| 1. |
- Bergström, Göran, 1964, et al.
(författare)
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Prevalence of Subclinical Coronary Artery Atherosclerosis in the General Population
- 2021
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Ingår i: Circulation. - Philadelphia : American Heart Association. - 0009-7322 .- 1524-4539. ; 144:12, s. 916-929
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Tidskriftsartikel (refereegranskat)abstract
- Background: Early detection of coronary atherosclerosis using coronary computed tomography angiography (CCTA), in addition to coronary artery calcification (CAC) scoring, may help inform prevention strategies. We used CCTA to determine the prevalence, severity, and characteristics of coronary atherosclerosis and its association with CAC scores in a general population.Methods: We recruited 30 154 randomly invited individuals age 50 to 64 years to SCAPIS (the Swedish Cardiopulmonary Bioimage Study). The study includes individuals without known coronary heart disease (ie, no previous myocardial infarctions or cardiac procedures) and with high-quality results from CCTA and CAC imaging performed using dedicated dual-source CT scanners. Noncontrast images were scored for CAC. CCTA images were visually read and scored for coronary atherosclerosis per segment (defined as no atherosclerosis, 1% to 49% stenosis, or ≥50% stenosis). External validity of prevalence estimates was evaluated using inverse probability for participation weighting and Swedish register data.Results: In total, 25 182 individuals without known coronary heart disease were included (50.6% women). Any CCTA-detected atherosclerosis was found in 42.1%; any significant stenosis (≥50%) in 5.2%; left main, proximal left anterior descending artery, or 3-vessel disease in 1.9%; and any noncalcified plaques in 8.3% of this population. Onset of atherosclerosis was delayed on average by 10 years in women. Atherosclerosis was more prevalent in older individuals and predominantly found in the proximal left anterior descending artery. Prevalence of CCTA-detected atherosclerosis increased with increasing CAC scores. Among those with a CAC score >400, all had atherosclerosis and 45.7% had significant stenosis. In those with 0 CAC, 5.5% had atherosclerosis and 0.4% had significant stenosis. In participants with 0 CAC and intermediate 10-year risk of atherosclerotic cardiovascular disease according to the pooled cohort equation, 9.2% had CCTA-verified atherosclerosis. Prevalence estimates had excellent external validity and changed marginally when adjusted to the age-matched Swedish background population.Conclusions: Using CCTA in a large, random sample of the general population without established disease, we showed that silent coronary atherosclerosis is common in this population. High CAC scores convey a significant probability of substantial stenosis, and 0 CAC does not exclude atherosclerosis, particularly in those at higher baseline risk.
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| 2. |
- Börjesson, Erik, et al.
(författare)
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Symptoms and ECG changes precede sudden cardiac death in hypertrophic cardiomyopathy-A nationwide study among the young in Sweden.
- 2022
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Ingår i: PloS one. - : Public Library of Science (PLoS). - 1932-6203. ; 17:9
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Tidskriftsartikel (refereegranskat)abstract
- Hypertrophic cardiomyopathy (HCM) is a major cause of sudden cardiac death (SCD) in the young. We aimed to characterize detailed family history, symptoms, hospital utilization and ECG changes before SCD.We extracted all cases suffering SCD with HCM from the SUDDY cohort, which includes all cases of SCD between 2000-2010 in Sweden among individuals aged 0-35 years along with their controls. We gathered data from mandatory national registries, autopsy reports, medical records, ECGs (including military conscripts), and detailed family history from an interview-based questionnaire (with relatives, post-mortem).Thirty-eight cases (7 female), mean age 22 years, with HCM were identified. Among these, 71% presented with possible cardiac symptoms (chest pain [26%], syncope [22%], palpitations [37%]), before death; 69% received medical care (vs 21% in controls) within 180 days before death. The majority (68%) died during recreational activity (n = 14) or exercise/competitive sports (n = 12). Fifteen (39%) had a known cardiac disorder prior to death, with HCM being diagnosed pre-mortem in nine cases. 58% presented with abnormal ECG recordings pre-mortem, and 50% had a positive family history (1st-3rd generation) for heart disease.In this comprehensive, nationwide study of SCD due to HCM, 87% (33/38) of cases had one or more abnormality prior to death, including cardiac symptoms, a positive family history, known cardiac disease or ECG abnormalities. They sought medical care prior death, to a larger extent than controls. These findings suggest that cardiac screening should be expanded beyond competitive athletes to aid SCD prevention in the young population with HCM.
