| 1. |
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| 2. |
- Erhardt, Leif RW
(författare)
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Managing cardiovascular risk: reality vs. perception
- 2005
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Ingår i: European Heart Journal Supplements. - : Oxford University Press (OUP). - 1520-765X .- 1554-2815 .- 1520-1554. ; 7:Suppl L, s. 11-15
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Tidskriftsartikel (refereegranskat)abstract
- Clinical practice guidelines attempt to bridge the gap between the generation of scientific evidence and its application. For cardiovascular risk reduction, the implementation of knowledge into practice, both with respect to lifestyle change and pharmacological treatment, has been shown to be poor. There are several reasons for this 'guidelines gap', with physician factors including insufficient time and underestimation of a patient's cardiovascular risk and patient factors including tack of adherence to lifestyle modification and lack of awareness about cardiovascular risk. Survey data indicate that physicians believe that they are implementing guidelines, but the majority of patients remains undertreated. There is a need for better physician and patient education and also for simplified guidelines to encourage their use by physicians. Cardiologists should work with primary care physicians to adapt national guidelines to ensure local acceptance.
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| 3. |
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| 4. |
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| 5. |
- Sutton, R, et al.
(författare)
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History of electrical therapy for the heart
- 2007
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Ingår i: EUROPEAN HEART JOURNAL SUPPLEMENTS. - : Oxford University Press (OUP). - 1520-765X .- 1554-2815 .- 1520-1554. ; 9:I, s. I3-I10
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Tidskriftsartikel (övrigt vetenskapligt/konstnärligt)
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| 6. |
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| 7. |
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| 8. |
- Wallentin, Lars
(författare)
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Dual antiplatelet therapy in the drug-eluting stent era
- 2008
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Ingår i: European Heart Journal, Supplement. - : Oxford University Press (OUP). - 1520-765X .- 1554-2815 .- 1520-1554. ; 10:D, s. D38-D44
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Tidskriftsartikel (refereegranskat)abstract
- Data continue to accumulate showing that implantation of coronary stents, particularly drug-eluting stents (DES), is associated with persistent, long-term risk of thrombotic events. Dual antiplatelet therapy with aspirin and clopidogrel has reduced the risk of early and late thrombosis. However, early risk persists due to implantation, stent-related factors, and suboptimal response to clopidogrel, whereas late risk persists due not only to these factors, but to the limited duration of dual antiplatelet therapy as well. Third-generation oral P2Y(12) antagonists that exhibit faster onset of action and greater and more consistent inhibition of platelet aggregation than clopidogrel include the new thienopyridine prasugrel and the reversible P2Y(12) inhibitor AZD6140. Prospective, randomized, Long-term trials are warranted to investigate the benefits and risks of more effective P2Y(12) antagonists as part of dual antiplatelet therapy after both bare-metal stent and DES implantation.
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| 9. |
- Willenheimer, Ronnie
(författare)
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How to begin treatment in chronic heart failure? Results of CIBISIII
- 2006
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Ingår i: European Heart Journal Supplements. - : Oxford University Press (OUP). - 1520-765X .- 1554-2815 .- 1520-1554. ; 8:C, s. 43-50
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Tidskriftsartikel (refereegranskat)abstract
