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Nylander, Eva
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Publications (10 of 102) Show all publications
Hedman, K., Sunnerud, S., Carlén, A., Janzon, M. & Nylander, E. (2019). From guidelines to the sidelines: implementation of cardiovascular preparticipation evaluation in sports clubs is lagging.. British Journal of Sports Medicine, 53(1), 3-4
Open this publication in new window or tab >>From guidelines to the sidelines: implementation of cardiovascular preparticipation evaluation in sports clubs is lagging.
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2019 (English)In: British Journal of Sports Medicine, ISSN 0306-3674, E-ISSN 1473-0480, Vol. 53, no 1, p. 3-4Article in journal, Editorial material (Other academic) Published
Place, publisher, year, edition, pages
BMJ Publishing Group Ltd, 2019
Keywords
athlete’s heart, implementation, position statement
National Category
Cardiac and Cardiovascular Systems
Identifiers
urn:nbn:se:liu:diva-152136 (URN)10.1136/bjsports-2018-099297 (DOI)000455231200003 ()29921655 (PubMedID)
Available from: 2018-10-18 Created: 2018-10-18 Last updated: 2019-01-29
Carlén, A., Nylander, E., Åström Aneq, M. & Gustafsson, M. (2019). ST/HR variables in firefighter exercise ECG - relation to ischemic heart disease. Physiological Reports, 7(2), Article ID e13968.
Open this publication in new window or tab >>ST/HR variables in firefighter exercise ECG - relation to ischemic heart disease
2019 (English)In: Physiological Reports, E-ISSN 2051-817X, Vol. 7, no 2, article id e13968Article in journal (Refereed) Published
Abstract [en]

Exercise electrocardiography (ExECG) is regularly performed by Swedish firefighters by law. Heart rate-corrected analysis of ST segment variables (ST/HR) has shown improved prediction of ischemic heart disease (IHD) compared to ST depression alone. This has not previously been extensively studied in asymptomatic persons with a low probability of IHD. We therefore evaluated the predictive performance of ST/HR analysis in firefighter ExECG. ExECG was studied in 521 male firefighters. During 8.4 ± 2.1 years, 2.3% (n = 12) were verified with IHD by catheterization or myocardial scintigraphy (age 51.5 ± 5.5 years) and were compared with firefighters without imaging proof of IHD (44.2 ± 10.1 years). The predictive value of ST depression, ST/HR index, ST/HR slope, and area and rotation of the ST/HR loop was calculated as age-adjusted odds ratios (OR), in 10 ECG leads. Predictive accuracy was analyzed with receiver operating characteristics (ROC) analysis. ST/HR index ≤-1.6 μV/bpm and ST/HR slope ≤-2.4 μV/bpm were associated with increased IHD risk in three individual leads (all OR > 1.0, P < 0.05). ST/HR loop area lower than the fifth percentile of non-IHD subjects indicated IHD risk in V4, V5, aVF, II, and -aVR (P < 0.05). ST depression ≤-0.1 mV was associated with IHD only in V4 (OR, 9.6, CI, 2.3-40.0). ROC analysis of each of these variables yielded areas under the curve of 0.72 or lower for all variables and leads. Clockwise-rotated ST/HR loops was associated with increased risk in most leads compared to counterclockwise rotation. The limited clinical value of ExECG in low-risk populations was emphasized, but if performed, ST/HR analysis should probably be given more importance.

