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FRIMEDBIO-Fri prosj.st. med.,helse,biol

Prevention of sudden cardiac death in young individuals - early detection of cardiomyopathies and personalized recommendations

Alternative title: Forebyggelse av plutselig hjertedød hos unge - tidlig påvisning av hjertemuskelsykdom og persontilpassede anbefalinger

Awarded: NOK 10.2 mill.

Sudden cardiac death is responsible for half of the deaths related to heart disease. In young individuals, sudden cardiac death is often the first manifestation of an inherited heart muscle disease, a cardiomyopathy, causing deadly arrhythmias. Exercise can trigger these arrhythmias and death often occurs at public arenas such as the soccer field. The implantable defibrillator (ICD) is the only effective therapy to prevent SCD. Selection of patients for this therapy is challenging and reliable methods for detecting the earliest signs of heart muscle disease are missing. Oslo University Hospital has a unique and large cohort of patients with heart muscle disease. We will collaborate with European and American centers to enable a significant and sufficient material for development of a risk calculator that can identify patients with highest risk of sudden cardiac death to help clinical practice for ICD selection. We will use high-end cardiac ultrasound scanners with sophisticated techniques for heart analyses to find novel risk markers. The research group has pioneered this field and has patented a groundbreaking tool for prediction of sudden cardiac death, which is implemented in the new generation of GE (General Electrics) echocardiographic scanners. We will also use a computational model on cardiovascular system mechanics to predict sudden cardiac death. We will use data from patients with heart muscle disease, including data from exercise tests, to test consequences on the heart in virtual patient simulations. This project will lead to better and earlier detection of heart muscle disease which will help focusing resources on high risk individuals and avoid over-treatment in low risk individuals. Patient-tailored advice on exercise and pregnancy and the development of better risk predictors will significantly improve selection of patients to ICD therapy and thereby prevent sudden cardiac death in the young. During 2021-2022 we have published the results from studies on pregancy in cardiomyopathies. Our findings showed that women with arrhythmogenic cardiomyopathy tolerated pregnancy well. Furthermore, patients with laminopathies had no harmful long-term effects of pregnancy on cardiac function. We published the Norwegian recommendations on genetic heart disease. The booklet was sent to all Norwegian cardiologists.

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Sudden cardiac death (SCD) is responsible for half of the deaths related to heart disease. In the young, SCD is often the first manifestation of a genetic heart muscle disease, a cardiomyopathy, causing lethal arrhythmias. Exercise can trigger these arrhythmias and death often occurs at public arenas such as the soccer field. The implantable defibrillator (ICD) is the only effective therapy to prevent SCD. Selection of patients for this therapy is challenging and reliable methods for detecting the earliest signs of cardiomyopathies are missing. Oslo University Hospital has a unique and large cohort of cardiomyopathy patients. We will collaborate with European and American centers to enable a significant and sufficient material for development of a predictive SCD risk calculator which will help clinical practice for ICD selection. We will use high-end echocardiographic scanners with sophisticated techniques for cardiac analyses to find novel risk markers. The research group has pioneered this field and has patented a groundbreaking tool for prediction of sudden cardiac death, which is implemented in the new generation of GE (General Electrics) echocardiographic scanners. We will collaborate with Maastricht university, NL using a computational model on cardiovascular system mechanics. The integration of patient specific data, including e.g. exercise and pregnancy, and regulation of cardiac electro-mechanics in virtual patient simulations will lead to the discovery of new electro-mechanical signatures facilitating prevention of SCD. This project will lead to better and earlier detection of cardiomyopathies which will help focusing resources on high risk individuals and avoid over-treatment in low risk individuals. Patient-tailored advice on exercise and pregnancy and the development of better risk predictors will significantly improve selection of patients to ICD therapy and thereby prevent SCD in the young.

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FRIMEDBIO-Fri prosj.st. med.,helse,biol

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