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[Aortic valve replacement for aortic stenosis in Iceland 2002-2006: Indications and short term complications].

https://arctichealth.org/en/permalink/ahliterature130491
Source
Laeknabladid. 2011 Oct;97(10):523-7
Publication Type
Article
Date
Oct-2011
Author
Inga Lára Ingvarsdóttir
Sindri Aron Viktorsson
Kári Hreinsson
Martin Ingi Sigurdsson
Sólveig Helgadóttir
Pórarinn Arnórsson
Ragnar Danielsen
Tómas Gudbjartsson
Source
Laeknabladid. 2011 Oct;97(10):523-7
Date
Oct-2011
Language
Icelandic
Geographic Location
Iceland
Publication Type
Article
Keywords
Acute Kidney Injury - etiology
Aged
Aortic Valve Stenosis - mortality - surgery
Atrial Fibrillation - etiology
Bioprosthesis
Female
Heart Valve Prosthesis
Heart Valve Prosthesis Implantation - adverse effects - instrumentation - mortality
Hospital Mortality
Humans
Iceland - epidemiology
Male
Multiple Organ Failure - etiology
Multivariate Analysis
Postoperative Hemorrhage - etiology - surgery
Prosthesis Design
Reoperation
Retrospective Studies
Risk assessment
Risk factors
Time Factors
Treatment Outcome
Abstract
Information on surgical outcome of aortic valve replacement (AVR) has not been available in Iceland. We therefore studied the indications, short-term complications and operative mortality in Icelandic patients that underwent AVR with aortic stenosis.
This was a retrospective study including all patients that underwent AVR for aortic stenosis at Landspitali between 2002 and 2006, a total of 156 patients (average age 71.7 years, 64.7% males). Short term complications and operative mortality (= 30 days) were registered and risk factors analysed with multivariate analysis.
The most common symptoms before AVR were dyspnea (86.9%) and angina pectoris (52.6%). Preop. max aortic valve pressure gradient was on average 74 mmHg, the left ventricular ejection fraction 57.2% and EuroSCORE (st) 6.9%. The average operating time was 282 min and concomitant CABG was performed in 55% of the patients and mitral valve surgery in nine. A bioprothesis was implanted in 127 of the patients (81.4%), of which 102 were stentless valves, and a mechanical valve in 29 (18.6%) cases. The mean prosthesis size was 25.6 mm (range 21-29). Atrial fibrillation (78.0%) and acute renal injury (36.0%) were the most common complications and 20 patients (13.0%) developed multiple-organ failure. Twenty-six patients (17.0%) needed reoperation due to bleeding. Median hospital stay was 13 days and operative mortality was 6.4%.
The rate of short term complications following AVR was relatively high, including reoperations for bleeding and atrial fibrillation. Operative mortality is twice that of CABG, which is in line with other studies.
Notes
Comment In: Laeknabladid. 2011 Oct;97(10):52121998149
PubMed ID
21998150 View in PubMed
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[Aortic valve replacement for aortic stenosis in Iceland 2002-2006: Long term complications and survival].

