Arne K Andreassen

Oslo University Hospital, Kristiania (historical), Oslo, Norway

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Publications (112)558.9 Total impact

  • Journal of Psychosomatic Research 06/2015; 78(6). DOI:10.1016/j.jpsychores.2015.03.036 · 2.74 Impact Factor
  • Kaspar Broch · Klaus Murbræch · Arne Kristian Andreassen · Einar Hopp · Svend Aakhus · Lars Gullestad
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    ABSTRACT: Outcome is better in patients with idiopathic dilated cardiomyopathy (IDC) than in ischemic heart failure (HF), but morbidity and mortality are nevertheless presumed to be substantial. Most data on the prognosis in IDC stem from research performed before the widespread use of current evidence-based treatment, including implantable devices. We report outcome data from a cohort of patients with IDC treated according to current HF guidelines and compare our results with previous figures: 102 consecutive patients referred to our tertiary care hospital with idiopathic IDC and a left ventricular ejection fraction <40% were included in a prospective cohort study. After extensive baseline work-up, follow-up was performed after 6 and 13 months. Vital status and heart transplantation were recorded. Over the first year of follow-up, the patients were on optimal pharmacological treatment, and 24 patients received implantable devices. Left ventricular ejection fraction increased from 26 ± 10% to 41 ± 11%, peak oxygen consumption increased from 19.5 ± 7.1 to 23.4 ± 7.8 ml/kg/min, and functional class improved substantially (all p values <0.001). After a median follow-up of 3.6 years, 4 patients were dead, and heart transplantation had been performed in 9 patients. According to our literature search, survival in patients with IDC has improved substantially over the last decades. In conclusion, patients with IDC have a better outcome than previously reported when treated according to current guidelines. Copyright © 2015 Elsevier Inc. All rights reserved.
    The American journal of cardiology 06/2015; 116(6). DOI:10.1016/j.amjcard.2015.06.022 · 3.28 Impact Factor
  • The Journal of Heart and Lung Transplantation 04/2015; 34(4):S239. DOI:10.1016/j.healun.2015.01.662 · 6.65 Impact Factor
  • The Journal of Heart and Lung Transplantation 04/2015; 34(4):S121-S122. DOI:10.1016/j.healun.2015.01.322 · 6.65 Impact Factor
  • A.K. Andreassen · H. Eiskjær · E. Gude · D. Mølbak · W. Stueflotten · L. Gullestad
    The Journal of Heart and Lung Transplantation 04/2015; 34(4):S289. DOI:10.1016/j.healun.2015.01.809 · 6.65 Impact Factor
  • The Journal of Heart and Lung Transplantation 04/2015; 34(4):S85. DOI:10.1016/j.healun.2015.01.225 · 6.65 Impact Factor
  • The Journal of Heart and Lung Transplantation 04/2015; 34(4):S159-S160. DOI:10.1016/j.healun.2015.01.432 · 6.65 Impact Factor
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    ABSTRACT: Early initiation of everolimus with calcineurin inhibitor therapy has been shown to reduce the progression of cardiac allograft vasculopathy (CAV) in de novo heart transplant recipients. The effect of de novo everolimus therapy and early total elimination of calcineurin inhibitor therapy has, however, not been investigated and is relevant given the morbidity and lack of efficacy of current protocols in preventing CAV. This 12-month multicenter Scandinavian trial randomized 115 de novo heart transplant recipients to everolimus with complete calcineurin inhibitor elimination 7-11 weeks after HTx or standard cyclosporine immunosuppression. Ninety-five (83%) patients had matched intravascular ultrasound examinations at baseline and 12 months. Mean (± SD) recipient age was 49.9 ± 13.1 years. The everolimus group (n = 47) demonstrated significantly reduced CAV progression as compared to the calcineurin inhibitor group (n = 48) (ΔMaximal Intimal Thickness 0.03 ± 0.06 and 0.08 ± 0.12 mm, ΔPercent Atheroma Volume 1.3 ± 2.3 and 4.2 ± 5.0%, ΔTotal Atheroma Volume 1.1 ± 19.2 mm(3) and 13.8 ± 28.0 mm(3) [all p-values ≤ 0.01]). Everolimus patients also had a significantly greater decline in levels of soluble tumor necrosis factor receptor-1 as compared to the calcineurin inhibitor group (p = 0.02). These preliminary results suggest that an everolimus-based CNI-free can potentially be considered in suitable de novo HTx recipients. © Copyright 2015 The American Society of Transplantation and the American Society of Transplant Surgeons.