- Aims To compare the effect of initial monotherapy with either bisoprolot or enalapril, followed by their combination, on mortality and hospitalization in patients with mild-to-moderate CHF. Methods and results One thousand and ten patients with mild-to-moderate CHF and left ventricular ejection fraction <= 35%, without ACE-inhibitor, beta-blocker, or angiotensin-receptor-blocker therapy were randomized to open-label monotherapy with either bisoprolot (target dose 10 mg od, n = 505) or enalapril (target dose 10 mg bid, n = 505) for 6 months, followed by their combination for 6-24 months. The combined primary endpoint was all-cause mortality or hospitalization; bisoprolol-first was considered non-inferior to enalapril-first if the upper limit of the 95% Cl for the absolute between-group difference was below +5%, corresponding to HR 1.17. In the intention-to-treat population, the primary endpoint occurred in 178 patients allocated bisoprotol-first vs. 186 allocated enalapril-first: absolute difference, -1.6%; 95% Cl, -7.6 to +4.4%; HR, 0.94; 95% Cl, 0.77-1.16. Thus, non-inferiority was demonstrated in the intention-to-treat population. In the per-protocol population, the primary endpoint occurred in 163 patients in the bisoprolol-first group vs. 165 in the enalapril-first group: absolute difference, -0.7%; 95% Cl, -6.6 to +5.1%; HR, 0.97; 95% Cl, 0.78-1.21. With bisoprolol-first, 65 patients died vs. 73 with enalapril-first (HR, 0.88; 95% Cl, 0.63-1.22; between-group difference P = 0.44), and 151 vs. 157 patients were hospitalized (HR, 0.95; 95% Cl, 0.76-1.19; between-group difference P = 0.66). Post hoc analysis of data from the first year indicated that a bisoprolol-first strategy reduced mortality by 31%, compared with an enalapril-first strategy (HR, 0.69; 95% CI, 0.46-1.02; between-group difference P = 0.065). Conclusion Initiating treatment with bisoprolot is as effective and well-tolerated as initiating treatment with enalapril. Post hoc analysis suggests that starting treatment with enalapril may reduce the risk of death, especially in the first year of treatment.
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| 10. |
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| 11. |
- Nilsson, Jan, et al.
(författare)
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Inflammation and cholesterol
- 2002
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Ingår i: European Heart Journal Supplements. - : Oxford University Press. - 1520-765X .- 1554-2815. ; 4:Suppl A, s. 18-25
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Tidskriftsartikel (refereegranskat)abstract
- Atherosclerosis develops as a result of a chronic arterial inflammation and intimal Fibrosis. The disease represents in many respects a vascular repair process activated in response to injury caused by toxic breakdown products of aggregated and oxidized lipoproteins. The initial response of the artery involves expression of adhesion molecules and recruitment of leukocytes. Degenerated lipoproteins are removed front the extracellular space by macrophages. If lipoproteins continue to I process becomes chronic and accumulate. the inflammatory cytokines stimulate smooth muscle to migrate into the intima. These cells proliferate and form an atherosclerotic plaque. Plaque cell death and inflammation in response to oxidized lipids and other toxic factors May Cause plaques to rupture.
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| 12. |
- Akhtar, Zubair, et al.
(författare)
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The impact of COVID-19 and COVID vaccination on cardiovascular outcomes
- 2023
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Ingår i: European Heart Journal, Supplement. - : Oxford University Press. - 1520-765X .- 1554-2815. ; 25:Suppl A., s. A42-A49
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Forskningsöversikt (refereegranskat)abstract
- COVID-19 is an independent risk factor for cardiovascular disease. COVID-19 vaccination may prevent this, but in some cases, COVID-19 vaccination may cause myocarditis or pericarditis. Patients with COVID-19 may present with non-specific symptoms that have a cardiac origin. This review examines the cardiovascular complications of COVID-19 infection and the impact of COVID-19 vaccination. COVID-19 cardiovascular complications include myocardial injury, pericarditis, coagulopathy, myocardial infarction, heart failure, arrhythmias, and persistent post-acute risk of adverse cardiovascular outcomes. Diagnostic and referral pathways for non-specific symptoms, such as dyspnoea and fatigue, remain unclear. COVID-19 vaccination is cardioprotective overall but is associated with myopericarditis in young males, though at a lower rate than following SARS-CoV-2 infection. Increased awareness among primary care physicians of potential cardiovascular causes of non-specific post-COVID-19 symptoms, including in younger adults, such as fatigue, dyspnoea, and chest pain, is essential. We recommend full vaccination with scheduled booster doses, optimal management of cardiovascular risk factors, rapid treatment of COVID-19, and clear diagnostic, referral, and management pathways for patients presenting with non-specific symptoms to rule out cardiac complications.
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| 13. |
- Arvanitis, Panagiotis, et al.
