| 1. |
- Friberg, Hans, et al.
(författare)
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Internationell och nationell konsensus om bästa vård efter hävt hjärtstopp. Många patienter blir helt återställda.
- 2010
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Ingår i: Läkartidningen. - 0023-7205 .- 1652-7518. ; 107:8, s. 2-514
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Forskningsöversikt (refereegranskat)abstract
- An international consensus report on postresuscitation care after cardiac arrest has recently been published. Its content and main messages are in line with the recommendations from The Swedish Resuscitation Council, which include: diagnosing and treating the underlying disease, offering good general intensive care, considering hypothermia treatment, standardising prognostication and follow-up.
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| 2. |
- Algurén, Beatrix, et al.
(författare)
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A scoping review and mapping exercise comparing the content of patient-reported outcome measures (PROMs) across heart disease-specific scales
- 2020
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Ingår i: Journal of Patient-Reported Outcomes. - : Springer. - 2509-8020. ; 4:1
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Forskningsöversikt (refereegranskat)abstract
- BACKGROUND: Over the past decade, the importance of person-centered care has led to increased interest in patient-reported outcome measures (PROMs). In cardiovascular care, selecting an appropriate PROM for clinical use or research is challenging because multimorbidity is often common in patients. The aim was therefore to provide an overview of heart-disease specific PROMs and to compare the content of those outcomes using a bio-psycho-social framework of health.METHODS: A scoping review of heart disease-specific PROMs, including arrhythmia/atrial fibrillation, congenital heart disease, heart failure, ischemic heart disease, and valve diseases was conducted in PubMed (January 2018). All items contained in the disease-specific PROMs were mapped to WHO's International Classification of Functioning, Disability and Health (ICF) according to standardized linking rules.RESULTS: A total of 34 PROMs (heart diseases in general n = 5; cardiac arrhythmia n = 6; heart failure n = 14; ischemic heart disease n = 9) and 147 ICF categories were identified. ICF categories covered Body functions (n = 61), Activities & Participation (n = 69), and Environmental factors (n = 17). Most items were about experienced problems of Body functions and less often about patients' daily activities, and most PROMs were specifically developed for heart failure and no PROM were identified for valve disease or congenital heart disease.CONCLUSIONS: Our results motivate and provide information to develop comprehensive PROMs that consider activity and participation by patients with various types of heart disease.
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| 3. |
- Ahlsson, Anders, 1962-, et al.
(författare)
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A Swedish consensus on the surgical treatment of concomitant atrial fibrillation
- 2012
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Ingår i: Scandinavian Cardiovascular Journal. - London, United Kingdom : Informa Healthcare. - 1401-7431 .- 1651-2006. ; 46:4, s. 212-218
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Forskningsöversikt (refereegranskat)abstract
- Atrial fibrillation (AF) is a common arrhythmia among patients scheduled for open heart surgery and is associated with increased morbidity and mortality. According to international guidelines, symptomatic and selected asymptomatic patients should be offered concomitant surgical AF ablation in conjunction with valvular or coronary surgery. The gold standard in AF surgery is the Cox Maze III ("cut-and-sew") procedure, with surgical incisions in both atria according to a specified pattern, in order to prevent AF reentry circuits from developing. Over 90% of patients treated with the Cox Maze III procedure are free of AF after 1 year. Recent developments in ablation technology have introduced several energy sources capable of creating nonconducting atrial wall lesions. In addition, simplified lesion patterns have been suggested, but results with these techniques have been unsatisfactory. There is a clear need for standardization in AF surgery. The Swedish Arrhythmia Surgery Group, represented by surgeons from all Swedish units for cardiothoracic surgery, has therefore reached a consensus on surgical treatment of concomitant AF. This consensus emphasizes adherence to the lesion pattern in the Cox Maze III procedure and the use of biatrial lesions in nonparoxysmal AF.
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| 4. |
- Gustafson, Deborah R., et al.
(författare)
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Obesity, vascular disease and frailty in aging women with HIV
- 2021
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Ingår i: Advances in Geriatric Medicine and Research. - : Hapres. - 2632-9921. ; 3:3
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Forskningsöversikt (refereegranskat)abstract
- Women with chronic HIV infection (WWH) living in the United States, experience a disproportionately high rate of obesity compared to uninfected populations. Both overweight and obesity, particularly central obesity, are major contributors to insulin resistance, hypertension, and dyslipidemia—the major components of metabolic syndromes, including type 2 diabetes, and leading to increased cardiovascular risk, including coronary heart disease, and cerebrovascular diseases. Notably, declining physical performance and frailty co-occur with vascular morbidities as well as changes in bone. These factors tend to exacerbate each other and accelerate the aging trajectory, leading to poorer quality of life, cognitive impairments, dementia, and eventually, death. In WWH, persistent HIV infection, sustained treatment for HIV infection, and concomitant obesity, may accelerate aging-related morbidities and poorer aging outcomes. Furthermore, health disparities factors common among some WWH, are independently associated with obesity and higher vascular risk. The purpose of this review is to describe the constellation of obesity, cardio- and cerebrovascular diseases, bone health and frailty among aging WWH, a 21st century emergence.
