| 11. |
- Hedman, Kristofer, et al.
(författare)
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Cardiac systolic regional function and synchrony in endurance trained and untrained females
- 2015
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Ingår i: BMJ Open Sport & Exercise Medicine. - : BMJ. - 2055-7647. ; 25:1
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Tidskriftsartikel (refereegranskat)abstract
- Background Most studies on cardiac function in athletes describe overall heart function in predominately male participants. We aimed to compare segmental, regional and overall myocardial function and synchrony in female endurance athletes (ATH) and in age-matched sedentary females (CON).Methods In 46 ATH and 48 CON, echocardiography was used to measure peak longitudinal systolic strain and myocardial velocities in 12 left ventricular (LV) and 2 right ventricular (RV) segments. Regional and overall systolic function were calculated together with four indices of dyssynchrony.Results There were no differences in regional or overall LV systolic function between groups, or in any of the four dyssynchrony indices. Peak systolic velocity (s′) was higher in the RV of ATH than in CON (9.7±1.5 vs 8.7±1.5 cm/s, p=0.004), but not after indexing by cardiac length (p=0.331). Strain was similar in ATH and CON in 8 of 12 LV myocardial segments. In septum and anteroseptum, basal and mid-ventricular s′ was 6–7% and 17–19% higher in ATH than in CON (p<0.05), respectively, while s′ was 12% higher in CON in the basal LV lateral wall (p=0.013). After indexing by cardiac length, s′ was only higher in ATH in the mid-ventricular septum (p=0.041).Conclusions We found differences between trained and untrained females in segmental systolic myocardial function, but not in global measures of systolic function, including cardiac synchrony. These findings give new insights into cardiac adaptation to endurance training and could also be of use for sports cardiologists evaluating female athletes.
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| 12. |
- Hedman, Kristofer, et al.
(författare)
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Decreased aerobic capacity 4 years after aortic valve replacement in male patients operated upon for chronic aortic regurgitation
- 2012
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Ingår i: Clinical Physiology and Functional Imaging. - : Wiley-Blackwell. - 1475-0961 .- 1475-097X. ; 32:3, s. 167-171
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Tidskriftsartikel (refereegranskat)abstract
- Exercise testing is underutilized in patients with valve disease. We have previously found a low physical work capacity in patients with aortic regurgitation 6 months after aortic valve replacement (AVR). The aim of this study was to evaluate aerobic capacity in patients 4 years after AVR, to study how their peak oxygen uptake (peakVO2) had changed postoperatively over a longer period of time. Twenty-one patients (all men, 52 +/- 13 years) who had previously undergone cardiopulmonary exercise testing (CPET) pre- and 6 months postoperatively underwent maximal exercise testing 49 +/- 15 months postoperatively using an electrically braked bicycle ergometer. Breathing gases were analysed and the patients physical fitness levels categorized according to angstrom strands and Wassermans classifications. Mean peakVO2 was 22.8 +/- 5.1 ml x kg-1 x min-1 at the 49-month follow-up, which was lower than at the 6-month follow-up (25.6 +/- 5.8 ml x kg-1 x min-1, P = 0.001). All but one patient presented with a physical fitness level below average using angstrom strands classification, while 13 patients had a low physical capacity according to Wassermans classification. A significant decrease in peakVO2 was observed from six to 49 months postoperatively, and the decrease was larger than expected from the increased age of the patients. CPET could be helpful in timing aortic valve surgery and for the evaluation of need of physical activity as part of a rehabilitation programme.
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| 13. |
- Hedman, Kristofer, et al.
(författare)
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ECHOCARDIOGRAPHIC CHARACTERIZATION OF THE INFERIOR VENA CAVA IN TRAINED AND UNTRAINED FEMALES
- 2016
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Ingår i: Ultrasound in Medicine and Biology. - : ELSEVIER SCIENCE INC. - 0301-5629 .- 1879-291X. ; 42:12, s. 2794-2802
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Tidskriftsartikel (refereegranskat)abstract
- The aim of the study was to explore the long-and short-axis dimensions, shape and collapsibility of the inferior vena cava in 46 trained and 48 untrained females (mean age: 21 +/- 2 y). Echocardiography in the subcostal view revealed a larger expiratory long-axis diameter (mean: 24 +/- 3 vs. 20 +/- 3 mm, p amp;lt; 0.001) and short-axis area (mean: 5.5 +/- 1.5 vs. 4.7 +/- 1.4 cm(2), p = 0.014) in trained females. IVC shape (the ratio of short-axis major to minor diameters) and the relative decrease in IVC dimension with inspiration were similar for the two groups. The IVC long-axis diameter reflected short-axis minor diameter and was correlated to maximal oxygen uptake (r = 0.52, p amp;lt; 0.01). In summary, the results indicate that trained females have a larger IVC similar in shape and respiratory decrease in dimensions to that of untrained females. The long-axis diameter corresponded closely to short-axis minor diameter and, thus, underestimates maximal IVC diameter. (E-mail: kristofer.hedman@liu.se) (C) 2016 The Authors. Published by Elsevier Inc. on behalf of World Federation for Ultrasound in Medicine amp; Biology.
