Symptoms and General Pathology

All Conditions

Gland and Hormone Related Diseases

Nutritional and Metabolic Diseases

Nervous System Diseases

Heart and Blood Diseases

Wounds and Injuries

Rare Diseases

Infarction

Thyroid Diseases

Diabetes Mellitus

Stroke

Fractures, Bone

Constriction, Pathologic

Aortic Valve Stenosis

Death

Ischemia

Necrosis

Aortic Valve Disease

Heart Valve Diseases

Heart Diseases

Ventricular Outflow Obstruction

All Drugs and Chemicals

Bone Density Conservation Agents

Micronutrients

Vitamins

Androgens

Hormones

Vitamin D

Cholecalciferol

Vitamin D3

Calciferol

subjects with myocardial infarction in the Tromsø study end point registry

subjects with type 2 diabetes in the Tromsø study end point registry

subjects with stroke in the Tromsø study end point registry

subjects with fracture in the Tromsø study end point registry

subjects with cancer in the Tromsø study end point registry

subjects registered as dead in the Tromsø study end point registry

subjects with aortic stenosis in the Tromsø study end point registry

randomly selected controls from the Tromsø study

Rolf Jorde, Professor

Polymorphisms in the vitamin D system appear to affect the serum 25(OH)D levels. If so one would expect these polymorphisms to be associated with vitamin D related conditions and diseases, which will be tested in the present study including DNA analyses in 9700 subjects

Vitamin D, which is essential in calcium metabolism, is produced in the skin after sun exposure or obtained from food, mainly fatty fish or vitamin D supplements. For activation vitamin D must be hydroxylated in the liver to 25(OH)D and thereafter in the kidney to 1,25(OH)2D. In the circulation 25(OH)D and 1,25(OH)2D are bound to a carrier protein (DBP), and for 1,25(OH)2D to exert its effect it has to bind to the vitamin D receptor (VDR).

The serum level of 25(OH)D, which is the metabolite used to evaluate a person's vitamin D status, is in part genetically determined and several polymorphisms with effects on serum 25(OH)D have been identified. These polymorphisms, where the minor allele frequencies vary between 16 and 40 %, appear as important for the serum 25(OH)D level as the effect of season, physical activity or vitamin D supplementation.

Vitamin D is not only vital for the skeleton, but appears to be related to a number of health outcomes, including mortality as previously demonstrated in the Tromsø study. However, as the serum level of 25(OH)D is strongly influenced by life-style factors that are also related to health outcomes, it is difficult to decide whether the relation between vitamin D and health is causal or not.

On the other hand, the polymorphisms are not influenced by life-style, and the effect of the polymorphisms will be life-long. Accordingly, they may be a better marker of vitamin D status than a single serum 25(OH)D measurement. Furthermore, there are a number of polymorphisms regarding the vitamin D receptor (VDR) that may be associated with health.

In the present study we will therefore relate the polymorphisms affecting the serum 25(OH)D level and the function of the VDR, with anthropometric and biochemical measures, mortality, diseases and risk factors for disease. DNA will be obtained from the 4th Tromsø study.

If we find the expected associations between the polymorphisms and diseases, this will further strengthen the role of vitamin D in human health, and may be important for recommendations regarding vitamin D supplementation. Considering the high prevalence of vitamin D deficiency world wide, this may potentially have huge consequences for public health.

The main purpose of the present study is the vitamin D system, but in the Tromsø study we have previously also found a number of associations between thyroid and androgen function and health. Obtaining DNA for analysis will be the major cost in the project, whereas analyses of individual polymorphisms are relatively cheap. We will therefore also include polymorphisms regarding thyroid and androgen function.