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| 5. |
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| 6. |
- Sheikine, Yuri, et al.
(författare)
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CXCL16/SR-PSOX : a friend or a foe in atherosclerosis?
- 2008
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Ingår i: Atherosclerosis. - Amsterdam : Elsevier. - 0021-9150 .- 1879-1484. ; 197:2, s. 487-495
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Forskningsöversikt (refereegranskat)abstract
- Chemokines, scavenger receptors and adhesion molecules have long been known as important players in the pathogenesis of atherosclerosis. A series of studies conducted in the past few years described CXCL16/SR-PSOX—a new molecule combining those three functions, and suggested that CXCL16/SR-PSOX can be a potential player in atherogenesis. Initial ex vivo studies showed that CXCL16/SR-PSOX is abundant in human and murine atherosclerotic lesions. Following in vitro studies suggested that as an adhesion molecule CXCL16/SR-PSOX might mediate T-cell adhesion to the endothelium, as a chemokine – drive T-cell migration, stimulate cell proliferation and elicit inflammatory phenotype in smooth muscle cells (SMC) and, finally, as a scavenger receptor – mediate uptake of atherogenic lipoproteins by macrophages and SMC. All these effects are known to be pro-atherogenic. Surprisingly, in vivo studies performed in murine models of atherosclerosis suggested that CXCL16/SR-PSOX is atheroprotective, while its receptor CXCR6 is harmful. In addition, studies investigating the association of circulating CXCL16/SR-PSOX plasma concentrations with the presence and extent of coronary artery disease (CAD) in humans are controversial suggesting both positive, negative and no association. To finally answer the question whether CXCL16/SR-PSOX can serve as a causative factor, biomarker or even a therapeutic target in atherosclerosis, we are currently in need of carefully designed animal and human studies investigating the effects of CXCL16/SR-PSOX and CXCR6 deficiency, inhibition and over-expression on the progression of atherosclerosis. Such complex approach will help us unravel the mystery of CXCL16/SR-PSOX in atherosclerosis and hopefully develop better ways of treating atherosclerosis by targeting this interesting molecule.
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| 7. |
- Hansmann, Georg, et al.
(författare)
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2019 updated consensus statement on the diagnosis and treatment of pediatric pulmonary hypertension: The European Pediatric Pulmonary Vascular Disease Network (EPPVDN), endorsed by AEPC, ESPR and ISHLT
- 2019
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Ingår i: The Journal of Heart and Lung Transplantation. - : Elsevier BV. - 1053-2498. ; 38:9, s. 879-901
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Forskningsöversikt (refereegranskat)abstract
- © 2019 The European Pediatric Pulmonary Vascular Disease Network is a registered, non-profit organization that strives to define and develop effective, innovative diagnostic methods and treatment options in all forms of pediatric pulmonary hypertensive vascular disease, including pulmonary hypertension (PH) associated with bronchopulmonary dysplasia, PH associated with congenital heart disease (CHD), persistent PH of the newborn, and related cardiac dysfunction. The executive writing group members conducted searches of the PubMed/MEDLINE bibliographic database (1990–2018) and held face-to-face and web-based meetings. Ten section task forces voted on the updated recommendations, based on the 2016 executive summary. Clinical trials, meta-analyses, guidelines, and other articles that include pediatric data were searched using the term “pulmonary hypertension” and other keywords. Class of recommendation (COR) and level of evidence (LOE) were assigned based on European Society of Cardiology/American Heart Association definitions and on pediatric data only, or on adult studies that included >10% children or studies that enrolled adults with CHD. New definitions by the World Symposium on Pulmonary Hypertension 2018 were included. We generated 10 tables with graded recommendations (COR/LOE). The topics include diagnosis/monitoring, genetics/biomarkers, cardiac catheterization, echocardiography, cardiac magnetic resonance/chest computed tomography, associated forms of PH, intensive care unit/lung transplantation, and treatment of pediatric PH. For the first time, a set of specific recommendations on the management of PH in middle- and low-income regions was developed. Taken together, these executive, up-to-date guidelines provide a specific, comprehensive, detailed but practical framework for the optimal clinical care of children and young adults with PH.
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| 8. |
- Shannon, Oliver M., et al.