(författare)
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Timing and degree of left atrial stunning and reverse functional remodeling following electrical cardioversion in patients with recent onset atrial fibrillation
- 2020
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Ingår i: European Heart Journal, Supplement. - : Oxford University Press (OUP). - 1520-765X .- 1554-2815 .- 0195-668X .- 1522-9645. ; 41:Supplement_2
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Tidskriftsartikel (övrigt vetenskapligt/konstnärligt)abstract
- BackgroundAtrial fibrillation (AF) results in left atrial electrical, structural and functional remodeling. Restoration of sinus rhythm hallmarks the beginning of reverse remodeling, the extent of which may depend on the type of AF.PurposeThe aim of the study was to assess resumption of left atrial function after electric cardioversion in patients with recent onset AF and to explore the association between reverse remodeling and the type of atrial fibrillation.MethodsPatients with AF duration <48 hours were prospectively included. Trans-thoracic echocardiography was performed prior, immediately after (2–4 hours) and 7–10 days following CV. Left atrial volume index (LAVI), left atrial global longitudinal strain during reservoir (LAGLS-res), conduit (LAGLS-cond) and contractile (LAGLS-contr) phases, left atrial ejection fraction (LAEF) and left ventricular ejection fraction (LVEF) were measured.ResultsForty-three patients (84% males) aged 55±9.6 years, (mean±SD), with median CHA2DS2-VASc score 1 (interquartile range 0–1) were included. Repeated measure analysis of variance revealed a statistically significant overall change for LAGLS-res F(2,78)=55.4, p<0,001, LAGLS-cond F(2,78)=23.3, p<0,001, LAGLS-contr F(2,78)=39.7, p<0,001, LAEF F(2,80)=28.5, p<0.001 and LVEF F(2,80)=8.4, p<0.001. At 7–10 days, LAGLS-contr 12±4%, LAEF 53±9% and LVEF 60±6 (mean±SD) return within normal reference intervals. Notably left atrial recovery seems to precede left ventricular recovery. No statistical significant interaction with the type of atrial fibrillation could be shown.ConclusionLeft atrial functional reverse remodeling occurs within ten days after successful electric cardioversion of patients with recent onset atrial fibrillation.
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| 14. |
- Bolse, Kärstin, et al.
(författare)
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Organisation of care for Swedish patients with an Implantable Cardioverter Defibrillator, a national survey
- 2010
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Ingår i: European Heart Journal, Supplement. - Oxford : Oxford University Press. - 1520-765X .- 1554-2815. ; 31:Supplement 1, s. 236-236
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Tidskriftsartikel (refereegranskat)abstract
- Background:ICD implantations have developed rapidly in recent years and is now an established arrhythmia treatment. The expanding indication for ICD implantation demands new competencies and resources in the ICD team members.Objectives:To describe the clinical aspects of Implantable Cardioverter Defibrillators (ICD) care in Sweden with focus on organisation, the role and education of nurses, patient information and education, and areas in need of improvement.Methods:Participants were recruited among physicians and nurses in all of the hospitals implanting ICDs (N=16). Data was collected by a questionnaire. The questionnaire was constructed based on a systematic literature review and then guided by an expert group with clinical and research expertise within the ICD area. The format was inspired by existing questionnaires on heart failure care. The questionnaire comprised of 23 questions, including both multiple choice questions and open questions. Additionally, all written educational materials provided to patients pre- and post-ICD implant were collected from all 16 hospitals. Deductive content analysis using Sarvimäki and Stenbock-Hult's five holistic dimensions was employed to ascertain how information was provided in brochures and information materials.Results:This study revealed variations in the organisation and follow-up of ICD patients between the different centres in Sweden. Half of the hospitals (n=8) had nurse-based outpatient clinics and several others planned to introduce them. Three hospitals carried out distance follow-ups by means of tele-monitoring. The nurses had received specific ICD education from ICD companies and/or various university courses. In all hospitals, ICD patients received verbal and written information both before and after implantation. The biophysical dimension dominated in the information material while the emotional, intellectual, and socio-cultural dimensions were scarcely described, and the spiritual- existential was not referred to at all. The majority of the ICD teams were in favour of the development of research and quality assurance by means of check lists, guidelines and the ICD-registry.Conclusion:Holistic care of ICD patients can be achieved by means of a multi-disciplinary ICD team and more patient-centred educational strategies. In Sweden, the organisation of ICD care and follow-up is developing towards more nurse-based clinics. The content of the written educational materials need to be more holistic, rather than mainly focusing on the biophysical and technical aspects of living with an ICD.