Polymorphisms in the Vitamin D System and Health

University of Tromso

Professor

Neoplasms

Respiratory Tract (Lung and Bronchial) Diseases

Infections

Lung Neoplasms

Lung Diseases

Pulmonary Embolism

Embolism

Pneumonia

Respiratory Tract Diseases

Thrombosis

Embolism and Thrombosis

Vascular Diseases

Imaging performed on scanner 1: Photon-Counting Detector CT

Imaging performed on scanner 2: Energy-Integrating Detector CT (128-slice)

Imaging performed on scanner 3: Energy-Integrating Detector CT (20-slice)

Patients will undergo imaging on a modern CT scanner with spectral imaging capabilities. A dose neutral spectral acquisition mode will routinely be used. Contrast material protocol and scan ranges are similar in all three arms.

Imaging on Scanner with Spectral Imaging Capabilities

Patients will undergo imaging on a modern 128-slice CT scanner (Siemens Healthineers) with energy-integrating detector and without spectral acquisition mode. Contrast material protocol and scan ranges are similar in all three arms.

CT Scan using an Energy-Integrating Detector CT (128 slice MDCT)

Patients will undergo imaging on a modern 20-slice CT scanner (Siemens Healthineers) with energy-integrating detector and without spectral acquisition mode. Contrast material protocol and scan ranges are similar in all three arms.

CT Scan using an Energy-Integrating Detector CT (20-slice MDCT)

Florian Schwarz, MD

CT scans of the chest / thorax are of great importance both in the initial diagnosis and in the follow-up of pulmonary or thoracic diseases. As an example, CT angiography of the pulmonary arteries (CTPA) is worldwide considered to be gold standard test in patients with a suspicion for pulmonary embolism.

The aim of this study is to measure and compare dose efficiency of modern CT scanners for unenhanced and contrast-enhanced scan protocols of the chest/thorax. Patients who are referred for a CT of the chest/thorax will be randomly assigned to one of the three CT scanners currently in use at our institution.

Randomization of patients referred for a CT scan of the thorax on one of three CT scanners routinely used for this purpose in our department

On Dose Efficiency of Modern CT-scanners in Chest Scans

On Dose Efficiency of Modern CT-scanners in Chest Scans- a Prospective, Randomized Study

We plan to share individual participant data upon request (pending final approval by the data protection officer).

Measured as signal, image noise and modulation transfer function equivalent parameters

measured as x-ray tube parameters such as dose length product (DLP)

measured by blinded evaluation by radiologists

University Hospital Augsburg

Urinary Tract, Sexual Organs, and Pregnancy Conditions

Neoplasm Metastasis

Hypertension

Renal Insufficiency

Essential Hypertension

Neoplastic Processes

Kidney Diseases

Urologic Diseases

Urogenital Diseases

Female Urogenital Diseases

Pregnancy Complications

Female Urogenital Diseases and Pregnancy Complications

Male Urogenital Diseases

Reproductive Control Agents

Respiratory System Agents

Vasodilator Agents

Anti-Inflammatory Agents

Antihypertensive Agents

Amino Acids

Herbal and Botanical

Albuterol

Nitroglycerin

Caseins

Glycyrrhizic Acid

Bisoprolol

Bronchodilator Agents

Anti-Asthmatic Agents

Tocolytic Agents

Adrenergic Agents

Adrenergic beta-Agonists

Adrenergic Agonists

Neurotransmitter Agents

Chelating Agents

Sympatholytics

Adrenergic beta-1 Receptor Antagonists

Adrenergic beta-Antagonists

Adrenergic Antagonists

Arginine

Licorice

Subjects with primary or secondary hypertension and normotensive control subjects. In addition haemodynamic recordings to 50 subjects suffering from chronic fatigue syndrome will be performed.

Subjects who had voluntarily decided to participate in a professionally coached marathon school (Varala Sports Institute, Tampere) were given the chance for haemodynamic recordings before, during and after the training protocol.

Normotensive subjects, daily liquorice ingestion (daily glycyrrhizin dose 290-370 mg) for 2 weeks, haemodynamic measurements before and after the intervention.

Daily ingestion of yoghurt containing small milk casein-derived polypeptides for 12 weeks versus placebo yoghurt.

Hypertensive subjects, bisoprolol 5 mg once daily versus placebo in a double-blind, cross-over protocol.

