| 1. |
- Carlsson, Lars, et al.
(författare)
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Enhanced systolic myocardial function in elite endurance athletes during combined arm-and-leg exercise
- 2011
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Ingår i: European Journal of Applied Physiology. - : Springer Science and Business Media LLC. - 1439-6319 .- 1439-6327. ; 111:6, s. 905-913
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Tidskriftsartikel (refereegranskat)abstract
- The aim here was to employ color tissue velocity imaging (TVI), to test the hypothesis that highly trained endurance athletes exhibit enhanced systolic function of the left ventricular (LV) myocardium both at rest and during combined arm-and-leg exercise in comparison with untrained subjects. For each of the ten elite male (EG) and ten matched control participants (CG), LV dimensions and systolic function were assessed at rest using echocardiography. Subsequently, these subjects exercised continuously on a combined arm-and-leg cycle ergometer for 3 min each at 50, 60, 70, 80, 90 and 100% of VO2max. Oxygen uptake, heart rate, systolic blood pressure (SBP) and peak contraction systolic velocities of the LV myocardium (PSV) were recorded in the end of each level. At rest, the trained and untrained groups differed with respect to LV dimensions, but not systolic function. At 60–100% VO2max, the EG group demonstrated both higher PSV and SBP. The observation that the EG athletes had higher PSV than CG during exercise at 60–100% VO2max, but not at rest or at 50% of VO2max, suggested an enhanced systolic capacity. This improvement is likely to be due to an enhanced inotropic contractility, which only becomes apparent during exercise.
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| 2. |
- Jacobsson, Josefin A., et al.
(författare)
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Detailed Analysis of Variants in FTO in Association with Body Composition in a Cohort of 70-Year-Olds Suggests a Weakened Effect among Elderly
- 2011
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Ingår i: PLOS ONE. - : Public Library of Science (PLoS). - 1932-6203. ; 6:5, s. e20158-
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Tidskriftsartikel (refereegranskat)abstract
- Background: The rs9939609 single-nucleotide polymorphism (SNP) in the fat mass and obesity (FTO) gene has previously been associated with higher BMI levels in children and young adults. In contrast, this association was not found in elderly men. BMI is a measure of overweight in relation to the individuals' height, but offers no insight into the regional body fat composition or distribution. Objective: To examine whether the FTO gene is associated with overweight and body composition-related phenotypes rather than BMI, we measured waist circumference, total fat mass, trunk fat mass, leg fat mass, visceral and subcutaneous adipose tissue, and daily energy intake in 985 humans (493 women) at the age of 70 years. In total, 733 SNPs located in the FTO gene were genotyped in order to examine whether rs9939609 alone or the other SNPs, or their combinations, are linked to obesity-related measures in elderly humans. Design: Cross-sectional analysis of the Prospective Investigation of the Vasculature in Uppsala Seniors (PIVUS) cohort. Results: Neither a single SNP, such as rs9939609, nor a SNP combination was significantly linked to overweight, body composition-related measures, or daily energy intake in elderly humans. Of note, these observations hold both among men and women. Conclusions: Due to the diversity of measurements included in the study, our findings strengthen the view that the effect of FTO on body composition appears to be less profound in later life compared to younger ages and that this is seemingly independent of gender.