https://arctichealth.org/en/permalink/ahliterature129765
Source
Laeknabladid. 2011 Nov;97(11):591-5
Publication Type
Article
Date
Nov-2011
Author
Sindri Aron Viktorsson
Inga Lára Ingvarsdóttir
Kári Hreinsson
Martin Ingi Sigurdsson
Sólveig Helgadóttir
Pórarinn Arnorsson
Ragnar Danielsen
Tómas Gudbjartsson
Source
Laeknabladid. 2011 Nov;97(11):591-5
Date
Nov-2011
Language
Icelandic
Geographic Location
Iceland
Publication Type
Article
Keywords
Aged
Aortic Valve Stenosis - diagnosis - mortality - surgery
Bioprosthesis
Female
Heart Valve Prosthesis
Heart Valve Prosthesis Implantation - adverse effects - instrumentation - mortality
Humans
Iceland - epidemiology
Logistic Models
Male
Patient Readmission
Risk assessment
Risk factors
Survival Rate
Time Factors
Treatment Outcome
Abstract
To investigate long-term complications and survival following aortic valve replacement (AVR) in patients with aortic stenosis (AS) in Iceland.
Included were 156 patients (average age 71.7 yrs, 64.7% males) that underwent AVR for AS at Landspitali between 2002 and 2006. A mechanical prosthesis was used in 29 patients (18.6%) and a bioprosthesis in 127. Long-term complications and operation-related admissions were registered from hospital and outpatient records until April 1, 2010. Overall survival was estimated and compared with the Icelandic population of the same age and gender.
The mean preop. EuroSCORE(st) was 6.9%, the max. transvalvular pressure gradient 74.1 mmHg and the left ventricular ejection fraction (LVEF) (57.2%). At six months following AVR the maximal pressure gradient was 19.8 mmHg (range; 2.5-38). Echocardiography results were not available for 23.6% of the patients 6 months postoperatively. In the follow-up period one in four patients was admitted due to valve-related problems. Re-admission rate was 6.0/100 patient-years (pt-y); most commonly due to cardiac failure (1.7/100 pt-y), emboli (1.6/100 pt-y), hemorrhage (1.6/100 pt-y), endocarditis (0.7/100 pt-y) and myocardial infarction (0.4/100 pt-y). Survival at 1 and 5 year was 89.7% and 78.2%, respectively, making survival comparable to the estimated survival of Icelanders of the same age and gender.
The rate of long-term complications following AVR in Iceland is in line with other studies. The same applies to long-term survival, which was similar to that of the Icelandic population of the same age and gender. Key words: Aortic valve replacement, aortic stenosis, heart surgery, results, long-term complication, survival.
PubMed ID
22071670 View in PubMed
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Biochemical diagnosis of myocardial infarction evolves towards ESC/ACC consensus: experiences from the Nordic countries.

https://arctichealth.org/en/permalink/ahliterature53097
Source
Scand Cardiovasc J. 2005 Jul;39(3):159-66
Publication Type
Article
Date
Jul-2005
Author
Søren Hjortshøj
Jan Erik Otterstad
Bertil Lindahl
Ragnar Danielsen
Kari Pulkki
Jan Ravkilde
Author Affiliation
Cardiovascular Research Center and Department of Cardiology, Aalborg Hospital, Denmark.
Source
Scand Cardiovasc J. 2005 Jul;39(3):159-66
Date
Jul-2005
Language
English
Publication Type
Article
Keywords
Biological Markers
Comparative Study
Consensus
Denmark
Emergency Service, Hospital - standards
Finland
Health Care Surveys
Humans
Iceland
Laboratory Techniques and Procedures
Myocardial Infarction - diagnosis - physiopathology
Norway
Practice Guidelines
Questionnaires
Sweden
Abstract
OBJECTIVES: To investigate the diagnostic approach in Nordic hospitals receiving patients suspected of acute myocardial infarction (MI), especially focusing on implementation of the recently proposed criteria by the European Society of Cardiology (ESC) and the American College of Cardiology (ACC) for the definition of MI. DESIGN: A survey with questionnaires of the diagnostic approach was conducted among all relevant departments (220) in the Nordic countries. RESULTS: Seventy-six percent (167) of hospitals responded. Troponins I and T (TnI and TnT) and creatinine kinase monobasic fraction (mass concentration) (CKMB(mass)) covered 93 and 65% of hospitals, respectively. Of troponin users, 34% indicated use of TnI vs 66% using TnT. Sporadic use of AST, CK, LD and myoglobin was reported. There was a tendency to lower cut-off levels in Sweden and Finland. Among troponin assays, there was considerable heterogeneity regarding cut-off levels. CONCLUSIONS: The Nordic countries are approaching ESC/ACC consensus on cardiac markers. Compared with previous national surveys (1995-1999), there is a shift towards the use of troponins. However, differences in cut-off levels of troponin emphasize the need for harmonization of assays.
PubMed ID
16146978 View in PubMed
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Cardiac myxoma in Iceland: a case series with an estimation of population incidence.