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| 3. |
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| 4. |
- Aagaard, Philip, et al.
(författare)
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Tidig repolarisation på EKG - Definitioner, prevalens och prognostisk betydelse.
- 2015
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Ingår i: Läkartidningen. - 1652-7518. ; 112
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Tidskriftsartikel (refereegranskat)abstract
- Early repolarization defined as antero-lateral ST-segment elevation exists in 1-2 % of the general population and has been considered a benign ECG finding for decades. However, early repolarization, defined as infero-lateral J-waves, has in recent studies been associated with an increased - albeit low - risk of sudden and cardiovascular death. This ECG pattern is present in 3-13% of the general population. However, exercise training can induce all types of early repolarization, and the prevalence in the athletic population rises to 20-90%. There is large variability between sports (higher in endurance athletes) and also throughout the season (higher during times of peak fitness). In athletes, early repolarization, regardless of type, is considered benign. In asymptomatic non-athletes, the absolute risk is too low to use this ECG finding in clinical practice. In individuals with J-wave syndrome, on the other hand, ICD implantation should be strongly considered to prevent sudden cardiac death.
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| 5. |
- af Geijerstam, Agnes, et al.
(författare)
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Fitness, strength and severity of COVID-19: a prospective register study of 1 559 187 Swedish conscripts
- 2021
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Ingår i: BMJ Open. - : BMJ. - 2044-6055. ; 11:7
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Tidskriftsartikel (refereegranskat)abstract
- Objective To investigate the possible connection between cardiorespiratory fitness (CRF) and muscle strength in early adulthood and severity of COVID-19 later in life. Design Prospective registry-based cohort study. Participants 1 559 187 Swedish men, undergoing military conscription between 1968 and 2005 at a mean age of 18.3 (SD 0.73) years. Main outcome measures Hospitalisation, intensive care or death due to COVID-19 from March to September 2020, in relation to CRF and muscle strength. Results High CRF in late adolescence and early adulthood had a protective association with severe COVID-19 later in life with OR (95% CI) 0.76 (0.67 to 0.85) for hospitalisation (n=2 006), 0.61 (0.48 to 0.78) for intensive care (n=445) and 0.56 (0.37 to 0.85) for mortality (n=149), compared with the lowest category of CRF. The association remains unchanged when controlled for body mass index (BMI), blood pressure, chronic diseases and parental education level at baseline, and incident cardiovascular disease before 2020. Moreover, lower muscle strength in late adolescence showed a linear association with a higher risk of all three outcomes when controlled for BMI and height. Conclusions Physical fitness at a young age is associated with severity of COVID-19 many years later. This underscores the necessity to increase the general physical fitness of the population to offer protection against future viral pandemics.
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| 6. |
- Andersson, Helena, et al.
(författare)
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Walking football for Health - physiological response to playing and characteristics of the players.
- 2023
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Ingår i: Science and medicine in football. - : Routledge. - 2473-3938 .- 2473-4446. ; , s. 1-8
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Tidskriftsartikel (refereegranskat)abstract
- Walking Football (WF) is one type of recreational football increasing in popularity, targeting older adults. Further knowledge on the intensity and physical workload of WF, characteristics of the players, the social context, and reasons for playing WF is needed. Thus, the aim of the study was to characterize the individuals that regularly play WF and their experience of WF, and the physiological characteristics of the sport. Sixty-three players from three clubs taking part in organised WF in Sweden were included. The players participated in up to four WF-games and underwent performance tests and answered a questionnaire. The participants mean age was 70.9 years, ranging from 63 to 85 years with 71% (n = 27) of the men and 68% (n = 13) of the women having a BMI > 25. Fifty-one percent (n = 27) of the players had hypertension, and 73% (n = 39) regularly used prescription drugs due to illness. During WF, the players covered on average 2,409 m (2,509 m for men and 2,205 m for women, p = .001). Expressed in percentage of their age-estimated maximal heart rate, mean heart rate represented 80 ± 9 and 80 ± 8% of max for men, and 78 ± 9 and 79 ± 9% of max for women in the first and second halves, respectively, hence WF can be considered a moderate intensity activity for older adults. The main reason for WF participation was to socialize. WF includes a considerable number of accelerations and decelerations, making it more energetically and mechanically demanding than walking.
