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- Jensen-Urstad, K, et al.
(författare)
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Heart rate variability in healthy subjects is related to age and gender.
- 1997
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Ingår i: Acta Physiologica Scandinavica. - 0001-6772 .- 1365-201X. ; 160:3, s. 235-41
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Tidskriftsartikel (refereegranskat)abstract
- The effects of age and gender on heart rate variability as measured by spectral and time domain analysis of 24 h ECG recordings were evaluated in 101 healthy subjects, 49 men and 52 women (20-69 years of age). In the frequency domain, total power, very low-frequency power, low-frequency power and high-frequency power were negatively correlated to age (P < 0.001 for all variables). Total power decreased by 30% between 20-29 and 60-69 years of age. In the time domain, SDNN-index, the mean of the standard deviations of all normal R-R intervals for all 5 min segments of a 24 h ECG recording, was negatively correlated to age (P < 0.001). Total power, very low-frequency power, low-frequency power and the low-frequency/high-frequency ratio were lower in women (P < 0.05, P < 0.05, P < 0.01 and P < 0.01), although the absolute differences were much smaller than for age. There was a pronounced circadian variation; at night total power increased in all age groups (P < 0.01). The results show that age, and to a lesser degree gender, are important determinants of heart rate variability in healthy subjects. Heart rate variability is a valuable tool for risk stratification in cardiovascular disease, but the physiological effects of ageing, with diminishing heart rate variability in older age groups, must also be taken into account.
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| 2. |
- Jensen-Urstad, K, et al.
(författare)
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Pronounced resting bradycardia in male elite runners is associated with high heart rate variability.
- 1997
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Ingår i: Scandinavian Journal of Medicine and Science in Sports. - : Wiley. - 0905-7188 .- 1600-0838. ; 7:5, s. 274-8
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Tidskriftsartikel (refereegranskat)abstract
- Forty-eight hour Holter monitoring was undertaken of 16 male elite middle- and long-distance runners, age 25 +/- 3 years, with peak oxygen uptake 4.83 +/- 0.43 1 O2/min or 73.0 +/- 3.9 ml O2/kg/min. The athletes had pronounced bradycardia during the night-time, with heart rate calculated from four RR intervals < 30 beats/min in five runners. Twelve of 16 runners had RR intervals > 2 s. Of those, 10 runners had sinus pauses exceeding 2 s, the longest being 3.06 s. Three runners had AV block II, two with Mobitz type 1, and one with both Mobitz type 1 and 2. Autonomic function was estimated by time domain and power spectral analysis of heart rate variability. The runners were compared with a control group of 13 sedentary or moderately active subjects. The runners had a mean of 14 b.p.m. lower heart rate at night than the controls. The runners had higher heart rate variability in all spectral bands. In the time domain pNN50 and rMSSD, which are considered to reflect strongly vagal tone, were markedly higher in the runners than the controls. The findings suggest that an increased parasympathetic tone might at least partly explain the pronounced resting sinus bradycardias found in endurance-trained runners.
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- Jensen-Urstad, M, et al.
(författare)
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Heart rate variability is related to leucocyte count in men and to blood lipoproteins in women in a healthy population of 35-year-old subjects.
- 1998
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Ingår i: Journal of Internal Medicine. - 0954-6820 .- 1365-2796. ; 243:1, s. 33-40
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Tidskriftsartikel (refereegranskat)abstract
- OBJECTIVES: To investigate if, in a healthy randomly-selected population of 35-year-old men and women, there already is a relation between decreased heart rate variability and conventional risk factors for cardiovascular disease. BACKGROUND: Analysis of heart rate variability (HRV) has been used for estimating tonic autonomic activity. HRV is reduced in patients with various cardiovascular diseases. If a decreased HRV is a late phenomenon in the progression of cardiovascular disease, or if it parallels or even precedes manifest disease is unknown. DESIGN: Spectral analysis of HRV was made from 24-hour ambulatory electrocardiograms in a randomised population of healthy 35-year-old men (n = 63) and women (n = 70). The different spectral indices of HRV were analysed against gender, leucocyte count (previously described as an independent risk factor for cardiovascular disease), blood lipoproteins, smoking, heredity, body mass index (BMI) and systolic blood pressure. SETTING: A research centre of general medicine and a university hospital. RESULTS: Mean heart rate was lower, total power (TP), very low frequency power (VLF) and low frequency power (LF) were higher in men than in women. In women TP, VLF and LF were negatively correlated to BMI, smoking, triglycerides and positively correlated to HDL cholesterol. TP and VLF were also negatively correlated to risk factor score. High frequency power (HF), a marker of parasympathetic activity, was positively related to HDL cholesterol. In men, at daytime, TP, VLF, LF and HF were negatively correlated to leucocyte count. TP, VLF and LF were also negatively correlated to triglycerides and VLF also to risk factor score. CONCLUSIONS: There are correlations between HRV and known risk factors for cardiovascular disease already in a healthy 35-year-old population. A novel observation is the relationship in men between leucocyte count and heart rate variability.
