Publications by authors named "Eivind Aabel"

5 Publications

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Electrical markers and arrhythmic risk associated with myocardial fibrosis in mitral valve prolapse.

Europace 2022 Jul;24(7):1156-1163

Department of Cardiology, ProCardio Centre for Innovation, Oslo University Hospital, Rikshospitalet, PO Box 4950 Nydalen, 0424 Oslo, Norway.

Aims: We aimed to characterize the substrate of T-wave inversion (TWI) using cardiac magnetic resonance (CMR) and the association between diffuse fibrosis and ventricular arrhythmias (VA) in patients with mitral valve prolapse (MVP).

Methods And Results: TWI was defined as negative T-wave ≥0.1 mV in ≥2 adjacent ECG leads. Diffuse myocardial fibrosis was assessed by T1 relaxation time and extracellular volume (ECV) fraction by T1-mapping CMR. We included 162 patients with MVP (58% females, age 50 ± 16 years), of which 16 (10%) patients had severe VA (aborted cardiac arrest or sustained ventricular tachycardia). TWI was found in 34 (21%) patients. Risk of severe VA increased with increasing number of ECG leads displaying TWI [OR 1.91, 95% CI (1.04-3.52), P = 0.04]. The number of ECG leads displaying TWI increased with increasing lateral ECV (26 ± 3% for TWI 0-1leads, 28 ± 4% for TWI 2leads, 29 ± 5% for TWI ≥3leads, P = 0.04). Patients with VA (sustained and non-sustained ventricular tachycardia) had increased lateral T1 (P = 0.004), also in the absence of late gadolinium enhancement (LGE) (P = 0.008).

Conclusions: Greater number of ECG leads with TWI reflected a higher arrhythmic risk and higher degree of lateral diffuse fibrosis by CMR. Lateral diffuse fibrosis was associated with VA, also in the absence of LGE. These results suggest that TWI may reflect diffuse myocardial fibrosis associated with VA in patients with MVP. T1-mapping CMR may help risk stratification for VA.
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http://dx.doi.org/10.1093/europace/euac017DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC9301977PMC
July 2022

Cardiac Arrest in a Patient With Arrhythmic Mitral Valve Prolapse Syndrome: Multiple Possible Etiologies.

JACC Case Rep 2021 Nov 17;3(16):1769-1773. Epub 2021 Nov 17.

ProCardio Centre for Innovation, Department of Cardiology, Oslo University Hospital, Rikshospitalet, Oslo, Norway.

Arrhythmic mitral valve prolapse syndrome is associated with a high risk of death. A 60-year-old man with arrhythmic mitral valve prolapse syndrome was monitored with an implantable loop recorder. Nine months later dyspnea developed, followed by cardiac arrest. Echocardiography showed mitral valve chordal rupture. He underwent successful surgical mitral valve repair. ().
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http://dx.doi.org/10.1016/j.jaccas.2021.08.019DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC8603045PMC
November 2021

The Authors' Reply.

JACC Cardiovasc Imaging 2021 08;14(8):1684-1685

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http://dx.doi.org/10.1016/j.jcmg.2021.06.006DOI Listing
August 2021

Mitral Annulus Disjunction: Arrhythmic But Not Deadly?

JACC Cardiovasc Imaging 2021 11 16;14(11):2088-2090. Epub 2021 Jun 16.

ProCardio Center for Innovation, Department of Cardiology, Oslo University Hospital, Rikshospitalet, Oslo, Norway; Institute of Clinical Medicine, Faculty of Medicine, University of Oslo, Oslo, Norway.

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http://dx.doi.org/10.1016/j.jcmg.2021.05.014DOI Listing
November 2021

Tricuspid Annulus Disjunction: Novel Findings by Cardiac Magnetic Resonance in Patients With Mitral Annulus Disjunction.

JACC Cardiovasc Imaging 2021 08 17;14(8):1535-1543. Epub 2021 Mar 17.

ProCardio Center for Innovation, Department of Cardiology, Oslo University Hospital, Rikshospitalet, Oslo, Norway; Institute of Clinical Medicine, University of Oslo, Oslo, Norway. Electronic address:

Objectives: This study aimed to assess whether patients with MAD also have disjunction of the tricuspid annulus.

Background: Mitral annulus disjunction (MAD) is an abnormal atrial displacement of the mitral annulus. Whether the disjunction extends to the right side of the heart is not known.

Methods: In a cohort of patients with MAD, we assessed the presence of tricuspid annulus disjunction (TAD) with the use of cardiac magnetic resonance. We explored the associations between TAD and MAD characteristics and the relationship to ventricular arrhythmias (nonsustained/sustained ventricular tachycardias and aborted cardiac arrest).

Results: We included 84 patients (mean age: 48 ± 16 years; 63% female). We observed TAD in 42 (50%). Patients with TAD were older (age 52 ± 16 years vs. 43 ± 15 years; p = 0.02), had greater circumferential extent of MAD (164 ± 57° vs. 115 ± 58°; p = 0.002), greater maximum longitudinal MAD distance (9.4 ± 2.9 mm vs. 6.2 ± 2.8 mm; p < 0.001), and more frequent mitral valve prolapse (n = 39 [92%] vs. n = 24 [57%]; p < 0.001). Ventricular arrhythmias had occurred in 34 patients (41%), who were younger (age 39 ± 14 years vs. 54 ± 14 years; p < 0.001) and had lower prevalence of TAD (n = 22 [29%] vs. n = 12 [52%]; p = 0.03). TAD was not associated with ventricular arrhythmias when adjusted for age (odds ratio adjusted for age: 0.54; 95% confidence interval: 0.20 to 1.45; p = 0.22).

Conclusions: We report for the first time the existence of right-sided annulus disjunction as a common finding in patients with MAD. TAD was associated with more severe left-sided annulus disjunction and mitral valve prolapse, but not with ventricular arrhythmias.
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http://dx.doi.org/10.1016/j.jcmg.2021.01.028DOI Listing
August 2021
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