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- Pettersson, Jonas, et al.
(författare)
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Muscular exercise can cause highly pathological liver function tests in healthy men.
- 2008
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Ingår i: British Journal of Clinical Pharmacology. - : Wiley. - 1365-2125 .- 0306-5251. ; 65:2, s. 253-259
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Tidskriftsartikel (refereegranskat)abstract
- What is already known about this subject • The occurrence of idiosyncratic drug hepatotoxicity is a major problem in all phases of clinical drug development and the leading cause of postmarketing warnings and withdrawals. • Physical exercise can result in transient elevations of liver function tests. • There is no consensus in the literature on which forms of exercise may cause changes in liver function tests and to what extent. What this study adds • Weightlifting results in profound increases in liver function tests in healthy men used to moderate physical activity, not including weightlifting. • Liver function tests are significantly increased for at least 7 days after weightlifting. • It is important to impose relevant restrictions on heavy muscular exercise prior to and during clinical studies. Aim To investigate the effect of intensive muscular exercise (weightlifting) on clinical chemistry parameters reflecting liver function in healthy men. Methods Fifteen healthy men, used to moderate physical activity not including weightlifting, performed an 1 h long weightlifting programme. Blood was sampled for clinical chemistry parameters [aspartate aminotransferase (AST), alanine aminotransferase (ALT), lactate dehydrogenase (LD), gamma-glutamyl transferase (γGT), alkaline phosphatase (ALP), bilirubin, creatine kinase (CK) and myoglobin] at repeated intervals during 7 days postexercise and at a follow-up examination 10–12 days postexercise. Results Five out of eight studied clinical chemistry parameters (AST, ALT, LD, CK and myoglobin) increased significantly after exercise (P < 0.01) and remained increased for at least 7 days postexercise. Bilirubin, γGT and ALP remained within the normal range. Conclusion The liver function parameters, AST and ALT, were significantly increased for at least 7 days after the exercise. In addition, LD and, in particular, CK and myoglobin showed highly elevated levels. These findings highlight the importance of imposing restrictions on weightlifting prior to and during clinical studies. Intensive muscular exercise, e.g. weightlifting, should also be considered as a cause of asymptomatic elevations of liver function tests in daily clinical practice.
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| 2. |
- Björk, Jonas, et al.
(författare)
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A simple statistical model for prediction of acute coronary syndrome in chest pain patients in the emergency department
- 2006
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Ingår i: BMC Medical Informatics and Decision Making. - : Springer Science and Business Media LLC. - 1472-6947. ; 6:28
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Tidskriftsartikel (refereegranskat)abstract
- Background Several models for prediction of acute coronary syndrome (ACS) among chest pain patients in the emergency department (ED) have been presented, but many models predict only the likelihood of acute myocardial infarction, or include a large number of variables, which make them less than optimal for implementation at a busy ED. We report here a simple statistical model for ACS prediction that could be used in routine care at a busy ED. Methods Multivariable analysis and logistic regression were used on data from 634 ED visits for chest pain. Only data immediately available at patient presentation were used. To make ACS prediction stable and the model useful for personnel inexperienced in electrocardiogram (ECG) reading, simple ECG data suitable for computerized reading were included. Results Besides ECG, eight variables were found to be important for ACS prediction, and included in the model: age, chest discomfort at presentation, symptom duration and previous hypertension, angina pectoris, AMI, congestive heart failure or PCI/CABG. At an ACS prevalence of 21% and a set sensitivity of 95%, the negative predictive value of the model was 96%. Conclusions The present prediction model, combined with the clinical judgment of ED personnel, could be useful for the early discharge of chest pain patients in populations with a low prevalence of ACS.
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| 5. |
- Brage, Søren, et al.
(författare)
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Hierarchy of individual calibration levels for heart rate and accelerometry to measure physical activity.
- 2007
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Ingår i: J Appl Physiol. - : American Physiological Society. - 8750-7587. ; 103:2, s. 682-92
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Tidskriftsartikel (refereegranskat)abstract
- Combining accelerometry with heart rate (HR) monitoring may improve precision of physical activity measurement. Considerable variation exists in the relationships between physical activity intensity (PAI) and HR and accelerometry, which may be reduced by individual calibration. However, individual calibration limits feasibility of these techniques in population studies, and less burdensome, yet valid, methods of calibration are required. We aimed to evaluate the precision of different individual calibration procedures against a reference calibration procedure: a ramped treadmill walking-running test with continuous measurement of PAI by indirect calorimetry in 26 women and 25 men [mean (SD): 35 ( 9 ) yr, 1.69 (0.10) m, 70 ( 14 ) kg]. Acceleration (along the longitudinal axis of the trunk) and HR were measured simultaneously. Alternative calibration procedures included treadmill testing without calorimetry, submaximal step and walk tests with and without calorimetry, and nonexercise calibration using sleeping HR and gender. Reference accelerometry and HR models explained >95% of the between-individual variance in PAI ( P < 0.001). This fraction dropped to 73 and 81%, respectively, for accelerometry and HR models calibrated with treadmill tests without calorimetry. Step-test calibration captured 62–64% (accelerometry) and 68% (HR) of the variance between individuals. Corresponding values were 63–76% and 59–61% for walk-test calibration. There was only little benefit of including calorimetry during step and walk calibration for HR models. Nonexercise calibration procedures explained 54% (accelerometry) and 30% (HR) of the between-individual variance. In conclusion, a substantial proportion of the between-individual variance in relationships between PAI, accelerometry, and HR is captured with simple calibration procedures, feasible for use in epidemiological studies.