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| 3. |
- Abdi, Adel
(författare)
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Efficient Winter Road Maintenance : A Study of Technical and Contractual Issues
- 2014
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Doktorsavhandling (övrigt vetenskapligt/konstnärligt)abstract
- Since ancient times, roads have tied people and cultures together. Roads have been createdwith the aim of facilitating trade and cultural exchange among different regions in the world. After the technologic development in vehicle industry and dramatically increase of motoring in the world during the past century road communication has gained a great importance for transporting people and goods. Thus, good safety and accessibility on roads all year round is now a vital necessity for a healthy economy in all modern societies. In order to keep roads safe, available for use with high transport quality they need to be maintained in real time. One of the most difficult tasks in this context is to keep the roads in good condition and accessible even during winter. The main objective of this doctoral thesis is to attempt to specify the most efficient ways of executing winter road maintenance. The preliminary issue in this context is whether it is the use of current assistive tools, that is, technical aspects that should be optimized and developed or whether it is the way in which winter maintenance services are procured and outsourced, that is, contractual aspects that should be improved which could give the optimal impact for both clients and contractors and make winter road maintenance more effective, or both issues. In order to define the outline of the research project a comprehensive state of the art survey was initiated with the intention of collecting and gaining insights into the earlier studies in the research area. Three basic areas associated with the performance of winter road maintenance were considered to be most relevant for review due to the anchorage between the areas. The selected areas were climatological, technical and contractual aspects. The literature review was followed by an electronic questionnaire survey. The results of the study in this stage showed that current technical methods almost functioned in a reasonable manner but there was an imprecise dissatisfaction with the current maintenance contract. The second stage of the research consisted of a number of additional empirical investigations in order to identify contractual problematic issues behind the current winter road maintenance in Sweden. Generally, those factors that are rarely considered as potential underlying causes to costly performance of winter road maintenance in Sweden were studied in this research project for example improper use of related technical assistive tools, procurement of improper bundled winter services and inappropriate contract structure. This thesis consists of six papers, five of which are related to each other, and the first one is completely independent but within research area. Findings in the thesis contributes to extend understanding about; how designing appropriate contracts can improve winter road maintenance, how proper use of assistive tools can reduce unnecessary winter road maintenance costs and minimize road traffic disruptions and delays, how a partnering structure in contracts can create confidence and trust between clients and contractors that in turn leads to minimizing or eliminating conflicts and disputes between parties involved, how choice of appropriate procurement methods through proper bundling of winter road services can contribute to shorten the procurement process and create incentives for contractors, and how selection of proper payment mechanisms can contribute to higher service quality of performed winter road measures. Additionally, an adequate knowledge and understanding of climate, proper knowledge of road weather and its impact on winter road traffic is essential for contribution of better planning of how to maintain the road network during winter. Since understanding about winter issues and its effect on winter road traffic is far from complete and winter road maintenance in the cold regions is a similar challenge, broad and complex, the results of this research may even contribute to improving winter maintenance problems in the countries with severe winters like Sweden.
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| 4. |
- Bjällmark, Anna, et al.
(författare)
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Effects of hemodialysis on the cardiovascular system: Quantitative analysis using wave intensity wall analysis and tissue velocity imaging
- 2010
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Ingår i: Heart and Vessels. - : Springer Science and Business Media LLC. - 0910-8327 .- 1615-2573.
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Tidskriftsartikel (refereegranskat)abstract
- Cardiovascular disease is the leading cause of death in patients with end stage renal disease (ESRD). The aim of this study was to investigate the changes in cardiovascular function induced by a single session of hemodialysis (HD) by the analysis of cardiovascular dynamics using wave intensity wall analysis (WIWA) and of systolic and diastolic myocardial function using tissue velocity imaging (TVI). Grey-scale cine loops of the left common carotid artery, conventional echocardiography and TVI images of the left ventricle were acquired before and after HD in 45 patients (17 women, mean age 54) with ESRD. The WIWA indexes, W1 preload-adjusted W1, W2 and preload-adjusted W2, and the TVI variables, isovolumic contraction velocity (IVCV), isovolumic contraction time (IVCT), peak systolic velocity (PSV), displacement, isovolumic relaxation velocity (IVRV), isovolumic relaxation time (IVRT), peak early diastolic velocity (E’) and peak late diastolic velocity (A’), were compared before and after HD. The WIWA measurements showed significant increases in W1 (p < 0.05) and preload-adjusted W1 (p < 0.01) after HD. W2 was significantly decreased (p < 0.05) after HD, whereas the change in preload-adjusted W2 was not significant. Systolic velocities, IVCV (p < 0.001) and PSV (p < 0.01), were increased after HD, whereas the AV-plane displacement were decreased (p < 0.01). For the measured diastolic variables, E’ was significantly decreased (p < 0.01) and IVRT was significantly prolonged (p < 0.05), after HD. A few correlations were found between WIWA and TVI variables. The WIWA and TVI measurements indicate that a single session of HD improves systolic function. The load dependency of the diastolic variables seems to be more pronounced than for the systolic variables. Preload-adjusted wave intensity indexes may contribute in the assessment of true LV contractility and relaxation.
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| 5. |
- Bjällmark, Anna, et al.