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| 15. |
- Bouchard, Phillipe, et al.
(författare)
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European workshop in periodontal health and cardiovascular disease consensus document
- 2010
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Ingår i: European Heart Journal, Supplement. - 1520-765X .- 1554-2815. ; 12:B, s. B13-B22
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Tidskriftsartikel (refereegranskat)abstract
- There is evidence from epidemiological research on the association between periodontal diseases (PD) and cardiovascular disease (CVD). In spite of these significant associations, however, there is still a lack of awareness in the cardiovascular community on their possible importance. In view of this evidence, an expert panel composed by six European periodontists and four cardiologists addressed the following questions: a) How important is the association of PD and CVD?; b) How do we measure exposure (PD) and outcome (CVD)?; c) What is the pathogenic link?; d) What is the relative importance of periodontal therapy as prevention of CVD?; e) Is it justified to recommend periodontal health with the goal of reducing CV risk?; f) What clinical and experimental research is needed?. The general conclusions were that even though these proven epidemiological association between PD and CVD, there is, however, no compelling evidence that preventive periodontal care or therapeutic intervention will influence cardiac health. As Periodontitis continues to have a high prevalence within the population and the fact that CVD remains as the major cause of human death in developed countries, in light of these associations we can legitimately, based on evidence, state that oral health has an influence on systemic health in general and in CVD in particular, and therefore, we should promote oral health in general and periodontal health in particular as part of a healthy life style and hence as an important component in the prevention of CVD.
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| 16. |
- Casadei, B, et al.
(författare)
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Prevention and treatment of venous thromboembolism
- 2020
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Ingår i: European heart journal supplements : journal of the European Society of Cardiology. - : Oxford University Press (OUP). - 1520-765X. ; 22:CSuppl C, s. C1-C1
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Tidskriftsartikel (refereegranskat)
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| 17. |
- Christersson, Christina, et al.
(författare)
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Haemorrhagic stroke and major bleeding after intervention with biological aortic valve prosthesis : risk factors and antithrombotic treatment
- 2020
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Ingår i: European Heart Journal, Supplement. - : OXFORD UNIV PRESS. - 1520-765X .- 1554-2815. ; 22:C, s. C26-C33
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Tidskriftsartikel (refereegranskat)abstract
- The majority of patients with severe aortic stenosis are recommended intervention with a surgical biological prosthesis (bioSAVR) or a transcatheter aortic valve intervention (TAVI). The antithrombotic strategies after aortic valve intervention vary and include drugs targeting both platelets and the coagulation cascade. Long-term exposure and changes of antithrombotic treatment influence the risk of both bleeding and thromboembolic events. The aim was to describe an unselected sample of patients who have experienced haemorrhagic stroke and other major bleeding events after biological aortic prosthesis, their antithrombotic treatment and changes of treatments in relation to the bleeding event. All patients performing an bioSAVR or a TAVI 2008-2014 were identified in the SWEDEHEART registry and included in the study (n =10 711). The outcome events were haemorrhagic stroke and other major bleeding event. Information of drug exposure was collected from the dispensed drug registry. The incidence rate of any bleeding event was 2.85/100 patient-years the first year after aortic valve intervention. Heart failure and atrial fibrillation were present more often in patients with a first haemorrhagic stroke or other major bleeding event compared to without. The proportion of exposure to warfarin was 28.7% vs. 21.3% in patients with and without a haemorrhagic stroke. Comparable figures were 31.2% vs. 19.0% in patients with and without other major bleeding event. During 1 month prior a haemorrhagic stroke or other major bleeding event 39.4% and 38.0%, respectively, of the patients not previously exposed to antithrombotic treatment started warfarin or single antiplatelet therapy. Major bleeding events are not uncommon after aortic valve intervention with a biological prosthesis. Evaluation of comorbidities and previous bleeding might improve risk stratification for bleeding in these elderly patients. The pattern of change of antithrombotic treatment was similar in the groups with and without a bleeding event and in most patients the antithrombotic regime was unchanged the month before an event.
