| 1. |
- Sjöberg, P., et al.
(författare)
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Ventricular kinetic energy in young fontan patients
- 2016
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Ingår i: Cardiology in the Young. - 1467-1107. ; 26:Suppl 1, s. 64-64
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Konferensbidrag (refereegranskat)abstract
- Introduction: Four-dimensional (4D) flow magnetic resonance imaging (MRI) enables kinetic energy (KE) quantification of intraventricular blood flow. In this study we aimed to quantify the KE in in patients with univentricular heart and to assess the change in the KE after different types of interventions. Methods: 4D flow MRI was acquired in patients with Fontan circulation (n=12; median age 12, range 3-29 years) and in healthy volunteers (n =8; median age 26, range 23-36 years). MRI was repeated after transcatheter embolization of significant aortopulmonary collaterals (APC; n = 1), after stenting of left pulmonary artery (n=1) and after surgical replacement of hepatic flow tunnel with a Y graft due to significant central pulmonary artery stenosis with secondary formation of arteriovenous (AV) fistulas in the right lung (n= 1). Intraventricular KE was calculated throughout the cardiac cycle and indexed to stroke volume (SV). Results: The systole/diastole ratio of KE in Fontan patients was similar to the ratio of the controls' left ventricle (LV) or right ventricle (RV) depending on the ventricular morphology (Coheńs kappa =1.0). Peak systolic KE/SV did not differ in patients compared to the LV in controls (0.016 ± 0.006 mJ/ml vs 0.020 ±0.004 mJ/ml, p= 0.09). Peak diastolic KE/SV in Fontan patients was lower than in the LV of the control group (0.028 ±0.010 vs 0.057± 0.011 mJ/ml, p
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| 2. |
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| 3. |
- I. FERNLUND, EVA, et al.
(författare)
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MYBPC3 hypertrophic cardiomyopathy can be detected by using advanced ECG in children and young adults
- 2016
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Ingår i: Journal of Electrocardiology. - : Elsevier BV. - 0022-0736 .- 1532-8430. ; 49:3, s. 392-400
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Tidskriftsartikel (refereegranskat)abstract
- Introduction The conventional ECG is commonly used to screen for hypertrophic cardiomyopathy (HCM), but up to 25% of adults and possibly larger percentages of children with HCM have no distinctive abnormalities on the conventional ECG, whereas 5 to 15% of healthy young athletes do. Recently, a 5-min resting advanced 12-lead ECG test ("A-ECG score") showed superiority to pooled criteria from the strictly conventional ECG in correctly identifying adult HCM. The purpose of this study was to evaluate whether in children and young adults, A-ECG scoring could detect echocardiographic HCM associated with the MYBPC3 genetic mutation with greater sensitivity than conventional ECG criteria and distinguish healthy young controls and athletes from persons with MYBPC3 HCM with greater specificity. Methods Five-minute 12-lead ECGs were obtained from 15 young patients (mean age 13.2 years, range 0-30 years) with MYBPC3 mutation and phenotypic HCM. The conventional and A-ECG results of these patients were compared to those of 198 healthy children and young adults (mean age 13.2, range 1 month-30 years) with unremarkable echocardiograms, and to those of 36 young endurance-trained athletes, 20 of whom had athletic (physiologic) left ventricular hypertrophy. Results Compared with commonly used, age-specific pooled criteria from the conventional ECG, a retrospectively generated A-ECG score incorporating results from just 2 derived vectorcardiographic parameters (spatial QRS-T angle and the change in the vectorcardiographic QRS azimuth angle from the second to the third eighth of the QRS interval) increased the sensitivity of ECG for identifying MYBPC3 HCM from 46% to 87% (p <0.05). Use of the same score also demonstrated superior specificity in a set of 198 healthy controls (94% vs. 87% for conventional ECG criteria; p <0.01) including in a subset of 36 healthy, young endurance-trained athletes (100% vs. 69% for conventional ECG criteria, p <0.001). Conclusions In children and young adults, a 2-parameter 12-lead A-ECG score is retrospectively significantly more sensitive and specific than pooled, age-specific conventional ECG criteria for detecting MYBPC3-HCM and in distinguishing such patients from healthy controls, including endurance-trained athletes.
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| 4. |
- Liuba, P., et al.