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| 7. |
- Andersson Hall, Ulrica, et al.
(författare)
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Physical activity during pregnancy and association with changes in fat mass and adipokines in women of normal-weight or with obesity
- 2021
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Ingår i: Scientific Reports. - : Springer Science and Business Media LLC. - 2045-2322. ; 11:1
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Tidskriftsartikel (refereegranskat)abstract
- Adipose tissue and adipokine concentrations change markedly during pregnancy, but the effects of physical activity on these changes are rarely studied. We aimed to assess physical activity levels in pregnant women of normal-weight (NW) or with obesity (OB), and to determine the relation with changes in fat mass and adipokines. In each trimester, pregnant women (136 NW, 51 OB) were interviewed about their physical activity and had their body composition, leptin, soluble leptin receptor (sOB-R) and adiponectin determined. NW reported higher activity and more aerobic exercise than OB during early pregnancy. Both groups maintained training frequency but reduced overall activity as pregnancy progressed. NW women reporting aerobic and/or resistance exercise and OB women reporting aerobic exercise had greater sOB-R increases (independent of BMI or gestational weight gain). In NW, exercise also associated with lower fat mass and leptin increases. Higher activity levels associated with lower gestational weight gain in both groups. The relationship between physical activity and adiponectin differed between NW and OB. Maternal exercise may partly mediate its beneficial effects through regulation of leptin bioavailability, by enhancing pregnancy-induced increases in sOB-R. This could be of particular importance in OB with pre-gestational hyperleptinemia and leptin resistance.
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| 8. |
- Andréll, Paulin, 1978, et al.
(författare)
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HEALTH-RELATED QUALITY OF LIFE IN FIBROMYALGIA AND REFRACTORY ANGINA PECTORIS: A COMPARISON BETWEEN TWO CHRONIC NON-MALIGNANT PAIN DISORDERS
- 2014
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Ingår i: Journal of Rehabilitation Medicine. - : Medical Journals Sweden AB. - 1650-1977 .- 1651-2081. ; 46:4, s. 341-347
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Tidskriftsartikel (refereegranskat)abstract
- Objective: To compare health-related quality of life in 2 different populations with chronic pain: patients with fibromyalgia and patients with refractory angina pectoris. Previous separate studies have indicated that these patient groups report different impacts of pain on health-related quality of life. Methods: The Short-Form 36 was used to assess health-related quality of life. In order to adjust for age and gender differences between the groups, both patient groups were compared with age- and gender-matched normative controls. The difference in health-related quality of life between the 2 patient groups was assessed by transforming the Short-Form 36 subscale scores to a z-score. Results: The patients with fibromyalgia (n=203) reported poorer health-related quality of life in all the subscale scores of Short-Form 36 (p < 0.05-0.0001) than the patients with refractory angina (n = 146) when both groups were compared with their corresponding normal population (z-score). Conclusion: Patients with fibromyalgia experience greater impairment in health-related quality of life compared with the normal population than do patients with refractory angina pectoris, despite the fact that the latter have a potentially life-threatening disease. The great impairment in health-related quality of life in patients with fibromyalgia should be taken into consideration when planning rehabilitation.
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| 9. |
- Andrell, Paulin, et al.
(författare)
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Smärta vid myokardischemi
- 2021
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Ingår i: Långvarig smärta- smärtmedicin vol 2. - Stockholm : Liber AB. - 9789147112883 ; , s. 673-86
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Bokkapitel (övrigt vetenskapligt/konstnärligt)
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