Subjects with aortic stenosis confirmed by echocardiography

35 normotensive subjects who received research drugs (nitroglycerin, salbutamol, placebo resoriblet, placebo inhalation, L-arginine infusion, saline infusion) in a placebo-controlled, double-blinded manner

Altogether 80 athletes participating in a full length Ironman competition. Non-invasive recordingds are performed under normal conditions during the training period and after completion of a full-length Ironman competition.

From the beginning of the study until the end of year 2016 a single dose of sublingual nitroglycerin was given to examine the associated acute haemodynamic effects (recordings completed).

Nitroglycerin 0.25 mg (single dose, no longer given since January 2017)

From the beginning of the study until the end of year 2016 a 400 µg dose of inhaled salbutamol was given to examine the associated acute haemodynamic effects (recordings completed).

Salbutamol 400 µg (single dose, no longer given since January 2017)

From the beginning of the study until the end of year 2016 L-arginine infusion 10 mg/kg/min could be given for 10 minutes to examine acute haemodynamic effects (recordings completed).

L-arginine (10 min infusion, no longer given since January 2017)

Daily liquorice intake (daily glycyrrhizin dose 290-370 mg) for two weeks, measurements before and after intervention (recordings completed).

Liquorice (2 weeks, glycyrrhizin 290-370 mg daily, no longer given since 2012)

Daily intake of yoghurt containing small milk casein-derived polypeptides (12 weeks) and placebo yoghurt (12 weeks), measurements before and after intervention (recordings completed 2011).

Small milk casein-derived polypeptides (12 weeks daily, recordings completed 2011)

Bisoprolol 5 mg daily for 3 weeks and placebo tablet daily for 3 weeks, double-blind, randomized, placebo-controlled cross-over protocol. Measurements before and after interventions (recordings completed 2011).

Bisoprolol (5 mg daily for 3 weeks, recordings completed 2011)

Ilkka H Pörsti, MD, PhD, Professor

Elina J Hautaniemi, PhD

Ilkka Pörsti, Professor

Ilkka H Pörsti, Professor

Ilkka Pörsti, MD, PhD, Professor

Ilkka Pörsti, MD, PhD

The primary aim of the present study was to examine the haemodynamic changes in primary hypertension and secondary hypertension (renal diseases, endocrine diseases, obesity-associated hypertension) with a non-invasive haemodynamic measurement protocol utilizing radial pulse wave analysis and whole-body impedance cardiography in both supine position and during head-up tilt. For comparison, haemodynamics of subjects with chronic fatigue syndrome will also be recorded.

Elevated blood pressure (BP) and related cardiovascular complications are the leading causes of morbidity and mortality in the modern world. In routine clinical practice, the haemodynamic status is commonly assessed by measuring heart rate and blood pressure at rest, which provides only limited information about functional haemodynamic status. In addition, the haemodynamic changes resulting in similar elevations of BP may differ substantially between patients and disorders.

Therefore, we investigated the haemodynamic changes in primary and secondary hypertension and in the control subjects with non-invasive radial pulse wave analysis and whole-body impedance cardiography. The method includes the determination of volume status using bioimpedance spectroscopy, determination of peripheral and central BP, cardiac function, vascular resistance, arterial compliance and indices of pulse wave reflection. Besides the measurements performed in the supine position, passive orthostatic challenge is included in the protocol to assess the upright functional haemodynamic status.

The repeatability and reproducibility of the protocol was first examined with a double-blind, randomized protocol in 35 subjects (methodological study group), and after that the administration of research drugs has been open-label. The effects of single doses of two largely endothelium-dependent agents, inhaled salbutamol and intravenous L-arginine, and one endothelium-independent agent, sublingual nitroglycerin, were investigated. However, challenges with the acute dosing of all medical compounds was terminated at the end of December 2016. Thereafter, the measurement protocol has included supine and upright recordings on the tilt-table, followed by supine measurements during paced breathing (15 breaths per minute for 5 minutes, 6 breaths per minute for 5 minutes) that modulate the autonomic nervous tone.

