1. |
- Oldgren, Jonas, 1964-, et al.
(author)
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Systematic Coronary Risk Evaluation estimated risk and prevalent subclinical atherosclerosis in coronary and carotid arteries: A population-based cohort analysis from the Swedish Cardiopulmonary Bioimage Study
- 2021
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In: European Journal of Preventive Cardiology. - : Oxford University Press (OUP). - 2047-4873 .- 2047-4881. ; 28:3, s. 250-259
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Journal article (peer-reviewed)abstract
- Background It is not clear if the European Systematic Coronary Risk Evaluation algorithm is useful for identifying prevalent subclinical atherosclerosis in a population of apparently healthy individuals. Our aim was to explore the association between the risk estimates from Systematic Coronary Risk Evaluation and prevalent subclinical atherosclerosis. Design The design of this study was as a cross-sectional analysis from a population-based study cohort. Methods From the general population, the Swedish Cardiopulmonary Bioimage Study randomly invited individuals aged 50-64 years and enrolled 13,411 participants mean age 57 (standard deviation 4.3) years; 46% males between November 2013-December 2016. Associations between Systematic Coronary Risk Evaluation risk estimates and coronary artery calcification and plaques in the carotid arteries by using imaging data from a computed tomography of the heart and ultrasonography of the carotid arteries were examined. Results Coronary calcification was present in 39.5% and carotid plaque in 56.0%. In men, coronary artery calcium score >0 ranged from 40.7-65.9% and presence of carotid plaques from 54.5% to 72.8% in the age group 50-54 and 60-65 years, respectively. In women, the corresponding difference was from 17.1-38.9% and from 41.0-58.4%. A doubling of Systematic Coronary Risk Evaluation was associated with an increased probability to have coronary artery calcium score >0 (odds ratio: 2.18 (95% confidence interval 2.07-2.30)) and to have >1 carotid plaques (1.67 (1.61-1.74)). Conclusion Systematic Coronary Risk Evaluation estimated risk is associated with prevalent subclinical atherosclerosis in two major vascular beds in a general population sample without established cardiovascular disease or diabetes mellitus. Thus, the Systematic Coronary Risk Evaluation risk chart may be of use for estimating the risk of subclinical atherosclerosis.
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2. |
- Ekblom Bak, Elin, 1981-, et al.
(author)
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Accelerometer derived physical activity and subclinical coronary and carotid atherosclerosis : cross-sectional analyses in 22 703 middle-aged men and women in the SCAPIS study
- 2023
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In: BMJ Open. - : BMJ Publishing Group Ltd. - 2044-6055. ; 13:11
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Journal article (peer-reviewed)abstract
- OBJECTIVES: The aim included investigation of the associations between sedentary (SED), low-intensity physical activity (LIPA), moderate-to-vigorous intensity PA (MVPA) and the prevalence of subclinical atherosclerosis in both coronaries and carotids and the estimated difference in prevalence by theoretical reallocation of time in different PA behaviours.DESIGN: Cross-sectional.SETTING: Multisite study at university hospitals.PARTICIPANTS: A total of 22 670 participants without cardiovascular disease (51% women, 57.4 years, SD 4.3) from the population-based Swedish CArdioPulmonary bioImage study were included. SED, LIPA and MVPA were assessed by hip-worn accelerometer.PRIMARY AND SECONDARY OUTCOMES: Any and significant subclinical coronary atherosclerosis (CA), Coronary Artery Calcium Score (CACS) and carotid atherosclerosis (CarA) were derived from imaging data from coronary CT angiography and carotid ultrasound.RESULTS: High daily SED (>70% ≈10.5 hours/day) associated with a higher OR 1.44 (95% CI 1.09 to 1.91), for significant CA, and with lower OR 0.77 (95% CI 0.63 to 0.95), for significant CarA. High LIPA (>55% ≈8 hours/day) associated with lower OR for significant CA 0.70 (95% CI 0.51 to 0.96), and CACS, 0.71 (95% CI 0.51 to 0.97), but with higher OR for CarA 1.41 (95% CI 1.12 to 1.76). MVPA above reference level, >2% ≈20 min/day, associated with lower OR for significant CA (OR range 0.61-0.67), CACS (OR range 0.71-0.75) and CarA (OR range 0.72-0.79). Theoretical replacement of 30 min of SED into an equal amount of MVPA associated with lower OR for significant CA, especially in participants with high SED 0.84 (95% CI 0.76 to 0.96) or low MVPA 0.51 (0.36 to 0.73).CONCLUSIONS: MVPA was associated with a lower risk for significant atherosclerosis in both coronaries and carotids, while the association varied in strength and direction for SED and LIPA, respectively. If causal, clinical implications include avoiding high levels of daily SED and low levels of MVPA to reduce the risk of developing significant subclinical atherosclerosis.