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| 14. |
- Hedman, Kristofer, et al.
(författare)
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Female athlete's heart : Systolic and diastolic function related to circulatory dimensions
- 2015
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Ingår i: Scandinavian Journal of Medicine and Science in Sports. - : Wiley-Blackwell. - 0905-7188 .- 1600-0838. ; 25:3, s. 372-381
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Tidskriftsartikel (refereegranskat)abstract
- There are relatively few studies on female athletes examining cardiac size and function and how these measures relate to maximal oxygen uptake (VO2max ). When determining sports eligibility, it is important to know what physiological adaptations and characteristics may be expected in female athletes, taking body and cardiac size into account. The purposes of this study were (a) to compare right and left heart dimensions and function in female endurance athletes (ATH) and in non-athletic female controls of similar age (CON); and (b) to explore how these measures related to VO2max . Forty-six ATH and 48 CON underwent a maximal bicycle exercise test and an echocardiographic examination at rest, including standard and color tissue Doppler investigation. All heart dimensions indexed for body size were larger in ATH (all P < 0.01). The diastolic mitral E/A ratio was 27% higher in ATH (P < 0.001) while systolic left and right atrio-ventricular longitudinal displacement was 7% (P = 0.002) and 15% (P < 0.001) larger in ATH, respectively. Half (50.3%) of the variability in VO2max could be explained by left ventricular end-diastolic volume. Our results could be useful in evaluating female endurance athletes with suspected cardiac disease and contribute to understanding differences between female athletes and non-athletes.
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| 15. |
- Hedman, Kristofer, et al.
(författare)
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The size and shape of the inferior vena cava in trained and untrained females in relation to maximal oxygen uptake
- 2015
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Annan publikation (övrigt vetenskapligt/konstnärligt)abstract
- Background. The increase in cardiac dimensions following endurance training is well acknowledged. A few studies report a larger inferior vena cava (IVC) in trained, predominatly male subjects while athlete-control studies upon females are lacking. Previous studies were constrained to long-axis measurements, and there are no reports in the literature on IVC short-axis dimensions and shape in athletes.Methods and Results. Forty-eight sedentary and 46 endurance trained females (mean age 21±2 years, VO2max 39±5 vs. 52±5 mL×kg-1×min-1, p<0.001) underwent echocardiographic examination including IVC diameter and cross-sectional area measured in the subcostal view. IVC shape was calculated as the ratio of short-axis major-to-minor diameter.Five out of eight IVC dimensions were larger in trained females, including maximal long-axis diameter (mean 24±3 vs. 20±3 mm, p<0.001) and maximal short-axis area (mean 5.5±1.5 vs. 4.7±1.4 cm2, p=0.022). Both groups presented with a slightly oval IVC with no differences between the groups in IVC shape or inspiratory decrease in any IVC dimension. The IVC long-axis diameter reflected the minor-axis diameter obtained in the short-axis view, during both expiration and inspiration. Positive correlations were seen between maximal IVC long-axis diameter and maximal oxygen uptake (r=0.52, p<0.01), left ventricular end-diastolic volume (r=0.46, p<0.01) and right atrial area (r=0.49, p<0.01).Conclusion. The IVC was larger in endurance trained than in untrained females but showed similar shape and inspiratory decrease in dimensions. The long-axis IVC diameter was related to maximal oxygen uptake.
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| 16. |
- Helin Forsberg,, Lena, et al.
