SwePub
Sök i SwePub databas

  Utökad sökning

Träfflista för sökning "WFRF:(Schaufelberger Maria) "

Sökning: WFRF:(Schaufelberger Maria)

  • Resultat 1-50 av 93
Sortera/gruppera träfflistan
   
NumreringReferensOmslagsbildHitta
1.
  •  
2.
  • Barywani, Salim B., 1968, et al. (författare)
  • Predictors of long-term outcome of percutaneous coronary intervention in octogenarians with acute coronary syndrome
  • 2014
  • Ingår i: IJC Heart and Vessels. - : Elsevier BV. - 2214-7632. ; 4:1, s. 138-144
  • Tidskriftsartikel (refereegranskat)abstract
    • The majority of patients with acute coronary syndrome (ACS) are elderly. Limited evidence makes decision-making on the use of percutaneous coronary intervention (PCI) mainly empirical. Old age is one risk factor, but other factors than age may have an impact on mortality as well. Therefore, we investigated predictors of long-term all-cause mortality among octogenarians who have undergone PCI due to ACS. A total of 182 patients ≥. 80 years who underwent PCI during 2006-2007 at Sahlgrenska University Hospital were studied consecutively from recorded clinical data. All-cause five-year mortality of follow-up was 46.2%. Mean age was 83.7. ±. 2.8, 62% were male, 76% were in sinus rhythm, and 42% had left ventricular ejection fraction. < 45%. Indications for PCI were STEMI (52%), NSTEMI (36%) and unstable angina (11%). Multivariate analysis in two steps identified atrial fibrillation, moderate tricuspid valve regurgitation, moderate mitral valve regurgitation, dependency in ADL and eGFR. ≤. 30. ml/min at the first step and moderate mitral valve regurgitation, atrial fibrillation and eGFR. ≤. 30 ml/min at the last step, as independent predictors of all-cause mortality. Kaplan Meier analysis of positive parameters from both steps of multivariate analysis showed high significant difference in survival between patients having these parameters and those who were free from these parameters, with worst prognosis in patients with accumulation of these parameters. Accordingly, we have, in an octogenarian patient cohort who suffered from ACS, undergone PCI in daily clinical practice, identified five prognostic predictors for all-cause death after five years' follow-up.
  •  
3.
  • Borland, Maria, 1967, et al. (författare)
  • Träning vid kronisk hjärtsvikt för att förbättra livskvaliteten
  • 2015
  • Ingår i: Läkartidningen. - 0023-7205. ; 112
  • Tidskriftsartikel (refereegranskat)abstract
    • Persons with chronic heart failure should be recommended aerobic and resistance exercise to be able to increase maximal oxygen uptake (VO2 max), walking distance, and health related quality of life (moderately strong scientific evidence - quality of evidence +++), and to reduce mortality and hospital admissions and increase muscle strength and endurance (low scientific evidence - quality of evidence ++). Prescription of exercise in chronic heart failure should always be preceded of assessments of aerobic and muscular fitness. The aerobic exercise could be conducted as continuous or interval exercise. In connection with ongoing exercise special attention is needed regarding heart rate, diverging blood pressure reactions, contingent occurrence of arrhythmias and the advent of symptoms such as dizziness and severe dyspnea.
  •  
4.
  • Lindgren, Martin, et al. (författare)
  • Cardiorespiratory fitness and muscle strength in late adolescence and long-term risk of early heart failure in Swedish men.
  • 2017
  • Ingår i: European journal of preventive cardiology. - : Oxford University Press (OUP). - 2047-4881 .- 2047-4873. ; 24:8, s. 876-884
  • Tidskriftsartikel (refereegranskat)abstract
    • Aims To investigate the association between cardiorespiratory fitness (CRF) and muscle strength in late adolescence and the long-term risk of heart failure (HF). Methods A cohort was created of Swedish men enrolled in compulsory military service between 1968 and 2005 with measurements for CRF and muscle strength ( n=1,226,623; mean age 18.3 years). They were followed until 31 December 2014 for HF hospitalization as recorded in the Swedish national inpatient registry. Results During the follow-up period (median (interquartile range) 28.4 (22.0-37.0) years), 7656 cases of first HF hospitalization were observed (mean±SD age at diagnosis 50.1±7.9 years). CRF and muscle strength were estimated by maximum capacity cycle ergometer testing and strength exercises (knee extension, elbow flexion and hand grip). Inverse dose-response relationships were found between CRF and muscle strength with HF as a primary or contributory diagnosis with an adjusted hazards ratio (95% confidence interval) of 1.60 (1.44-1.77) for low CRF and 1.45 (1.32-1.58) for low muscle strength categories. The associations of incident HF with CRF and muscle strength persisted, regardless of adjustments for the other potential confounders. The highest risk was observed for HF associated with coronary heart disease, diabetes or hypertension. Conclusions In this longitudinal study of young men, we found inverse and mutually independent associations between CRF and muscle strength with risk of hospitalization for HF. If causal, these results may emphasize the importance of the promotion of CRF and muscle strength in younger populations.
  •  
5.
  • Lindgren, Martin, et al. (författare)
  • Cognitive performance in late adolescence and long-term risk of early heart failure in Swedish men.
  • 2018
  • Ingår i: European journal of heart failure. - : Wiley. - 1879-0844 .- 1388-9842. ; 20:6, s. 989-97
  • Tidskriftsartikel (refereegranskat)abstract
    • Heart failure (HF) incidence appears to increase among younger individuals, raising questions of how risk factors affect the younger population. We investigated the association of cognitive performance in late adolescence with long-term risk of early HF.We followed a cohort of Swedish men enrolled in mandatory military conscription in 1968-2005 (n=1 225 300; mean age 18.3years) until 2014 for HF hospitalization, using data from the Swedish National Inpatient Registry. Cognitive performance (IQ) was measured through a combination of tests, separately evaluating logical, verbal, visuospatial, and technical abilities. The results were standardized, weighted, and presented as stanines of IQ. The association between IQ and risk of HF was estimated using Cox proportional hazards models. In follow-up, there were 7633 cases of a first HF hospitalization (mean age at diagnosis 50.1years). We found an inverse relationship between global IQ and risk of HF hospitalization. Using the highest IQ stanine as reference, the adjusted hazard ratio for the lowest IQ with risk of HF was 3.11 (95% confidence interval 2.60-3.71), corresponding to a hazard ratio of 1.32 (95% CI 1.28-1.35) per standard deviation decrease of IQ. This association proved persistent across predefined categories of HF with respect to pre-existing or concomitant co-morbidities; it was less apparent among obese conscripts (P for interaction =0.0004).In this study of young men, IQ was strongly associated with increased risk of early HF. The medical profession needs to be aware of this finding so as to not defer diagnosis.
  •  
6.
  • Lindgren, Martin, et al. (författare)
  • Elevated resting heart rate in adolescent men and risk of heart failure and cardiomyopathy.
  • 2020
  • Ingår i: ESC heart failure. - : Wiley. - 2055-5822. ; 7:3, s. 1178-1185
  • Tidskriftsartikel (refereegranskat)abstract
    • This study aims to investigate the association of resting heart rate (RHR) measured in late adolescence with long-term risk of cause-specific heart failure (HF) and subtypes of cardiomyopathy (CM), with special attention to cardiorespiratory fitness.We performed a nation-wide, register-based cohort study of all Swedish men enrolled for conscription in 1968-2005 (n=1008363; mean age=18.3years). RHR and arterial blood pressure were measured together with anthropometrics as part of the enlistment protocol. HF and its concomitant diagnoses, as well as all CM diagnoses, were collected from the national inpatient, outpatient, and cause of death registries. Risk estimates were calculated by Cox-proportional hazards models while adjusting for potential confounders. During follow-up, there were 8400 cases of first hospitalization for HF and 3377 for CM. Comparing the first and fifth quintiles of the RHR distribution, the hazard ratio (HR) for HF associated with coronary heart disease, diabetes, or hypertension was 1.25 [95% confidence interval (CI)=1.13-1.38] after adjustment for body mass index, blood pressure, and cardiorespiratory fitness. The corresponding HR was 1.43 (CI=1.08-1.90) for HF associated with CM and 1.34 (CI=1.16-1.54) for HF without concomitant diagnosis. There was an association between RHR and dilated CM [HR=1.47 (CI=1.27-1.71)] but not hypertrophic, alcohol/drug-induced, or other cardiomyopathies.Adolescent RHR is associated with future risk of HF, regardless of associated aetiological condition. The association was strongest for HF associated with CM, driven by the association with dilated CM. These findings indicate a causal pathway between elevated RHR and myocardial dysfunction that warrants further investigation.
  •  
7.
  • Lindgren, Martin, et al. (författare)
  • Resting heart rate in late adolescence and long term risk of cardiovascular disease in Swedish men
  • 2018
  • Ingår i: International Journal of Cardiology. - : Elsevier BV. - 0167-5273. ; 259, s. 109-115
  • Tidskriftsartikel (refereegranskat)abstract
    • Aim: To investigate the association of resting heart rate (RHR) measured in late adolescence with the long term risk of myocardial infarction (MI), ischemic stroke (IS), heart failure (HF), atrial fibrillation (AF), cardiovascular- and all-cause death. Methods and results: We followed a cohort of Swedish men enrolled for conscription in 1968–2005 (n = 1,008,485; mean age = 18.3 years) until December 2014. Outcomes were collected from the national inpatient - (IPR), outpatient - (OPR) and cause of death registries. Cox proportional hazard models were used to analyze the longitudinal association between RHR and outcomes while adjusting for potential confounders. While we found no independent association between RHR and risk of IS or MI when comparing the highest with the lowest quintile of the RHR distribution, but a positive association persisted between RHR and incident HF (Hazard ratio (HR) = 1.39 [95% confidence interval (CI) = 1.29–1.49]) after adjustment for body mass index (BMI) and blood pressure (BP). In similarly adjusted models, an inverse association was found for AF while there were weaker associations with death from cardiovascular disease (CVD) and all causes (adjusted HR = 1.12 [CI = 1.04–1.21] and 1.20 [CI = 1.17–1.24]). After further adjustment for cardiorespiratory fitness (CRF), the associations persisted for HF (HR = 1.26 [1.17–1.35] for any diagnostic position and HR = 1.43 [1.28–1.60] for HF as a main diagnosis) and for all-cause death (HR 1.09 [1.05–1.12]) but not for CVD death. Conclusion: Adolescent RHR is associated with future risk of HF and death, independently of BP, BMI and CRF, but not with CVD death, MI or IS, suggesting a causal pathway between elevated heart rate and myocardial dysfunction. © 2018 The Authors
  •  
8.