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3. |
- Angerås, Oskar, 1976, et al.
(author)
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Impact of Thrombus Aspiration on Mortality, Stent Thrombosis, and Stroke in Patients with ST-Segment-Elevation Myocardial Infarction: A Report From the Swedish Coronary Angiography and Angioplasty Registry
- 2018
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In: Journal of the American Heart Association. - : John Wiley & Sons. - 2047-9980. ; 7:1
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Journal article (peer-reviewed)abstract
- Background-Thrombus aspiration is still being used in a substantial number of patients despite 2 large randomized clinical trials showing no favorable effect of routine thrombus aspiration during primary percutaneous coronary intervention in patients with STsegment- elevation myocardial infarction. The aim of this observational study was to evaluate the impact of thrombus aspiration on mortality, stent thrombosis, and stroke using all available data from the Swedish Coronary Angiography and Angioplasty Registry (SCAAR). Methods and Results--We identified 42 829 consecutive patients registered in SCAAR between January 2005 and September 2014 who underwent percutaneous coronary intervention for ST-segment-elevation myocardial infarction. Thrombus aspiration was used in 25% of the procedures. We used instrumental variable analysis with administrative healthcare region as the treatmentpreference instrumental variable to evaluate the effect of thrombus aspiration on mortality, stent thrombosis, and stroke. Thrombus aspiration was not associated with mortality at 30 days (risk reduction: -1.2; 95% confidence interval [CI] , -5.4 to 3.0; P=0.57) and 1 year (risk reduction: -2.4; 95% CI, -7.6 to 3.0; P=0.37). Thrombus aspiration was associated with a lower risk of stent thrombosis both at 30 days (risk reduction: -2.7; 95% CI, -4.1 to -1.4; P < 0.001) and 1 year (risk reduction: -3.5; 95% CI, -5.3 to -1.7; P < 0.001). In-hospital stroke and neurologic complications did not differ between groups (risk reduction: 0.1; 95% CI, -0.8 to 1.1; P=0.76). Conclusions--Mortality was not different between the groups. Thrombus aspiration was associated with decreased risk of stent thrombosis. Our study provides important evidence for the external validity of previous randomized studies regarding mortality.
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4. |
- Edebol Carlman, Hanna M. T., et al.