Keywords
Electrocardiography, ST depression, ST/HR variables, low risk
National Category
Cardiac and Cardiovascular Systems
Identifiers
urn:nbn:se:liu:diva-159752 (URN)10.14814/phy2.13968 (DOI)30688031 (PubMedID)
Available from: 2019-08-20 Created: 2019-08-20 Last updated: 2019-08-21
Hedman, K., Carlén, A., Sunnerud, S., Nylander, E. & Janzon, M. (2018). Hjärtscreening av elitidrottare: Låg följsamhet till RF:s rekommendationer. Idrottsmedicin, 1/18, 16-19
Open this publication in new window or tab >>Hjärtscreening av elitidrottare: Låg följsamhet till RF:s rekommendationer
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2018 (Swedish)In: Idrottsmedicin, ISSN 1103-7652, Vol. 1/18, p. 16-19Article in journal (Refereed) Published
National Category
Cardiac and Cardiovascular Systems
Identifiers
urn:nbn:se:liu:diva-152134 (URN)
Available from: 2018-10-18 Created: 2018-10-18 Last updated: 2018-10-31
Sunnerud, S., Nylander, E., Janzon, M., Carlén, A. & Hedman, K. (2018). Låg följsamhet till rekommenderad hjärtscreening av elitidrottare - Lägesanalys i Östergötland. Läkartidningen, 115, 185-187, Article ID EWLM.
Open this publication in new window or tab >>Låg följsamhet till rekommenderad hjärtscreening av elitidrottare - Lägesanalys i Östergötland
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2018 (Swedish)In: Läkartidningen, ISSN 0023-7205, E-ISSN 1652-7518, Vol. 115, p. 185-187, article id EWLMArticle in journal (Refereed) Published
Abstract [en]

Low adherence to recommended pre-participation cardiac evaluation of Swedish athletes Pre-participation cardiac evaluation of athletes is recommended by international organizations like the European Society of Cardiology and the American Heart Association, as well as by the Swedish Sports Confederation. The purpose of the evaluation is to prevent sudden cardiac death in athletes by early identification of individuals at risk. To our knowledge, no previous study has been made regarding the implementation of pre-participation cardiac evaluation of athletes in Sweden. We performed an electronical survey addressing sports clubs in one out of 21 districts in which the Swedish Sports Confederation is geographically divided. Only four out of 22 responding clubs with elite athletes preformed cardiac evaluation. Lack of knowledge about the recommendations as well as how to perform the evaluation were mentioned as reasons not to evaluate the athletes. Our results indicate the need for more information about pre-participation cardiac evaluation of athletes in Sweden.

National Category
Cardiac and Cardiovascular Systems
Identifiers
urn:nbn:se:liu:diva-152133 (URN)29381184 (PubMedID)
Available from: 2018-10-18 Created: 2018-10-18 Last updated: 2019-04-12Bibliographically approved
Lans, C., Cider, Å., Nylander, E. & Brudin, L. (2018). Peripheral muscle training with resistance exercise bands in patients with chronic heart failure. Long-term effects on walking distance and quality of life; a pilot study. ESC Heart Failure, 5(2), 241-248
Open this publication in new window or tab >>Peripheral muscle training with resistance exercise bands in patients with chronic heart failure. Long-term effects on walking distance and quality of life; a pilot study
2018 (English)In: ESC Heart Failure, E-ISSN 2055-5822, Vol. 5, no 2, p. 241-248Article in journal (Refereed) Published
Abstract [en]

This study aimed to describe a method of peripheral muscle training with resistance bands in patients with chronic heart failure (CHF) and to evaluate its effects on the 6 min walk test and quality of life up to 12 months using a home-based programme.

Place, publisher, year, edition, pages
John Wiley & Sons, 2018
Keywords
6 min walk test; Cardiac rehabilitation; Heart failure; Home rehabilitation; Long time follow-up; Quality of life
National Category
Physiotherapy
Identifiers
urn:nbn:se:liu:diva-155853 (URN)10.1002/ehf2.12230 (DOI)000428992300004 ()29168621 (PubMedID)
Available from: 2019-03-29 Created: 2019-03-29 Last updated: 2019-03-29
Carlén, A., Åström Aneq, M., Nylander, E. & Gustafsson, M. (2017). Loaded treadmill walking and cycle ergometry to assess work capacity: a retrospective comparison in 424 firefighters.. Clinical Physiology and Functional Imaging, 37(1), 37-44
Open this publication in new window or tab >>Loaded treadmill walking and cycle ergometry to assess work capacity: a retrospective comparison in 424 firefighters.
2017 (English)In: Clinical Physiology and Functional Imaging, ISSN 1475-0961, E-ISSN 1475-097X, Vol. 37, no 1, p. 37-44Article in journal (Refereed) Published
Abstract [en]

