| 1. |
- Volkmann, E, et al.
(författare)
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Effect of varicose vein surgery on venous reflux scoring and plethysmographic assessment of venous function.
- 2008
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Ingår i: European journal of vascular and endovascular surgery : the official journal of the European Society for Vascular Surgery. - : Elsevier BV. - 1532-2165. ; 36:6, s. 731-7
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Tidskriftsartikel (refereegranskat)abstract
- BACKGROUND: Colour duplex ultrasonography (CDU) is widely recommended before varicose vein surgery, combined with quantification of venous reflux by plethysmography where required. This study assessed venous haemodynamics before and after varicose vein surgery by venous outflow plethysmography (VOP), venous reflux plethysmography (VRP) and by adoption of a modified segmental venous reflux score (VRS). The effect of wearing one or two class I medical compression stockings was also assessed. The aim of the study was to identify parameters which reflect the outcome of treatment using medical compression stockings or surgical intervention. METHODS: 24 legs of 21 patients with superficial vein incompetence of clinical grade C(2-4a) (CEAP) were assessed before and a mean of 8 S.D. 4 months after superficial vein surgery. Investigations were CDU, as well as VOP and VRP using mercury in rubber gauges fitted either around the calf or the forefoot. Venous reflux was semi-quantitatively graded by CDU in relation to the actual vein diameter and transformed into a VRS with respect to the number of involved serial vein segments. The venous reflux rates were measured in standing patients after knee bending before and after application of one or two superimposed compression stockings (class I). RESULTS: According to VRP, one compression stocking reduced the maximum venous reflux rates (VR(max)) by about 30% which was comparable with the effect of surgery on VR(max). Two superimposed compression stockings were almost twice as effective and diminished VR(max) pre- and post operatively by around 60%. Varicose surgery reduced the maximum venous outflow rates significantly (pre-op: 166 S.D. 77 ml/min x 100 ml tissue, post op: 120 S.D. 34) and improved VRS (pre-op median 5.0 IQR: 4.5-5.5, post-op median 0.5 IQR: 0-1.0). Surgery had no effect on venous refilling time or venous reflux rates when measured without compression stockings. CONCLUSION: Venous reflux assessed by plethysmography was moderated by the use of compression stockings pre-operatively but did not reflect the outcome of surgical treatment of superficial venous reflux. Increased venous volume and venous outflow were restored to the levels of normal contralateral limbs by surgery. The VRS decreased considerably following surgery, reflecting the effect of surgical treatment on the number of incompetent venous segments. Changes in this parameter did not correlate with any of the plethysmographic measurements.
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| 2. |
- Zachrisson, Helene, et al.
(författare)
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Functional assessment of high-grade ICA stenosis with duplex ultrasound and transcranial Doppler.
- 2012
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Ingår i: Clinical physiology and functional imaging. - : Wiley-Blackwell. - 1475-097X .- 1475-0961. ; 32:3, s. 241-6
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Tidskriftsartikel (refereegranskat)abstract
- Duplex ultrasound (DUS) has shown a >90% accuracy compared to angiography, concerning the degree of internal carotid artery (ICA) stenosis. However, uncertainty may occur in a severe stenosis, in which peak systolic velocity (PSV) may decrease owing to high flow resistance or high backward pressure. We investigated intracranial collateral flows using transcranial Doppler (TCD) to further evaluate the hemodynamic significance of high-grade ICA stenosis.
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| 3. |
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| 4. |
- Dangardt, Frida, 1977, et al.
