| 1. |
- Sundström, Emilia, et al.
(författare)
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Implantable cardioverter defibrillator treatment in long QT syndrome patients : a national study on adherence to international guidelines
- 2017
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Ingår i: Scandinavian Cardiovascular Journal. - : Informa UK Limited. - 1401-7431 .- 1651-2006. ; 51:2, s. 88-94
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Tidskriftsartikel (refereegranskat)abstract
- Objectives. Implantable cardioverter defibrillator (ICD) treatment is effective among long QT syndrome (LQTS) patients at a high risk of sudden cardiac death. Previous studies show that the international guidelines are not always followed, and that risk stratification may be based on genotype rather than individual risk profile. We analysed data from the Swedish ICD & Pacemaker Registry and medical records to examine how international guidelines were followed with regards to phenotype and genotype. Methods and results. ICD treatment was used in 150 Swedish LQTS patients from 1989-2013. The annual number of implantations increased over the study period. A total of 109 patients were included in the analysis. Most patients (91%) were symptomatic before the implantation. Seventy percent of patients who received ICD treatment met the 2006 Class I or Class IIa recommendations for LQTS treatment. Thirty-one percent of the LQT3 patients received ICD treatment despite being asymptomatic. Among LQT1 patients, 45% received ICD treatment after syncope despite beta-blockers. Conclusions. Thirty percent of Swedish LQTS patients with ICD received the treatment without a strong indication based on international guidelines. LQT3 patients were over-represented among asymptomatic patients. Many LQT1 patients received ICD despite the known effect of beta-blockers in this group.
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| 2. |
- Barywani, Salim B., 1968, et al.
(författare)
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Octogenarians died mainly of cardiovascular diseases five years after acute coronary syndrome.
- 2016
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Ingår i: Scandinavian cardiovascular journal : SCJ. - : Informa UK Limited. - 1651-2006 .- 1401-7431. ; 50:5-6, s. 300-304
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Tidskriftsartikel (refereegranskat)abstract
- A substantial part of deaths and readmissions in octogenarians with acute coronary syndrome (ACS) is assumed to be of non-cardiovascular causes. However, limited data on cause-specific long-term mortality and hospital readmissions are available. This study was aimed to investigate 5-year cause-specific deaths and re-hospitalizations as well as their prognostic predictors among octogenarians with ACS managed with percutaneous coronary intervention (PCI).A total of 181 octogenarians managed with PCI on ACS indication during 2006-2007 at Sahlgrenska University Hospital were included. The time-period was chosen to allow a follow-up period of five years.All-cause 5-year mortality was 46%. Approximately 70% of deaths were cardiovascular. All-cause hospital readmissions were 71%. The majority of readmissions were due to non-cardiovascular diseases, 61% of all readmissions. Cox proportional-hazard regression analyses for cardiovascular mortality identified female sex and culprit lesion in left coronary arteries as independent predictors. Negative binomial regression models showed female sex and complications during index hospitalization as independent predictors of increased cardiovascular re-hospitalizations and prior smoking as independent predictor of increased non-cardiovascular re-hospitalizations.In an octogenarian cohort presented with ACS treated with PCI, cardiovascular diseases were the main causes of deaths, whereas non-cardiovascular diseases were the main causes of re-hospitalizations.
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| 3. |
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| 4. |
- Acosta, Stefan, et al.
(författare)
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Stable population-based incidence of acute type A and B aortic dissection
- 2019
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Ingår i: Scandinavian Cardiovascular Journal. - : Informa UK Limited. - 1401-7431 .- 1651-2006. ; 53:5, s. 274-279
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Tidskriftsartikel (refereegranskat)abstract
- Background. Aortic dissection (AD) and abdominal aortic aneurysm (AAA) share the same risk factors. Whereas the incidence of AAA is falling, it is unclear whether population-based incidences of acute type A and B AD have changed. The aim of this study was to investigate incidences of AD subtypes over time. Methods. Citizens in the municipality of Malmö, Sweden, diagnosed with AD in 2000–2004 and 2014–2016 were identified through the in-patient, clinical, and forensic autopsy registers. Results. The overall and gender-specific incidences of acute type A and B AD were stable over time. The overall autopsy rate declined from 25.2% in 2000–2004 to 16.1% in 2014–2016 (p =.0001) and patients with acute type A AD were more often encountered at autopsy (78% of cases) during the first time period, compared to 43% of cases during the second time period (p =.005), when the ratio of acute type A: acute type B AD was 2.6: 1. The proportion of individuals <65 years of age tended to be higher in acute type A AD compared to acute type B AD (p =.07). The frequencies of hypertension and smoking were 90% and 91%, respectively, in type A AD, and 86% and 86%, respectively in type B AD. Conclusions. Population-based incidences of acute type A and type B AD were stable over time, but the decreasing autopsy rate has led to a lower proportion of AD diagnosed at autopsy. Primary prevention towards hypertension and smoking seem necessary to reduce AD incidence.
