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- Ekman, Inger, 1952, et al.
(författare)
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Impact of device-guided slow breathing on symptoms of chronic heart failure: a randomized, controlled feasibility study
- 2011
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Ingår i: European journal of heart failure. - : Wiley. - 1879-0844 .- 1388-9842. ; 13:9, s. 1000-5
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Tidskriftsartikel (refereegranskat)abstract
- AIMS: In many patients with chronic heart failure (CHF) even normal daily life activities cause dyspnoea and fatigue, well-being might be considerably improved by even a modest decrease in such symptoms. The aim of this study was to investigate if lowering breathing rate with the help of a respiratory modulation (RM) device could improve symptoms in patients with CHF. METHODS AND RESULTS: Stable CHF patients with symptoms of dyspnoea were randomized to twice-daily 20 min sessions using an RM device or to music listening (ML) using a CD player, for a 4-week study period. Respiratory modulation guides the user to achieve a slow breathing rate (<10 breaths/min) while increasing exhalation time (Tex) relative to inhalation time (Tin). Lower breathing rate was accomplished by synchronizing respiratory movements with musical tones generated in response to breathing movements monitored with a belt-type sensor. Endpoints were reduced breathlessness and New York Heart Association (NYHA) class. Seventy-two patients (52 male, age 73 +/- 11 years, NYHA 3.1 +/- 0.9) were randomized and 65 completed the study (30 RM and 35 ML, respectively). There was no in-between group improvement in breathlessness and NYHA class. Patients in the RM group who displayed an average increase in Tex/Tin of >0.2 and a reduction in the average respiration rate during 30 sessions were considered responders. Responders reported reduced breathlessness (-0.86 +/- 0.23 units, P < 0.005) and improved NYHA class (-0.64 +/- 0.20, P < 0.01) compared with non-responders. CONCLUSION: Device-guided RM might have the potential to relieve symptoms of heart failure in outpatients by changing their breathing pattern.
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- Kjellstrom, B
(författare)
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Portrait of an AP - who are we?
- 2020
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Ingår i: EUROPEAN JOURNAL OF CARDIOVASCULAR NURSING. - 1474-5151. ; 19:5, s. 451-451
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Tidskriftsartikel (övrigt vetenskapligt/konstnärligt)
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- Kjellstrom, Tord, et al.
(författare)
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Occupational heat effects : a global health and economic threat due to climate change
- 2014
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Ingår i: Climate change and Global health. - : CABI Publishing. - 9781780642659 ; , s. 38-44
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Bokkapitel (refereegranskat)abstract
- This chapter discusses the role of climate change in increasing workplace heat exposures and the association of human physiology and performance with ambient heat exposure. The clinical effects of heat exposure as well as its economic and well-being impacts are described. Preventive actions are suggested.
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| 42. |
- Kylhammar, David, et al.
(författare)
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Predicting mortality during long-term follow-up in pulmonary arterial hypertension
- 2021
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Ingår i: ERJ open research. - : European Respiratory Society (ERS). - 2312-0541. ; 7:2
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Tidskriftsartikel (refereegranskat)abstract
- The European Society of Cardiology (ESC) and European Respiratory Society (ERS) guideline recommendation of comprehensive risk assessments, which classify patients with pulmonary arterial hypertension (PAH) as having low, intermediate or high mortality risk, has not been evaluated during long-term follow-up in a “real-life” clinical setting. We therefore aimed to investigate the utility of risk assessment in a clinical setting for up to 5 years post diagnosis.386 patients with PAH from the Swedish PAH Registry were included. Risk group (low/intermediate/high) and proportion of low-risk variables were investigated at 3-, 4- and 5-year follow-ups after time of diagnosis. In an exploratory analysis, survival rates of patients with low-intermediate or high-intermediate risk scores were compared.A low-risk profile was in multivariate Cox proportional hazards regressions found to be a strong, independent predictor of longer transplant-free survival (p<0.001) at the 3-, 4- and 5-year follow-ups. Also, for the 3-, 4- and 5-year follow-ups, survival rates significantly differed (p<0.001) between the three risk groups. Patients with a greater proportion of low-risk variables had better (p<0.001) survival rates. Patients with a high-intermediate risk score had worse survival rates (p<0.001) than those with a low-intermediate risk score. Results were similar when excluding patients with ≥3 risk factors for heart failure with preserved ejection fraction, atrial fibrillation and/or age >75 years at diagnosis.Our findings suggest that the ESC/ERS guideline strategy for comprehensive risk assessments in PAH is valid also during long-term follow-up in a “real-life” clinical setting.