  •  
9.
  • Robertson, Josefina, et al. (författare)
  • Body Mass Index in Young Women and Risk of Cardiomyopathy: A Long-Term Follow-Up Study in Sweden
  • 2020
  • Ingår i: Circulation. - 0009-7322. ; 141:7, s. 520-529
  • Tidskriftsartikel (refereegranskat)abstract
    • BACKGROUND: Incidence rates of cardiomyopathies, which are a common cause of heart failure in young people, have increased during the last decades. An association between body weight in adolescence and future cardiomyopathy among men was recently identified. Whether or not this holds true also for women is unknown. The aim was therefore to determine whether for young women being overweight or obese is associated with a higher risk of developing cardiomyopathy. METHODS: This was a registry-based national prospective cohort study with data collected from the Swedish Medical Birth Register, 1982 to 2014, with up to 33 years of follow-up. Included women were of childbearing age (18-45 years) during the initial antenatal visit in their first or second pregnancy (n=1393 346). We obtained baseline data on body mass index (BMI), smoking, education, and previous disorders. After exclusions, mainly because of previous disorders, the final sample was composed of 1388 571 women. Cardiomyopathy cases were identified by linking the Medical Birth Register to the National Patient and Cause of Death registers. RESULTS: In total, we identified 1699 cases of cardiomyopathy (mean age at diagnosis, 46.2 [SD 9.1] years) during the follow-up with an incidence rate of 5.9 per 100000 observation years. Of these, 481 were diagnosed with dilated cardiomyopathy, 246 had hypertrophic cardiomyopathy, 61 had alcohol/drug-induced cardiomyopathy, and 509 had other forms. The lowest risk for being diagnosed with a cardiomyopathy was detected at a BMI of 21 kg/m2, with a gradual increase in risk with higher BMI, particularly for dilated cardiomyopathy, where a hazard ratio of 4.71 (95% CI, 2.81-7.89) was found for severely obese subjects (BMI ≥35 kg/m2), as compared with BMI 20 to <22.5. CONCLUSIONS: Elevated BMI among young women was associated with an increased risk of being diagnosed with a subsequent cardiomyopathy, especially dilated cardiomyopathy, starting already at mildly elevated body weight, whereas severe obesity entailed an almost 5-fold increase in risk. With the increasing numbers of persons who are overweight or obese, higher rates of cardiomyopathy can be expected in the future, along with an altered disease burden related to adiposity.
  •  
10.
  • Robertson, Josefina, et al. (författare)
  • Higher Body Mass Index in Adolescence Predicts Cardiomyopathy Risk in Midlife Long-Term Follow-Up Among Swedish Men
  • 2019
  • Ingår i: Circulation. - : Ovid Technologies (Wolters Kluwer Health). - 0009-7322 .- 1524-4539. ; 140:2, s. 117-125
  • Tidskriftsartikel (refereegranskat)abstract
    • Background: Modifiable lifestyle factors in relation to risk for cardiomyopathy, a common and increasing cause of heart failure in the young, have not been widely studied. We sought to investigate a potential link between obesity, a recognized predictor of early heart failure, in adolescence and being diagnosed with cardiomyopathy in adulthood. Methods: This was a nationwide register-based prospective cohort study of 1 668 893 adolescent men (mean age, 18.3 years; SD, 0.7 years) who enlisted for compulsory military service from 1969 to 2005. At baseline, body mass index (BMI), blood pressure, and medical disorders were registered, along with test results for fitness and muscle strength. Cardiomyopathy diagnoses were identified from the National Hospital Register and Cause of Death Register during an up to 46-year follow-up and divided into categories: dilated, hypertrophic, alcohol/drug-induced, and other. Hazard ratios were calculated with Cox proportional hazards models. Results: During follow-up (median, 27 years; Q1-Q3, 19-35 years), 4477 cases of cardiomyopathy were identified, of which 2631 (59%) were dilated, 673 (15%) were hypertrophic, and 480 (11%) were alcohol/drug-induced. Increasing BMI was strongly associated with elevated risk of cardiomyopathy, especially dilated, starting at levels considered normal (BMI, 22.5-<25 kg/m(2); hazard ratio, 1.38 [95% CI, 1.22-1.57]), adjusted for age, year, center, and baseline comorbidities, and with a >8-fold increased risk at BMI >= 35 kg/m(2) compared with BMI of 18.5 to <20 kg/m(2). For each 1-unit increase in BMI, similarly adjusted hazard ratios were 1.15 (95% CI, 1.14-1.17) for dilated cardiomyopathy, 1.09 (95% CI, 1.06-1.12) for hypertrophic cardiomyopathy, and 1.10 (1.06-1.13) for alcohol/drug-induced cardiomyopathy. Conclusions: Even mildly elevated body weight in late adolescence may contribute to being diagnosed with cardiomyopathy in adulthood. The already marked importance of weight control in youth is further strengthened by these findings, as well as greater evidence for obesity as a potential important cause of adverse cardiac remodeling that is independent of clinically evident ischemic heart disease.
  •  
11.
  • Rosengren, Annika, 1951, et al. (författare)
  • Body weight in adolescence and long-term risk of early heart failure in adulthood among men in Sweden
  • 2017
  • Ingår i: European heart journal. - : Oxford University Press (OUP). - 0195-668X .- 1522-9645. ; 38:24, s. 1926-1933
  • Tidskriftsartikel (refereegranskat)abstract
    • AIMS: To study the relation between body mass index (BMI) in young men and risk of early hospitalization with heart failure. METHODS AND RESULTS: In a prospective cohort study, men from the Swedish Conscript Registry investigated 1968-2005 (n = 1 610 437; mean age, 18.6 years were followed 5-42 years (median, 23.0 years; interquartile range, 15.0-32.0), 5492 first hospitalizations for heart failure occurred (mean age at diagnosis, 46.6 (SD 8.0) years). Compared with men with a body mass index (BMI) of 18.5-20.0 kg/m2, men with a BMI 20.0-22.5 kg/m2 had an hazard ratio (HR) of 1.22 (95% CI, 1.10-1.35), after adjustment for age, year of conscription, comorbidities at baseline, parental education, blood pressure, IQ, muscle strength, and fitness. The risk rose incrementally with increasing BMI such that men with a BMI of 30-35 kg/m2 had an adjusted HR of 6.47 (95% CI, 5.39-7.77) and those with a BMI of >/=35 kg/m2 had an HR of 9.21 (95% CI, 6.57-12.92). The multiple-adjusted risk of heart failure per 1 unit increase in BMI ranged from 1.06 (95% CI, 1.02-1.11) in heart failure associated with valvular disease to 1.20 (95% CI, 1.18-1.22) for cases associated with coronary heart disease, diabetes, or hypertension. CONCLUSION: We found a steeply rising risk of early heart failure detectable already at a normal body weight, increasing nearly 10-fold in the highest weight category. Given the current obesity epidemic, heart failure in the young may increase substantially in the future and physicians need to be aware of this.
  •  
12.
  • Schaufelberger, Maria, 1954, et al. (författare)
  • Validity of heart failure diagnoses made in 2000-2012 in western Sweden
  • 2020
  • Ingår i: ESC Heart Failure. - : WILEY PERIODICALS, INC. - 2055-5822. ; 7:1, s. 37-46
  • Tidskriftsartikel (refereegranskat)abstract
    • Aims The aim of this study is to validate a diagnosis of heart failure (HF) according to the European Society of Cardiology (ESC) guidelines among patients hospitalized at Sahlgrenska University Hospital, Gothenburg, Sweden, between 2000 and 2012. Methods and results In Sweden, it is mandatory to report all hospital discharge diagnoses to the Swedish national inpatient register. In total, 27 517 patients were diagnosed with HF at the Sahlgrenska University hospital between 2000 and 2012. Altogether, 1100 records with a primary (n = 550) or contributory (n = 550) diagnosis of HF were randomly selected. The diagnosis was validated according to the ESC guidelines from 1995, 2001, 2005, and 2008, and cases were divided into three groups: definite, probable, and miscoded. In total, 965 cases were validated, while 135 records were excluded for various reasons. Of the 965 records, the diagnosis was validated as definite in 601 (62.3%) and as probable in 310 (32.1%); only 54 (5.6%) of cases had been miscoded. Echocardiography, as an objective evidence of cardiac dysfunction, had been performed in 581 (96.7%) of the definite, 106 (34.2%) of the probable, and 31 (57.4%) of the miscoded cases. Among the probable cases, the main reason they had not been classified as a definitive diagnosis of HF was lack of examination by echocardiography (63.8%). Conclusions The overall validity of HF diagnosis at Sahlgrenska University Hospital is high. This may reflect a high diagnostic validity at the time of diagnosis in the national Swedish patient register, supporting the continued use of this register in epidemiological research.
  •  
13.
  • Wideqvist, Maria, et al. (författare)
  • Hospital readmissions of patients with heart failure from real world: timing and associated risk factors
  • 2021
  • Ingår i: ESC Heart Failure. - : Wiley. - 2055-5822. ; 8:2, s. 1388-1397
  • Tidskriftsartikel (refereegranskat)abstract
    • Aims This study aims to investigate hospital readmissions and timing, as well as risk factors in a real world heart failure (HF) population. Methods and results All patients discharged alive in 2016 from Sahlgrenska University Hospital/ostra, Gothenburg, Sweden, with a primary diagnosis of HF were consecutively included. Patient characteristics, type of HF, treatment, and follow-up were registered. Time to first all-cause or HF readmission, as well as number of 1 year readmissions from discharge were recorded. In total, 448 patients were included: 273 patients (mean age 78 +/- 11.8 years) were readmitted for any cause within 1 year (readmission rate of 60.9%), and 175 patients (mean age 76.6 +/- 13.7) were never readmitted. Among readmissions, 60.1% occurred during the first quarter after index hospitalization, giving a 3 month all-cause readmission rate of 36.6%. HF-related 1 year readmission rate was 38.4%. Patients who were readmitted had significantly more renal dysfunction (52.4% vs. 36.6%, P = 0.001), pulmonary disease (25.6% vs. 15.4%, P = 0.010), and psychiatric illness (24.9% vs. 12.0%, P = 0.001). Number of co-morbidities and readmissions were significantly associated (P P = 0.012 for 1 year HF readmission rate). Worsening HF constituted 63% of all-cause readmissions. Psychiatric disease was an independent risk factor for 1 month and 1 year all-cause readmissions. Poor compliance to medication was an independent risk factor for 1 month and 1 year HF readmission. Conclusions In our real world cohort of HF patients, frequent hospital readmissions occurred in the early post-discharge period and were mainly driven by worsening HF. Co-morbidity was one of the most important factors for readmission.