https://arctichealth.org/en/permalink/ahliterature132045
Source
APMIS. 2011 Sep;119(9):611-7
Publication Type
Article
Date
Sep-2011
Author
Hannes Sigurjonsson
Karl Andersen
Marianna Gardarsdottir
Vigdis Petursdottir
Gudmundur Klemenzson
Gunnar Gunnarsson
Ragnar Danielsen
Tomas Gudbjartsson
Author Affiliation
Department of Cardiothoracic Surgery, University of Iceland, Reykjavik, Iceland.
Source
APMIS. 2011 Sep;119(9):611-7
Date
Sep-2011
Language
English
Publication Type
Article
Keywords
Adult
Aged
Aged, 80 and over
Female
Follow-Up Studies
Heart Atria
Heart Neoplasms - diagnosis - epidemiology - surgery
Humans
Iceland - epidemiology
Incidence
Male
Middle Aged
Myxoma - diagnosis - epidemiology - surgery
Registries
Retrospective Studies
Abstract
Cardiac myxoma (CM) is the most common primary benign tumor of the heart, but the true age-standardized incidence rate (ASR) has remained unknown. We therefore used nationwide registries in Iceland to study CM and establish its incidence rate. This was a retrospective study involving all patients diagnosed with CM in Iceland between 1986 and 2010. Cases were identified through three different registries, and hospital charts and histology results reviewed. An ASR was estimated based on a world standard population (w). Nine cases of CM (six women) were identified with a mean age of 62.8 years (range: 37-85), giving an ASR of 0.11 (95% CI: 0.05-0.22) per 100,000. The mean tumor size was 4.4 cm (range: 1.5-8.0) with all the tumors located in the left atrium. Dyspnea (n = 6) and ischemic stroke (n = 2) were the most common symptoms. All patients underwent complete resection of the tumor and there were no postoperative deaths or CM-related deaths at follow-up (mean 85 months). The ASR of CM in Iceland was 0.11 per 100,000. To our knowledge, this is the first study to determine the incidence of CM in an entire population. In Iceland, the presenting symptoms and mode of detection of CM are similar to those in other series.
PubMed ID
21851419 View in PubMed
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[Comparison between coronary angiography with multislice computed tomography and by cardiac catheterisation for assessing atherosclerotic lesions and stenosis]

https://arctichealth.org/en/permalink/ahliterature53049
Source
Laeknabladid. 2006 Jan;92(1):27-32
Publication Type
Article
Date
Jan-2006
Author
Birna Jónsdóttir
Ragnar Danielsen
Author Affiliation
Röntgen Domus, Domus Medica, 101 Reykjavík, Iceland. birna@rd.is
Source
Laeknabladid. 2006 Jan;92(1):27-32
Date
Jan-2006
Language
Icelandic
Publication Type
Article
Keywords
Adult
Aged
Aged, 80 and over
Comparative Study
Coronary Angiography - methods
Coronary Arteriosclerosis - radiography
Coronary Stenosis - radiography
English Abstract
Female
Heart Catheterization
Humans
Male
Middle Aged
Reproducibility of Results
Retrospective Studies
Severity of Illness Index
Tomography, X-Ray Computed - methods
Abstract
AIM OF STUDY: To compare the utility and reliability of coronary angiography with multislice computed tomography (MSCT) and by cardiac catheterisation in assessing atherosclerotic lesions and stenosis. MATERIAL AND METHODS: Data were assessed from 44 subjects (25 men, 19 women) (mean age 63 years; range 34-80 years) referred to MSCT who also had undergone invasive coronary angiography within a time frame of one year. Coronary angiograms from both studies were assessed by segmental analysis and the atherosclerotic severity graded. The frequency of coronary calcification on MSCT was separately assessed in 150 subjects. RESULTS: By retrospective evaluation, 29 segments were found to have significant stenosis (> or = 50%) on the invasive coronary angiogram. Of these 17 had a diameter over 2.0 mm and 14 (83%) thereof were correctly diagnosed by MSCT. On the other hand, MSCT assessed four stenosis to be significant that were not judged so on the invasive angiogram. On MSCT, the frequency of coronary calcifications increased with age and in those 60 years and older it was 96% in males and 71% in females (p=0.025). CONCLUSION: Good agreement was found between MSCT and invasive coronary angiography in assessing significant stenosis in vessel segments over 2.0 mm. In older subjects coronary calcification on MSCT is frequent and diminishes its accuracy. MSCT seems most useful in relatively young subjects in whom the coronary arteries need to be evaluated to avoid unnecessary cardiac catheterisation.
PubMed ID
16400195 View in PubMed
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[Constrictive pericarditis with severe heart failure - a case report and review of the literature.]