(författare)
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Matrix Metalloproteinase-8 Activity is Increased in Type 1 Diabetes Children with High-Risk Diabetes HLA and Systemic Inflammation
- 2012
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Ingår i: Cardiology in the Young. - 1467-1107. ; 22:S1, s. 115-116
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Konferensbidrag (refereegranskat)abstract
- Background: Matrix metalloproteinases (MMPs) and myeloperoxidase (MPO) are colocalized to lipid-laden macrophages, and play a central role in initiation and propagation of chronic vascular diseases including atherosclerosis. Prior cross-sectional studies from our centre on children and adolescents with type 1 diabetes suggested possible propensity conferred by diabetes-risk HLA DQ2/8, particularly in an inflammatory milieu, to peripheral vascular dysfunction, an important precursor of atherosclerosis. In the same population, we aimed to assess whether this putative interplay between DQ2/8 and inflammation also reflects into increased activity of MMP and MPO. Methods: Blood pressure, inflammatory, lipid, HbA1c, cyclic guanilate monophospate (cGMP), along with degree of exposure to secondhand tobacco smoke (STS) were determined in 74 children and adolescents with type 1 diabetes at baseline and 1 year later. MMP-8 and MPO levels were measured only at the 2nd time-point. Results: In univariate regression, baseline BMI, HbA1c, CRP(log), and TC/HDL were all predictors of 1-year MMP-2 (p,.05 for all), while exposure to STS, BMI, cGMP, and TC/ HDL predicted levels of MPO (p,.05 for all). The rise in serum MMP-8 was most increased in those with both DQ2/8 and CRP .1 mg/l (p=0.01), but no such difference was noted with regard to MPO. Conclusion: In young patients with type 1 diabetes, increased activities of MMP and MPO appear to relate mainly to dyslipidemia, but inflammation, particularly in those with diabetes-risk HLA, and exposure to tobacco smoke could be important stimuli as well.
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| 5. |
- Ahlström, L., et al.
(författare)
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Surgical age and morbidity after arterial switch of transposition of the great arteries
- 2014
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Ingår i: Cardiology in the Young. - 1467-1107. ; 24:S1, s. 151-152
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Konferensbidrag (refereegranskat)abstract
- Background: Although transposition of the great arteries (TGA) accounts for less than 5% of congenital heart disease, the clinical course is often dramatic with need for early diagnosis and careful preoperative care as well as advanced surgical correction and postoperative support. Since 1993, Lund is one of the two tertiary referral centers for pediatric cardiac surgery in Sweden, with nearly 400 surgical procedures each year. Methods: A single-institution 12-year retrospective survey of 127 neonates and infants (median for birth weight, gestational week, and age at surgery: 3.5 kg, 39 weeks, and 4 days, respectively) with TGA corrected via arterial switch operation (ASO). Postoperative morbidity and mortality during the hospital stay were reviewed. Patients with double outlet right ventricle and chromosome abnormalities were excluded. “Major postoperative morbidity” (MPM) was defined as presence of 1 or more of the following: prolonged mechanical ventilation (MV), delayed sternum closure, reoperation, CPAP/NIV after extubation, and ECMO. Patients were grouped based on distance between Lund and referral clinic as follows: “local”- within 200 km radius (n=67), and “external” >200 km (n=60). Results: There was only 1 death, born preterm (gestational week 34) with a body weight 7 days, n=25) surgical age had impact on MPM (p>0.4). Among those without fetal diagnosis of TGA, neither age at surgery (p=0.8) nor MPO (p=0.5) differed between “local” and “external” groups. Conclusion: ASO can be performed safely in full term neonates and in infants with TGA regardless of surgical age. This finding, along with the similar postoperative outcome regardless the distance between Lund and the referral clinic lend further support to the concept of centralization of pediatric cardiac surgery.
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| 6. |
- Belkin, Liuba, et al.
(författare)
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When Bad is Good (and Good is Bad):Examining the Ironic Antecedents and Consequences of Bad Behavior
- 2023
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Ingår i: Academy of Management Annual Meeting Proceedings. - New York : Academy of Management. - 2151-6561 .- 0065-0668.
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Konferensbidrag (refereegranskat)abstract
- It is a common assumption that organizations should avoid “bad” behaviors, as such behaviors have very few positive outcomes or they are likely motivated by undesirable antecedents. In this symposium, we question this prevailing wisdom, in several ways. We suggest that bad behaviors may both inspire positive outcomes (task performance) and be motivated by seemingly “positive” or innocuous antecedents (gratitude, psychological distance). Additionally, we find that engaging in “bad” behaviors (expressing anger) may have positive relational consequences. Together this symposium explores a series of counterintuitive findings that help explain why bad may be good, and good bad in ways that helps illuminate unexpected behavioral mechanism in workplace relationships.
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| 7. |
- Charitakis, Emmanouil, et al.