  •  
14.
  • Wideqvist, Maria, et al. (författare)
  • Ten year age- and sex-specific temporal trends in incidence and prevalence of heart failure in Västra Götaland, Sweden.
  • 2022
  • Ingår i: ESC heart failure. - : Wiley. - 2055-5822. ; 9:6, s. 3931-3941
  • Tidskriftsartikel (refereegranskat)abstract
    • Heart failure (HF) is predominantly a disorder of the elderly. During the last decades, cardiovascular primary and secondary prevention and life expectancy have improved. Accordingly, trends in incidence and prevalence of HF are dynamic and may differ over time by age and gender. We aim to investigate the overall and age-specific and sex-specific trends, in incidence, prevalence, and the proportion with co-morbidities of HF over a 10year period in Region Västra Götaland, Sweden.The VEGA database is an administrative database of all patients managed in hospital and/or in primary care (private and public) living in Region Västra Götaland. All patients with a main or contributory diagnosis of HF (I50) aged 18years or older between 2008 and 2017 were included. Incidence and prevalence of HF were calculated based on the entire adult population of Region Västra Götaland. The adult population in Region Västra Götaland increased by 8% from 2008 (n=1234609) to 2017 (n=1338906). Half the population was female and 69%<60years of age, both constant over time. In total, 62228 incident cases of HF were identified. In 2008, we identified 6464 cases, mean age 78.7 (11.5) years, and 49.8% (n=3222) men, while in 2017, 5727 cases were identified, mean age 78.3 (11.8) years, and 52.5% (n=3006) men. The overall yearly incidence rate of HF decreased by 3%, RR 0.97 (95% CI 0.96-0.97) per year, P<0.0001, mainly driven by the age categories >75years. A constantly higher incidence of HF was seen for men compared with women in all age categories, RR 1.46 (95% CI 1.44-1.49), P<0.0001. During the same period, we observed a steady increase in overall prevalence from 1.8% for women and 2.0% for men in 2008, to 2.4% in women and 2.8% in men in 2017, particularly in those >85years of age who had a prevalence of 16.5% (men) and 14.6% (women) in 2008 and 23.5% (men) and 21.5% (women) in 2017. The overall 1year mortality rate was 22.7%. When adjusted for age, women had a lower risk for death by 13% compared with men [hazard ratio 0.87 (95% CI 0.84-0.90, P<0.0001)].We saw a decrease in overall incidence, but incidence of HF remains high, particularly in the oldest age groups. Prevalence of HF keeps increasing particularly in those aged >85years. Our findings emphasize the need for implementation of effective preventive strategies for HF.
  •  
15.
  • Åberg, Maria A I, 1972, et al. (författare)
  • Body Weight in Adolescent Men in Sweden and Risk of an Early Acute Coronary Event: A Prospective Population-Based Study
  • 2023
  • Ingår i: Journal of the American Heart Association (JAHA). - 2047-9980. ; 12:12
  • Tidskriftsartikel (refereegranskat)abstract
    • BackgroundCoronary heart disease remains the dominant cause of death worldwide. To improve cardiovascular disease prevention, knowledge of early key risk factors, especially those that are modifiable, is essential. The ongoing global obesity epidemic is of particular concern. We aimed to determine whether body mass index at conscription predicts early acute coronary events among men in Sweden. Methods and ResultsThis was a population-based Swedish cohort study of conscripts (n=1 668 921; mean age, 18.3 years; 1968-2005), with follow-up through linkage to the nationwide Swedish patient and death registries. Risk of a first acute coronary event (hospitalization for acute myocardial infarction or coronary death) during follow-up (1-48 years) was calculated with generalized additive models. Objective baseline measures of fitness and cognition were included in the models in secondary analyses. During follow-up, there were 51 779 acute coronary events, of which 6457 (12.5%) were fatal within 30 days. Compared with men at the lowest end of the normal body mass index spectrum (body mass index, 18.5 kg/m(2)), an increasing risk for a first acute coronary event was observed, with hazard ratios (HRs) peaking at 40 years of age. After multivariable adjustments, men with a body mass index of 35 kg/m(2) had an HR of 4.84 (95% CI, 4.29-5.46) for an event before the age of 40 years. ConclusionsAn increased risk of an early acute coronary event was detectable within normal levels of body weight at the age of 18 years, increasing to almost 5-fold in the highest weight category at 40 years of age. Given increasing levels of body weight and prevalence of overweight and obesity in young adults, the current decrease in coronary heart disease incidence in Sweden may flatten or even reverse in the near future.
  •  
16.
  • Åberg, N David, 1970, et al. (författare)
  • Diverging trends for onset of acute myocardial infarction, heart failure, stroke and mortality in young males: role of changes in obesity and fitness
  • 2021
  • Ingår i: Journal of Internal Medicine. - : Wiley. - 0954-6820 .- 1365-2796. ; 290:2, s. 373-385
  • Tidskriftsartikel (refereegranskat)abstract
    • Background As opposed to the decreasing overall rates of coronary heart disease (CHD) incidence and overall cardiovascular disease (CVD) mortality, heart failure (HF) and stroke incidence are increasing in young people, potentially due to rising rates of obesity and reduced cardiorespiratory fitness (CRF). Objectives We investigated trends in early major CVD outcomes in a large cohort of young men. Methods Successive cohorts of Swedish military conscripts from 1971 to 1995 (N = 1,258,432; mean age, 18.3 years) were followed, using data from the National Inpatient and Cause of Death registries. Cox proportional hazard models were used to analyse changes in 21-year CVD event rates. Results 21-year CVD and all-cause mortality and incidence of acute myocardial infarction (AMI) decreased progressively. Compared with the cohort conscripted in 1971-1975 (reference), the hazard ratios (HRs) for the last 1991-1995 cohort were 0.50 [95% confidence interval (CI) 0.42-0.59] for CVD mortality; 0.57 (95% CI 0.54-0.60) for all-cause mortality; and 0.63 (95% CI 0.53-0.75) for AMI. In contrast, the incidence of ischaemic stroke, intracerebral haemorrhage and HF increased with HRs of 1.43 (95% CI 1.17-1.75), 1.30 (95% CI 1.01-1.68) and 1.84 (95% CI 1.47-2.30), respectively. During the period, rates of obesity increased from 1.04% to 2.61%, whilst CRF scores decreased slightly. Adjustment for these factors influenced these secular trends only moderately. Conclusion Secular trends of young-onset CVD events demonstrated a marked shift from AMI and CVD mortality to HF and stroke incidence. Trends were significantly, though moderately, influenced by changing baseline BMI and CRF.
  •  
17.
  • Barasa, Anders, 1973, et al. (författare)
  • Heart Failure in Late Pregnancy and Postpartum: Incidence and Long-Term Mortality in Sweden From 1997 to 2010
  • 2017
  • Ingår i: Journal of Cardiac Failure. - : Elsevier BV. - 1071-9164. ; 23:5, s. 370-378
  • Tidskriftsartikel (refereegranskat)abstract
    • Background: Heart failure (HF) in late pregnancy and postpartum (HFPP), of which peripartum cardiomyopathy (PPCM) constitutes the larger part, is still a rare occurrence in Sweden. Population-based data are scarce. Our aim was to characterize HFPP and determine the incidence and mortality in a Swedish cohort. Methods and Results: Through merging data from the National Inpatient, Cause of Death, and Medical Birth Registries, we identified ICD-10 codes for HF and cardiomyopathy within 3 months before delivery to 6 months postpartum. Each case was assigned 5 age -matched control subjects from the Medical Birth Registry. From 1997 to 2010, 241 unique HFPP case subjects and 1063 matched control subjects were identified. Mean incidence was 1 in 5719 deliveries. HFPP was strongly associated with preeclampsia (odds ratio [OR] 11.91, 95% confidence interval [CI] 7.86-18.06), obesity (OR 2.5, 95% CI 1.7-3.7), low-and middle -income country (LMIC) of origin (OR 1.73, 95% CI 1.14-2.63), and twin deliveries (OR 4.39 CI 95% 2.24-8.58). By the end of the study period deaths among cases were > 35 -fold those of controls: 9 cases (3.7 %) and 1 control (0.1 %; P <.0001). Among control subjects, 17.9% of mortalities occurred within 3 years, of diagnosis compared with 100% among cases. Conclusions: The mean incidence and mortality among women with HFPP in Sweden from 1997 to 2010 was low but carried a marked excess risk of death compared with control subjects and was strongly linked to preeclampsia, obesity, multifetal births, and LMIC origin of the mother. (J Cardiac Fail 2017;23:370-378)
  •  
18.
  • Barasa, Anders, 1973, et al. (författare)
  • Heart failure in young adults: 20-year trends in hospitalization, aetiology, and case fatality in Sweden
  • 2014
  • Ingår i: European Heart Journal. - : Oxford University Press (OUP). - 0195-668X .- 1522-9645. ; 35:1, s. 25-32
  • Tidskriftsartikel (refereegranskat)abstract
    • AIMS: To describe trends in incidence and case fatality among younger (18-54 years) and older (55-84 years) Swedish patients with heart failure (HF). METHODS AND RESULTS: Through linking the Swedish national hospital discharge and the cause-specific death registries, we identified patients aged 18-84 years that were discharged 1987-2006 with a diagnosis of HF. Age-specific mean incidence rates per 100 000 person-years were calculated in four 5-year periods. Kaplan-Meier survival curves were plotted up to 3 years. From 1987 to 2006, there were 443 995 HF hospitalizations among adults 18-84 years. Of these, 4660 (1.0%) and 13 507 (3.0%) occurred in people aged 18-44 and 45-54 years (31.6% women), respectively. From the first to the last 5-year period, HF incidence increased by 50 and 43%, among people aged 18-34 and 35-44 years, respectively. Among people >/=45 years, incidence peaked in the mid-1990s and then decreased. Heart failure in the presence of cardiomyopathy increased more than two-fold among all age groups. Case fatality decreased for all age groups until 2001, after which no further significant decrease <55 years was observed. CONCLUSION: Increasing HF hospitalization in young adults in Sweden opposes the general trend seen in older patients, a finding which may reflect true epidemiological changes. Cardiomyopathy accounted for a substantial part of this increase. High case fatality and lack of further case fatality reduction after 2001 are causes for concern.
  •  
19.