https://arctichealth.org/en/permalink/ahliterature96471
Source
Laeknabladid. 2010 Juli;96(7):475-480
Publication Type
Article
Author
Jon Thorkell Einarsson
Ragnar Danielsen
Olafur Skuli Indridaon
Tomas Gudbjartsson
Source
Laeknabladid. 2010 Juli;96(7):475-480
Language
Icelandic
Publication Type
Article
Abstract
Constricitve pericarditis is an uncommon condition, often of unknown etiology but can be caused by infections, such as tuberculosis, inflammation of the pericardium, radiation therapy or asbestos exposure. Constrictive pericarditis is characterized by fibrosis and often severe calcifications of the pericardial sac which eventually restricts normal diastolic filling of the heart. This consequently leads to a combination of left and right heart failure, often with prominent jugular venous distentsion, liver enlargement, peripheral edema and lethargy. Diagnosis can be difficult and is often delayed. Surgery, involving partial removal of the pericardial sac, usually leads to relief of symptoms. Here we report a case from Landspitali together with a review of the literature. Key words: Constrictive pericarditis, cardiac failure, oedema, echocardiography, cardiac cathederization, pericardectomy. Correspondence: Tomas Gudbjartsson, tomasgud@landspitali.is.
PubMed ID
20601748 View in PubMed
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[Heart failure among elderly Icelanders: Incidence, prevalence, underlying diseases and long-term survival].

https://arctichealth.org/en/permalink/ahliterature286477
Source
Laeknabladid. 2017 Oktober;103(10):429-436
Publication Type
Article
Author
Haukur Einarsson
Gudmundur Thorgeirsson
Ragnar Danielsen
Orn Olafsson
Thor Aspelund
Vilmundur Gudnason
Source
Laeknabladid. 2017 Oktober;103(10):429-436
Language
Icelandic
Publication Type
Article
Abstract
Heart failure (HF) is a common and a serious condition that predominantly affects elderly people. On the basis of the left ventricular ejection fraction (EF) it can be divided into HF with reduced or preserved ejection fraction (HFrEF and HFpEF, respectively). The goal of this study was to investigate the prevalence and incidence of HF among elderly Icelanders, explore underlying diseases and estimate the effect of HF on overall survival.
Included were 5706 participants of the AGES study. The hospital records of those diagnosed with HF before entry into AGES were used to calculate prevalence and the records of those diagnosed from entry into AGES until 28.2.2010 were used to calculate incidence. All cases of HF were verified according to predetermined criteria for diagnosis. Information on underlying diseases and EF of HF patients were obtained from hospital records. Survival was estimated using Kaplan-Meier survival curves.
Lifetime prevalence of HF was 3.6% as of 2004, higher among men than women (p
PubMed ID
29044038 View in PubMed
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[Heart failure among elderly Icelanders: Incidence, prevalence, underlying diseases and long-term survival].