(author)
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Probiotic Mixture Containing Lactobacillus helveticus, Bifidobacterium longum and Lactiplantibacillus plantarum Affects Brain Responses to an Arithmetic Stress Task in Healthy Subjects : A Randomised Clinical Trial and Proof-of-Concept Study
- 2022
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In: Nutrients. - : MDPI. - 2072-6643. ; 14:7
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Journal article (peer-reviewed)abstract
- Probiotics are suggested to impact physiological and psychological stress responses by acting on the gut-brain axis. We investigated if a probiotic product containing Bifidobacterium longum R0175, Lactobacillus helveticus R0052 and Lactiplantibacillus plantarum R1012 affected stress processing in a double-blinded, randomised, placebo-controlled, crossover proof-of-concept study (NCT03615651). Twenty-two healthy subjects (24.2 ± 3.4 years, 6 men/16 women) underwent a probiotic and placebo intervention for 4 weeks each, separated by a 4-week washout period. Subjects were examined by functional magnetic resonance imaging while performing the Montreal Imaging Stress Task (MIST) as well as an autonomic nervous system function assessment during the Stroop task. Reduced activation in regions of the lateral orbital and ventral cingulate gyri was observed after probiotic intervention compared to placebo. Significantly increased functional connectivity was found between the upper limbic region and medioventral area. Interestingly, probiotic intervention seemed to predominantly affect the initial stress response. Salivary cortisol secretion during the task was not altered. Probiotic intervention did not affect cognitive performance and autonomic nervous system function during Stroop. The probiotic intervention was able to subtly alter brain activity and functional connectivity in regions known to regulate emotion and stress responses. These findings support the potential of probiotics as a non-pharmaceutical treatment modality for stress-related disorders.
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6. |
- Menelaou, Georgios, et al.
(author)
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Hippocampal subfield volumes and olfactory performance : Emerging longitudinal associations over a 5-year interval
- 2022
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In: Neuropsychologia. - : Elsevier. - 0028-3932 .- 1873-3514. ; 176
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Journal article (refereegranskat)abstract
- Olfaction, the sense of smell, provides important behavioral functions in many species. The hippocampus (HC) is critical for identifying odors, and hippocampal volume is associated with odor identification ability. Impaired odor identification is often reported in old age and might provide an early marker of cognitive decline and dementia. Here, we explored cross-sectional (n = 225) and longitudinal (n = 118) associations between odor identification ability and hippocampal subfield volumes in a sample of middle-aged and older persons (25-80 years). In older participants, longitudinally decreasing volumes of the hippocampal tail, subiculum, CA4 and the dentate gyrus correlated with changes in odor identification. None of these correlations were observed in younger participants, but there was a significant correlation between longitudinal volume reduction in the tail subfield of the hippocampus and odor identification change across all participants. There were no significant cross-sectional associations between hippocampal subfields and odor identification. These exploratory results provide new information regarding precisely where and when declining HC subfield volumes might be associated with odor identification.
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7. |
- Mohammad, Moman A., et al.
(författare)
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Incidence and outcome of myocardial infarction treated with percutaneous coronary intervention during COVID-19 pandemic
- 2020
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Ingår i: Heart. - : BMJ Publishing Group Ltd. - 1355-6037 .- 1468-201X. ; 106:23, s. 1812-1818
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Tidskriftsartikel (refereegranskat)abstract
- OBJECTIVE: Most reports on the declining incidence of myocardial infarction (MI) during the COVID-19 have either been anecdotal, survey results or geographically limited to areas with lockdowns. We examined the incidence of MI during the COVID-19 pandemic in Sweden, which has remained an open society with a different public health approach fighting COVID-19.METHODS: We assessed the incidence rate (IR) as well as the incidence rate ratios (IRRs) of all MI referred for coronary angiography in Sweden using the nationwide Swedish Coronary Angiography and Angioplasty Registry (SCAAR), during the COVID-19 pandemic in Sweden (1 March 2020-7 May 2020) in relation to the same days 2015-2019.RESULTS: A total of 2443 MIs were referred for coronary angiography during the COVID-19 pandemic resulting in an IR 36 MIs/day (204 MIs/100 000 per year) compared with 15 213 MIs during the reference period with an IR of 45 MIs/day (254 MIs/100 000 per year) resulting in IRR of 0.80, 95% CI (0.74 to 0.86), p<0.001. Results were consistent in all investigated patient subgroups, indicating no change in patient category seeking cardiac care. Kaplan-Meier event rates for 7-day case fatality were 439 (2.3%) compared with 37 (2.9%) (HR: 0.81, 95% CI (0.58 to 1.13), p=0.21). Time to percutaneous coronary intervention (PCI) was shorter during the pandemic and PCI was equally performed, indicating no change in quality of care during the pandemic.CONCLUSION: The COVID-19 pandemic has significantly reduced the incidence of MI referred for invasive treatment strategy. No differences in overall short-term case fatality or quality of care indicators were observed.