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| 6. |
- Carlsson, Marcus, et al.
(författare)
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Center of volume and total heart volume variation in healthy subjects and patients before and after coronary bypass surgery.
- 2005
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Ingår i: Clinical Physiology and Functional Imaging. - 1475-0961. ; 25:4, s. 226-233
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Tidskriftsartikel (refereegranskat)abstract
- BACKGROUND: Total heart volume variation (THVV) and center of volume variation (COVV) likely affects the efficiency of cardiac pumping, but no study has determined COVV of the heart throughout the cardiac cycle or the effect of surgery on THVV in adults. Therefore, the purposes of this study were to determine COVV in healthy adults and patients with cardiac failure due to ischemic heart disease (IHD), identify any difference in THVV between these two groups, and determine how these parameters are affected by coronary bypass surgery. METHODS: Six healthy volunteers and eight patients before and after surgery were investigated with cardiovascular magnetic resonance imaging. The atrioventricular plane movement (AVPM), THVV and time resolved three-dimensional coordinates of the center of the cardiac volume (COVV) were measured. RESULTS: COVV followed a loop in 3D space that between the end-points was approximately 2 mm with no difference between healthy subjects and patients before surgery (P = 0.093), although AVPM was significantly lower in patients (P = 0.002). However, after surgery the COVV during the cardiac cycle doubled (P = 0.012) and the increase in THVV was significant (P = 0.050), although of very small magnitude, and the AVPM remained unchanged (P = 0.401). CONCLUSION: COVV and THVV were similar in patients and healthy subjects even though AVPM was lower in the patient population. After surgery, however, COVV doubled despite a very small change in THVV and no change in AVPM. Taken together, the results of this study may provide new insights into the energy expenditure and efficiency of cardiac pumping.
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| 7. |
- Corder, Kirsten, et al.
(författare)
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Physical activity
- 2008. - 2
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Ingår i: Paediatric exercise science and medicine. - Oxford : Oxford University Press. - 9780199232482 ; , s. 129-144
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Bokkapitel (övrigt vetenskapligt/konstnärligt)
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| 10. |
- Dimitrijevic, Ivan, et al.
(författare)
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Increased expression of endothelin ETB and angiotensin AT(1) receptors in peripheral resistance arteries of patients with suspected acute coronary syndrome
- 2009
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Ingår i: Heart and Vessels. - : Springer Science and Business Media LLC. - 1615-2573 .- 0910-8327. ; 24:6, s. 393-398
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Tidskriftsartikel (refereegranskat)abstract
- Patients who experience chest pain, in which ischemic heart disease has been ruled out, still have an increased risk of future ischemic cardiac events and premature death, possibly due to subclinical endothelial dysfunction. A feature of endothelial dysfunction is an increased expression of arterial vasoconstrictor endothelin (ET) and angiotensin (AT) receptors. Our aim was to investigate if the arterial expressions of these receptors are changed in patients with suspected but ruled out acute coronary syndrome (ACS). Small subcutaneous arteries (diameter of 100 A mu m) were surgically removed in an abdominal biopsy from 12 patients suspicious of ACS (susp ACS), admitted to the medical telemetry unit for chest pain. The vessels were analyzed for their receptor protein expression by quantitative immunohistochemistry using specific antibodies directed against ETA, ETB, AT(1), and AT(2) receptors. The control group (controls) consisted of eight healthy volunteers matched for age and sex with no previous cardiac illness or medication. The susp ACS group had an increased expression of ETB (by 94%) and AT(1) (by 34%) receptors in the smooth muscle cells of resistance arteries as compared to the control group. There were no significant differences in AT(2) and ETA receptor expression between the groups. The results indicate that the expression of arterial smooth muscle ETB and AT(1) receptors are increased in patients with suspected but ruled out ACS. These receptor changes could be important in the regulation of coronary tone and in the development of atherosclerosis, and may be related to increased cardiovascular risk.
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