(författare)
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Comparing efficacy and safety in catheter ablation strategies for atrial fibrillation: a network meta-analysis
- 2022
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Ingår i: BMC Medicine. - : BMC. - 1741-7015. ; 20:1
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Tidskriftsartikel (refereegranskat)abstract
- Background: There is no consensus on the most efficient catheter ablation (CA) strategy for patients with atrial fibrillation (AF). The objective of this study was to compare the efficacy and safety of different CA strategies for AF ablation through network meta-analysis (NMA). Methods: A systematic search of PubMed, Web of Science, and CENTRAL was performed up to October 5th, 2020. Randomized controlled trials (RCT) comparing different CA approaches were included. Efficacy was defined as arrhythmia recurrence after CA and safety as any reported complication related to the procedure during a minimum follow-up time of 6 months. Results: In total, 67 RCTs (n = 9871) comparing 19 different CA strategies were included. The risk of recurrence was significantly decreased compared to pulmonary vein isolation (PVI) alone for PVI with renal denervation (RR: 0.60, CI: 0.38-0.94), PVI with ganglia-plexi ablation (RR: 0.62, CI: 0.41-0.94), PVI with additional ablation lines (RR: 0.8, CI: 0.68-0.95) and PVI in combination with bi-atrial modification (RR: 0.32, CI: 0.11-0.88). Strategies including PVI appeared superior to non-PVI strategies such as electrogram-based approaches. No significant differences in safety were observed. Conclusions: This NMA showed that PVI in combination with additional CA strategies, such as autonomic modulation and additional lines, seem to increase the efficacy of PVI alone. These strategies can be considered in treating patients with AF, since, additionally, no differences in safety were observed. This study provides decision-makers with comprehensive and comparative evidence about the efficacy and safety of different CA strategies.
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| 8. |
- Charitakis, Emmanouil, et al.
(författare)
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Comparing Efficacy and Safety in Catheter Ablation Strategies for Paroxysmal Atrial Fibrillation : A Network Meta-Analysis of Randomized Controlled Trials
- 2022
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Ingår i: Diagnostics. - : MDPI. - 2075-4418. ; 12:2
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Forskningsöversikt (refereegranskat)abstract
- Although catheter ablation (CA) is an established treatment for paroxysmal atrial fibrillation (PAF), there is no consensus regarding the most efficient CA strategy. The objective of this network meta-analysis (NMA) was to compare the efficacy and safety of different CA strategies for PAF. A systematic search was performed in PubMed, Web of Science, and CENTRAL until the final search date, 5 October 2020. Randomised controlled trials (RCT) comparing different CA strategies and methods for pulmonary vein isolation (PVI) were included. Efficacy was defined as lack of arrhythmia recurrence after CA and safety as any reported complication related to the procedure during a minimum follow-up time of six months. In total, 43 RCTs comparing 11 different CA strategies involving 6701 patients were included. The risk of recurrence was significantly decreased in comparison with PVI with radiofrequency only for the following treatments: PVI with adjuvant ablation (RR: 0.79, CI: 0.65-0.97) and PVI with sympathetic modulation (RR: 0.64, CI: 0.46-0.88). However, PVI with radiofrequency was superior to non-PVI strategies (RR: 1.65, CI: 1.2-2.26). No statistically significant difference was found in safety between different CA strategies. Concerning different PVI strategies, no difference was observed either in efficacy or in safety between tested strategies. This NMA suggests that different PVI strategies are generally similar in terms of efficacy, while PVI with additional ablation or sympathetic modulation may be more effective than PVI alone. This study provides decision-makers with insights into the efficacy and safety of different CA strategies.
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| 9. |
- Eriksson, Peter J, 1959, et al.
(författare)
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Transcatheter Intervention for Coarctation of the Aorta A Nordic Population-Based Registry With Long-Term Follow-Up
- 2023
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Ingår i: Jacc-Cardiovascular Interventions. - : Elsevier BV. - 1936-8798 .- 1876-7605. ; 16:4, s. 444-453
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Tidskriftsartikel (refereegranskat)abstract
- BACKGROUND Coarctation of the aorta (CoA), a congenital narrowing of the proximal descending thoracic aorta, is a relatively common form of congenital heart disease. Untreated significant CoA has a major impact on morbidity and mortality. In the past 3 decades, transcatheter intervention (TCI) for CoA has evolved as an alternative to surgery.OBJECTIVES The authors report on all TCIs for CoA performed from 2000 to 2016 in 4 countries covering 25 million inhabitants, with a mean follow-up duration of 6.9 years.METHODS During the study period, 683 interventions were performed on 542 patients.RESULTS The procedural success rate was 88%, with 9% considered partly successful. Complications at the intervention site occurred in 3.5% of interventions and at the access site in 3.5%. There was no in-hospital mortality. During follow-up, TCI for CoA reduced the presence of hypertension significantly from 73% to 34%, but despite this, many patients remained hypertensive and in need of continuous antihypertensive treatment. Moreover, 8% to 9% of patients needed aortic and/or aortic valve surgery during follow-up.CONCLUSIONS TCI for CoA can be performed with a low risk for complications. Lifetime follow-up after TCI for CoA seems warranted. (J Am Coll Cardiol Intv 2023;16:444-453) & COPY; 2023 by the American College of Cardiology Foundation.
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