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8. |
- Persson, Ninni, et al.
(författare)
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Effects of DARPP-32 Genetic Variation on Prefrontal Cortex Volume and Episodic Memory Performance
- 2017
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Ingår i: Frontiers in Neuroscience. - : Frontiers Media S.A.. - 1662-4548 .- 1662-453X. ; 11
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Tidskriftsartikel (refereegranskat)abstract
- Despite evidence of a fundamental role of DARPP-32 in integrating dopamine and glutamate signaling, studies examining gene coding for DARPP-32 in relation to neural and behavioral cor-relates in humans are scarce. Post mortem findings evidence genotype specific expressions of DARPP-32 in the dorsal frontal lobes. We therefore investigated the effects of genomic variation in DARPP-32 coding on frontal lobe volumes and episodic memory. Volumetric data from the dorsolateral (DLPFC), and visual cortices (VC) were obtained from 61 younger and older adults (♀54%). The major homozygote G, T or A genotypes in single nucleotide polymorphisms (SNPs: rs879606; rs907094; rs3764352), at the DARPP-32 regulating PPP1R1B gene influenced frontal gray matter volume and episodic memory (EM). Homozygous carriers of allelic variants with lower DARPP-32 expression had overall larger prefrontal volumes, in addition to greater EM recall accuracy. The SNPs did not influence VC volume. The genetic effects on DLPFC were greater in younger adults, and selective to this group for EM. Our findings suggest that genomic variation maps on to individual differences in frontal brain volumes, and cognitive functions. Larger DLPFC volumes were also related to better EM performance, suggesting that gene-related differences in frontal gray matter may contribute to individual differences in EM. These results need further replication from experimental and longitudinal reports to determine directions of causality.
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9. |
- Persson, Ninni, et al.
(författare)
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Effects of the gene coding for DARPP-32 (PPP1R1B) on the prefrontal cortex and declarative memory
- 2016
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Konferensbidrag (övrigt vetenskapligt/konstnärligt)abstract
- Introduction: Both glutamate and dopamine can influence the prefrontal cortex and formation of memories through long-term potentiation (1). The frontal cortex itself is rich in glutamatergic and dopaminergic cells (2) and has been identified as an important site for the mediation of the behavioral effects of glutamatergic and dopaminergic agents (3–5). The PPP1R1B gene influences DARPP-32 availability in the frontal lobes. A allelic carriers (rs879606), have higher enzyme activity of DARPP-32, than G carriers (6). DARPP-32 integrates dopaminergic and glutaminergic transmission (7), and DARPP-32 concentrations can further influence cortical gray matter integrity (8). The individuals' age may enhance, or attenuate the influence of genetic variation on the brain and cognitive functions, due to additional impact from neuronal processes, relating to brain maturation in younger age and brain reduction in older age. We therefore wanted to investigate the effects of the gene coding for DARPP-32 (rs879606, in PPP1R1B) on frontal cortical volumes and declarative memory (episodic recall and semantic memory).Methods: Data was used from 61 younger and older adults (°‚ 54%), from the following regions of interest (ROIs): orbito-frontal cortex (OFC), inferior prefrontal cortex (iPFC), medial prefrontal cortex (mPFC), the superior prefrontal cortex (sPFC), and the visual cortex (VC) (the calcarine fissure; cuneus), applying Freesurfer image analysis suite. Gray matter volumes were derived from gradient echo T1-weighted images acquired by a 3-Tesla scanner (Siemens Magnetom Tim Trio), using a 32-channel head coil. A series of structural equation models with latent variables were performed to assess: (1) simple genetic effects on regional brain volumes and memory. (2) We further investigated if the individuals' age could magnify the genetic effects on brain volumes and memory performance. (3) Last, we assessed if size of regional brain volumes could mediate the relationship between the rs879606 polymorphism and declarative memory.Results: We found that the major allelic variant (G) in the single nucleotide polymorphism (SNP): rs879606 in the PPP1R1B gene influenced both frontal gray matter volume and episodic memory (EM). Homozygous carriers of the low