(författare)
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Ultrasonographic strain imaging is superior to conventional non-invasive measures of vascular stiffness in the detection of age-dependent differences in the mechanical properties of the common carotid artery
- 2010
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Ingår i: European Journal of Echocardiography. - : Oxford University Press (OUP). - 1525-2167 .- 1532-2114. ; 11:7, s. 630-636
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Tidskriftsartikel (refereegranskat)abstract
- Aims: Elastic properties of large arteries have been shown to deteriorate with age and in the presence of atherosclerotic vascular disease. In this study, the performance of ultrasonographic strain measurements was compared to conventional measures of vascular stiffness in the detection of age-dependent differences in the elastic properties of the common carotid artery.Methods and results: In 10 younger (25-28 years, 4 women) and 10 older (50-59 years, 4 women) healthy individuals, global and regional circumferential and radial strain variables were measured in the short-axis view of the right common carotid artery using ultrasonographic two-dimensional (2D) strain imaging with recently introduced speckle tracking technique. Conventional elasticity variables, elastic modulus (Ep) and β stiffness index, were calculated using M-mode sonography and non-invasive blood pressure measurements. Global and regional circumferential systolic strain and strain rate values were significantly higher (p < 0.001, p < 0.01 for regional late systolic strain rate) in the younger individuals, whereas the values of conventional elasticity variables in the same group were lower (p < 0.05). Among all strain and conventional elasticity variables, principal component analysis and its regression extension identified only circumferential systolic strain variables as contributing significantly to the observed discrimination between the younger and older age groups.Conclusion: Ultrasonographic 2D-strain imaging is a sensitive method for the assessment of elastic properties in the common carotid artery, being in this respect superior to conventional measures of vascular elasticity. The method has potential to become a valuable non-invasive tool in the detection of early atherosclerotic vascular changes.
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| 6. |
- Elmstedt, Nina, et al.
(författare)
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Fetal cardiac muscle contractility decreases with gestational age : a color-coded tissue velocity imaging study
- 2012
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Ingår i: Cardiovascular Ultrasound. - : Springer Science and Business Media LLC. - 1476-7120. ; 10, s. 19-
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Tidskriftsartikel (refereegranskat)abstract
- Background: Present data regarding how the fetal heart works and develops throughout gestation is limited. However, the possibility to analyze the myocardial velocity profile provides new possibilities to gain further knowledge in this area. Thus, the objective of this study was to evaluate human fetal myocardial characteristics and deformation properties using color-coded tissue velocity imaging (TVI). Methods: TVI recordings from 55 healthy fetuses, at 18 to 42 weeks of gestation, were acquired at a frame rate of 201-273 frames/s for offline analysis using software enabling retrieval of the myocardial velocity curve and 2D anatomical information. The measurements were taken from an apical four-chamber view, and the acquired data was correlated using regression analysis. Results: Left ventricular length and width increased uniformly with gestational age. Atrioventricular plane displacement and the E'/A' ratio also increased with gestational age, while a longitudinal shortening was demonstrated. Conclusions: Fetal cardiac muscle contractility decreases with gestational age. As numerous fetal-and pregnancy-associated conditions directly influence the pumping function of the fetal heart, we believe that this new insight into the physiology of the human fetal cardiovascular system could contribute to make diagnosis and risk assessment easier and more accurate.
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| 7. |
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| 8. |
- Elmstedt, Nina
(författare)
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Prenatal Tisse Velocity Imaging of the Heart : A new approach to assess fetal myocardial function
- 2013
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Doktorsavhandling (övrigt vetenskapligt/konstnärligt)abstract
- The general aim of this thesis has been to evaluate color‐coded tissue velocity imaging (TVI) as an approach to developing a new, non‐invasive assessment method for fetal myocardial function. Such a method could hypothetically give early indications of fetal pathology, as myocardial dysfunction is often the consequence when the circulation tries to adapt to deteriorating situations. This would be beneficial in clinical decision making when evaluating fetal well‐being in a wide range of pregnancy associated conditions, to facilitate risk assessment and to monitor the benefit of therapeutic interventions.TVI is an ultrasound technique that enables quantification of longitudinal myocardial motion with high temporal resolution, which is essential in the identification of fetal myocardial movements of short duration. Furthermore, the longitudinal motion is mainly determined by subendocardial fibers that usually become abnormal in the very early stages of cardiac dysfunction as they are sensitive to milder degrees of hypoxia. Thus, TVI has the potential to give early indications of impaired fetal myocardial function and hypothetically facilitate the detection of intrauterine hypoxia. Hypoxia is a common phenomenon of many pathological conditions in pregnancy, from which a substantial number of children either die or acquire permanent brain injury during delivery every year.After having established optimal sampling requirements and ensured an acceptable reproducibility for TVI measurements of the fetal myocardium, normal reference values were determined feasible and sensitive enough to provide insight into maturational changes in myocardial function. This provided a foundation that should enable further investigations and was partly accomplished using the cardiac state diagram (CSD) to accurately time the myocardial events during a cardiac cycle according to the motion shifts of the atrioventricular plane.The demonstrated results are promising and the general conclusion of this thesis is that TVI contributes to increasing the knowledge and understanding of fetal myocardial function and dysfunction. Used together with CSD this technique has great potential as an assessment method. However, further testing of the clinical potential is needed in larger study populations concerning the pathological or physiological questions at issue, and additional development of the method is required to render the method simple enough to be of potential aid in clinical practice.