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| 5. |
- Almer, Jakob, et al.
(författare)
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Ischemic QRS prolongation as a predictor of ventricular fibrillation in a canine model
- 2018
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Ingår i: Scandinavian Cardiovascular Journal. - : Informa UK Limited. - 1401-7431 .- 1651-2006. ; 52:5, s. 262-267
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Tidskriftsartikel (refereegranskat)abstract
- Objectives. An acute coronary occlusion and its possible subsequent complications is one of the most common causes of death. One such complication is ventricular fibrillation (VF) due to myocardial ischemia. The severity of ischemia is related to the amount of coronary arterial collateral flow. In dog studies collateral flow has also been shown to be associated with QRS prolongation. The aim of this study was to investigate whether ischemic QRS prolongation (IQP) is associated with impending VF in an experimental acute ischemia dog model. Methods. Degree of IQP and occurrence of VF were measured in dogs (n = 21) during coronary occlusion for 15 min and also during subsequent reperfusion (experiments conducted in 1984). Results. There was a significant difference in absolute IQP between dogs which developed VF during reperfusion (47 ± 29 ms, mean ± SD) and those which did not (12 ± 10 ms; p =.001). Conclusions. IQP during acute coronary occlusion is associated with reperfusion VF in an experimental dog model and might therefore be a potential predictor of malignant arrhythmias in patients with acute coronary syndrome.
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| 6. |
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| 7. |
- Barywani, Salim B., 1968, et al.
(författare)
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Prognostic impact of heart rate in elderly with systolic heart failure and concomitant atrial fibrillation
- 2017
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Ingår i: Scandinavian Cardiovascular Journal. - : Informa UK Limited. - 1401-7431 .- 1651-2006. ; 51:4, s. 190-196
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Tidskriftsartikel (refereegranskat)abstract
- Objective: The present study aimed to investigate the impact of resting heart rate (HR) on 5-year all-cause mortality in patients 80 years with heart failure (HF) with reduced ejection fraction (HFrEF) and concomitant atrial fibrillation (AF) after optimal up-titration of beta-blockers (BBs).Methods: Patients (n=185) aged 80 years with HF and left ventricular ejection fraction 40% were included between January 2000 and January 2008 from two university hospitals, Sahlgrenska and ostra and retrospectively studied from January 2 to May 30, 2013. Up-titrations of guideline recommended medications were performed at HF outpatient clinics.Results: Of whole study population, 54% (n=100) had AF. After optimal up-titration of BBs and angiotensin converting enzyme inhibitors (ACEIs)/angiotensin receptor blockers (ARBs), mean HR in patients with AF was 7315 beats/minute (bpm), 36% had resting HR65 bpm. Five-year all-cause mortality among patients with AF was significantly lower in patients with HR65 bpm (63%) compared to HR>65 (80%). Cox proportional-hazard regression analysis adjusted for clinically important baseline variables and doses of ACEIs/ARBs and BBs demonstrated resting HR65 bpm as an independent predictor of improved survival compared to resting HR>65 bpm (HR 0.3, 95%CI 0.1-0.7, P 0.005).Discussion: In octogenarians with HFrEF and concomitant AF, lowering resting HR to levels as low as HR65 bpm was still associated with improved survival from all-cause mortality. Our data indicate that mortality in AF became comparable to SR when patients were on maximally up-titrated beta-blocker doses with HR as low as 75 bpm.
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| 8. |
- Bech-Hanssen, Odd, 1956, et al.
(författare)
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Atrial function in heart transplant recipients operated with the bicaval technique.
- 2016
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Ingår i: Scandinavian cardiovascular journal : SCJ. - : Informa UK Limited. - 1651-2006 .- 1401-7431. ; 50:1, s. 42-51
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Tidskriftsartikel (refereegranskat)abstract
- In heart transplantation (HTx) with the bicaval technique the whole right atrium (RA) is donor tissue while the left atrium (LA) consists of both donor and recipient tissue. The aims of the study were to describe atrial function in comparison with healthy controls and to identify determinants of dysfunction.
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| 9. |
- Bech-Hanssen, Odd, 1956, et al.
(författare)
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Left ventricular volumes by echocardiography in chronic aortic and mitral regurgitation.
- 2016
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Ingår i: Scandinavian cardiovascular journal : SCJ. - : Informa UK Limited. - 1651-2006 .- 1401-7431. ; 50:3, s. 154-161
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Tidskriftsartikel (refereegranskat)abstract
- Cut-off values for left ventricular (LV) dimensions indicating severe valve regurgitation have not been defined. The aim of the study was to establish echocardiographic cut-off values for LV dimensions indicating severe chronic aortic (AR) or mitral (MR) regurgitation.
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| 10. |
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