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- Reichard, P, et al.
(författare)
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Autonomic neuropathy--a complication less pronounced in patients with Type 1 diabetes mellitus who have lower blood glucose levels.
- 2000
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Ingår i: Diabetic Medicine. - : Wiley. - 0742-3071 .- 1464-5491. ; 17:12, s. 860-6
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Tidskriftsartikel (refereegranskat)abstract
- AIMS: Autonomic neuropathy is a serious diabetic complication, probably contributing to the death of many young people with Type 1 diabetes mellitus. It is often not diagnosed. METHODS: Patients with Type 1 diabetes from the Stockholm Diabetes Intervention Study were investigated with power spectral analysis (n = 88), heart rate and blood pressure reactions to tilting (n = 66), and heart rate variability during deep breathing (n = 70) a mean of 11.4 years after randomization to intensified conventional treatment (ICT) or standard treatment (ST), the treatment groups similar with regard to age, duration of diabetes and metabolic control at baseline (HbA1c 9.4 (1.3)%, mean (SD)). Blood glucose levels (mean of 29 HbA1c values) during the 10 years were lower in the patients from the ICT group (7.2 (0.6) vs. 8.3 (1.0)%, P = 0.001). RESULTS: Heart rate variability (HRV) in the high frequency range (P = 0.034), the expiration-inspiration ratio (P = 0.020), and the brake index during tilt (P = 0.044) were lower in the ST group, indicating more pronounced parasympathetic insufficiency. Systolic blood pressure fell by 10 (16) mmHg in the ST group, and by 2.5 (15) mmHg in the ICT group 8 min after rising from the supine to a 70 degrees upright position (P = 0.034). A decreased autonomic function was associated with age and higher HbA1c. CONCLUSION: Better autonomic nerve function is associated with lower HbA1c and lower age which were both the same in the intensively and the conventionally treatment groups at baseline. After a mean of 11.4 years autonomic function was better in the intensively treated group.
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- Grankvist, R., et al.
(författare)
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Superselective endovascular tissue access using trans-vessel wall technique : feasibility study for treatment applications in heart, pancreas and kidney in swine
- 2019
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Ingår i: Journal of Internal Medicine. - : Wiley. - 0954-6820 .- 1365-2796. ; 285:4, s. 398-406
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Tidskriftsartikel (refereegranskat)abstract
- Objectives. With the emergence of targeted cell transplantation and gene therapy, there is a need for minimally invasive tissue access to facilitate delivery of therapeutic substrate. The objective of this study was to demonstrate the suitability of an endovascular device which is able to directly access tissue and deliver therapeutic agent to the heart, kidney and pancreas without need to seal the penetration site. Methods. In vivo experiments were performed in 30 swine, including subgroups with follow-up to evaluate complications. The previously described trans-vessel wall (VW) device was modified to be sharper and not require tip detachment to seal the VW. Injections into targets in the heart (n = 13, 24-h follow-up n = 5, 72-h follow-up n = 3), kidney (n = 8, 14-day follow-up n = 3) and pancreas (n = 5) were performed. Some animals were used for multiple organ injections. Follow-up consisted of clinical monitoring, angiography and necropsy. Transvenous (in heart) and transarterial approaches (in heart, kidney and pancreas) were used. Injections were targeted towards the subepicardium, endomyocardium, pancreas head and tail, and kidney subcapsular space and cortex. Results. Injections were successful in target organs, visualized by intraparenchymal contrast on fluoroscopy and by necropsy. No serious complications (defined as heart failure or persistent arrhythmia, haemorrhage requiring treatment or acute kidney injury) were encountered over a total of 157 injections. Conclusions. The trans-VW device can achieve superselective injections to the heart, pancreas and kidney for delivery of therapeutic substances without tip detachment. All parts of these organs including the subepicardium, pancreas tail and renal subcapsular space can be efficiently reached.
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- Jensen, J., et al.