  • Barasa, Anders, 1973, et al. (författare)
  • Symptomatic recovery and pharmacological management in a clinical cohort with peripartum cardiomyopathy
  • 2018
  • Ingår i: Journal of Maternal-Fetal & Neonatal Medicine. - : Informa UK Limited. - 1476-7058 .- 1476-4954. ; 31:10, s. 1342-1349
  • Tidskriftsartikel (refereegranskat)abstract
    • Aim: We aimed to characterize the clinical course with focus on pharmacological management of peripartum cardiomyopathy (PPCM) in Sweden. Methods: Twenty-four consecutive patients were retrospectively identified among women presenting with PPCM in Western Sweden. Of these, 14 had concomitant preeclampsia. There was only one fatality. The mean (standard deviation) left ventricular ejection fraction (LVEF) at diagnosis was 35.0 ± 9.9%. Ten women, 47.6%, required intensive care unit (ICU) admission. All patients received b-blockers (BB) and angiotensin-converting enzyme inhibitors/angiotensin II receptor blockers (ACE-I/ARB), which were tapered off over a mean/median period of 3.3/2.5 years with only one case of worsening heart failure. The mean follow-up for medication was 7.9± 2.6 years. Early and late/non-recovery was defined as New York Heart Association (NYHA) functional class I and NYHA II–IV at one year, respectively. Late recovery was associated with larger LVEDD at diagnosis (56.8 versus 62.4 mm) was associated with late recovery, p=.02. Results and conclusions: PPCM had an overall good prognosis in this cohort. Left ventricular dilation at presentation was a predictor of worse prognosis. Concurrent preeclampsia was common, but was associated with better prognosis. Medication was safely discontinued in 75% of patient.
  •  
20.
  • Barywani, Salim B., 1968, et al. (författare)
  • Does the target dose of neurohormonal blockade matter for outcome in Systolic heart failure in octogenarians?
  • 2015
  • Ingår i: International Journal of Cardiology. - : Elsevier BV. - 0167-5273. ; 187, s. 666-672
  • Tidskriftsartikel (refereegranskat)abstract
    • Background: In elderly patients with chronic heart failure (CHF), a gap exists between widespread use of lower doses of angiotensin-converting enzyme inhibitors (ACEIs)/angiotensin-receptor blockers (ARBs) and beta-blockers (BBs) and guideline recommendations. Therefore, the aim of the present study was to investigate whether patients receiving >= 50% target dose outperform those receiving <50% target dose, despite maximum up-titration, and whether the target dose outperforms all other doses. Methods and Results: Patients (n=185) aged >= 80 years with CHF and left ventricular ejection fraction >= 40% referred (between January 2000 and January 2008) to two CHF outpatient clinics at two university hospitals, were included and retrospectively studied. Of the study population, 53% received the target dose of ACEIs/ARBs, whereas 26% received <50% of the target dose. Half received <50% of the target dose of BBs and 21% received the target dose. After >= 5 years of follow-up, all-cause mortality was 76.8%. Patients who received the target dose of ACEIs/ARBs had higher survival rates from all-cause mortality than those receiving <50% of target dose (HR = 0.6, 95% CI 0.4-0.9, P = 0.033), but those receiving >= 50% of target dose did not statistically differ from those who achieved target dose. This dose-survival relationship was not the case for BBs. Conclusions: Target dose of ACEIs/ARBs is associated with reduced all-cause five-year mortality in very old patients with systolic heart failure, despite that this was achievable in only about half of the patients. However, the clinical outcome of BB therapy is independent of BB dose when the target heart rate is achieved. (C) 2015 Elsevier Ireland Ltd. All rights reserved.
  •  
21.
  • Basic, Carmen, 1975, et al. (författare)
  • High validity of cardiomyopathy diagnoses in western Sweden (1989-2009)
  • 2018
  • Ingår i: ESC heart failure. - : Wiley. - 2055-5822. ; 5:2, s. 233-240
  • Tidskriftsartikel (refereegranskat)abstract
    • AIM: Hospital discharges with a diagnosis of cardiomyopathy have more than doubled in Sweden since 1987. We validated the cardiomyopathy diagnoses over this time period to investigate that the increase was real and not a result of improved recognition of the diagnosis and better diagnostic methods. METHODS AND RESULTS: Every fifth year from 1989 to 2009, records for all patients with a cardiomyopathy diagnosis were identified by searching the local registers in three hospitals in Vastra Gotaland, Sweden. The diagnoses were validated according to criteria defined by the European Society of Cardiology from 2008. The population comprised 611 cases with cardiomyopathy diagnoses [mean age 58.9 (SD 15.5) years, 68.2% male], divided into three major groups: dilated, hypertrophic, and other cardiomyopathies. Hypertrophic cardiomyopathy and hypertrophic obstructive cardiomyopathy were analysed as a group. Cardiomyopathies for which there were few cases, such as restrictive, arrhythmogenic right ventricular, left ventricular non-compaction, takotsubo, and peripartum cardiomyopathies, were analysed together and defined as 'other cardiomyopathies'. Relevant co-morbidities were registered. The use of echocardiography was 99.7%, of which 94.6% was complete echocardiography reports. The accuracy rates of the diagnoses dilated cardiomyopathy, hypertrophic cardiomyopathy, and other cardiomyopathies were 85.5%, 87.5%, and 100%, respectively, with no differences between the three hospitals or years studied; nor did the prevalence of co-morbidities differ. CONCLUSIONS: The accuracy rate of the cardiomyopathy diagnoses from in-hospital records from >600 patients in western Sweden during a 20 year period was 86.6%, with no significant trend over time, strengthening epidemiological findings that this is likely due to an actual increase in cardiomyopathy diagnoses rather than changes in coding practices. The use of echocardiography was high, and there was no significant difference in co-morbidities during the study period. The accuracy rate of the cardiomyopathy diagnoses during the 20 year period was high. The use of diagnostic tools did not increase under the study period, and once cardiomyopathy diagnoses were suspected, echocardiography was performed in almost all cases. In this study, the occurrence of cardiomyopathy was increasing over time without significant increase of co-morbidity, supporting that an actual increase of cardiomyopathy has occurred.
  •  
22.
  •  
23.
  • Basic, Carmen, 1975, et al. (författare)
  • Sex-related differences among young adults with heart failure in Sweden
  • 2022
  • Ingår i: International Journal of Cardiology. - : Elsevier BV. - 0167-5273 .- 1874-1754. ; 362, s. 97-103
  • Tidskriftsartikel (refereegranskat)abstract
    • Background: Differences between the sexes among the non-elderly with heart failure (HF) have been insufficiently evaluated. This study aims to investigate sex-related differences in early-onset HF. Methods: Patients aged 18 to 54 years who were registered from 2003 to 2014 in the Swedish Heart Failure Register were included. Each patient was matched with two controls from the Swedish Total Population Register. Data on comorbidities and outcomes were obtained through the National Patient Register and Cause of Death Register. Results: We identified 3752 patients and 7425 controls. Of the patients, 971 (25.9%) were women and 2781 (74.1%) were men with a mean (standard deviation) age of 44.9 (8.4) and 46.4 (7.3) years, respectively. Men had more hypertension and ischemic heart disease, whereas women had more congenital heart disease and obesity. During the median follow-up of 4.87 years, 26.5 and 24.7 per 1000 person-years male and female patients died, compared with 3.61 and 2.01 per 1000 person-years male and female controls, respectively. The adjusted hazard ratios for all-cause mortality, compared with controls, were 4.77 (3.78-6.01) in men and 7.84 (4.85-12.7) in women (p for sex difference = 0.11). When HF was diagnosed at 30, 35, 40, and 45 years, women and men lost up to 24.6 and 24.2, 24.4 and 20.9, 20.5 and 18.3, and 20.7 and 16.5 years of life, respectively. Conclusion: Long-term mortality was similar between the sexes. Women lost more years of life than men.
  •  
24.
  • Basic, Carmen, 1975, et al. (författare)
  • Young patients with heart failure: clinical characteristics and outcomes. Data from the Swedish Heart Failure, National Patient, Population and Cause of Death Registers
  • 2020
  • Ingår i: European Journal of Heart Failure. - : Wiley. - 1388-9842 .- 1879-0844. ; 22:7, s. 1125-1132
  • Tidskriftsartikel (refereegranskat)abstract
    • Aims The prevalence and hospitalizations of patients with heart failure (HF) aged <55 years have increased in Sweden during the last decades. We aimed to compare characteristics of younger and older patients with HF, and examine survival in patients All patients >= 18 years in the Swedish Heart Failure Register from 2003 to 2014 were included. Data were merged with National Patient and Cause of Death Registers. Among 60 962 patients, 3752 (6.2%) were <55 years, and were compared with 7425 controls from the Population Register. Compared with patients >= 55 years, patients <55 years more frequently had registered diagnoses of obesity, dilated cardiomyopathy, congenital heart disease, and an ejection fraction <40% (9.8% vs. 4.7%, 27.2% vs. 5.5%, 3.7% vs. 0.8%, 67.9% vs. 45.1%, respectively; allP < 0.001). One-year all-cause mortality was 21.2%, 4.2%, and 0.3% in patients >= 55 years, patients <55 years, and controls <55 years, respectively (allP < 0.001). Patients <55 years had a five times higher mortality risk compared with controls [hazard ratio (HR) 5.48, 95% confidence interval (CI) 4.45-6.74]; the highest HR was in patients 18-34 years (HR 38.3, 95% CI 8.70-169; bothP < 0.001). At the age of 20, the estimated life-years lost was up to 36 years for 50% of patients, with declining estimates with increasing age. Conclusion Patients with HF <55 years had different comorbidities than patients >= 55 years. The highest mortality risk relative to that of controls was among the youngest patients.
  •  
25.
  •  
26.
  • Björck, Lena, 1959, et al. (författare)
  • Body mass index in women aged 18 to 45 and subsequent risk of heart failure.
  • 2020
  • Ingår i: European journal of preventive cardiology. - : Oxford University Press (OUP). - 2047-4881 .- 2047-4873. ; 27:11, s. 1165-1174
  • Tidskriftsartikel (refereegranskat)abstract
    • The incidence of heart failure (HF) is decreasing in older ages, but increasing rates have been observed among younger persons in Sweden. Therefore, we investigated the relationship between risk of hospitalization for HF and body mass index (BMI).This was a prospective registry-based cohort study. We included 1,374,031 women aged 18-45 years (mean age 27.9 years) who gave birth during 1982-2014, and were registered in the Medical Birth Register. Information on hospitalization because of HF was collected through linkage to the National Inpatient Register.Compared to women with a BMI of 20-<22.5kg/m2, women with a BMI of 22.5-<25.0 had a hazard ratio (HR) of 1.24 (95% confidence interval (CI), 1.10-1.39) for HF after adjustment for age, year, parity, baseline disorders, smoking, and education. The HR (95% CI) increased to 1.56 (1.36-1.78), 2.39 (2.05-2.78), 2.82 (2.43-3.28), and 4.51 (3.63-5.61) in women with a BMI of 25-<27.5, 27.5-<30, 30-<35, and ≥35kg/m2, respectively. The multiple-adjusted HRs (95% CI) associated with risk of HF per one-unit increase in BMI in women with a BMI≥22.5kg/m2 ranged from 1.01 (0.97-1.06) for HF related to valvular disease to 1.14 (1.12-1.15) for coronary heart disease, diabetes, or hypertension.Increasing body weight was strongly associated with the risk of early HF in women. Compared with lean women, the risk for HF started to increase at high-normal BMI levels, and was nearly five-fold in women with a BMI≥35kg/m2.