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| 9. |
- Elmstedt, Nina, et al.
(författare)
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Reference values for fetal tissue velocity imaging and a new approach to evaluate fetal myocardial function
- 2013
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Ingår i: Cardiovascular Ultrasound. - : Springer Science and Business Media LLC. - 1476-7120. ; 11:1, s. 29-
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Tidskriftsartikel (refereegranskat)abstract
- Objectives: Myocardial function can be evaluated using color-coded tissue velocity imaging (TVI) to analyze the longitudinal myocardial velocity profile, and by expressing the motion of the atrioventricular plane during a cardiac cycle as coordinated events in the cardiac state diagram (CSD). The objective of this study was to establish gestational age specific reference values for fetal TVI measurements and to introduce the CSD as a potential aid in fetal myocardial evaluation. Methods: TVI recordings from 125 healthy fetuses, at 18 to 42 weeks of gestation, were performed with the transducer perpendicular to the apex to provide a four-chamber view. The myocardial velocity data was extracted from the basal segment of septum as well as the left and right ventricular free wall for subsequent offline analysis. Results: During a cardiac cycle the longitudinal peak velocities of septum increased with gestational age, as did the peak velocities of the left and right ventricular free wall, except for the peak velocity of post ejection. The duration of rapid filling and atrial contraction increased during pregnancy while the duration of post ejection decreased. The duration of pre ejection and ventricular ejection did not change significantly with gestational age. Conclusion: Evaluating fetal systolic and diastolic performance using TVI together with CSD could contribute to increase the knowledge and understanding of fetal myocardial function and dysfunction. The pre and post ejection phases are the variables most likely to indicate fetuses with abnormal myocardial function.
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| 10. |
- Elmstedt, Nina, et al.
(författare)
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Reproducibility and variability in the assessment of color-coded tissue velocity imaging of the fetal myocardium
- 2013
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Ingår i: Journal of biomedical graphics and computing. - : Sciedu Press. - 1925-4008 .- 1925-4016. ; 3:2
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Tidskriftsartikel (refereegranskat)abstract
- Objective: The introduction of color-coded tissue velocity imaging (TVI) in fetal medicine is quite recent, and as this method is presently evaluated and developed in regard to diagnostic precision it is of outmost importance to evaluate the reproducibility for adequate clinical use. In this study, reproducibility and intra- and inter-observer variability was assessed for offline analysis as well as echocardiography investigations. Also, we evaluated the importance of exact placement of the region of interest (ROI).Methods: TVI recordings from 21 fetuses, at a gestational age of 27 to 41 weeks, were acquired at 208-239 frames/s for subsequent offline analysis. All recordings were performed with the transducer positioned to provide an apical four-chamber view and the myocardial velocity data was obtained from basal inferoseptum. The data set was analyzed according to Bland-Altman and reproducibility was expressed as the standard error of a single determination, estimated from duplicate determinations in percentage of the total.Results: The variation of reproducibility for the echocardiography investigation ranged from 2.0% to 9.8%. The duration of left ventricular ejection, and the peak velocities of early diastolic filling and atrial contraction being the most robust events measured. The variation of inter-observer variability for the echocardiography investigation ranged from 1.5% to 8.4%, and the variation of intra- and inter-observer variability for the offline analysis ranged from 1.2% to 10.4%. Least robust were the events of shortest duration, including isovolumetric contraction and relaxation.Conclusion: We believe that TVI measurements of the fetal myocardium could be performed in the clinical routine with acceptable reproducibility.
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