(författare)
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Preoperative Longitudinal Left Ventricular Function by Tissue Doppler Echocardiography at Rest and During Exercise Is Valuable in Timing of Aortic Valve Surgery in Male Aortic Regurgitation Patients
- 2010
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Ingår i: Journal of the American Society of Echocardiography. - : Elsevier Science B.V. Amsterdam. - 0894-7317 .- 1097-6795. ; 23:4, s. 387-395
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Tidskriftsartikel (refereegranskat)abstract
- Background: The aim of this study was to evaluate if left ventricular (LV) systolic function by tissue Doppler echocardiography at rest and during exercise preoperatively could predict postoperative LV function and thereby be useful in the timing of aortic valve surgery in patients with severe aortic regurgitation. Methods: In 29 patients (median age, 59 years; interquartile range, 39-64 years), echocardiography, tissue Doppler echocardiography, and radionuclide ventriculography were performed preoperatively and postoperatively at rest and during supine bicycle exercise. Results: Preoperative ejection fraction (EF) was 62%. Patients formed two groups, with basal LV peak systolic velocity (PSV) 5.9 cm/s preoperatively as the cutoff value between low and high PSV. Preoperatively, patients with low PSV had lower PSV during exercise (Pandlt;.005), EF during exercise (Pandlt;.05), and atrioventricular plane displacement (AVPD) at rest (Pandlt;.005) and during exercise (P andlt;.05) than those with high PSV. Postoperatively, patients with low PSV had smaller AVPD at rest (P andlt;.05), AVPD during exercise (Pandlt;.01), and PSV during exercise (Pandlt;.01). Conclusion: In patients with chronic aortic regurgitation with EFs and LV dimensions not fulfilling criteria for surgery according to guidelines, preoperative PSV and AVPD at rest and during exercise detected postoperative LV dysfunction.
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| 17. |
- Holmberg, Erica, et al.
(författare)
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Right ventricular function in severe aortic stenosis assessed by echocardiography and MRI
- 2023
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Ingår i: Clinical Physiology and Functional Imaging. - : WILEY. - 1475-0961 .- 1475-097X.
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Tidskriftsartikel (refereegranskat)abstract
- Background: The prevalence of aortic valve stenosis (AS) is increasing due to an ageing population. Despite that right ventricular function has prognostic value for postoperative outcome, the right ventricle (RV) is not extensively studied and often not routinely assessed in AS. Our aim was to explore the relation between severe AS and RV function in a surgical aortic valve replacement (SAVR) cohort, comparing two imaging modalities for RV evaluation.Methods: Patients with severe AS, underwent cardiovascular magnetic resonance imaging (CMR) and transthoracic echocardiography (TTE) before SAVR. RV dysfunction was defined as one or more of the following: tricuspid annular plane systolic excursion (TAPSE) < 17 mm, RV free wall strain (RVFWS) > -20% by TTE and RV ejection fraction (RVEF) <50% by CMR.Results: Sixteen (33%) patients were found to have RV dysfunction. Patients with RV dysfunction showed significantly lower indexed aortic valve area, left ventricular (LV) ejection fraction as well as RV and LV stroke volumes compared to patients with maintained RV function. All patients with reduced RVEF also had changes in TAPSE or RVFWS and a larger number of patients had a reduced longitudinal RV function despite a normal RVEF.Conclusion: In a SAVR cohort one-third of the patients had RV dysfunction, defined by RVEF, TAPSE or RVFW strain. Echocardiography detected subtle changes in RV function before RVEF was reduced. It is likely that the more pronounced the AS, the more frequent the occurrence of RV dysfunction.
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| 18. |
- Kvernby, Sofia, et al.
(författare)
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Longitudinal Changes in Myocardial T-1 and T-2 Relaxation Times Related to Diffuse Myocardial Fibrosis in Aortic Stenosis; Before and After Aortic Valve Replacement
- 2018
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Ingår i: Journal of Magnetic Resonance Imaging. - : WILEY. - 1053-1807 .- 1522-2586. ; 48:3, s. 799-807
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Tidskriftsartikel (refereegranskat)abstract
- Background: Diffuse myocardial fibrosis is associated with adverse outcomes, although detection and quantification is challenging. Cardiac MR relaxation times mapping represents a promising imaging biomarker for diffuse myocardial fibrosis. Purpose: To investigate whether relaxation times can detect longitudinal changes in myocardial tissue composition associated with diffuse fibrosis in patients with severe aortic stenosis (AS) before and after aortic valve replacement (AVR). Study type: Prospective longitudinal study. Population/Subjects/Phantom/Specimen/Animal Model: Fifteen patients with severe AS. Field Strength/Sequence: 3T /3(3) 3(3) 5-MOLLI, T2-GraSE, and 3D-QALAS. Assessment: Patients underwent MR examinations at three timepoints: before AVR, as well as 3 and 12 months after AVR. Data from each patient was analyzed in 16 myocardial segments. Statistical Tests: The segment-wise T1 and T2 data were analyzed over time after surgery using linear mixed models for repeated measures analysis. Results: The results showed that T1 relaxation times were significantly (Pamp;lt; 0.05) shorter 3 and 12 months postoperative than preoperative and that the T2 relaxation times were significantly (Pamp;lt; 0.05) longer 3 and 12 months postoperative than preoperative for both 3D and 2D mapping methods. No significant changes were seen between 3 and 12 months postoperative for any of the methods (P50.06/0.19 for T1 with 3D-QALAS/MOLLI and P50.09/0.25 for T2 with 3DQALAS/ GraSE). Data Conclusion: We demonstrated that changes in myocardial relaxation times and thus tissue characteristics can be observed within 3 months after AVR surgery. The significant changes in relaxation times from preoperative examinations to the follow-up may be interpreted as a reduction of interstitial fibrosis in the left ventricular wall. Level of Evidence: 1 Technical Efficacy: Stage 3
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| 19. |
- Nilsson, Henric, et al.