(författare)
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Deterioration in peak systolic velocity is closely related to ischaemia during angioplasty : a vectorcardiographic and tissue Doppler imaging study
- 2001
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Ingår i: Clinical Science. - : Portland Press Ltd.. - 0143-5221 .- 1470-8736. ; 100:2, s. 137-143
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Tidskriftsartikel (refereegranskat)abstract
- We tested the hypothesis that the extent of signs of ischaemia detected by vectorcardiography (VCG) during elective coronary angioplasty (percutaneous transluminal coronary angioplasty: PTCA) is related to systolic and diastolic myocardial velocities, as determined by tissue Doppler echocardiography. A total of 15 patients undergoing PTCA (12 men/three women; age 61 +/- 9 years), without prior myocardial infarction and with an election fraction of > 50%, were included. The balloon inflation was repeated three times, with minimum intervals of 2 min between inflations. Tissue Doppler echocardiography was performed. in an apical two- or four-chamber view, before and at the end of each inflation. Peak systolic velocity, time-to-peak systolic velocity (TTP), peak early (E-m) and late (A(m)) diastolic velocities, the E-m/A(m) ratio and jsovolumic relaxation time were measured in the basal segments of the left ventricle. VCG recordings were carried out during the whole procedure. ST vector magnitude (ST-VM) and ST change vector magnitude (STC-VM) were monitored. The total duration and area of each VCG change during inflation were calculated for each patient. Isovolumic relaxation time, peak E-m and A(m) values and the E-m/A(m) ratio did not change significantly during inflation. Peak systolic velocity decreased (6.7+/-2.0 to 5.3 +/- 1.9 cm/s; P < 0.001) and TTP increased (157 +/- 60 to 192 +/- 60 ms; P<0.01) during inflation. Both STC-VM rime (r = -0.68, P<0.01) and STC-VM area (r = -0.68, P < 0.01) were related to peak systolic velocity during inflation. STC-VM time was also related (r = 0.55, P < 0.05) to the difference in peak systolic velocity during compared with before inflation. ST-VM was less closely related to peak systolic velocity. Thus the duration and degree of ischaemia, as measured by VCG, are related to peak systolic velocity in the basal segments of the left ventricle.
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| 38. |
- Jensen-Urstad, M, et al.
(författare)
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Impact of smoking: all-cause and cardiovascular mortality in a cohort of 55-year-old Swedes and Estonians
- 2014
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Ingår i: Scandinavian journal of public health. - : SAGE Publications. - 1651-1905 .- 1403-4948. ; 42:8, s. 780-785
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Tidskriftsartikel (refereegranskat)abstract
- Aim: In the 1990s, several studies noted a large gap in life expectancy between Western and Eastern European countries. It was speculated that this could be explained by environmental pollution, socioeconomic factors, lifestyle and psychosocial stress. A weakness in addressing the issue has been the lack of prospective studies with mortality as end point. Methods: We used the national population registries (between 1996 and 1998) to screen a cohort of 269 55-year-old subjects in Sweden and Estonia. We assessed conventional risk factors, lifestyle and socio-economic factors. A 13-year follow-up regarding all-cause and cardiovascular mortality was done. Results: Smoking and, to a lesser extent, plasma levels of interleukin-6 were significant predictors for CVD and non-CVD mortality in men, but none of the other conventional risk factors reached statistical significance. During the follow-up period, 22 of the 52 male smokers died compared to 8 of the 85 male non-smokers ( p<0.01). Ten of the smokers died of CVD compared to three of the non-smokers ( p<0.002). In total, only two women died. Conclusions: These data emphasize that smoking prevention is extremely important in preventing premature death. Although smoking prevalence is diminishing, it is still the most important risk factor to treat.
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| 48. |
- Bastani, H, et al.
(författare)
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Cryoablation of superoparaseptal and septal accessory pathways: a single centre experience
- 2010
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Ingår i: Europace : European pacing, arrhythmias, and cardiac electrophysiology : journal of the working groups on cardiac pacing, arrhythmias, and cardiac cellular electrophysiology of the European Society of Cardiology. - : Oxford University Press (OUP). - 1532-2092. ; 12:7, s. 972-977
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| 50. |
- Bastani, H, et al.
(författare)
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Cryothermal vs. radiofrequency ablation as atrial flutter therapy: a randomized comparison
- 2013
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Ingår i: Europace : European pacing, arrhythmias, and cardiac electrophysiology : journal of the working groups on cardiac pacing, arrhythmias, and cardiac cellular electrophysiology of the European Society of Cardiology. - : Oxford University Press (OUP). - 1532-2092. ; 15:3, s. 420-428
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