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Sökning: WFRF:(Smiseth Otto)

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  • Swedberg, Karl, 1944, et al. (författare)
  • Guidelines for the diagnosis and treatment of chronic heart failure: executive summary (update 2005): The Task Force for the Diagnosis and Treatment of Chronic Heart Failure of the European Society of Cardiology
  • 2005
  • Ingår i: European heart journal. - 0195-668X .- 1522-9645. ; 26:11, s. 1115-40
  • Forskningsöversikt (refereegranskat)abstract
    • Preamble Guidelines and Expert Consensus Documents aim to present all the relevant evidence on a particular issue in order to help physicians to weigh the benefits and risks of a particular diagnostic or therapeutic procedure. They should be helpful in everyday clinical decision-making. A great number of Guidelines and Expert Consensus Documents have been issued in recent years by the European Society of Cardiology (ESC) and by different organizations and other related societies. This profusion can put at stake the authority and validity of guidelines, which can only be guaranteed if they have been developed by an unquestionable decision-making process. This is one of the reasons why the ESC and others have issued recommendations for formulating and issuing Guidelines and Expert Consensus Documents. In spite of the fact that standards for issuing good quality Guidelines and Expert Consensus Documents are well defined, recent surveys of Guidelines and Expert Consensus Documents published in peer-reviewed journals between 1985 and 1998 have shown that methodological standards were not complied with in the vast majority of cases. It is therefore of great importance that guidelines and recommendations are presented in formats that are easily interpreted. Subsequently, their implementation programmes must also be well conducted. Attempts have been made to determine whether guidelines improve the quality of clinical practice and the utilization of health resources. The ESC Committee for Practice Guidelines (CPG) supervises and coordinates the preparation of new Guidelines and Expert Consensus Documents produced by Task Forces, expert groups, or consensus panels. The chosen experts in these writing panels are asked to provide disclosure statements of all relationships they may have which might be perceived as real or potential conflicts of interest. These disclosure forms are kept on file at the European Heart House, headquarters of the ESC. The Committee is also responsible for the endorsement of these Guidelines and Expert Consensus Documents or statements. The Task Force has classified and ranked the usefulness or efficacy of the recommended procedure and/or treatments and the Level of Evidence as indicated in the tables on page 3.
  • Flachskampf, Frank A., et al. (författare)
  • Cardiac Imaging to Evaluate Left Ventricular Diastolic Function
  • 2015
  • Ingår i: JACC Cardiovascular Imaging. - Uppsala Univ, Inst Med Vetenskaper, Akad Sjukhuset, S-75185 Uppsala, Sweden.. - 1936-878X .- 1876-7591. ; 8:9, s. 1071-1093
  • Tidskriftsartikel (refereegranskat)abstract
    • Left ventricular diastolic dysfunction in clinical practice is generally diagnosed by imaging. Recognition of heart failure with preserved ejection fraction has increased interest in the detection and evaluation of this condition and prompted an improved understanding of the strengths and weaknesses of different imaging modalities for evaluating diastolic dysfunction. This review briefly provides the pathophysiological background for current clinical and experimental imaging parameters of diastolic dysfunction, discusses the merits of echocardiography relative to other imaging modalities in diagnosing and grading diastolic dysfunction, summarizes Lessons from clinical trials that used parameters of diastolic function as an inclusion criterion or endpoint, and indicates current areas of research.
  • Komajda, Michel, et al. (författare)
  • Relations between professional medical associations and the health-care industry, concerning scientific communication and continuing medical education: a Policy Statement from the European Society of Cardiology.
  • 2012
  • Ingår i: European Heart Journal. - : Oxford University Press. - 0195-668X .- 1522-9645. ; 67:3, s. 379-390
  • Tidskriftsartikel (refereegranskat)abstract
    • Physicians have an ethical duty to keep up-to-date with current knowledge. Professional medical associations such as the European Society of Cardiology (ESC) support these obligations. In Europe, the costs of continuing medical education (CME) are insufficiently supported from governments and employers; however, medical associations have been criticized for accepting alternative financial support from industry. Medical education and training in research include learning how to assess the quality and reliability of any information. There is some risk of bias in any form of scientific communication including intellectual, professional, and financial and it is essential that in particular, the latter must be acknowledged by full disclosure. It is essential that there is strong collaboration between basic and clinical researchers from academic institutions on the one hand, with engineers and scientists from the research divisions of device and pharmaceutical companies on the other. This is vital so that new diagnostic methods and treatments are developed. Promotion of advances by industry may accelerate their implementation into clinical practice. Universities now frequently exhort their academic staff to protect their intellectual property or commercialize their research. Thus, it is not commercial activity or links per se that have become the target for criticism but the perceived influence of commercial enterprises on clinical decision-making or on messages conveyed by professional medical organizations. This document offers the perspective of the ESC on the current debate, and it recommends how to minimize bias in scientific communications and CME and how to ensure proper ethical standards and transparency in relations between the medical profession and industry.
  • Lindström, Lena (författare)
  • Annular Motion : Assessment of Cardiac Function using Echocardiography and Magnetic Resonance Imaging
  • 2000
  • Doktorsavhandling (övrigt vetenskapligt)abstract
    • This thesis concentrates on the assessment of cardiac function, both systolic and diastolic using variables originating from the longitudinal motion of the heart using both established and novel non-invasive imaging techniques. We developed a new magnetic resonance imaging (MRI) technique that creates an M-mode MRI image, analogous to the one used in echocardiography and enables quantitative assessment of cardiac motion. The MRI M-mode method was compared with M-mode echocardiography in a phantom study, by measuring mitral and tricuspid annular motion in 20 normal subjects, and in a study of right ventricular function in 17 patients after coronary artery bypass surgery. The agreement between M-mode MRI and Mmode echocardiography was good. However, the amplitudes were somewhat higher measured by MRI, probably because of less angle error in the MRI calculation, furthermore the lower resolution in the MRI image may have contributed.Pulsed tissue Doppler, a recently developed Doppler modality that gives the possibility of recording instantaneous annular /or myocardial velocities on-line, was used to obtain reference values of mitral and tricuspid annular motion in 27 normal subjects of different ages. Diastolic left ventricular function was assessed in 15 patients with systemic hypertension and in 10 patients with moderate to severe aortic stenosis. Furthermore, pulsed tissue Doppler was used in the evaluation of right and left ventricular function in 15 patients with arrhythmogenic right ventricular cardiomyopathy (ARVC).The mitral and tricuspid annular velocity pattern in normal subjects is characterised by three major components: asystolic (SA) velocity, an early (EA) diastolic velocity, and a late (AA) diastolic velocity. In normal young subjects, the EA-peak velocity was highest; with increasing age, the EA-peak velocity decreases and the AA-peak velocity increases, with similar changes in both the mitral and tricuspid annular velocity pattern. In patients with left ventricular hypertrophy the EA/AA-ratio was significantly decreased compared with age- match normal subjects. Comparing ARVC patients with normal subjects the tricuspid annular EA-peak velocity was significantly decreased as well as the lateral SA-peak velocity. Our result indicates that abnormal diastolic tricuspid annular velocity pattern may be an early sign of right ventricular myocardial dysfunction in patients with ARVC. The septal mitral annular SA-peak velocity was significantly decreased in ARVC patients compared to the controls. This in accordance with subjective analysis of echocardiographic wall motion and T1-201 SPECT that showed left ventricular abnormalities in 93% of the patients predominantly located in the anteroseptal and posteroseptal segments.
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