(författare)
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Cardiopulmonary exercise testing for evaluation of a randomized exercise training intervention following aortic valve replacement
- 2019
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Ingår i: Clinical Physiology and Functional Imaging. - : WILEY. - 1475-0961 .- 1475-097X. ; 39:1, s. 103-110
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Tidskriftsartikel (refereegranskat)abstract
- Aortic valve surgery is the definitive treatment for aortic stenosis (AS). No specific recommendation is available on how exercise training should be conducted and evaluated after aortic valve replacement (AVR). This study aimed to examine the effect of aerobic exercise training on exercise capacity following AVR. In addition to our primary outcome variable, peak oxygen uptake (peakVO(2)), the effect on submaximal cardiopulmonary variables including oxygen uptake kinetics (tau), oxygen uptake efficiency slope (OUES) and ventilatory efficiency (VE/VCO2 slope) was evaluated. Following AVR due to AS, 12 patients were randomized to either a group receiving 12 weeks of supervised aerobic exercise training (EX) or a control group (CON). Exercise capacity was assessed by a maximal cardiopulmonary exercise test (CPET). There was a significant increase in peak load (+28%, P = 0 center dot 031) and in peakVO(2) (+23%, P = 0 center dot 031) in EX, corresponding to an increase in achieved percentage of predicted peakVO(2) from 88 to 104% (P = 0 center dot 031). For submaximal variables, there were only non-statistically significant trends in improvement between CPETs in EX. In CON, there were no significant differences in any maximal or submaximal variable between CPETs. We conclude that 12 weeks of supervised aerobic exercise training induces significant adaptations in cardiopulmonary function following AVR, especially in regard to maximal variables including peakVO(2). In addition, we provide novel data on the effect on several submaximal variables following exercise training in this group of patients.
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| 20. |
- Nilsson, Jessica, et al.
(författare)
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Bis- and tris(pyridyl)amine-oxidovanadium complexes: characteristics and insulin-mimetic potential.
- 2009
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Ingår i: Dalton Transactions. - : Royal Society of Chemistry (RSC). - 1477-9234 .- 1477-9226. ; :38, s. 7902-7911
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Tidskriftsartikel (refereegranskat)abstract
- Two novel vanadium complexes, [V(IV)O(bp-O)(HSO4)] (1) and [V(IV)O(bp-OH)Cl2] x CH3OH (2 x CH3OH), where bp-OH is 2-{[bis(pyrid-2-yl)methyl]amine}methylphenol, were prepared and structurally characterised. EPR spectra of methanol solutions of 2 suggest exchange of Cl- for CH3OH and partial conversion to [VO(bp-OH)(CH3OH)3]2+. Speciation studies on the VO2+-bpOH system in a water/dmso mixture (4:1 v/v) revealed [VO(bp-O)(H2O)n]+ as the dominating species in the pH range 2-7. The insulin-mimetic properties of 1 and 2, [V(IV)O(SO4)tpa] (3), [V(IV)O(pic-trpMe)2] (5) and the new mixed-ligand complexes [V(V)O(pic-trpH)tpa]Cl2 (4Cl2) and [V(V)O(pic-OEt)tpa]Cl2 (6Cl2), tpa = tris(pyrid-2-yl)methylamine, picH-trpH = 2-carboxypyridine-5-(L-tryptophan)carboxamide (picH-trpMe is the respective tryptophanmethyl ester), pic-OEt = 5-carboethoxypyridine-2-carboxylic acid, were evaluated with rat adipocytes, employing two lipolysis assays (release of glycerol and free fatty acids (FFA)), respectively and a lipogenesis assay (incorporation of glucose into lipids). The IC50 values for the inhibition of lipolysis in the FFA assay vary between 0.41 (+/-0.03) (5) and 21.2 (+/-0.6) mM (2), as compared to 0.81 (+/-0.2) mM for VOSO4.
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