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Broqvist, Mats
Publications (10 of 11) Show all publications
Tamás, É., Broqvist, M., Olsson, E., Franzén, S. & Nylander, E. (2009). Exercise radionuclide ventriculography for predicting postoperative left ventricular function in chronic aortic regurgitation. JACC: Cardiovascular Imaging, 2(1), 48-55
Open this publication in new window or tab >>Exercise radionuclide ventriculography for predicting postoperative left ventricular function in chronic aortic regurgitation
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2009 (English)In: JACC: Cardiovascular Imaging, ISSN 1936-878X, Vol. 2, no 1, p. 48-55Article in journal (Refereed) Published
Abstract [en]

Objectives: Ejection fraction (EF) reaction upon exercise by radionuclide ventriculography and standard echocardiographic parameters was evaluated as predictors for post-operative left ventricular (LV) function in chronic aortic regurgitation (AR).

Background: The optimal timing of surgery for chronic AR is when the left ventricle is still compensating for the volume and pressure overload without irreversible dysfunction. For asymptomatic patients when EF is normal and LV diameters are borderline, exercise testing is recommended by present guidelines. However, only a limited number of studies have been performed, and data are scarce on this subject.

Methods: Radionuclide ventriculography with multiple gated acquisition at rest and during exercise was performed in 29 consecutive patients with severe chronic aortic regurgitation pre-operatively and 6 months post-operatively. Patient subgroups were formed based on pre-operative EF exercise response (ΔEF) and were categorized as decreasing (ΔEF <−5%), unaltered (−5% ≤ ΔEF ≤ 5%), and increasing (ΔEF > 5%). A 5% or higher increase was considered normal. The LV diameters and mass were measured by echocardiography.

Results: Pre-operative LV diameters were markedly elevated before surgery and diminished significantly after surgery. Left ventricular diameters, LV mass, EF at rest (EFrest), and EF change from rest to exercise (ΔEF) were independent of New York Heart Association functional class. Pre-operative end-diastolic diameter proved to be a predictor for pre- and post-operative ΔEF (p = 0.003; p = 0.04) but not for the nature of the exercise response post-operatively. Patients with decreasing and unaltered EF pre-operatively presented a significantly higher but still abnormal ΔEF post-operatively. Those with increasing EF pre-operatively had a similar response and a normal ΔEF post-operatively. Pre-operative ΔEF was not only a predictor for post-operative ΔEF (p = 0.02) but also classified patients into post-operative subgroups (EF decreasing, p = 0.03; unaltered, p = 0.02; increasing, p = 0.0008).

Conclusions: An abnormal EF response to exercise may also occur in patients who do not fulfill criteria for surgery based on LV dimensions or EF. A follow-up of exercise LV function and adjusting the timing of surgery according to the nature of exercise response could, therefore, be beneficial.

