Abstract
We investigated the relationship between C-reactive protein (CRP) and homocysteine on follow-up and subsequent mortality in young ischemic stroke patients in a population-based study.
Young ischemic stroke patients were followed-up on average 6 years after the index stroke. CRP and homocysteine levels were measured and risk factors were recorded, including myocardial infarction, diabetes mellitus, hypertension, smoking, alcoholism, and cancer. Stroke outcome was measured using the modified Rankin Scale score. Subsequent survival was obtained by examining the official population registry. Cox regression analyses were performed.
In total, 198 patients were included in this study (82 [41%] women and 116 [59%] men). The mean age on follow-up was 47.8 years. In total, 36 (18.2%) patients died during the subsequent mean follow-up of 12.4 years. Cox regression analysis revealed that mortality was associated with CRP (hazard ratio [HR] 1.05; P=.001) and homocysteine levels (HR 1.04; P=.02) in patients without dissection. Kaplan-Meier curves grouped by dichotomized CRP (CRP=1 v >1 mg/L) showed increasing separation between the survival curves, and likewise for dichotomized homocysteine (=9 v >9 µg/L).
There is an independent association between CRP and homocysteine levels obtained several years after ischemic stroke in young adults and subsequent mortality, even when adjusting for traditional risk factors. This association seems to continue for at least 12 years after the measurements.
PubMed ID
23735372 View in PubMed
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A dark side of subcortical diffusion-weighted lesions? Characteristics, cause, and outcome in large subcortical infarction: the Bergen Norwegian stroke cooperation study.

https://arctichealth.org/en/permalink/ahliterature258806
Source
Stroke. 2014 Sep;45(9):2710-6
Publication Type
Article
Date
Sep-2014
Author
Christopher Elnan Kvistad
Halvor Oygarden
Nicola Logallo
Gunnar Moen
Lars Thomassen
Ulrike Waje-Andreassen
Halvor Naess
Source
Stroke. 2014 Sep;45(9):2710-6
Date
Sep-2014
Language
English
Publication Type
Article
Keywords
Aged
Brain Ischemia - physiopathology
Brain Stem - physiopathology
Cerebellum - physiopathology
Databases, Factual
Diffusion Magnetic Resonance Imaging
Female
Humans
Male
Middle Aged
Norway
Prospective Studies
Registries
Stroke - diagnosis - physiopathology
Stroke, Lacunar - physiopathology
Treatment Outcome
Abstract
Diffusion-weighted imaging (DWI) is highly accurate in identifying and locating ischemic stroke injury. Few studies using DWI have investigated large subcortical infarctions (LSIs). We aimed to study clinical characteristics, cause, and outcome in patients with ischemic stroke with LSI diagnosed on DWI and compare these with those who had lacunar DWI lesions or DWI lesions located elsewhere.
Patients with stroke admitted between February 2006 and July 2013 were prospectively registered in a stroke database and examined with DWI. Patients with DWI lesions classified as LSI (subcortical, =15 mm) were compared with those with lacunar lesions (subcortical,
PubMed ID
25013025 View in PubMed
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42 records – page 1 of 5.