  •  
27.
  • Björck, Lena, 1959, et al. (författare)
  • Body weight in midlife and long-term risk of developing heart failure-a 35-year follow-up of the primary prevention study in Gothenburg, Sweden
  • 2015
  • Ingår i: Bmc Cardiovascular Disorders. - : Springer Science and Business Media LLC. - 1471-2261. ; 15
  • Tidskriftsartikel (refereegranskat)abstract
    • Background: This study aimed to determine whether midlife obesity predicts heart failure (HF) over an extended follow-up into old age. Methods: We studied 7495 men (from a population sample of 9,998 men) without HF, who were 47-55 years old when investigated in 1970 to 1973. All participants were followed up for 35 years, or until death, using the Swedish National Inpatient Register (IPR) and the Cause of Death Register. Over follow-up, 1855 men (24.7%) were discharged from hospital or died with a diagnosis of HF. Results: There was a strong relation between obesity and future risk of HF, which was accentuated over the last years of the long follow-up. After adjusting for age, the risk of HF increased stepwise with increasing body mass index (BMI), even in those with a normal BMI (22.5-24.9) The subdistribution hazard ratio (SHR) was 1.20 (95% CI: 1.02-1.39) in men with a normal BMI, 1.29 (95% CI: 1.11-1.50) for a BMI of 25-27.49, 1.50 (95% CI: 1.27-1.77) for a BMI of 27.5-29.99, and 1.62 (95% CI: 1.33-1.97) for a BMI >30. After adjusting for, age, smoking, occupational class, and physical activity, the results were unchanged. Conclusion: Obesity in midlife is strongly related to the long-term risk of developing HF extending into old age where the risk is highest. Even normal body weight (BMI <25) was related to an increased risk of developing HF during life. Because overweight and obesity are largely preventable, our findings further emphasize the importance of public health interventions against the development of obesity.
  •  
28.
  • Björck, Lena, 1959, et al. (författare)
  • Trends in survival of Swedish men and women with heart failure from 1987 to 2014: a population-based case-control study
  • 2022
  • Ingår i: Esc Heart Failure. - : Wiley. - 2055-5822. ; 9:1, s. 486-495
  • Tidskriftsartikel (refereegranskat)abstract
    • Aims To compare trends in short-term and long-term survival of patients with heart failure (HF) compared with controls from the general population. Methods and results We used data from the Swedish National Inpatient Registry to identify all patients aged >= 18 years with a first recorded diagnosis of HF between 1 January 1987 and 31 December 2014 and compared them with controls matched on age and sex from the Total Population Register. We included 702 485 patients with HF and 1 306 183 controls. In patients with HF aged 18-64 years, short-term (29 days to 6 months) and long-term mortality (>11 years) decreased from 166 and 76.6 per 1000 person-years in 1987 to 2000 to 99.6 and 49.4 per 1000 person-years, respectively, in 2001 to 2014. During the same period, mortality improved marginally, in those aged >= 65 years: short-time mortality from 368.8 to 326.2 per 1000 person-years and long-term mortality from 219.6 to 193.9 per 1000 person-years. In 1987-2000, patients aged <65 years had more than three times higher risk of dying at 29 days to 6 months, with an hazard ratio (HR) of 3.66 [95% confidence interval (CI) 3.46-3.87], compared with controls (P < 0.0001) but substantially higher in 2001-2014 with an HR of 11.3 (95% CI 9.99-12.7, P < 0.0001). HRs for long-term mortality (6-10 and >11 years) increased moderately from 2.49 (95% CI 2.41-2.57) and 3.16 (95% CI 3.07-3.24) in 1987-2000 to 4.35 (95% CI 4.09-4.63) and 4.11 (95% CI 3.49-4.85) in 2001-2014, largely because survival among controls improved more than that among patients with HF (P < 0.0001). Conclusions Absolute survival improved in HF patients aged <65 years, but only marginally so in those aged >= 65 years. Compared with controls, both short-term and long-term relative risk of dying increased, especially in younger patients with HF.
  •  
29.
  • Chen, Xiaojing, et al. (författare)
  • The eligible population of the PARADIGM-HF trial in a real-world outpatient clinic and its cardiovascular risk between 2005 and 2016.
  • 2020
  • Ingår i: Journal of cardiovascular medicine. - 1558-2035. ; 21:1, s. 6-12
  • Tidskriftsartikel (refereegranskat)abstract
    • The PARADIGM-HF trial showed that sacubitril-valsartan - an angiotensin receptor-neprilysin inhibitor (ARNI) - is more effective than enalapril for some patients with heart failure. However, the eligibility of the PARADIGM-HF study to a real-world heart failure population was not well established.We made secondary analysis of patients (n=4872) with heart failure prospectively enrolled in the Swedish Heart Failure Registry from Sahlgrenska University Hospital/Östra Hospital, Sweden during 2005-2016. The eligibility of the PARADIGM-HF trial in the real world was studied based on patients whether they were either fully or partially compatible with the PARADIGM-HF population. Patients were judged to be fully eligible for the PARADIGM-HF trial if they completely met the inclusion and exclusion criteria, and partially eligible if they did not stay on target dose of angiotensin-converting enzyme inhibitor (ACEI)/angiotensin receptor blocker (ARB), despite their having been treated with ACEI/ARB for at least 6 months.Among patients who had heart failure with reduced left ventricular ejection fraction (≤40%) (HFrEF) (n=2165), 653 (30%) and 958 (44%) patients were fully and partially compatible with PARADIGM-HF criteria, respectively. In both fully and partially eligible groups, patients were more male. Despite those fully eligible patients being younger (77.6±12.7 vs. 84.0±13.7 years) than noneligible patients, they were much older than in the PARADIGM-HF trial. Moreover, those fully eligible patients had lower all-cause mortality compared with both partially and noneligible patients. However, both fully and partially eligible patients had higher all-cause mortality than that in the PARADIGM-HF trial.In a real-world outpatient clinical setting, around 1/3-1/2 of HFrEF were eligible for treatment of Sac/Val except that they are older, sicker, and carry higher risk for all-cause mortality than the PARADIGM-HF trial population.
  •  
30.
  • Cider, Åsa, 1960, et al. (författare)
  • Aquatic Exercise Is Effective in Improving Exercise Performance in Patients with Heart Failure and Type 2 Diabetes Mellitus
  • 2012
  • Ingår i: Evidence-Based Complementary and Alternative Medicine. - : Hindawi Limited. - 1741-427X .- 1741-4288. ; 2012
  • Tidskriftsartikel (refereegranskat)abstract
    • Background. Peak oxygen uptake (VO2peak) and muscle function are more decreased in patients with a combination of chronic heart failure (CHF) and type 2 diabetes mellitus (2DM) compared to patients with only one of the conditions. Further, patients with 2DM have peripheral complications that hamper many types of conventional exercises. Aim. To evaluate the efficacy and applicability of eight-week aquatic exercise in patients with the combination of CHF and 2DM. Methods. Twenty patients (four women) with both CHF and 2DM (age 67.4 +/- 7.1, NYHA II-III) were randomly assigned to either aquatic exercise or a control group. The patients exercised for 45 minutes 3 times/week in 33-34 degrees C, swimming pool. Results. The training programme was well tolerated. Work rate (+11.7 +/- 6.6 versus -6.4 +/- 8.1watt, P < 0.001) and VO2peak (+2.1 +/- 0.8 versus -0.9 +/- 1.4 mL.kg(-1) . min(-1), P < 0.001) and walking capacity (P = 0.01) increased significantly in the training group. Muscle function was also significantly improved and Hba1c decreased significantly (P < 0.01) during training, while fasting glucose, insulin, c-peptide, and lipids were unchanged. Training also increased vitality measured by SF-36 significantly (P = 0.05). Conclusion. Aquatic exercise could be used to improve exercise capacity and muscle function in patients with the combination of CHF and 2DM.
  •  
31.
  • Cider, Åsa, 1960, et al. (författare)
  • Cardiorespiratory effects of warm water immersion in elderly patients with chronic heart failure
  • 2005
  • Ingår i: Clin Physiol Funct Imaging. ; 25:6, s. 313-7
  • Tidskriftsartikel (refereegranskat)abstract
    • BACKGROUND: Hydrotherapy might be included in the rehabilitation of patients with chronic heart failure (CHF), but little is known about the acute cardiorespiratory reaction in warm water. The aim of this study was to assess the acute cardiorespiratory effect of immersion in warm water, in a clinical setting, in elderly patients with CHF compared with healthy age and sex matched persons. METHODS: Twelve patients (three females) with CHF, NYHA II-III, age 64 +/- 6 years, and 12 healthy subjects were studied. Cardiorespiratory changes, on land and in a temperature-controlled swimming pool (33-34 degrees C) were assessed during rest and exercise, in a sitting position, using continuous gas analyses. RESULTS: There were no significant differences, land versus water, in carbon dioxide production, total ventilation, respiratory frequency, respiratory exchange ratio, heart rate or blood pressure in either of the groups. A significant difference was found in oxygen uptake, at rest, land versus water in patients with CHF in comparison with healthy subjects (-0.2 +/- 0.4 versus +0.3 +/- 0.6 ml kg(-1) min(-1), P < 0.01). Oxygen kinetics (tau) increased significantly (P = 0.01) in both groups during exercise in water. CONCLUSION: Hydrotherapy was well tolerated and the vast majority of the cardiorespiratory responses, during warm water immersion in a clinical setting, are similar in patients with CHF compared with healthy subjects. However, further larger studies, are needed to better understand the physiological reactions during hydrotherapy.
  •  
32.
  •  
33.