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| 18. |
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| 19. |
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| 20. |
- Małyszko, Jolanta, et al.
(författare)
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Do we know more about hypertension in Poland after the May Measurement Month 2017? - Europe
- 2019
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Ingår i: European Heart Journal, Supplement. - : Oxford University Press (OUP). - 1520-765X .- 1554-2815. ; 21, s. 97-100
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Forskningsöversikt (refereegranskat)abstract
- Elevated blood pressure (BP) is a worldwide burden, leading to over 10 million deaths yearly. May Measurement Month (MMM) is a global initiative organized by the International Society of Hypertension aimed at raising awareness of hypertension and the need for BP screening. An opportunistic cross-sectional survey of volunteers aged ≥18 was carried out in May 2017. BP measurement, the definition of hypertension and statistical analysis followed the globally approved MMM17 Study Protocol. In Poland 5834 (98.9%, Caucasian) individuals were screened. After multiple imputation, 2601 (35.3%) had hypertension. Of individuals not receiving anti-hypertensive medication, 976 (20.6%) were hypertensive. Of individuals receiving anti-hypertensive medication, 532 (49.1%) had uncontrolled BP. In the crude screened group, 81.4% declared to not receive any anti-hypertensive treatment, while the remaining 18.6% were on such medications. In overweight and obese patients both systolic and diastolic BP were significantly higher than in normal weight and underweight subjects. In addition, BP measured on Sundays was significantly lower than on Mondays. MMM17 was one of the largest recent BP screening campaigns in Poland. We found that over 1/3 of participants were hypertensive. Almost half of the treated subjects had uncontrolled BP. These results suggest that opportunistic screening can identify substantial numbers with raised BP.
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| 21. |
- Manzi, Maria Virginia, et al.
(författare)
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SEX-RELATED DIFFERENCES IN THROMBUS BURDEN IN ST-ELEVATION MYOCARDIAL INFARCTION PATIENTS UNDERGOING PRIMARY PERCUTANEOUS CORONARY INTERVENTION
- 2022
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Ingår i: European Heart Journal, Supplement. - : Oxford University Press. - 1520-765X .- 1554-2815. ; 24:Suppl. K, s. K124-K125
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Tidskriftsartikel (övrigt vetenskapligt/konstnärligt)abstract
- Background: Women have a worse prognosis after ST-segment elevation myocardial infarction (STEMI) than men. The prognostic role of thrombus burden (TB) in influencing the sex-related differences in clinical outcomes after STEMI has not been clearly investigated.Objectives: The aim of this study was to assess the sex-related differences in TB and its clinical implication in patients with STEMI.Methods: We analyzed individual patient data from the 3 major randomized clinical trials of manual thrombus aspiration, encompassing a total of 19,047 patients with STEMI, of whom 13,885 (76.1%) were men and 4,371 (23.9%) were women. The primary outcome of interest was 1-year cardiovascular (CV) death. The secondary outcomes of interest were recurrent myocardial infarction, heart failure, all-cause mortality, stroke, stent thrombosis (ST), and target vessel revascularization at 1 year.Results: Patients with high TB (HTB) had worse 1-year outcomes compared with those presenting with low TB (adjusted HR for CV death; 1.52; 95% CI: 1.10-2.12; P=0.01). In unadjusted analyses, female sex was associated with an increased risk for 1-year CV death regardless of TB. After adjustment, this risk for 1-year CV death was higher only in women with HTB (HR 1.23, 95% CI: 1.18-1.28; P<0.001) who also had an increased risk for all-cause death and ST than men.Conclusion: In patients with STEMI, angiographic evidence of HTB negatively affected prognosis. Among patients with HTB, women had an excess risk for stent thrombosis, CV and all-cause mortality than men. Further investigations are warranted to better understand the pathophysiological mechanisms leading to excess mortality in women with STEMI and HTB.