The study population has consisted of subgroups described below. The study protocol of each subgroup has been approved by the ethics committee of the Pirkanmaa Hospital District (Ethics committee ID's above), and the administration of research drugs has also been approved by the Finnish Agency for Medicines (EudraCT-numbers above).

HaemoDYNAMICs in Primary and Secondary Hypertension

Non-Invasive HaemoDYNAMICs in Primary and Secondary Hypertension: the DYNAMIC-study

Haemodynamic measurements are performed at baseline, and after approximately 10 years of follow-up

All cardiovascular events during follow-up

Rapid haemodynamic responses are assessed during the same measurement session (the response to head-up tilt and to research drugs salbutamol, nitroglycerin and L-arginine)

The change in haemodynamic variables after daily consumption of liquorice (2 weeks); bisoprolol (3 weeks); small milk casein-derived polypeptides (12 weeks)

Recordings are performed during normal conditions (training peroid) and after completion of a full-length Ironman competition

Finnish Foundation for Cardiovascular Research

Paavo Nurmi Foundation

Sigrid Jusélius Foundation

Finnish Cultural Foundation

Tampere Tuberculosis Foundation

Medical Research Fund of the Tampere University Hospital, Finland

Aarne Koskelo Foundation

Finnish Medical Foundation

Finnish Kidney Foundation

Päivikki and Sakari Sohlberg Foundation, Finland

Tampere University

MD, PhD, Professor of Internal Medicine

Substance Related Disorders

Myocardial Infarction

Syndrome

Fibrosis

Systolic Murmurs

Carcinoid Tumor

Malignant Carcinoid Syndrome

Serotonin Syndrome

Coronary Artery Disease

Myocardial Ischemia

Neuroendocrine Tumors

Neuroectodermal Tumors

Neuroectodermal Tumors, Primitive

Neoplasms, Germ Cell and Embryonal

Neoplasms by Histologic Type

Adenocarcinoma

Carcinoma

Neoplasms, Glandular and Epithelial

Neoplasms, Nerve Tissue

Drug-Related Side Effects and Adverse Reactions

Chemically-Induced Disorders

Chronic Graft Versus Host Disease

Carcinoid Syndrome

Neuroendocrine Tumor

Neuroepithelioma

Serotonin

The investigators will recruit 70 patients with aortic stenosis (25 patients with asymptomatic moderate aortic stenosis and 25 patients with symptomatic severe aortic stenosis, 10 patients with mild aortic stenosis and 10 patients with aortic sclerosis) and 10 healthy volunteers, who will undergo baseline 68Ga-FAPI or 18F-AlF-FAPI PET/MR imaging to establish fibrosis activity in healthy myocardium and in context of chronic myocardial injury. All patients will have a follow up FAPI PET/ MR scan 1 year after their baseline scan to assess whether myocardial fibrosis activity reverses following aortic valve replacement and restoration of normal afterload in patients with severe aortic stenosis and if baseline myocardial fibrosis activity can predict progression in the fibrosis burden and clinical progression in patients with mild or moderate aortic stenosis or aortic sclerosis. Healthy volunteers will not undergo any repeat imaging.

The investigators will recruit 60 patients who have undergone anthracycline treatment \>1 year from enrollment and 10 healthy volunteers as part of this cohort. This will include 50 patients who have either clear evidence of cardiotoxicity (Ejection fraction \<50% and a 10%point fall in ejection fraction) or a subclinical cardiac injury (elevated troponin, elevated T2, impaired global longitudinal strain) and 10 patients with no evidence of cardiotoxicity on their cardiac MRI scan (performed as part of the ongoing Cardiac CARE study). These patients will undergo baseline FAPI PET/MR imaging to establish the extent and pattern of myocardial fibrosis activity in context of delayed myocardial injury (chemotherapy-induced cardiotoxicity). All patients will have a follow up cardiac MRI scan 1-2 years after their baseline scan to assess whether baseline fibrosis activity is associated with a deterioration in cardiac function. Healthy volunteers will not undergo any repeat imaging.