  • Cider, Åsa, 1960, et al. (författare)
  • Hydrotherapy--a new approach to improve function in the older patient with chronic heart failure
  • 2003
  • Ingår i: Eur J Heart Fail. ; 5:4, s. 527-35
  • Tidskriftsartikel (refereegranskat)abstract
    • AIMS: Hydrotherapy, i.e. exercise in warm water, as a rehabilitation program has been considered potentially dangerous in patients with chronic heart failure (CHF) due to the increased venous return caused by the hydrostatic pressure. However, hydrotherapy has advantages compared to conventional training. We studied the applicability of an exercise programme in a temperature-controlled swimming pool, with specific reference to exercise capacity, muscle function, quality of life and safety. METHODS AND RESULTS: Twenty-five patients with CHF (NYHA II-III, age 72.1+/-6.1) were randomised into either 8 weeks of hydrotherapy (n=15), or into a control group (n=10). The training program was well tolerated with no adverse events. Patients in the hydrotherapy group improved their maximal exercise capacity (+6.5 vs.-5.9 W, P=0.001), isometric endurance in knee extension (+4 vs.-9 s, P=0.01) together with an improvement in the performance of heel-lift (+4 vs. -3 n.o., P=<0.01), shoulder abduction (+12 vs. -8 s, P=0.01) and shoulder flexion (+6 vs. +4, P=0.01) in comparison to patients in the control group. CONCLUSION: Physical training in warm water was well tolerated and seems to improve exercise capacity as well as muscle function in small muscle groups in patients with CHF. This new approach broadens the variety of training regimes for older patients with CHF.
  •  
34.
  • Cider, Åsa, 1960, et al. (författare)
  • Immersion in warm water induces improvement in cardiac function in patients with chronic heart failure
  • 2006
  • Ingår i: Eur J Heart Fail. - : Wiley. - 1388-9842. ; 8:3, s. 308-13
  • Tidskriftsartikel (refereegranskat)abstract
    • BACKGROUND: The effects of immersion and training of patients with chronic heart failure (CHF) in warm water has not been thoroughly investigated. The aim of this study was to assess the acute hemodynamic response of immersion and peripheral muscle training in elderly patients with CHF. METHODS: Thirteen CHF patients and 13 healthy subjects underwent echocardiography on land and in a temperature-controlled swimming pool (33-34 degrees C). RESULTS: Rest. Heart rate decreased (CHF, p=0.01; control, p=0.001) and stroke volume increased (CHF, p=0.01; control, p=0.001) during water immersion in both groups, with no change in systolic or diastolic blood pressure. Ejection fraction (p<0.05) and transmitral Doppler E/A ratio (p=0.01) increased in the CHF group, with no changes in left ventricular volumes. The healthy subjects had similar responses, but also displayed an increase in cardiac output (p<0.01) and left ventricular volumes (p<0.001). Exercise. Cardiac output and systolic blood pressure increased significantly in water, in both groups. CONCLUSION: A general increase in early diastolic filling was accompanied by a decrease in heart rate, leading to an increase in stroke volume and ejection fraction in most patients with CHF during warm water immersion. These beneficial hemodynamic effects might be the reason for the previously observed good tolerability of this exercise regime.
  •  
35.
  • Dalin, Martin, 1982, et al. (författare)
  • Massive parallel sequencing questions the pathogenic role of missense variants in dilated cardiomyopathy
  • 2017
  • Ingår i: International Journal of Cardiology. - : Elsevier BV. - 0167-5273 .- 1874-1754. ; 228, s. 742-748
  • Tidskriftsartikel (refereegranskat)abstract
    • Background: Germline genetic variants are an important cause of dilated cardiomyopathy (DCM). However, recent sequencing studies have revealed rare variants in DCM-associated genes also in individuals without known heart disease. In this study, we investigate variant prevalence and genotype-phenotype correlations in Swedish DCM patients, and compare their genetic variants to those detected in reference cohorts. Methods and results: We sequenced the coding regions of 41 DCM-associated genes in 176 unrelated patients with idiopathic DCM and found 102 protein-altering variants with an allele frequency of <0.04% in reference cohorts; the majority were missense variants not previously described in DCM. Fifty-five (31%) patients had one variant, and 24 (14%) patients had two or more variants in the analysed genes. Detection of genetic variants in any gene, and in LMNA, MYII7 or TTN alone, was associated with early onset disease and reduced transplant-free survival. As expected, nonsense and frameshift variants were more common in DCM patients than in healthy individuals of the reference cohort 1000 Genomes Europeans. Surprisingly however, the prevalence, conservation and pathogenicity scores, and localization of missense variants were similar in DCM patients and healthy reference individuals. Conclusion: To our knowledge, this is the first study to identify correlations between genotype and prognosis when sequencing a large number of genes in unselected DCM patients. The similar distribution of missense variants in DCM patients and healthy reference individuals questions the pathogenic role of many variants, and suggests that results from genetic testing of DCM patients should be interpreted with caution.
  •  
36.
  •  
37.
  • Dudas, Kerstin, 1963, et al. (författare)
  • Uncertainty in illness among patients with chronic heart failure is less in person-centred care than in usual care
  • 2013
  • Ingår i: European Journal of Cardiovascular Nursing. - : Oxford University Press (OUP). - 1474-5151 .- 1873-1953. ; 12:6, s. 521-528
  • Tidskriftsartikel (refereegranskat)abstract
    • Background:Many patients with chronic heart failure (CHF) experience uncertainty regarding the treatment and characteristics of their illness. Person-centred care (PCC) emphasizes patient involvement in care. We have previously shown that PCC improved outcomes such as length of hospital stay and activities of daily living in patients with CHF. The impact of PCC on self-reported uncertainty in illness among patients hospitalized for CHF is still unknown.Aim:To evaluate whether PCC is associated with less self-reported uncertainty in illness compared with usual care in patients hospitalized for worsening CHF.Methods:Using a controlled before-and-after design, eligible CHF patients were assigned to either a usual care group or a PCC intervention group. Patient-reported uncertainty in illness was assessed at hospital discharge with the Cardiovascular Population Scale (CPS). The CPS consists of two domains: 1) Ambiguity (about illness severity); and 2) Complexity (of treatment and system of care).Results:Two hundred and forty-eight patients were included in the study; 123 in the usual care group and 125 in the PCC intervention. The PCC group had better scores than the usual care group in the CPS domains complexity (M=15.2, SD=4.7 vs. M=16.8, SD=4.7; p=0.020) and ambiguity (M=27.8, SD=6.6 vs. M=29.8, SD=6.9; p=0.041).Conclusion:Patients with CHF were less uncertain in their illness after PCC, which may help to equip and empower patients to manage their illness. Together with earlier findings of shortened hospital stay and improved activities of daily living, this indicates that PCC should be a standard approach for hospital care of patients with worsening CHF.
  •  
38.
  • Ekestubbe, Sofia, et al. (författare)
  • Increasing home-time after a first diagnosis of heart failure in Sweden, 20 years trends
  • 2022
  • Ingår i: Esc Heart Failure. - : Wiley. - 2055-5822. ; 9:1, s. 555-563
  • Tidskriftsartikel (refereegranskat)abstract
    • Aims This study was performed to compare trends in home-time for patients with heart failure (HF) between those of working age and those of retirement age in Sweden from 1992 to 2012. Methods and results The National Inpatient Register (IPR) was used to identify all patients aged 18 to 84 years with a first hospitalization for HF in Sweden from 1992 to 2012. Information on date of death, comorbidities, and sociodemographic factors were collected from the Swedish National Register on Cause of Death, the IPR, and the longitudinal integration database for health insurance and labour market studies, respectively. The patients were divided into two groups according to their age: working age (<65 years) and retirement age (>= 65 years). Follow-up was 4 years. In total, following exclusions, 388 775 patients aged 18 to 84 years who were alive 1 day after discharge from a first hospitalization for HF were included in the study. The working age group comprised 62 428 (16%) patients with a median age of 58 (interquartile range, 53-62) years and 31.2% women, and the retirement age group comprised 326 347 (84%) patients with a median age of 77 (interquartile range, 73-81) years and 47.4% women. Patients of working age had more home-time than patients of retirement age (83.8% vs. 68.2%, respectively), mainly because of their lower 4 year mortality rate (14.2% vs. 29.7%, respectively). Home-time increased over the study period for both age groups, but the increase levelled off for older women after 2007, most likely because of less reduction in mortality in older women than in the other groups. Conclusions This nationwide study showed increasing home-time over the study period except for women of retirement age and older for whom the increase stalled after 2007, mainly because of a lower mortality reduction in this group. Efforts to improve patient-related outcome measures specifically targeted to this group may be warranted.
  •  
39.
  • Ekman, Inger, 1952, et al. (författare)
  • Effects of person-centred care in patients with chronic heart failure: the PCC-HF study
  • 2012
  • Ingår i: European Heart Journal. - : Oxford University Press (OUP). - 1522-9645 .- 0195-668X. ; 33:9, s. 1112-1119
  • Tidskriftsartikel (refereegranskat)abstract
    • Aims: Person-centred care (PCC), emphasizes a partnership in care between patients and health care professionals and is advocated by WHO as a key component of quality health care. We evaluated outcomes of PCC in hospitalized patients with chronic heart failure (CHF) with respect to length of hospital stay (LOS), activities of daily living (ADL), health-related quality of life (HRQL) and 6-month readmission rate. Methods and results: During 2008-2010, 248 consecutive patients hospitalized for symptoms of worsening CHF were enrolled in a controlled before and after designed study. A Usual care group (n=123) was recruited according to pre-defined criteria to map usual CHF care and assess outcomes at 5 designated hospital wards. Based on the mapping, a panel of in-house clinicians and researchers developed measures aimed at aligning usual care with basic PCC principles. These measures were incorporated into a study protocol to guide care procedures at the same 5 wards. PCC was then implemented at these wards and evaluated in 125 patients. LOS and 6-month readmission were extracted from patient records. ADL was evaluated at baseline and discharge and HRQL at baseline and after three months. In the analysis of all patients, LOS was reduced by one day (p=0.16) while retaining ADL (p=0.07). When PCC was fully implemented (per protocol analysis), LOS was reduced by 2.5 days (p=0.01) and ADL level better preserved (p=0.04). HRQL and time-to-first readmission did not differ. Conclusions: In this proof-of-concept study, our findings suggest that a fully implemented PCC approach shortens hospital stay and maintains functional performance in patients hospitalized for worsening CHF, without increasing risk for readmission or jeopardizing patients’ HRQL.
  •  
40.
  • Ekman, Inger, 1952, et al. (författare)
  • Pulmonary oedema - A life threatening disease
  • 2007
  • Ingår i: Eur J Cardiovasc Nurs. - 1474-5151.