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| 22. |
- Medic Spahic, Jasmina, et al.
(författare)
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Malmö POTS symptom score : Assessing symptom burden in postural orthostatic tachycardia syndrome
- 2022
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Ingår i: European Heart Journal, Supplement. - : Oxford University Press (OUP). - 1520-765X .- 1554-2815. ; 24:Supplement K
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Konferensbidrag (refereegranskat)abstract
- BackgroundPostural orthostatic tachycardia syndrome (POTS) is a common cardiovascular autonomic disorder characterized by excessive heart rate increase on standing and symptoms of orthostatic intolerance, posing significant limitations on functional capacity. No objective tool exists to classify symptom burden in POTS.MethodsWe conducted a case-control study in 62 POTS patients and 50 healthy controls to compare symptom burden between groups using the newly developed, self-rating, 12-item, Malmö POTS Score (MAPS; 0-10 per item, total range 0-120) based on patients’ own perception of symptoms through visual analogue scale assessment. We have also explored correlations between symptom severity assessed by MAPS, basic clinical parameters and postural haemodynamic changes.ResultsPOTS patients showed significantly higher total MAPS score (78±20 vs. 14±12, pConclusionsSymptom severity, as assessed by MAPS score, is 5-fold higher in POTS compared with healthy individuals. The new MAPS score can be useful as a semi-quantitative system to assess symptom burden, monitor disease progression and evaluate pre-test likelihood of disease.
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| 23. |
- Nieminen, Markku S., et al.
(författare)
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The potential of the inodilator levosimendan in maintaining quality of life in advanced heart failure
- 2017
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Ingår i: European Heart Journal, Supplement. - : OXFORD UNIV PRESS. - 1520-765X .- 1554-2815. ; 19:C, s. C15-C21
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Tidskriftsartikel (refereegranskat)abstract
- Maintaining adequate quality of life (QoL) is an important therapeutic objective for patients with advanced heart failure and, for some patients, may take precedence over prolonging life. Achieving good QoL in this context may involve aspects of patient care that lie outside the familiar limits of heart failure treatment. The inodilator levosimendan may be advantageous in this setting, not least because of its sustained duration of action, ascribed to a long-acting metabolite designated OR-1896. The possibility of using this drug in an outpatient setting is a notable practical advantage that avoids the need for patients to attend a clinic appointment. Intermittent therapy can be integrated into a wider system of outreach and patient monitoring. Practical considerations in the use of levosimendan as part of a palliative or end-of-life regimen focused on preserving QoL include the importance of starting therapy at low doses and avoiding bolus administration unless immediate effects are required and patients have adequate baseline arterial blood pressure.
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| 24. |
- Poulter, Neil R., et al.
(författare)
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May Measurement Month : results of 12 national blood pressure screening programmes between 2017 and 2019
- 2022
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Ingår i: European Heart Journal, Supplement. - : Oxford University Press (OUP). - 1520-765X .- 1554-2815. ; 24:Sf, s. 1-5
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Tidskriftsartikel (refereegranskat)abstract
- The frst May Measurement Month (MMM) campaign, a global blood pressure (BP) screening programme, began in 2017 as an initiative of the International Society of Hypertension.1 Two subsequent annual campaigns have also been completed in consecutive years2,3 and having had to defer activities due to the COVID-19 pandemic in 2020 the fourth campaign was run in 2021, the results of which are currently in press. Since its initiation in 2017, volunteers from more than 100 countries have participated. The aims of MMM have remained consistent from the start-to raise awareness of the importance of the measurement of BP at the individual and population level and to provide a temporary pragmatic solution to the shortfall in BP screening programmes in countries around the world.
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| 25. |
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| 26. |
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| 27. |
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| 28. |
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| 29. |
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| 30. |
- Erhardt, Leif RW, et al.