    American Journal of Transplantation 03/2015; 15(7). DOI:10.1111/ajt.13214 · 5.68 Impact Factor
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    ABSTRACT: Heart failure patients with reduced and preserved left ventricular (LV) ejection fraction (EF) show reduced exercise capacity. We explored the relationship between exercise capacity and systolic and diastolic myocardial function in heart failure patients. Exercise capacity, by peak oxygen uptake (VO2), was assessed in 100 patients (56 ± 12 years, NYHA functional class: 2.5 ± 0.9, EF: 42 ± 19%). LV systolic function, as EF and global longitudinal strain (GLS), and right ventricular function were assessed by echocardiography. Left atrial volume index and the ratio of peak early diastolic filling velocity (E) to early diastolic mitral annular velocity (e') were measures of diastolic function. Thirty-seven patients had heart failure with preserved EF (HFpEF), defined as EF ≥50% and echocardiographic diastolic dysfunction. LV GLS and peak pulmonary arterial systolic pressure were independently correlated to peak VO2 in the total study population and in HFpEF separately. LV GLS was superior to EF in identifying patients with impaired peak VO2 <20 mL/kg/min as shown by receiver operating characteristic analyses [areas under curves 0.93 (0.89-0.98) vs. 0.85 (0.77-0.93), P < 0.05]. In patients with HFpEF, GLS was reduced below normal (-17.5 ± 3.2%) and correlated to E/e' (R = 0.45, P = 0.005) and left atrial volume index (R = 0.48, P = 0.003), while EF did not. GLS correlated independently to peak VO2 in patients with reduced and preserved EF and was superior in identifying patients with reduced exercise capacity. In HFpEF, systolic function by GLS was impaired. There was a significant relationship between diastolic function and GLS, confirming a coupling between diastolic and longitudinal systolic function in HFpEF. © The Author 2014. Published by Oxford University Press on behalf of the European Society of Cardiology.
    European Heart Journal – Cardiovascular Imaging 12/2014; 16(2). DOI:10.1093/ehjci/jeu277 · 2.65 Impact Factor
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    ABSTRACT: Elevated levels of soluble ST2 (sST2) are associated with adverse outcome in heart failure. A change in sST2 levels has also been shown to presage outcome. In vitro, ST2 expression is induced by myocardial stress and pro-inflammatory stimuli. The determinants of sST2 levels in vivo, and how they vary with clinical status over time, have not been well described. In a cohort of patients with non-ischemic heart failure, we aimed to assess the association between sST2-levels and hemodynamic parameters reflecting right and left ventricular pre- and afterload, and how these vary with time and clinical status.Methods We prospectively recruited 102 patients with a left ventricular ejection fraction of 26 ± 10% and a diagnosis of idiopathic dilated cardiomyopathy based on patient history, clinical examination, echocardiography and coronary angiography. Patients went through extensive baseline work-up and were re-examined after one year. Subsequently, heart transplantations and deaths were recorded. Determinants of sST2 were analyzed at baseline and after one year. Soluble ST2 was measured with a highly sensitive immunoassay.ResultsSoluble ST2 levels were associated with hemodynamic parameters, but these associations were attenuated with clinical improvement. Soluble ST2 was elevated in patients with severe symptoms, but did not vary with etiology, viral presence or the amount of myocardial fibrosis. Heart rate and right atrial pressure remained independent predictors of sST2 on multiple regression analysis.Conclusions Our results imply that in non-ischemic heart failure, sST2 reflects hemodynamic stress rather than pathogenic processes in the myocardium.