(författare)
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Reduced cardiac vagal activity in obese children and adolescents
- 2011
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Ingår i: Clinical Physiology and Functional Imaging. - 1475-0961. ; 31:2, s. 108-13
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Tidskriftsartikel (refereegranskat)abstract
- OBJECTIVE: Obese children present with various cardiovascular risk factors affecting their future health. In adults, cardiac autonomic function is a major risk factor, predicting cardiovascular morbidity and mortality. We hypothesized that obese children and adolescents had a lower cardiac vagal activity than lean subjects. We measured cardiac spontaneous baroreflex sensitivity (BRS), reflecting the dynamic regulation of cardiac vagal function, in large groups of obese and lean young individuals. METHODS AND RESULTS: Cardiac BRS, using the sequence approach, was assessed in 120 obese (59 girls), 43 overweight (23 girls) and 148 lean subjects (78 girls). Obese subjects showed a decreased BRS compared to both overweight and lean subjects [16+/-7 versus 21+/-9 (P<0.01) and 22+/-10 ms per mmHg (P<0.0001), respectively]. The differences remained after correcting for age, gender and pubertal status. CONCLUSION: Children with obesity had low vagal activity at rest, and there was no gender difference.
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| 5. |
- Hägg Samuelsson, Ulrika, 1973, et al.
(författare)
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Physical exercise capacity is associated with coronary and peripheral vascular function in healthy young adults.
- 2005
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Ingår i: American journal of physiology. Heart and circulatory physiology. - : American Physiological Society. - 0363-6135 .- 1522-1539. ; 289:4
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Tidskriftsartikel (refereegranskat)abstract
- Short-term exercise training has been shown to improve cardiovascular function, whereas long-term effects of a physically active lifestyle, on coronary artery function in particular, are still not well studied. We explored possible relationships between physical exercise capacity and coronary and peripheral vascular function in healthy young adults. Twenty-nine healthy young male and female volunteers participated in the study. They underwent 1) basic clinical and echocardiographic characterization, 2) coronary flow velocity reserve (CFVR) measurement of the left anterior descending coronary artery (LAD), 3) common carotid artery (CCA) intima-media thickness (IMT) measurement, 4) assessment of CCA stiffness index (SI), 5) forearm flow-mediated vasodilation (FMD), and 6) submaximal exercise test. The calculated weight-adjusted maximal oxygen uptake capacity (Vo(2 max)(c)) was positively correlated to LAD CFVR and inversely correlated to IMT and SI. Also, subjects with high compared with moderate exercise capacity had higher FMD. In addition, subjects with LAD CFVR in the upper median had greater ratios between endothelium-dependent and -independent vasodilation in the forearm and lower SI in CCA. High exercise capacity due to a physically active lifestyle is associated with high coronary and peripheral artery function, indicating an early protective role of physical exercise for cardiovascular health.
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| 6. |
- Magnusson, M B, et al.
(författare)
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Leg ulcer recurrence and its risk factors: a duplex ultrasound study before and after vein surgery.
- 2006
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Ingår i: European journal of vascular and endovascular surgery : the official journal of the European Society for Vascular Surgery. - : Elsevier BV. - 1078-5884. ; 32:4, s. 453-61
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Tidskriftsartikel (refereegranskat)abstract
- OBJECTIVES: Assessment of risk factors for ulcer recurrence in chronic leg ulcer patients treated by varicose vein surgery. DESIGN: Retrospective follow-up study. MATERIALS: 62 patients, 43 women and 19 men (Median=56.5 years, range 24-77) with the CEAP classifications of C(5)-C(6) and E(P) (primary venous insufficiency). METHODS: Patients underwent colour duplex ultrasound (CDU) investigation before varicose vein surgery. Post-operatively CDU, ambulatory venous pressure (AVP) and an interview were performed. The median clinical follow-up was 5.5 years (range 2-11 years). RESULTS: The estimated 5-year ulcer recurrence rate was 19% in all patients. The risk of ulcer recurrence was significantly lower (p<0.05) in legs without residual varices or recurrence. The five year risk of ulcer recurrence depended on the time interval between ulcer appearance and the surgical intervention (index operation), post-operative venous axial reflux and AVP (mmHg). More than 50% of the patients had a calculated probability of ulcer recurrence of less than 3%, but 13% had a probability of more than 23% based on our analysis. CONCLUSIONS: A long history of venous ulcer is a pre- and post-operative risk factor for recurrent ulceration. Total elimination of incompetent superficial and perforator veins lowers the risk of ulcer recurrence, whereas residual axial reflux increases the risk. Postoperative CDU is effective in identifying patients at risk of ulcer recurrence.