(författare)
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Introduction
- 2002
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Ingår i: European Heart Journal Supplements. - 1520-765X. ; 4:F, s. 1-1
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Tidskriftsartikel (övrigt vetenskapligt/konstnärligt)
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| 31. |
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| 32. |
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| 33. |
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| 34. |
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| 35. |
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| 36. |
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| 37. |
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| 38. |
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| 39. |
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| 40. |
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| 41. |
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| 42. |
- Bouchard, Phillipe, et al.
(författare)
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European workshop in periodontal health and cardiovascular disease consensus document
- 2010
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Ingår i: European Heart Journal, Supplement. - : Oxford University Press. - 1520-765X. ; 12:B, s. B13-B22
-
Tidskriftsartikel (refereegranskat)abstract
- There is evidence from epidemiological research on the association between periodontal diseases (PD) and cardiovascular disease (CVD). In spite of these significant associations, however, there is still a lack of awareness in the cardiovascular community on their possible importance. In view of this evidence, an expert panel composed by six European periodontists and four cardiologists addressed the following questions: a) How important is the association of PD and CVD?; b) How do we measure exposure (PD) and outcome (CVD)?; c) What is the pathogenic link?; d) What is the relative importance of periodontal therapy as prevention of CVD?; e) Is it justified to recommend periodontal health with the goal of reducing CV risk?; f) What clinical and experimental research is needed?. The general conclusions were that even though these proven epidemiological association between PD and CVD, there is, however, no compelling evidence that preventive periodontal care or therapeutic intervention will influence cardiac health. As Periodontitis continues to have a high prevalence within the population and the fact that CVD remains as the major cause of human death in developed countries, in light of these associations we can legitimately, based on evidence, state that oral health has an influence on systemic health in general and in CVD in particular, and therefore, we should promote oral health in general and periodontal health in particular as part of a healthy life style and hence as an important component in the prevention of CVD.
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| 43. |
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| 44. |
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| 45. |
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| 46. |
- Johansson, Madeleine, et al.
(författare)
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Downregulation of growth hormone in postural orthostatic tachycardia syndrome: insights from the SYSTEMA cohort
- 2020
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Ingår i: European Heart Journal, Supplement. - : Oxford University Press (OUP). - 1520-765X .- 0195-668X .- 1522-9645. ; 41:Issue Supplement_2
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Konferensbidrag (refereegranskat)abstract
- Background Postural orthostatic tachycardia syndrome (POTS) is a variant of cardiovascular autonomic disorder occurring predominantly in young women. POTS is characterized by an excessive heart rate increase when assuming upright posture accompanied by symptoms of orthostatic intolerance. The pathophysiology of POTS has not been fully established and is believed to be multifactorial. Purpose We aimed to investigate the alterations in circulating growth hormone level in POTS. Methods We conducted an age-matched case-control study enrolling 42 patients with POTS (age 31±9 years; 36 women) verified by positive head-up tilt testing and cardiovascular autonomic tests, and 46 controls (32±9 years; 35 women) with negative active standing test and no history of syncope, orthostatic intolerance and endocrine disease. We measured plasma levels of growth hormone using a high-sensitivity chemiluminescence immunoassay in relation to presence of POTS diagnosis. All study participants completed the validated Orthostatic Hypotension Questionnaire (OHQ), consisting of two components: the symptoms assessment scale (OHSA) and daily activity scale (OHDAS) to evaluate the burden of symptoms. We applied standard statistical tests for group differences. Growth hormone values were log-transformed and standardized before the group comparison. Results POTS patients had significantly lower plasma levels of growth hormone (ng/mL) (median=0.53, IQR, 0.10–2.83 vs. median=2.33, IQR, 0.26–7.2, p=0.04) than controls. Levels of growth hormone were reversely related to OHDAS (p=0.049) among POTS patients. Supine heart rate was significantly higher in POTS patients (69.0±11.1 beats/min vs. 63.3±10.8 beats/min, p=0.02), as well as diastolic blood pressure (72.9±9.1 mmHg vs. 69.0±8.5 mmHg, p=0.04). We observed no significant difference in supine systolic blood pressure (116.6±13.3 mmHg vs. 115.2±10.0 mmHg, p=0.60). POTS patients had a significantly higher composite OHQ score than controls (60.0±18.6 vs. 4.2±7.5, p<0.001), as well as OHSA (36.2±10.0 vs. 3.6±6.4, p<0.001) and OHDAS (23.8±9.7 vs. 0.6±1.3, p<0.001). Conclusion(s) Our study shows that patients with POTS have significantly reduced plasma levels of circulating growth hormone. Lower growth hormone levels among POTS patients are associated with increased impairment of daily life activities. Further studies are necessary to confirm our findings in the independent populations and explain the mechanisms behind this alteration.