Place, publisher, year, edition, pages
Elsevier, 2009
Keywords
radionuclide ventriculography, ejection fraction, exercise testing, aortic regurgitation, cardiac surgery
National Category
Medical and Health Sciences
Identifiers
urn:nbn:se:liu:diva-13338 (URN)10.1016/j.jcmg.2008.09.009 (DOI)000287651900008 ()
Available from: 2008-06-18 Created: 2008-06-18 Last updated: 2011-03-11
Wallby, L., Janerot Sjöberg, B., Jonasson, L., Locht, H. & Broqvist, M. (2008). History and signs of rheumatic disease in patients with significant heart valve disease.
Open this publication in new window or tab >>History and signs of rheumatic disease in patients with significant heart valve disease
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2008 (English)Article in journal (Refereed) Submitted
National Category
Medical and Health Sciences
Identifiers
urn:nbn:se:liu:diva-13049 (URN)
Available from: 2008-03-18 Created: 2008-03-18
Wallby, L., Steffensson, T., Jonasson, L. & Broqvist, M. (2008). Inflammatory characteristics of aortic stenotic valves: a comparison between rheumatic and non-rheumatic aortic stenosis.
Open this publication in new window or tab >>Inflammatory characteristics of aortic stenotic valves: a comparison between rheumatic and non-rheumatic aortic stenosis
2008 (English)Article in journal (Refereed) Submitted
National Category
Medical and Health Sciences
Identifiers
urn:nbn:se:liu:diva-13048 (URN)
Available from: 2008-03-18 Created: 2008-03-18
Escobar Kvitting, J.-P., Engvall, J., Broqvist, M., FranzÉn, S., Andersson, M., Ohlsson, U. & Nielsen, N. E. (2008). Recurrence of myxoma in the left ventricle with concurrent cerebral fusiform aneurysms after previous atrial myxoma surgery. Journal of Thoracic and Cardiovascular Surgery, 135(5), 1172-1173
Open this publication in new window or tab >>Recurrence of myxoma in the left ventricle with concurrent cerebral fusiform aneurysms after previous atrial myxoma surgery
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2008 (English)In: Journal of Thoracic and Cardiovascular Surgery, ISSN 0022-5223, E-ISSN 1097-685X, Vol. 135, no 5, p. 1172-1173Article in journal, Editorial material (Other academic) Published
Place, publisher, year, edition, pages
Maryland Heights, Missouri: Mosby, Inc., 2008
National Category
Medical and Health Sciences
Identifiers
urn:nbn:se:liu:diva-43542 (URN)10.1016/j.jtcvs.2007.12.020 (DOI)000255512800030 ()18455603 (PubMedID)2-s2.0-42949154752 (Scopus ID)74138 (Local ID)74138 (Archive number)74138 (OAI)
Available from: 2009-10-10 Created: 2009-10-10 Last updated: 2017-12-13Bibliographically approved
Wallby, L., Steffensen, T. & Broqvist, M. (2007). Role of inflammation in non-rheumatic, regurgitant heart valve disease: A comparative, descriptive study regarding apolipoproteins and inflammatory cells in non-rheumatic heart valve disease. Cardiovascular pathology, 16(3), 171-178
Open this publication in new window or tab >>Role of inflammation in non-rheumatic, regurgitant heart valve disease: A comparative, descriptive study regarding apolipoproteins and inflammatory cells in non-rheumatic heart valve disease
2007 (English)In: Cardiovascular pathology, ISSN 1054-8807, E-ISSN 1879-1336, Vol. 16, no 3, p. 171-178Article in journal (Refereed) Published
Abstract [en]

Background: Nonrheumatic aortic stenosis is the predominant cause of heart valve surgery in the Western world. Aortic and mitral regurgitation account for a lesser amount of the heart valve surgery. During the 1990s, inflammatory cell infiltrates have been demonstrated in nonrheumatic stenotic aortic valves. These findings suggest an inflammatory component in the pathogenesis of nonrheumatic aortic valve stenosis. However, nonrheumatic regurgitant aortic and mitral valves have not been investigated in this respect. The aim of this study was to compare nonrheumatic regurgitant aortic and mitral valves with stenotic aortic valves regarding the presence of T lymphocytes, macrophages, apolipoprotein B, and apolipoprotein A-I.

Methods: Valve specimens were obtained from 42 patients referred to hospital for surgery because of significant heart valve disease. From these patients, 29 aortic stenotic valves, 9 aortic regurgitant, and 6 mitral regurgitant valves, all nonrheumatic, were obtained for the study. Fourteen valves collected from subjects undergoing clinical/medicolegal autopsy were used as control. In order to identify mononuclear inflammatory cells and apolipoproteins, sections were investigated with immunohistochemical analyses and then categorized semiquantitatively.

Results: Regurgitant and control valves showed a significantly lower degree of inflammatory cell infiltrate and a lower degree of apolipoprotein deposition as compared to stenotic aortic valves.

Conclusions: The signs of inflammation seen in nonrheumatic aortic stenosis are not prominent features in the nonrheumatic, regurgitant valves. This is consistent with the multi-factorial pathogenesis of these conditions.