    International Journal of Cardiology 11/2014; 179. DOI:10.1016/j.ijcard.2014.11.003 · 4.04 Impact Factor
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    ABSTRACT: In a randomized, open-label trial, everolimus was compared to cyclosporine in 115 de novo heart transplant recipients. Patients were assigned within 5 days posttransplant to low-exposure everolimus (3–6 ng/mL) with reduced-exposure cyclosporine (n = 56), or standard-exposure cyclosporine (n = 59), with both mycophenolate mofetil and corticosteroids. In the everolimus group, cyclosporine was withdrawn after 7–11 weeks and everolimus exposure increased (6–10 ng/mL). The primary efficacy end point, measured GFR at 12 months posttransplant, was significantly higher with everolimus versus cyclosporine (mean ± SD: 79.8 ± 17.7 mL/min/1.73 m2 vs. 61.5 ± 19.6 mL/min/1.73 m2; p < 0.001). Coronary intravascular ultrasound showed that the mean increase in maximal intimal thickness was smaller (0.03 mm [95% CI 0.01, 0.05 mm] vs. 0.08 mm [95% CI 0.05, 0.12 mm], p = 0.03), and the incidence of cardiac allograft vasculopathy (CAV) was lower (50.0% vs. 64.6%, p = 0.003), with everolimus versus cyclosporine at month 12. Biopsy-proven acute rejection after weeks 7–11 was more frequent with everolimus (p = 0.03). Left ventricular function was not inferior with everolimus versus cyclosporine. Cytomegalovirus infection was less common with everolimus (5.4% vs. 30.5%, p < 0.001); the incidence of bacterial infection was similar. In conclusion, everolimus-based immunosuppression with early elimination of cyclosporine markedly improved renal function after heart transplantation. Since postoperative safety was not jeopardized and development of CAV was attenuated, this strategy may benefit long-term outcome.
    American Journal of Transplantation 07/2014; DOI:10.1111/ajt.12809 · 5.68 Impact Factor
  • The Journal of Heart and Lung Transplantation 04/2014; 33(4):S154. DOI:10.1016/j.healun.2014.01.412 · 6.65 Impact Factor
  • The Journal of Heart and Lung Transplantation 04/2014; 33(4):S281. DOI:10.1016/j.healun.2014.01.748 · 6.65 Impact Factor
  • The Journal of Heart and Lung Transplantation 04/2014; 33(4):S134. DOI:10.1016/j.healun.2014.01.361 · 6.65 Impact Factor
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    ABSTRACT: Calcineurin inhibitors have constituted the cornerstone of immunosuppressive regime following heart transplantation. The transplanted heart is subjected to increased hypertrophy and the risk of developing graft vasculopathy. To what extent these negative effects are influenced by different immunosuppressive drugs, is largely unknown. We conducted a randomised, open-label, parallel group clinical trial to assess early introduction of everolimus followed by withdrawal of cyclosporine (EVE) in de novo heart transplant recipients, compared to a standard protocol of cyclosporine-based immunosuppression (CYA). In a substudy we investigated cardiac reserve by invasive hemodynamics during rest and exercise, early (7 weeks) and later (52 weeks) after heart transplantation, in 28 (EVE) and 34 (CYA) patients. The aim was to compare cardiac reserve in the two treatment arms. Methods: Patients had a right heart catheterisation at rest and during submaximal supine bicycle exercise. Pressures and cardiac output (CO) were measured. Results: At baseline (7 w) PCWP and CO increased from rest to exercise. After 52 w the hemodynamic pattern was similar, with a non-significant trend towards higher CO during exercise. There were no significant differences between treatment groups. View this table:Enlarge table
    The Journal of Heart and Lung Transplantation 04/2014; 33(4):S173-S174. DOI:10.1016/j.healun.2014.01.469 · 6.65 Impact Factor