The fitness of firefighters is regularly evaluated using exercise tests. We aimed to compare, with respect to age and body composition, two test modalities for the assessment work capacity. A total of 424 Swedish firefighters with cycle ergometer (CE) and treadmill (TM) tests available from Jan 2004 to Dec 2010 were included. We compared results from CE (6 min at 200 W, 250 W or incremental ramp exercise) with TM (6 min at 8° inclination, 4·5 km h(-1) or faster, wearing 24-kg protective equipment). Oxygen requirements were estimated by prediction equations. It was more common to pass the TM test and fail the supposedly equivalent CE test (20%), than vice versa (0·5%), P<0·001. Low age and tall stature were significant predictors of passing both CE and TM tests (P<0·05), while low body mass predicted accomplishment of TM test only (P = 0·006). Firefighters who passed the TM but failed the supposedly equivalent CE test within 12 months had significantly lower body mass, lower BMI, lower BSA and shorter stature than did those who passed both tests. Calculated oxygen uptake was higher in TM tests compared with corresponding CE tests (P<0·001). Body constitution affected approval differently depending on the test modality. A higher approval rate in TM testing suggests lower cardiorespiratory requirements compared with CE testing, even though estimated oxygen uptake was higher during TM testing. The relevance of our findings in relation to the occupational demands needs reconsidering.

National Category
Sport and Fitness Sciences
Identifiers
urn:nbn:se:liu:diva-120004 (URN)10.1111/cpf.12265 (DOI)000390688200006 ()26096157 (PubMedID)
Note

Funding agencies: ALF grants; County Council of Ostergotland, Sweden; Olav Axelssons memorial fund

Available from: 2015-07-02 Created: 2015-07-02 Last updated: 2019-08-21
Kalnina, L., Sauka, M., Timpka, T., Dahlström, Ö., Nylander, E., Selga, G., . . . Larins, V. (2015). Body fat in children and adolescents participating in organized sports: Descriptive epidemiological study of 6048 Latvian athletes. Scandinavian Journal of Public Health, 43(6), 615-622
Open this publication in new window or tab >>Body fat in children and adolescents participating in organized sports: Descriptive epidemiological study of 6048 Latvian athletes
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2015 (English)In: Scandinavian Journal of Public Health, ISSN 1403-4948, E-ISSN 1651-1905, Vol. 43, no 6, p. 615-622Article in journal (Refereed) Published
Abstract [en]

Background: Pressure among young athletes to meet body composition goals may lead to poor nutrition and affect growth. Aims: To examine the proportion of body fat (%BF), measured by bioimpedance analysis, among Latvian children and adolescents participating in organized sports. Methods: Our study had a nationally representative sample of 6048 young athletes, aged 10-17 years. Their %BF was measured using a multifrequency, 8-pole, bioelectrical impedance leg-to-hand analyzer. Results: About 19.2% (CI 14.4-20.0) of boys and 15.1% (CI 14.0-16.3) of girls had a %BF value below the recommended levels. The %BF in young female athletes participating in aesthetic sports was lower than among their peers participating in other sports. Young male athletes participating in aesthetic sports had lower %BF levels at 10 and 12 years of age, compared with participants in weight-class sports; and lower levels of %BF from age 10-14 years, compared with participants in non-weight-sensitive sports. Conclusions: Almost every fifth child and adolescent participating in organized sports displayed critically low body fat levels. Body fat needs to be assessed regularly in young athletes, to prevent negative consequences on health.