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| 7. |
- Svedlund, Sara, et al.
(författare)
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Retrograde Blood Flow in the Aortic Arch Determined by Transesophageal Doppler Ultrasound
- 2009
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Ingår i: Cerebrovascular Diseases. - : S. Karger AG. - 1015-9770 .- 1421-9786. ; 27:1, s. 22-28
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Tidskriftsartikel (refereegranskat)abstract
- <i>Background:</i> Aortic arch atheromas may be important sources of cerebral embolism. Aortic plaques are frequently found somewhat distal to the origin of the cerebral arteries, implying that cerebral embolization from such plaques depends on local retrograde blood flow components in this area. Therefore, we investigated the occurrence of blood flow reversal in this part of the aorta. Furthermore, since the presence and magnitude of retrograde flow might be influenced by aortic wall properties, we also studied the relationship between plaque size and distribution, aortic strain and degree of retrograde flow. <i>Methods:</i> We evaluated aortic arch ante- and retrograde blood flow velocities in 56 patients by transesophageal echocardiography using color-Doppler-guided pulsed-Doppler techniques. The velocity-time integrals (VTI) were measured and the diastolic/systolic VTI ratio was calculated. <i>Results:</i> Retrograde diastolic blood flow was noted in all subjects, and diastolic/systolic VTI ratios were higher (p < 0.05) in patients with plaque ≥4 mm (n = 17) compared to those (n = 39) without. Patients exhibiting plaques exclusively in the aortic arch showed the highest VTI ratios (p < 0.01) and tended to have the lowest strain values. Aortic strain was also reduced in patients >50 years of age (p < 0.01). <i>Conclusions:</i> Our findings demonstrate retrograde aortic flow in all subjects and its proportion increases in subjects with atherosclerosis, particularly in the aortic arch. Aortic plaques situated distally to the origin of the cerebral arteries are therefore possible sources of cerebral emboli.
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| 8. |
- Thelandersson, Annelie, et al.
(författare)
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Blood flow velocity and vascular resistance during passive leg exercise in the critically ill patient
- 2012
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Ingår i: Clinical Physiology and Functional Imaging. - 1475-0961. ; 32:5, s. 338-342
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Tidskriftsartikel (refereegranskat)abstract
- Passive range of motion exercise is a very common physical therapy treatment for patients admitted to an intensive care unit. However is the knowledge scarce regarding its impact on blood circulation in the extremities. The objective of this study was therefore to investigate the effect of passive range of motion on arterial peripheral leg blood flow velocity (BFV) and vascular resistance. A cross-sectional consecutive study of twelve patients admitted to an intensive care unit and twelve healthy age- and gender-matched controls was conducted. Passive range of motion was performed in one leg by a physical therapist. Blood flow velocities and resistance index in the common femoral artery (CFA), blood pressure and heart rate were measured before, directly after and at rest after passive range of motion. No changes were seen in BFV or resistance index in the patient group or the control group. No changes were found in blood pressure or heart rate in the patient group. In the control group, changes were found in systolic and mean blood pressure, with a higher pressure before passive range of motion. The controls had lower BFV and higher resistance index than the patients when comparing the groups. The conclusion of this study including twelve patients is that passive range of motion does not alter BFV or resistance index in the CFA in comatose and/or sedated critically ill patients.
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| 9. |
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| 10. |
- Volkmann, Reinhard, 1942
(författare)
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Transkraniell ultraljudsdiagnostik
- 2007
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Ingår i: och cerenbrovaskulär sjukdom. - Lund : Studentlitteratur. - 9144033915 - 9144033915 ; , s. 161-179
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Bokkapitel (övrigt vetenskapligt/konstnärligt)
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