  • Tidskriftsartikel (refereegranskat)abstract
    • AIM: The aim was to describe the health history of patients after pulmonary oedema and investigate how they perceive their condition and treatment. METHODS: In part one of the study medical records of patients treated for acute pulmonary oedema (n=44) were reviewed regarding social status, health history, medication and cause of the pulmonary oedema. In part two, interviews were performed focusing on the patients' conceptions of the illness, current situation and effects of pulmonary oedema on daily life. RESULTS: One-year mortality was 65% and all but 3 patients had a previous heart diagnosis. Analyses of the interviews yielded five categories: A suffocating feeling; trust in care providers; medication - an annoyance but also a saviour; dealing with existential issues alone or with relatives; concurrent diseases affecting daily life. CONCLUSION: Patients' who experience a pulmonary oedema have several heart-related conditions and a very poor prognosis. Experiencing pulmonary oedema is an anxiety-provoking situation and patients should be regularly and carefully monitored.
  •  
41.
  • Ekman, Inger, 1952, et al. (författare)
  • Standard medication information is not enough : poor concordance of patient and nurse perceptions
  • 2007
  • Ingår i: Journal of Advanced Nursing. - : Wiley-Blackwell. - 0309-2402 .- 1365-2648. ; 60:2, s. 181-186
  • Tidskriftsartikel (refereegranskat)abstract
    • AIM:This paper is a report of a study to describe patient and nurse perceptions of patient satisfaction with information about the medicines at two heart failure clinics after medication up-titration and information-giving.BACKGROUND:Chronic heart failure is a major cause of hospitalization. Poor adherence to medications increases mortality and heart failure-related hospitalizations. To achieve mutual goal-setting (concordance) regarding medication-taking behaviours, health providers need to understand patient information needs regarding the prescribed medicines.METHODS:A convenience sample of 56 patients with chronic heart failure referred for an up-titration of medicines and information-giving about the condition and treatment completed the Satisfaction about Information about Medicines Scale at their first and last visits. Nurses completed the same questionnaire after each patient's final visit, assessing the patient's need for further information. The data were collected between 2002 and 2004.RESULTS:Patient scores indicated statistically significantly more satisfaction with their information at the final visit compared with the first visit (P = 0.005). However, at the programme conclusion, nurses (n = 7) rated patients to be appropriately informed while patients reported a persistent need for further information (P = 0.011).CONCLUSION:Further research should evaluate more advanced pedagogical strategies such as how to address patients' expectations about the effect of medicines when actual effects of the treatment are related to mortality and morbidity at the population level and may not result directly in symptom relief at an individual level.
  •  
42.
  • Ergatoudes, Constantinos, et al. (författare)
  • Non-cardiac comorbidities and mortality in patients with heart failure with reduced vs. preserved ejection fraction: a study using the Swedish Heart Failure Registry
  • 2019
  • Ingår i: Clinical Research in Cardiology. - : Springer Science and Business Media LLC. - 1861-0684 .- 1861-0692. ; 108, s. 1025-33
  • Tidskriftsartikel (refereegranskat)abstract
    • Background: Heart failure (HF) and non-cardiac comorbidities often coexist and are known to have an adverse effect on outcome. However, the prevalence and prognostic impact of non-cardiac comorbidities in patients with HF with reduced ejection fraction (HFrEF) vs. those with preserved (HFpEF) remain inadequately studied. Methods and results: We used data from the Swedish Heart Failure Registry from 2000 to 2012. HFrEF was defined as EF < 50% and HFpEF as EF ≥ 50%. Of 31 344 patients available for analysis, 79.3% (n = 24 856) had HFrEF and 20.7% (n = 6 488) HFpEF. The outcome was all-cause mortality. We examined the association between ten non-cardiac comorbidities and mortality and its interaction with EF using adjusted hazard ratio (HR). Stroke, anemia, gout and cancer had a similar impact on mortality in both phenotypes, whereas diabetes (HR 1.57, 95% confidence interval [CI] [1.50–1.65] vs. HR 1.39 95% CI [1.27–1.51], p = 0.0002), renal failure (HR 1.65, 95% CI [1.57–1.73] vs. HR 1.44, 95% CI [1.32–1.57], p = 0.003) and liver disease (HR 2.13, 95% CI [1.83–2.47] vs. HR 1.42, 95% CI [1.09–1.85] p = 0.02) had a higher impact in the HFrEF patients. Moreover, pulmonary disease (HR 1.46, 95% CI [1.40–1.53] vs. HR 1.66 95% CI [1.54–1.80], p = 0.007) was more prominent in the HFpEF patients. Sleep apnea was not associated with worse prognosis in either group. No significant variation was found in the impact over the 12-year study period. Conclusions: Non-cardiac comorbidities contribute significantly but differently to mortality, both in HFrEF and HFpEF. No significant variation was found in the impact over the 12-year study period. These results emphasize the importance of including the management of comorbidities as a part of a standardized heart failure care in both HF phenotypes. © 2019, The Author(s).
  •  
43.
  • Feng, Y. Z., et al. (författare)
  • Patient-level comparison of heart failure patients in clinical phenotype and prognosis from China and Sweden
  • 2022
  • Ingår i: Bmc Cardiovascular Disorders. - : Springer Science and Business Media LLC. - 1471-2261. ; 22:1
  • Tidskriftsartikel (refereegranskat)abstract
    • Background Clinical phenotype and prognosis of heart failure (HF) may be variable among different racial populations. Therefore, a patient-level comparison of hospitalized HF patients in two university hospitals from China and Sweden was performed. Methods and results This study was a pooled data analysis of the patients prospectively enrolled in two single-center studies in China (n = 949) and Sweden (n = 1639) from 2011 to 2015. Clinical characteristics and 6-month all-cause mortality were collected. Higher systolic blood pressure (126.1 +/- 20.3 vs. 114.2 +/- 15.4 mmHg, p < 0.001) and NT-proBNP level (4540 vs. 3251 pg/mL, p = 0.013) were found in the Swedish cohort, also more patients with ischemic heart disease (32.0% vs. 19.2%), hypertension (64.2% vs. 36.8%), valvular heart disease (40.9% vs.31.6%) and atrial fibrillation (55.3% vs. 39.6%) (all p < 0.001). The use of ACEIs/ARBs (48.8% vs. 80.8%) or beta-blockers (58.8% vs. 86.5%) (both p < 0.001) was lower in Chinese cohort. Given younger age in Chinese cohort (61.6 vs. 76.4 years, p < 0.001), age-stratified analyses were conducted, as there were similar patient numbers in 50-74 years in Chinese (n = 550) and Swedish (n = 554) cohorts, therefore baseline characteristics and prognosis were further compared. The age- and sex-adjusted outcome (HR 0.80 [95% CI 0.55-1.19], p = 0.273) was comparable between the two populations. The NT-proBNP and eGFR independently predicted 6-month mortality in both Chinese (HR [95% CI] 1.006 [1.003-1.008], 0.986 [0.976-0.999]) and Swedish cohort (1.003 [1.000-1.007], 0.988 [0.976-0.999]). Conclusions Patient-level comparison of real-world HF populations from China and Sweden demonstrated different clinical phenotypes and therapy but similar prognosis and their predictors.
  •  
44.
  • Fu, Michael, 1963, et al. (författare)
  • Optimizing the Management of Heart Failure with Preserved Ejection Fraction in the Elderly by Targeting Comorbidities (OPTIMIZE-HFPEF).
  • 2016
  • Ingår i: Journal of cardiac failure. - : Elsevier BV. - 1532-8414 .- 1071-9164. ; 22:7, s. 539-544
  • Tidskriftsartikel (refereegranskat)abstract
    • The pathophysiology of heart failure with preserved ejection fraction (HFPEF) is not fully understood. A recently proposed mechanism for HFPEF is that it is a systemic pro-inflammatory state induced by comorbidities, leading to microvascular endothelial dysfunction and subsequent cardiac remodelling and dysfunction. We hypothesize that targeting comorbidities will improve outcomes in elderly patients with HFPEF. Thus, the aim of this study is to determine whether the combination of systematic screening of patients with HFPEF and optimal management of comorbidities associated with HFPEF improves outcomes.
  •  
45.
  • Fu, Michael, 1963, et al. (författare)
  • Trends in myocarditis incidence, complications and mortality in Sweden from 2000 to 2014.
  • 2022
  • Ingår i: Scientific reports. - : Springer Science and Business Media LLC. - 2045-2322. ; 12:1
  • Tidskriftsartikel (refereegranskat)abstract
    • Investigate trends in myocarditis incidence and prognosis in Sweden during 2000-2014. Little data exist concerning population-trends in incidence of hospitalizations for myocarditis and subsequent prognosis. Linking Swedish National Patient and Cause of Death Registers, we identified individuals≥16years with first-time diagnosis of myocarditis during 2000-2014. Reference population, matched for age and birth year (n=16,622) was selected from Swedish Total Population Register. Among the 8 679 cases (75% men, 64%<50years), incidence rate/100,000 inhabitants rose from 6.3 to 8.6 per 100,000, mostly in men and those<50years. Incident heart failure/dilated cardiomyopathy occurred in 6.2% within 1year after index hospitalization and in 10.2% during 2000-2014, predominantly in those≥50years (12.1% within 1year, 20.8% during 2000-2014). In all 8.1% died within 1year, 0.9% (<50years) and 20.8% (≥50years). Hazard ratios (adjusted for age, sex) for 1-year mortality comparing cases and controls were 4.00 (95% confidence interval 1.37-11.70), 4.48 (2.57-7.82), 4.57 (3.31-6.31) and 3.93 (3.39-4.57) for individuals aged<30, 30 to<50, 50 to<70, and≥70years, respectively. The incidence of myocarditis during 2000-2014 increased, predominantly in men<50years. One-year mortality was low, but fourfold higher compared with reference population.
  •  
46.