activity G allele had larger frontal volumes and more accurate recall of episodic information. The effect sizes were moderate for mPFC (19.1% explained variance), and OFC (14.9%) and smaller for iPFC (9.4%), and EM (5%) (moderate: >10%(9)). The gene-related difference in mPFC was moderated by age, so that younger GG carriers had larger volumes in this region, than A carriers. Regional brain volumes in the mPFC, OFC, and iPFC mediated the relationship between rs879606 and EM. No effects were present for semantic memory, the superior part of the PFC and the VC.Conclusions: The present study replicates previous associations between cognitive performance and rs879606 (10), and shed light on the potential influence of rs879606 on structural integrity of the frontal lobes. The influence of younger age on the relationship between rs879606 and the mPFC region may reflect gene-related variation in post adolescence brain maturation. The medial part of the frontal lobes is subject to dynamic changes through young adulthood (11) and DARPP-32 can influence dendritogenesis, through glutamatergic pathways (12). The mediated effect of the frontal lobes on EM recall may reflect a pathway by which genomic differences lead to variations at cellular levels of the frontal lobes that result in change in cognition. The findings reported herein need further replication from experimental reports including direct measures of glutamate and dopamine integration to determine the specific directions of causality.
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10. |
- Rode, Julia, 1992-, et al.
(författare)
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Probiotic Mixture Containing Lactobacillus helveticus, Bifidobacterium longum and Lactiplantibacillus plantarum Affects Brain Responses Toward an Emotional Task in Healthy Subjects : A Randomized Clinical Trial
- 2022
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Ingår i: Frontiers in nutrition. - : Frontiers Media S.A.. - 2296-861X. ; 9
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Tidskriftsartikel (refereegranskat)abstract
- Background: Evidence from preclinical studies suggests that probiotics affect brain function via the microbiome-gut-brain axis, but evidence in humans remains limited.Objective: The present proof-of-concept study investigated if a probiotic product containing a mixture of Bifidobacterium longum R0175, Lactobacillus helveticus R0052 and Lactiplantibacillus plantarum R1012 (in total 3 × 109 CFU/day) affected functional brain responses in healthy subjects during an emotional attention task.Design: In this double-blinded, randomized, placebo-controlled crossover study (Clinicaltrials.gov, NCT03615651), 22 healthy subjects (24.2 ± 3.4 years, 6 males/16 females) were exposed to a probiotic intervention and a placebo for 4 weeks each, separated by a 4-week washout period. Subjects underwent functional magnetic resonance imaging while performing an emotional attention task after each intervention period. Differential brain activity and functional connectivity were assessed.Results: Altered brain responses were observed in brain regions implicated in emotional, cognitive and face processing. Increased activation in the orbitofrontal cortex, a region that receives extensive sensory input and in turn projects to regions implicated in emotional processing, was found after probiotic intervention compared to placebo using a cluster-based analysis of functionally defined areas. Significantly reduced task-related functional connectivity was observed after the probiotic intervention compared to placebo. Fecal microbiota composition was not majorly affected by probiotic intervention.Conclusion: The probiotic intervention resulted in subtly altered brain activity and functional connectivity in healthy subjects performing an emotional task without major effects on the fecal microbiota composition. This indicates that the probiotic effects occurred via microbe-host interactions on other levels. Further analysis of signaling molecules could give possible insights into the modes of action of the probiotic intervention on the gut-brain axis in general and brain function specifically. The presented findings further support the growing consensus that probiotic supplementation influences brain function and emotional regulation, even in healthy subjects. Future studies including patients with altered emotional processing, such as anxiety or depression symptoms are of great interest.Clinical Trial Registration: [http://clinicaltrials.gov/], identifier [NCT03615651].
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