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- Nordendahl, E, et al.
(författare)
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Invasive Dental Treatment and Risk for a First Myocardial Infarction
- 2018
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Ingår i: Journal of dental research. - : SAGE Publications. - 1544-0591 .- 0022-0345. ; 97:10, s. 1100-1105
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Tidskriftsartikel (refereegranskat)abstract
- Invasive dental treatment is suggested to be associated with an increased risk for the development of cardiovascular events. We tested the hypothesis that the incidence of a first myocardial infarction (MI) within 4 wk after invasive dental treatments is increased. A registry-based case-control study within nationwide health care and population registries in Sweden was performed. The case patients included 51,880 individuals with a first fatal or nonfatal MI between January 2011 and December 2013. For each case, 5 control subjects, free from prior MI and matched for age, sex, and geographic area of residence, were randomly selected from the national population registry through risk set sampling with replacement, resulting in 246,978 control subjects. Information on dental treatments was obtained from the Dental Health Register, and the procedures were categorized into invasive dental treatments or other dental treatments. Conditional logistic regression was used to estimate odds ratios (ORs) for MI with corresponding 95% confidence intervals (CIs). In addition to the matching variables, adjustments were made for the following confounders: diabetes, previous cardiovascular disease (CVD), CVD drug treatment, education, and income. The mean age for case patients and controls subjects was 72.6 ± 13.0 y and 72.3 ± 13.0 y, respectively. Case patients more often had previous CVD (49% vs. 23%; P < 0.001) and diabetes (19% vs. 11%; P < 0.001) and received more treatment with CVD drugs (68% vs. 56%; P < 0.001) than control subjects. There was no association between invasive dental treatments during the 4 wk preceding the MI index date (crude OR = 0.99; 95% CI, 0.92 to 1.06; adjusted for confounders OR = 0.98; 95% CI, 0.91 to 1.06). This study did not support the hypothesis of an increased incidence of MI after recent invasive dental treatment.
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| 45. |
- Nordendahl, E., et al.
(författare)
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Severe Periodontitis Is Associated with Myocardial Infarction in Females
- 2018
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Ingår i: Journal of Dental Research. - : SAGE PUBLICATIONS INC. - 0022-0345 .- 1544-0591. ; 97:10, s. 1114-1121
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Tidskriftsartikel (refereegranskat)abstract
- The aim of the present study was to test the hypothesis that there is a sex difference in the association between periodontitis (PD) and a first myocardial infarction (MI). The analysis in the case-control study was based on 785 patients (147 females and 638 males) with a first MI and 792 matched controls (147 females and 645 males), screened for cardiovascular risk factors and subjected to a panoramic dental X-ray. Periodontal status was defined by alveolar bone loss and diagnosed as no PD (>= 80% remaining alveolar bone), mild to moderate PD (66% to 79%), or severe PD (<66%). Logistic regression was used when analyzing PD as a risk factor for MI, adjusting for age, smoking, diabetes, education, and marital status. The mean age was 64 +/- 7 y for females and 62 +/- 8 y for males. Severe PD was more common in female patients than female controls (14 vs. 4%, P = 0.005), with an increased risk for severe PD among female patients with a first MI (odds ratio [OR] = 3.92, 95% confidence interval [CI] = 1.53 to 10.00, P = 0.005), which remained (OR = 3.72, 95% CI = 1.24 to 11.16, P = 0.005) after adjustments. Male patients had more severe PD (7% vs. 4%; P = 0.005) than male controls and an increased risk for severe PD (OR = 1.88, 95% CI = 1.14 to 3.11, P = 0.005), but this association did not remain following adjustment (OR = 1.67, 95% CI = 0.97 to 2.84, NS). Severe PD was associated with MI in both females and males. After adjustments for relevant confounders, this association did, however, remain only in females. These data underline the importance of considering poor dental health when evaluating cardiovascular risk, especially in females.
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