Place, publisher, year, edition, pages
SAGE PUBLICATIONS LTD, 2015
Keywords
Adolescents; aesthetic sports; body fat; body mass index; children; eating disorders; Latvia; percentage body fat; reference curves; sports; sport types; young athletes
National Category
Basic Medicine Clinical Medicine
Identifiers
urn:nbn:se:liu:diva-121440 (URN)10.1177/1403494815581696 (DOI)000360391600008 ()25948090 (PubMedID)
Note

Funding Agencies|State Sports Medicine Centre of the Latvian Ministry of Health

Available from: 2015-09-18 Created: 2015-09-18 Last updated: 2018-04-07
Hedman, K., Tamás, É., Bjarnegård, N., Brudin, L. & Nylander, E. (2015). Cardiac systolic regional function and synchrony in endurance trained and untrained females. BMJ Open Sport & Exercise Medicine, 25(1), Article ID :e000015.
Open this publication in new window or tab >>Cardiac systolic regional function and synchrony in endurance trained and untrained females
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2015 (English)In: BMJ Open Sport & Exercise Medicine, ISSN 2055-7647, Vol. 25, no 1, article id :e000015Article in journal (Refereed) Published
Abstract [en]

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.

National Category
Cardiac and Cardiovascular Systems
Identifiers
urn:nbn:se:liu:diva-122839 (URN)10.1136/bmjsem-2015-000015 (DOI)
Available from: 2015-11-26 Created: 2015-11-26 Last updated: 2016-04-24Bibliographically approved
Hedman, K., Tamás, E., Henriksson, J., Bjarnegård, N., Brudin, L. & Nylander, E. (2015). Female athlete's heart: Systolic and diastolic function related to circulatory dimensions. Scandinavian Journal of Medicine and Science in Sports, 25(3), 372-381
Open this publication in new window or tab >>Female athlete's heart: Systolic and diastolic function related to circulatory dimensions
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2015 (English)In: Scandinavian Journal of Medicine and Science in Sports, ISSN 0905-7188, E-ISSN 1600-0838, Vol. 25, no 3, p. 372-381Article in journal (Refereed) Published
Abstract [en]

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.

Place, publisher, year, edition, pages
Wiley-Blackwell, 2015
National Category
Clinical Medicine
Identifiers
urn:nbn:se:liu:diva-113770 (URN)10.1111/sms.12246 (DOI)000354568800021 ()24840312 (PubMedID)
Available from: 2015-01-30 Created: 2015-01-30 Last updated: 2017-12-05
Szabó, Z., Harangi, M., Nylander, E., Ljungman, A., Theodorsson, A., Ahn, H. & Davidsson, B. (2015). How students perceive problem-based learning (PBL) group tutorials at a Swedish Medical College. Med Ed Publish, 6(17)
Open this publication in new window or tab >>How students perceive problem-based learning (PBL) group tutorials at a Swedish Medical College
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2015 (English)In: Med Ed Publish, ISSN 2312-7996, Vol. 6, no 17Article in journal (Refereed) Published
Abstract [en]

Introduction: student perception of problem-based learning (PBL) group tutorials was investigated at a Swedish University Medical College 27 years after the introduction of PBL into the curriculum.

Methods: a survey questionnaire comprising 43 questions answered on a Likert-type scale, together with one open question was used. The questionnaire was distributed to all 821 students taking part in the Linköping University medical program at the beginning of the Spring Term 2013. The results were subjected to explorative factor analysis, descriptive statistics and ANOVA. Responses to the open question where analyzed qualitatively by categorization.

Results: 84 per cent of the 821 students completed the survey. Four factors describing student perception were identified: 1) PBL as a method of learning; 2) the tutor’s role; 3) PBL, stress and feelings of insecurity; and 4) traditional teaching methods within the PBL curriculum. The Cronbach´s alpha value was 0,788 overall. Two hundred and seventy-six students answered the open question declaring that they would appreciate more precise aims and objectives, smaller tutorial groups, and more formal lectures.

Conclusions: the results of this study on PBL group tutorials, as seen from the student’s perspective, stress the importance of tutorial quality, tutor competence, tutorial group size and the quality and aims of the curriculum. Too much emphasis on the teacher’s research merits against the educational ones, and the inability to adapt to the needs and wishes of new generations of students seems a probable cause for the erosion of PBL.

Keywords
Problem-based learning, group work, tutors, self-directed learning
National Category
Clinical Medicine
Identifiers
urn:nbn:se:liu:diva-122164 (URN)10.15694/mep.2015.006.0017 (DOI)
Available from: 2015-10-22 Created: 2015-10-22 Last updated: 2018-02-21
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