(författare)
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Mediterranean Diet Increases Endothelial Function in Adults: A Systematic Review and Meta-Analysis of Randomized Controlled Trials
- 2020
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Ingår i: Journal of Nutrition. - : Elsevier BV. - 1541-6100 .- 0022-3166. ; 150:5, s. 1151-1159
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Forskningsöversikt (refereegranskat)abstract
- Background: The endothelium plays a key role in the maintenance of vascular health and represents a potential physiological target for dietary and other lifestyle interventions designed to reduce the risk of cardiovascular diseases (CVD) including stroke or coronary heart disease. Objective: To conduct a systematic review and meta-analysis of randomized controlled trials (RCTs) investigating the effects of the Mediterranean dietary pattern (MedDiet) on endothelial function. Methods: Medline, Embase, and Scopus databases were searched from inception until January 2019 for studies that met the following criteria: 1) RCTs including adult participants, 2) interventions promoting the MedDiet, 3) inclusion of a control group, and 4) measurements of endothelial function. A random-effects meta-analysis was conducted. Metaregression and subgroup analyses were performed to identify whether effects were modified by health status (i.e., healthy participants versus participants with existing comorbidities), type of intervention (i.e., MedDiet alone or with a cointervention), study duration, study design (i.e., parallel or crossover), BMI, and age of participants. Results: Fourteen articles reporting data for 1930 participants were included in the meta-analysis. Study duration ranged from 4 wk to 2.3 y. We observed a beneficial effect of the MedDiet on endothelial function [standardized mean difference (SMD): 0.35; 95% CI: 0.17, 0.53; P <0.001; I-2 = 73.68%]. MedDiet interventions improved flow-mediated dilation (FMD)-the referencemethod for noninvasive, clinical measurement of endothelial function-by 1.66% (absolute change; 95% CI: 1.15, 2.17; P <0.001; I-2 = 0%). Effects of the MedDiet on endothelial function were not modified by health status, type of intervention, study duration, study design, BMI, or age of participants (P >0.05). Conclusions: MedDiet interventions improve endothelial function in adults, suggesting that the protective effects of the MedDiet are evident at early stages of the atherosclerotic process with important implications for the early prevention of CVD.
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| 9. |
- Birgander, Mats, et al.
(författare)
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Relationship Between Mild Primary Hyperparathyroidism and Left Ventricular Structure and Diastolic Performance
- 2009
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Ingår i: The Endocrinologist. - 1539-9192. ; 19:4, s. 187-191
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Forskningsöversikt (refereegranskat)abstract
- Aim: This study aims to investigate cardiac structure and function in patients with asymptomatic primary hyperparathyroidism (pHPT) and if there is any relation to severity regarding serum levels of calcium (Ca) and parathyroid hormone. Methods and Results: We consecutively included 50 patients (mean age 62.9 +/- 11 years, 45 women) with clinically diagnosed pHPT. We prospectively recruited 50 healthy control subjects, matched for age and sex. Standard transthoracic echocardiographic examination was performed using the 4 standard views and structural parameters as well as left ventricular (LV) systolic and diastolic function was determined. Mean LV ejection fraction and atrioventricular plane displacement were on average normal and did not differ between patients and controls. However, pHPT patients had significantly greater LV mass (148 +/- 37 vs. 127 +/- 29 g, P = 0.002), LV end diastolic area (81 +/- 20 vs. 68 +/- 18 cm(2), p = 0.003), LV posterior wall diameter (8.9 +/- 1 vs. 8.1 +/- 1 min, P = 0.006), and LA size (21 +/- 3 vs. 19 +/- 2 mm, P < 0.001). A moderate to severe LV diastolic filling impairment was present in substantially more pHPT patients, compared with control subjects (36% vs. 4%, P < 0:001). Conclusion: Patients with asymptomatic pHPT showed LV structural changes and impaired LV diastolic function.
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| 10. |
- Theorell, Töres, et al.
(författare)
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A systematic review of studies in the contributions of the work environment to ischaemic heart disease development
- 2016
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Ingår i: European Journal of Public Health. - : Oxford University Press. - 1101-1262 .- 1464-360X. ; 26:3, s. 470-477
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Forskningsöversikt (refereegranskat)abstract
- Background: There is need for an updated systematic review of associations between occupational exposures and ischaemic heart disease (IHD), using the GRADE system. Methods: Inclusion criteria: (i) publication in English in peer-reviewed journal between 1985 and 2014, (ii) quantified relationship between occupational exposure (psychosocial, organizational, physical and other ergonomic job factors) and IHD outcome, (iii) cohort studies with at least 1000 participants or comparable case-control studies with at least 50 + 50 participants, (iv) assessments of exposure and outcome at baseline as well as at follow-up and (v) gender and age analysis. Relevance and quality were assessed using predefined criteria. Level of evidence was then assessed using the GRADE system. Consistency of findings was examined for a number of confounders. Possible publication bias was discussed. Results: Ninety-six articles of high or medium high scientific quality were finally included. There was moderately strong evidence (grade 3 out of 4) for a relationship between job strain and small decision latitude on one hand and IHD incidence on the other hand. Limited evidence (grade 2) was found for iso-strain, pressing work, effort-reward imbalance, low support, lack of justice, lack of skill discretion, insecure employment, night work, long working week and noise in relation to IHD. No difference between men and women with regard to the effect of adverse job conditions on IHD incidence. Conclusions: There is scientific evidence that employees, both men and women, who report specific occupational exposures, such as low decision latitude, job strain or noise, have an increased incidence of IHD.
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