  • The Journal of Heart and Lung Transplantation 04/2014; 33(4):S128. DOI:10.1016/j.healun.2014.01.343 · 6.65 Impact Factor
  • Arne K Andreassen · Asgrimur Ragnarsson · Einar Gude · Odd Geiran · Rune Andersen
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    ABSTRACT: To examine the effect of balloon pulmonary angioplasty (BPA) on chronic thromboembolic pulmonary hypertension (CTEPH) in patients with inoperable disease or persistent pulmonary hypertension after pulmonary endarterectomy. Observational cohort study. Referred patients with inoperable or persistent CTEPH. Twenty consecutive CTEPH patients (10 females), aged 60±10 years. Right heart catheterisation, functional capacity (cardiopulmonary exercise testing (CPET) and NYHA class) and blood sampled biomarkers N-terminal pro-brain natriuretic peptide (NT-proBNP) and troponin T examined at the time of diagnosis and repeated in all patients 3 months after the last BPA. Seventy-three catheterisations were performed with 18.6±6.1 BPAs per patient on segmental and subsegmental arteries. Two deaths occurred following the first BPA, with an overall 10% periprocedural death rate. Reperfusion oedema complicated seven procedures. Comparisons before and after BPA showed significant haemodynamic improvements, including decreased mean pulmonary artery pressure (mPAP) (45±11 mm Hg vs 33±10 mm Hg; p<0.001) and increased cardiac output (4.9±1.6 L/min vs 5.4±1.9 L/min; p=0.011). Reduced right ventricular strain was indicated by significantly lower plasma levels of NT-proBNP and troponin T. Significant improvement in functional capacity was evident as assessed by NYHA class (3.0±0.5 vs 2.0±0.5; p<0.001) and CPET (13.6±5.6 mL/kg/min vs 17.0±6.5 mL/kg/min; p<0.001). Seventeen patients (85%) were alive after 51±30 months of follow-up. BPA may offer an alternative form of treatment in selected CTEPH patients. While prognostic markers such as haemodynamics, functional capacity and biomarkers improve, significant periprocedural complications must be recognised. Randomised trials are warranted.
    Heart (British Cardiac Society) 07/2013; 99(19). DOI:10.1136/heartjnl-2012-303549 · 5.60 Impact Factor
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    ABSTRACT: Objectives: Due to the need for suitable donors for heart transplantation (HTx), older grafts and grafts with prolonged graft ischaemic time (GIT) are accepted. The impact of GIT and donor age on post-transplant cardiac function has not been examined with either newer echocardiographic techniques (tissue Doppler imaging, TDI) or cardiopulmonary exercise testing (CPET). Thus, we studied the influence of GIT and donor age on post-transplant cardiac function and exercise capacity. Methods: Fifty-two stable recipients underwent echocardiography with colour TDI and CPET at a median of 4 years after HTx. Left ventricular (LV) systolic (s') and early diastolic (e') mitral annular velocities, right ventricular (RV) s', RVe' as well as LV ejection fraction (EF) and VO(2peak) were analysed. Results: HTx recipients with GIT ≥ median value (200 min) had significantly lower septal LVs' (15%, P = 0.005), LVEF (9%, P = 0.015), RVs' (21%, P = 0.007), septal LVe' (22%, P = 0.001) and RVe' velocities (23%, P = 0.011), and slightly lower VO(2peak) (P = 0.098). Recipients with grafts from donor ≥ median age (37 years) had significantly lower LVe' velocities (septal LVe' P = 0.047 and lateral LVe' P = 0.010), but not LV systolic or RV parameters. Conclusions: Prolonged GIT impairs both systolic and diastolic function at the interventricular septum and RV free wall, while increasing donor age impairs LV diastolic function. The duration of graft ischaemia and donor age should be taken into account when evaluating for cardiac dysfunction in HTx recipients.