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| 47. |
- Linde, C
(författare)
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Reuse of pacemakers
- 1999
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Ingår i: EUROPEAN HEART JOURNAL SUPPLEMENTS. - 1520-765X. ; 1:G, s. G8-G11
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Tidskriftsartikel (övrigt vetenskapligt/konstnärligt)
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| 48. |
- Olsson, Bertil
(författare)
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Atrial fibrillation and flutter: aeromedical considerations. New strategies for management and intervention
- 1999
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Ingår i: European Heart Journal Supplements. - 1520-765X. ; 1:Suppl. D, s. 94-97
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Tidskriftsartikel (refereegranskat)abstract
- Few cases of atrial fibrillation can be completely excused from the possibility of having some impact of potential importance in the aviation environment. The clinical pattern in paroxysmal disturbance is very wide and possible incapacitating phenomena are mainly haemodynamic. In contrast, chronic atrial fibrillation is mostly well-tolerated with only minimal haemodynamic effect, but there is a risk of thromboembolism, suggesting the need for anti-thromboembolic treatment. A subgroup with chronic atrial fibrillation with a very low risk may be defined, allowing avoidance of anti-thromboembolic treatment and a positive attitude towards aeromedical certification. Such individuals are likely to be normotensive males, under the age of 60 years, with a normal left (and right) heart configuration on electrocardiography.
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- Olsson, Bertil
(författare)
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New advances in stroke prevention in atrial fibrillation: ximelagatran and direct thrombin inhibition
- 2004
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Ingår i: European Heart Journal Supplements. - : Oxford University Press (OUP). - 1520-765X. ; 6:B, s. 20-24
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Tidskriftsartikel (refereegranskat)abstract
- Ximelagatran is the first oral agent in a new class of direct thrombin inhibitors and is under investigation for the prevention and treatment of a range of thromboembolic disorders. Atrial. fibrillation (AF) is associated with a markedly increased risk of stroke and, while study results have consistently demonstrated that anticoagulant therapy with warfarin reduces this risk, there are substantial unmet needs in the management of AF-associated thrombotic risk. In particular, warfarin has unpredictable activity leading to the risk of bleeding complications and the need for routine anticoagulant monitoring. Ximelagatran has a range of potential benefits over warfarin in the prevention of AF-associated stroke, including predictable anticoagulant activity that is not affected by food and a tow potential for drug-drug interactions. Consequently, the risk of bleeding complications may be,reduced and there is a fixed-dose regimen with no requirement for routine anticoagulant monitoring. The SPORTIF (Stroke Prevention using an ORal Thrombin Inhibitor in atrial. Fibrillation) series of studies is investigating the extent to which these potential advantages translate into clinical benefits. SPORTIF III is a Phase III study of the efficacy and safety of ximelagatran compared with warfarin in the prevention of stroke in 3407 patients with AF. The results demonstrate that ximelagatran has effectiveness non-inferior to well-controlled warfarin in the prevention of stroke and is associated with a lower risk of bleeding complications. With its predictable anticoagulant effect and the enhanced convenience offered by a fixed-dose regimen and with no requirement for routine coagulation monitoring, these results indicate that ximelagatran promises clinical benefits over warfarin that could improve the management of stroke risk in patients with AF. (C) 2004 The European Society of Cardiology. Published by Elsevier Ltd. All rights reserved.
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