https://arctichealth.org/en/permalink/ahliterature301810
Source
Laeknabladid. 2017 Oktober; 103(10):429-436
Publication Type
Journal Article
Author
Haukur Einarsson
Gudmundur Thorgeirsson
Ragnar Danielsen
Orn Olafsson
Thor Aspelund
Vilmundur Gudnason
Source
Laeknabladid. 2017 Oktober; 103(10):429-436
Language
Icelandic
Publication Type
Journal Article
Keywords
Age Distribution
Aged
Aged, 80 and over
Comorbidity
Female
Heart Failure - diagnosis - epidemiology - mortality
Humans
Iceland - epidemiology
Incidence
Male
Prevalence
Prognosis
Risk factors
Sex Distribution
Time Factors
Abstract
Heart failure (HF) is a common and a serious condition that predominantly affects elderly people. On the basis of the left ventricular ejection fraction (EF) it can be divided into HF with reduced or preserved ejection fraction (HFrEF and HFpEF, respectively). The goal of this study was to investigate the prevalence and incidence of HF among elderly Icelanders, explore underlying diseases and estimate the effect of HF on overall survival.
Included were 5706 participants of the AGES study. The hospital records of those diagnosed with HF before entry into AGES were used to calculate prevalence and the records of those diagnosed from entry into AGES until 28.2.2010 were used to calculate incidence. All cases of HF were verified according to predetermined criteria for diagnosis. Information on underlying diseases and EF of HF patients were obtained from hospital records. Survival was estimated using Kaplan-Meier survival curves.
Lifetime prevalence of HF was 3.6% as of 2004, higher among men than women (p
PubMed ID
29044038 View in PubMed
Less detail

Hypertrophic cardiomyopathy in myosin-binding protein C (MYBPC3) Icelandic founder mutation carriers.

https://arctichealth.org/en/permalink/ahliterature306130
Source
Open Heart. 2020; 7(1):e001220
Publication Type
Journal Article
Observational Study
Research Support, N.I.H., Extramural
Research Support, Non-U.S. Gov't
Date
2020
Author
Berglind Adalsteinsdottir
Michael Burke
Barry J Maron
Ragnar Danielsen
Begoña Lopez
Javier Diez
Petr Jarolim
Jonathan Seidman
Christine E Seidman
Carolyn Y Ho
Gunnar Th Gunnarsson
Author Affiliation
Department of Medicine, University of Iceland, Reykjavik, Iceland.
Source
Open Heart. 2020; 7(1):e001220
Date
2020
Language
English
Publication Type
Journal Article
Observational Study
Research Support, N.I.H., Extramural
Research Support, Non-U.S. Gov't
Keywords
Adult
Age of Onset
Aged
Cardiomyopathy, Hypertrophic - diagnosis - genetics - physiopathology
Carrier Proteins - genetics
Cross-Sectional Studies
Female
Founder Effect
Genetic Predisposition to Disease
Hemodynamics - genetics
Heredity
Heterozygote
Humans
Iceland
Male
Middle Aged
Mutation
Pedigree
Penetrance
Phenotype
Risk factors
Sarcomeres - genetics
Ventricular Function, Left - genetics
Ventricular Remodeling - genetics
Abstract
The myosin-binding protein C (MYBPC3) c.927-2A>G founder mutation accounts for >90% of sarcomeric hypertrophic cardiomyopathy (HCM) in Iceland. This cross-sectional observational study explored the penetrance and phenotypic burden among carriers of this single, prevalent founder mutation.
We studied 60 probands with HCM caused by MYBPC3 c.927-2A>G?and 225 first-degree relatives. All participants underwent comprehensive clinical evaluation and relatives were genotyped.
Genetic and clinical evaluation of relatives identified 49 genotype-positive (G+) relatives with left ventricular hypertrophy (G+/LVH+), 59 G+without?LVH (G+/LVH-) and 117 genotype-negative relatives (unaffected). Compared with HCM probands, G+/LVH+ relatives were older at HCM diagnosis, had less LVH, a less prevalent diastolic dysfunction, fewer ECG abnormalities, lower serum N-terminal pro-B-type natriuretic peptide (NT-proBNP) and high-sensitivity cardiac troponin I levels, and fewer symptoms. The penetrance of HCM was influenced by age and sex; specifically, LVH was present in 39% of G+males?but only 9% of G+females under age 40 years (p=0.015), versus 86% and 83%, respectively, after age 60 (p=0.89). G+/LVH- subjects had normal wall thicknesses, diastolic function and NT-proBNP levels, but subtle changes in LV geometry and more ECG abnormalities than their unaffected relatives.
Phenotypic expression of the Icelandic MYBPC3 founder mutation varies by age, sex and proband status. Men are more likely to have LVH at a younger age, and disease manifestations were more prominent in probands than in relatives identified via family screening. G+/LVH- individuals had subtle clinical differences from unaffected relatives well into adulthood, indicating subclinical phenotypic expression of the pathogenic mutation.
PubMed ID
32341788 View in PubMed
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Lipoprotein(a) Concentration and Risks of Cardiovascular Disease and Diabetes.