    European journal of cardio-thoracic surgery: official journal of the European Association for Cardio-thoracic Surgery 05/2013; 44(2). DOI:10.1093/ejcts/ezt233 · 3.30 Impact Factor
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    ABSTRACT: Background In the early phases following heart transplantation a main challenge is to reduce the impact of acute rejections. Previous studies indicate that intracellular ciclosporin A (CsA) concentration may be a sensitive acute rejection marker in renal transplant recipients. The aims of this study were to evaluate the relationships between CsA concentrations at different target sites as potential therapeutic drug monitoring (TDM) tools in heart transplant recipients. Methods Ten heart transplant recipients (8 men, 2 women) on CsA-based immunosuppression were enrolled in this prospective single-center pilot study. Blood samples were obtained once to twice weekly up to 12 weeks post-transplant. One of the routine biopsies was allocated to this study at each sampling time. Whole blood, intralymphocyte, and endomyocardial CsA concentrations were determined with validated HPLC-MS/MS-methods. Mann–Whitney U test was used when evaluating parameters between the two groups of patients. To correlate whole blood, intralymphocyte, and endomyocardial CsA concentrations linear regression analysis was used. Results Three patients experienced mild rejections. In the study period, the mean (range) intralymphocyte CsA trough concentrations were 10.1 (1.5 to 39) and 8.1 (1.3 to 25) ng/106 cells in the rejection and no-rejection group, respectively (P=0.21). Corresponding whole blood CsA concentrations were 316 (153 to 564) and 301 (152 to 513) ng/mL (P=0.33). There were no correlations between whole blood, intralymphocyte, or endomyocardial concentrations of CsA (P >0.11). Conclusions The study did not support an association between decreasing intralymphocyte CsA concentrations and acute rejections. Further, there were no association between blood concentrations and concentrations at sites of action, potentially challenging TDM in these patients.
    04/2013; 2(1):5. DOI:10.1186/2047-1440-2-5
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    ABSTRACT: Calcineurin inhibitors (CNIs) remain the mainstay of immunosuppression following heart transplantation (HTx) but are associated with significant complications such as nephrotoxicity. We therefore designed a randomized trial to assess whether early introduction of everolimus (Evr) followed by withdrawal of cyclosporine (CsA) would lead to superior renal function and less chronic allograft vasculopathy (CAV) in de novo HTx recipients compared to a standard protocol of CsA-based immunosuppression.Methods and MaterialsA 12 months’ prospective, multicenter, parallell group, open-labeled study with randomization within 5 days post-HTx to CsA, mycophenolate mofetil (MMF) and corticosteroids (CS) (Group A) or to low dose Evr and reduced dose CsA, MMF and CS, with CsA withdrawal and full-dose Evr after 7-11 weeks (Group B).ResultsThe primary objective was to compare renal function assessed by measured glomerual filtration rate (mGFR) 12 months after HTx. Secondary objectives included differences in progression of CAV assessed by IVUS, renal function evaluated by change of mGFR between weeks 7-11 to month 12, renal function estimated by calculated GFR (cGFR) at each follow-up visit, number of rejections and occurence of treatment failures up to 12 months (graft loss, death, loss to follw-up or discontinuation due to lack of efficacy or toxicity), proteinuria, lipid profile, left ventricular function, safety and tolerability). Altogether 116 patients were recruited and randomized to Group A (n = 59) and Group B (n = 57) with mean (SD) age of 51.5 (12.4) and 51.1 (12.8), respectively, from 1. of December 2009 to 31. of December 2011. The last patient will complete the study in December 2012.Conclusions To be presented at the meeting.
    The Journal of Heart and Lung Transplantation 04/2013; 32(4):S134. DOI:10.1016/j.healun.2013.01.298 · 6.65 Impact Factor

Publication Stats

2k Citations
558.90 Total Impact Points


  • 2001–2015
    • Oslo University Hospital
      • Department of Cardiology
      Kristiania (historical), Oslo, Norway
  • 1998–2015
    • University of Oslo
      • • Department of Cardiology
      • • Division of Medicine
      Kristiania (historical), Oslo, Norway
  • 2008–2013
    • Diakonhjemmet Hospital (Norway)
      Kristiania (historical), Oslo, Norway
    • Cleveland Clinic
      • Department of Infectious Disease
      Cleveland, Ohio, United States
  • 2007
    • Harbor-UCLA Medical Center
      • Department of Pediatrics
      Torrance, California, United States