  • Gund, Anna, 1980, et al. (författare)
  • Attitudes among healthcare professionals towards ICT and home follow-up in chronic heart failure care
  • 2012
  • Ingår i: BMC Medical Informatics and Decision Making. - : Springer Science and Business Media LLC. - 1472-6947. ; 12:1, s. 138-
  • Tidskriftsartikel (refereegranskat)abstract
    • Background: eHealth applications for out-of-hospital monitoring and treatment follow-up have been advocated for many years as a promising tool to improve treatment compliance, promote individualized care and obtain a person-centred care. Despite these benefits and a large number of promising projects, a major breakthrough in everyday care is generally still lacking. Inappropriate organization for eHealth technology, reluctance from users in the introduction of new working methods, and resistance to information and communication technology (ICT) in general could be reasons for this. Another reason may be attitudes towards the potential in out-of-hospital eHealth applications. It is therefore of interest to study the general opinions among healthcare professionals to ICT in healthcare, as well as the attitudes towards using ICT as a tool for patient monitoring and follow-up at home. One specific area of interest is in-home follow-up of elderly patients with chronic heart failure (CHF). The aim of this paper is to investigate the attitudes towards ICT, as well as distance monitoring and follow-up, among healthcare professionals working with this patient group. Method: This paper covers an attitude survey study based on responses from 139 healthcare professionals working with CHF care in Swedish hospital departments, i.e. cardiology and medicine departments. Comparisons between physicians and nurses, and in some cases between genders, on attitudes towards ICT tools and follow-up at home were performed. Results: Out of the 425 forms sent out, 139 were collected, and 17 out of 21 counties and regions were covered in the replies. Among the respondents, 66% were nurses, 30% physicians and 4% others. As for gender, 90% of nurses were female and 60% of physicians were male. Internet was used daily by 67% of the respondents. Attitudes towards healthcare ICT were found positive as 74% were positive concerning healthcare ICT today, 96% were positive regarding the future of healthcare ICT, and 54% had high confidence in healthcare ICT. Possibilities for distance monitoring/follow-up are good according to 63% of the respondents, 78% thought that this leads to increased patient involvement, and 80% thought it would improve possibilities to deliver better care. Finally, 72% of the respondents said CHF patients would benefit from home monitoring/follow-up to some extent, and 19% to a large extent. However, the best method of follow-up was considered to be home visits by nurse, or phone contact. Conclusion: The results indicate that a majority of the healthcare professionals in this study are positive to both current and future use of ICT tools in healthcare and home follow-up. Consequently other factors have to play an important role in the slow penetration of out-of-hospital eHealth applications in daily healthcare practice.
  •  
47.
  • Halldin, Anna-Karin, 1969, et al. (författare)
  • Obesity in Middle Age Increases Risk of Later Heart Failure in Women - Results from the Prospective Population Study of Women and H70 Studies in Gothenburg, Sweden.
  • 2017
  • Ingår i: Journal of cardiac failure. - : Elsevier BV. - 1532-8414 .- 1071-9164. ; 23:5, s. 363-369
  • Tidskriftsartikel (refereegranskat)abstract
    • Obesity has been shown to be a risk factor for heart failure, but whether the association varies by age is not understood.To examine the impact of obesity/overweight on the risk of developing heart failure in women of different ages by analysing prospective data from 2 population studies.Data were obtained from the Population Study of Women in Gothenburg and the Gerontological and Geriatric Population Studies concerning Body Mass Index (BMI) collected in 1980 or later. Follow-up ended 2006. Cox proportional hazard methods were used to determine associations between developing HF and BMI in 2574 women, 1243 aged 26-65 and 1331 aged 66-76 at baseline.Women aged 26-65 years at baseline with BMI≥30 had an increased risk of developing heart failure (hazard ratio (HR) 2.61, 95% confidence interval (CI) 1.56-4.35) even when controlling for age, glucose, smoking, alcohol consumption, s-triglycerides, and systolic blood pressure (reference group: women with BMI 18.5-22.4). Obese older women 66-76 years at baseline did not show increased risk of developing HF (HR 0.55, 95% CI 0.23-1.29).Obesity in middle aged women increases their risk of developing heart failure later in life. In contrast, obesity in late life shows no association with heart failure.
  •  
48.
  • Hedemalm, Azar, 1960, et al. (författare)
  • A review of records from follow-up visits for immigrant and Swedish patients at a heart failure clinic
  • 2007
  • Ingår i: Eur J Cardiovasc Nurs. - 1474-5151. ; 6:3, s. 216-22
  • Forskningsöversikt (refereegranskat)abstract
    • Today, nearly 20% of the Swedish population originates from multiethnic backgrounds. Patients' symptom expressions, adherence to health regimens, and communication with health-care professionals have been shown to be related to their ethnic and cultural backgrounds. PURPOSE: To describe documented care of immigrant patients and matched Swedish patients at a heart failure clinic. METHOD: Journal audit of records of 25 immigrant and 25 matched Swedish patients with HF included from the patient registration database at the hospital where they were cared for. RESULTS: In the immigrant group, significantly fewer clinical parameters were assessed during their visits and fewer patients were scheduled for follow-up visits. Analyses revealed that some of the items recommended in the European Society of Cardiology guidelines for non-pharmacological HF care were overlooked for both of the groups. CONCLUSIONS: We found that medication adjustments and information about the condition and treatment were fairly similarly documented between Swedish and immigrant patients while significantly fewer clinical measurements and follow-up visits were documented for the immigrant group.
  •  
49.
  • Hedemalm, Azar, 1960, et al. (författare)
  • Equality in the care and treatment of immigrants and native Swedes--a comparative study of patients hospitalised for heart failure
  • 2008
  • Ingår i: European Journal of Cardiovascular Nursing. - : Oxford University Press (OUP). - 1474-5151 .- 1873-1953. ; 7:3, s. 222-8
  • Tidskriftsartikel (refereegranskat)abstract
    • The aim of this study was to compare immigrant and Swedish patients with heart failure (HF) regarding symptoms, diagnosis, medical treatment, discharge planning, readmission and mortality. The method was descriptive and retrospective using an audit protocol to review data from 214 medical records of 107 immigrants and 107 Swedish patients hospitalised for HF or chronic heart failure during 1994-2003. Descriptive statistics and significance testing were performed. Few differences between the patient groups were observed. Significantly larger number of immigrants were referred to the nurse-led HF clinic follow-up visits (P=0.026). Significantly more immigrants had ischemic heart disease on admission (P=0.025) and were prescribed short-acting nitrates at discharge (P=0.026). More Swedes were prescribed medications for insomnia (P=0.029). More immigrants than Swedes are referred to HF clinic after discharge, suggesting that physicians rely on specialised nurses to provide follow-ups, tailored to the needs of immigrant patients. The study indicates that the Swedish health care system has achieved its aim of equality in the care and treatment of this patient group. Further studies are needed to determine if this also applies to the quality of the provided care and treatment.
  •  
50.
  • Hedemalm, Azar, 1960, et al. (författare)
  • Reported adherence and social support among immigrants compared to native Swedes
  • 2010
  • Ingår i: Journal of Immigrant and Minority Health. - : Springer Science and Business Media LLC. - 1557-1912 .- 1557-1920. ; 12:1, s. 124-131
  • Tidskriftsartikel (refereegranskat)abstract
    • Challenges experienced by heart failure patients have seldom been studied from the perspective of immigrants. OBJECTIVE: To describe and compare immigrant and native Swedish patients regarding changes in physical limitation, emotional state, social support and self-care. METHOD: A comparative study was conducted including 23 consecutively selected immigrants and 46 Swedish patients. Baseline and 4-month follow-up interviews were conducted using the Kansas City Cardiomyopathy Questionnaire, Short Form-36, Hospital Anxiety and Depression Scale, MOS Social Support Survey, and European Heart Failure Self-Care Behaviour Scale. RESULTS: A larger number of immigrants adhered to prescribed medications (P = 0.02) and significantly less (P = 0.048) felt having somebody to confide to compared to Swedish patients. However the distress level, frequency and severity of symptoms and signs, physical function, emotional state and self care were similar between the groups over time. CONCLUSION: Caregivers should be aware that immigrants may be in need of greater emotional support than has previously been anticipated.
  •  
Skapa referenser, mejla, bekava och länka
  • Resultat 1-50 av 93
Typ av publikation
tidskriftsartikel (78)
konferensbidrag (9)
forskningsöversikt (2)
rapport (1)
annan publikation (1)
doktorsavhandling (1)
visa fler...
bokkapitel (1)
visa färre...
Typ av innehåll
refereegranskat (84)
övrigt vetenskapligt/konstnärligt (9)
Författare/redaktör
Schaufelberger, Mari ... (90)
Rosengren, Annika, 1 ... (31)
Ekman, Inger, 1952 (20)
Swedberg, Karl, 1944 (16)
Patel, Harshida, 195 ... (16)
Fu, Michael, 1963 (16)
visa fler...
Åberg, Maria A I, 19 ... (9)
Lindgren, Martin (9)
Robertson, Josefina (8)
Andersson, Bert, 195 ... (8)
Åberg, N David, 1970 (7)
Zverkova Sandström, ... (7)
Torén, Kjell, 1952 (6)
Adiels, Martin, 1976 (6)
Cider, Åsa, 1960 (6)
Schiöler, Linus, 197 ... (6)
Björck, Lena, 1959 (6)
Dahlström, Ulf (5)
Barasa, Anders, 1973 (5)
Lappas, Georg, 1962 (5)
Waern, Margda, 1955 (4)
Berg, Marie, 1955 (4)
Bollano, Entela, 197 ... (4)
Petzold, Max, 1973 (3)
Stibrant Sunnerhagen ... (3)
Ljungman, Charlotta, ... (3)
Kuhn, Hans-Georg, 19 ... (3)
Olsson, Lars-Eric, 1 ... (3)
Dudas, Kerstin, 1963 (3)
Thunström, Erik, 198 ... (3)
Wolf, Axel (3)
Taft, Charles, 1950 (3)
Edner, M (3)
Ekman, Tor, 1953 (2)
McMurray, John J. V. (2)
Sattar, Naveed (2)
Persson, Hans (2)
Schaufelberger, Mari ... (2)
Lissner, Lauren, 195 ... (2)
Dahlström, Ulf, 1946 ... (2)
Böhm, Michael (2)
Eggertsen, Robert, 1 ... (2)
Ladfors, Lars, 1951 (2)
Johansson, Magnus C, ... (2)
Hjalmarsson, Clara, ... (2)
van Veldhuisen, Dirk ... (2)
Giang, Kok Wai, 1984 (2)
Andersson, Björn, 19 ... (2)
Barywani, Salim B., ... (2)
Ergatoudes, Constant ... (2)
visa färre...
Lärosäte
Göteborgs universitet (90)
Linköpings universitet (8)
Karolinska Institutet (7)
Umeå universitet (2)
Kungliga Tekniska Högskolan (1)
Uppsala universitet (1)
visa fler...
Stockholms universitet (1)
Örebro universitet (1)
Chalmers tekniska högskola (1)
RISE (1)
visa färre...
Språk
Engelska (88)
Svenska (5)
Forskningsämne (UKÄ/SCB)
Medicin och hälsovetenskap (84)
Teknik (1)
Lantbruksvetenskap (1)
Samhällsvetenskap (1)

År

Kungliga biblioteket hanterar dina personuppgifter i enlighet med EU:s dataskyddsförordning (2018), GDPR. Läs mer om hur det funkar här.
Så här hanterar KB dina uppgifter vid användning av denna tjänst.

 
pil uppåt Stäng

Kopiera och spara länken för att återkomma till aktuell vy