https://arctichealth.org/en/permalink/ahliterature307564
Source
J Am Coll Cardiol. 2019 12 17; 74(24):2982-2994
Publication Type
Journal Article
Date
12-17-2019
Author
Daniel F Gudbjartsson
Gudmundur Thorgeirsson
Patrick Sulem
Anna Helgadottir
Arnaldur Gylfason
Jona Saemundsdottir
Eythor Bjornsson
Gudmundur L Norddahl
Aslaug Jonasdottir
Adalbjorg Jonasdottir
Hannes P Eggertsson
Solveig Gretarsdottir
Gudmar Thorleifsson
Olafur S Indridason
Runolfur Palsson
Fridbert Jonasson
Ingileif Jonsdottir
Gudmundur I Eyjolfsson
Olof Sigurdardottir
Isleifur Olafsson
Ragnar Danielsen
Stefan E Matthiasson
Snaedis Kristmundsdottir
Bjarni V Halldorsson
Astradur B Hreidarsson
Einar M Valdimarsson
Thorarinn Gudnason
Rafn Benediktsson
Valgerdur Steinthorsdottir
Unnur Thorsteinsdottir
Hilma Holm
Kari Stefansson
Author Affiliation
deCODE genetics/Amgen, Reykjavik, Iceland; School of Engineering and Natural Sciences, University of Iceland, Reykjavik, Iceland.
Source
J Am Coll Cardiol. 2019 12 17; 74(24):2982-2994
Date
12-17-2019
Language
English
Publication Type
Journal Article
Keywords
Case-Control Studies
Coronary Artery Disease - blood - genetics
DNA Copy Number Variations
Diabetes Mellitus, Type 2 - blood - genetics
Humans
Iceland
Kringles
Lipoprotein(a) - blood - genetics
Mendelian Randomization Analysis
Molecular Weight
Protein Isoforms - blood
Risk factors
Abstract
Lipoprotein(a) [Lp(a)] is a causal risk factor for cardiovascular diseases that has no established therapy. The attribute of Lp(a) that affects cardiovascular risk is not established. Low levels of Lp(a) have been associated with type 2 diabetes (T2D).
This study investigated whether cardiovascular risk is conferred by Lp(a) molar concentration or apolipoprotein(a) [apo(a)] size, and whether the relationship between Lp(a) and T2D risk is causal.
This was a case-control study of 143,087 Icelanders with genetic information, including 17,715 with coronary artery disease (CAD) and 8,734 with T2D. This study used measured and genetically imputed Lp(a) molar concentration, kringle IV type 2 (KIV-2) repeats (which determine apo(a) size), and a splice variant in LPA associated with small apo(a) but low Lp(a) molar concentration to disentangle the relationship between Lp(a) and cardiovascular risk. Loss-of-function homozygotes and other subjects genetically predicted to have low Lp(a) levels were evaluated to assess the relationship between Lp(a) and T2D.
Lp(a) molar concentration was associated dose-dependently with CAD risk, peripheral artery disease, aortic valve stenosis, heart failure, and lifespan. Lp(a) molar concentration fully explained the Lp(a) association with CAD, and there was no residual association with apo(a) size. Homozygous carriers of loss-of-function mutations had little or no Lp(a) and increased the risk of T2D.
Molar concentration is the attribute of Lp(a) that affects risk of cardiovascular diseases. Low Lp(a) concentration (bottom 10%) increases T2D risk. Pharmacologic reduction of Lp(a) concentration in the 20% of individuals with the greatest concentration down to the population median is predicted to decrease CAD risk without increasing T2D risk.
Notes
CommentIn: J Am Coll Cardiol. 2019 Dec 17;74(24):2995-2997 PMID 31865967
PubMed ID
31865966 View in PubMed
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21 records – page 1 of 3.