Keywords
Aortic valve regurgitation, Mitral valve regurgitation, T Lymphocytes, Apolipoproteins
National Category
Medical and Health Sciences
Identifiers
urn:nbn:se:liu:diva-13047 (URN)10.1016/j.carpath.2006.10.004 (DOI)
Available from: 2008-03-18 Created: 2008-03-18 Last updated: 2017-12-13
Valladares, C., Broqvist, M., Nylander, E. & Callander, M. (2006). Var det paradoxal embolism? Cerebellär infarkt, öppetstående foramen ovale och APC-resistens - en kontroversiell kombination och terapeutisk utmaning. Läkartidningen, 103, 845-848
Open this publication in new window or tab >>Var det paradoxal embolism? Cerebellär infarkt, öppetstående foramen ovale och APC-resistens - en kontroversiell kombination och terapeutisk utmaning
2006 (Swedish)In: Läkartidningen, ISSN 0023-7205, E-ISSN 1652-7518, Vol. 103, p. 845-848Article in journal (Other academic) Published
National Category
Medical and Health Sciences
Identifiers
urn:nbn:se:liu:diva-33434 (URN)19453 (Local ID)19453 (Archive number)19453 (OAI)
Available from: 2009-10-09 Created: 2009-10-09 Last updated: 2017-12-13
Ekdahl, C., Broqvist, M., Franzén, S., Ljunghusen, O., Maller, R. & Sander, B. (2002). IL-8 and tumor necrosis factor alpha in heart valves from patients with infective endocarditis. Scandinavian Journal of Infectious Diseases, 34(10), 759-762
Open this publication in new window or tab >>IL-8 and tumor necrosis factor alpha in heart valves from patients with infective endocarditis
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2002 (English)In: Scandinavian Journal of Infectious Diseases, ISSN 0036-5548, Vol. 34, no 10, p. 759-762Article in journal (Refereed) Published
Abstract [en]

The embedding of bacteria in the vegetation of infective endocarditis impedes the penetration of phagocytic cells. IL-8 has a stimulating effect on the immune system, particularly with respect to chemotaxis and activation of granulocytes. Tumor necrosis factor alpha (TNF-) is 1 of the major proinflammatory cytokines. IL-8 and TNF- were visualized by means of immunohistochemistry in paraffin-embedded heart valve biopsies from 6 patients with infective endocarditis who required cardiac surgery during the active phase of the infection. In 5/6 patients there were signs of inflammation, and in these patients IL-8- and TNF- -containing cells were visualized in the heart valve stromas or vegetations. The largest numbers of IL-8-containing cells, and the greatest amount of inflammation, were seen in patients with short preoperative treatment courses. No such relationships were seen with respect to TNF- -containing cells. These observations may suggest that the occurrence of IL-8-containing cells in infected heart valves could be used as a marker of disease activity.

National Category
Medical and Health Sciences
Identifiers
urn:nbn:se:liu:diva-13332 (URN)10.1080/00365540210147912 (DOI)
Available from: 2008-06-18 Created: 2008-06-18 Last updated: 2009-08-17
Wallby, L., Janerot Sjöberg, B., Steffensen, T. & Broqvist, M. (2002). T lymphocyte infiltration in non-rheumatic aortic stenosis: a comparative descriptive study between tricuspid and bicuspid aortic valves. Heart, 88(4), 348-351
Open this publication in new window or tab >>T lymphocyte infiltration in non-rheumatic aortic stenosis: a comparative descriptive study between tricuspid and bicuspid aortic valves
2002 (English)In: Heart, ISSN 1355-6037, Vol. 88, no 4, p. 348-351Article in journal (Refereed) Published
Abstract [en]

Background: The two most common causes of aortic stenosis are primary "degenerative" calcification of tricuspid aortic valves and secondary calcification of congenital bicuspid valves. T lymphocyte infiltration occurs in stenotic tricuspid aortic valves, indicating an inflammatory component, but it has not been shown whether it also occurs in stenotic bicuspid valves.

Objective: To compare non-rheumatic tricuspid and bicuspid stenotic aortic valves for the presence and distribution of T lymphocytes.

Setting: University hospital.