In collaboration with the South East Scotland NET Service, the investigators will recruit 30 patients with carcinoid syndrome for this cohort. These patients will undergo a baseline echocardiogram and a FAPI PET/MR scan to investigate fibrosis activity within the cardiac chambers and valves. The investigators will recruit patients with established cardiac involvement as well as carcinoid syndrome patients with high circulating 5-HT concentrations who have no evidence of valve disease on echocardiography. All patients will have a follow up cardiac MRI scan and an echocardiogram, 6 months - 1 year after their baseline scan to assess whether baseline fibrosis activity is associated with subsequent deterioration in cardiac and valvular function.

Hybrid Cardiac PET-MR with 68Ga-FAPI and 18F-AlF-FAPI radiotracer

68Ga-FAPI and 18F-AlF-FAPI PET-MR

Krithika Loganath, MBBS

Krithika Loganath

Marc Dweck, MBBS PhD

In this study the investigators aim to examine the role that fibrosis plays in heart conditions such as aortic stenosis , chemotherapy-induced cardiotoxicity and carcinoid syndrome . Fibrosis is a common final result following any injury to the heart muscle and the investigators aim to identify this process early and in its active state. This will be examined by using a radiotracer 68Ga-FAPI or 18F-AlF-FAPI and PET-MRI or PET-CT.

The investigators aim to investigate the role of fibrosis activity using 68Ga-FAPI and 18F-AlF-FAPI PET in chronic and delayed valvular, myocardial and endocardial injury states, in particular aortic stenosis, chemotherapy induced cardiotoxicity and carcinoid heart disease. The investigators also aim to analyse serum markers of myocardial injury and fibrosis at different time-points in these patient cohorts.

Research Hypothesis

1. In patients with aortic stenosis, myocardial fibrosis activity will correlate with markers of left ventricular decompensation and aortic valve fibrosis activity, will predict progression in fibrosis burden and will decline following aortic valve replacement.
2. Increased myocardial fibrosis activity will be observed in the early stages of anthracycline- induced cardiotoxicity and will predict later deterioration in cardiac function.
3. In patients with carcinoid syndrome, increased endocardial fibrosis activity will be observed in patients with subclinical and clinically significant valve involvement.

Study title	NCT ID	Conditions	Interventions	Eligibility	Organization
Polymorphisms in the Vitamin D System and Health	NCT01395303	Infarction Stroke Diabetes Fracture Aortic Stenosis Cancer Death		30 Years - 90 Years	University of Tromso
On Dose Efficiency of Modern CT-scanners in Chest Scans	NCT04996693	Pneumonia Lung Cancer Pulmonary Embol... Pulmonary Disea... Aortic Stenosis	Imaging on Scan... CT Scan using a... CT Scan using a...	18 Years -	University Hospital Augsburg
HaemoDYNAMICs in Primary and Secondary Hypertension	NCT01742702	Primary Hyperte... Secondary Hyper... Aortic Stenosis Renal Insuffici...	Nitroglycerin 0... Salbutamol 400 ... L-arginine (10 ... Liquorice (2 we... Small milk case... Bisoprolol (5 m...	18 Years - 99 Years	Tampere University
Polymorphisms in the Vitamin D System and Health	NCT01395303	Infarction Stroke Diabetes Fracture Aortic Stenosis Cancer Death		30 Years - 90 Years	University of Tromso
Fibrosis in Chronic and Delayed Myocardial Infarction	NCT05756608	Aortic Stenosis Chemotherapy In... Carcinoid Syndr...	68Ga-FAPI and 1...	40 Years - 90 Years	University of Edinburgh
Prospective Project to Identify Biomarkers of Morbidity and Mortality in Cardiovascular Interventional Patients	NCT03444259	Atrial Fibrilla... Coronary Artery... Aortic Valve St... Aortic Valve Di... Mitral Valve Di... Cardiac Arrythm... Cardiac Tumor Cardiac Surgery	Cardiac surgery	18 Years -	University of Turku

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