Patients and design: Valve specimens were obtained from 29 patients (15 women, 14 men, mean age 69 years (range 52–81 years)), referred to the hospital for aortic valve replacement because of symptomatic aortic valve stenosis. There were 17 tricuspid valves (from 10 women and seven men, mean age 71 years) and 12 bicuspid valves (from five women and seven men, mean age 67 years). To identify mononuclear inflammatory cells, sections were stained with antibodies for CD3 (pan-T cell antigen, Dako 1:400) and then graded histologically according to the degree of T cell infiltrate.

Results: T lymphocyte infiltration was present in both tricuspid and bicuspid stenotic aortic valves, without any significant differences in extent or localisation.

Conclusions: Stenotic bicuspid aortic valves show the same degree of T lymphocyte infiltration as degenerative tricuspid aortic valves. Inflammation needs to be considered in the pathogenesis of acquired aortic stenosis, irrespective of the primary valve anomaly.

Keywords
aortic valve stenosis, pathology, lymphocytes, inflammation
National Category
Medical and Health Sciences
Identifiers
urn:nbn:se:liu:diva-13046 (URN)10.1136/heart.88.4.348 (DOI)
Available from: 2008-03-18 Created: 2008-03-18 Last updated: 2009-08-21
Svedjeholm, R., Broqvist, M. & Wranne, B. (2001). Freely mobile right-sided atrial thrombus mimicking myxoma. European Journal of Cardio-Thoracic Surgery, 20(1), 195
Open this publication in new window or tab >>Freely mobile right-sided atrial thrombus mimicking myxoma
2001 (English)In: European Journal of Cardio-Thoracic Surgery, ISSN 1010-7940, E-ISSN 1873-734X, Vol. 20, no 1, p. 195-Article in journal (Refereed) Published
Abstract [en]

[No abstract available]

National Category
Medical and Health Sciences
Identifiers
urn:nbn:se:liu:diva-26826 (URN)10.1016/S1010-7940(01)00745-X (DOI)11440 (Local ID)11440 (Archive number)11440 (OAI)
Available from: 2009-10-08 Created: 2009-10-08 Last updated: 2017-12-13
Janerot-Sjöberg, B., Broqvist, M. & Fransson, S.-G. (1998). Femoral artery haemostasis with a pneumatic compression device versus a clamp after coronary angiography. Scandinavian Cardiovascular Journal, 32(5), 281-284
Open this publication in new window or tab >>Femoral artery haemostasis with a pneumatic compression device versus a clamp after coronary angiography
1998 (English)In: Scandinavian Cardiovascular Journal, ISSN 1401-7431, E-ISSN 1651-2006, Vol. 32, no 5, p. 281-284Article in journal (Refereed) Published
Abstract [en]

To evaluate the safety and efficacy of a new pneumatic compression device for achieving haemostasis after femoral artery catheterization, 1,017 patients undergoing selective coronary angiography by a SF unilateral femoral route were prospectively randomised to pneumatic or the routinely used clamp compression technique. All initial bleedings could be controlled in the pneumatic group, whereas in 38 patients (8%) of the clamp group the initial positioning of the clamp was unsuccessful or was not tolerated by the patient (p less than 0.05). Ultrasound Doppler study of the puncture site because of suspected postcatheterization vascular complication revealed two haematomas which needed no further measure and two pseudoaneurysms which were successfully treated with ultrasound-guided compression or surgical repair. The rate of complications requiring treatment (pseudoaneurysms) was 0.2% overall, 0.5% in the clamp group and nil in the pneumatic compression group (NS). We conclude that the pneumatic compression device is effective, convenient and at least as safe as the clamp and, by shortening the time in the catheterization laboratory, offers time for further angiograms.

Place, publisher, year, edition, pages
Informa Healthcare, 1998
Keywords
coronary angiography, pneumatic compression haemostasis
National Category
Clinical Medicine
Identifiers
urn:nbn:se:liu:diva-110747 (URN)10.1080/14017439850139870 (DOI)000076993900004 ()9835002 (PubMedID)
Available from: 2014-10-24 Created: 2014-09-19 Last updated: 2017-12-05
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