liu.seSearch for publications in DiVA
Change search
Link to record
Permanent link

Direct link
BETA
Tamás, Éva
Alternative names
Publications (10 of 27) Show all publications
Tamás, É. & Nylander, E. (2018). Decision support for assessment of left ventricular diastolic function. Physiological Reports, 6(16)
Open this publication in new window or tab >>Decision support for assessment of left ventricular diastolic function
2018 (English)In: Physiological Reports, E-ISSN 2051-817X, Vol. 6, no 16Article in journal (Refereed) Published
Abstract [en]

Echocardiographic assessment of the left ventricular diastolic function (LVDF), an integrated part of evaluation of left ventricular function is still a delicate task and is performed with substantial inter-rater variability. Therefore, we aimed to create and evaluate a guidelines-based automated decision support. An algorithm was created for a hierarchical analysis of LVDF based on variables as recommended by the latest guidelines. Age-adjusted normal ranges were pooled from previously published studies into an integrated reference table. For proof-of-concept, 20 echocardiographic examinations were analyzed offline by four experienced physicians with more than 10 years of echocardiographic experience. The first assessments were to be performed as they would be in the clinical practice. Six months later, the assessments were repeated based on the 2017 ASE/EACVI guidelines. The overall inter-rater agreement for the first clinical assessments was moderate, while the guidelines-based assessments had only fair inter-rater agreement. Both kinds of manual assessment had poor agreement with the standardized automated assessment algorithm of LVDF. In conclusion, the presented automated decision support for evaluation of diastolic LV function by Doppler echocardiography is mainly based on current guidelines involving multiple parameters in combination. Incorporating age dependency aspects in our program (available for use at https://liu.se/en/research/left-ventricular-diastolic-function-decision-support) enhances the accuracy of the evaluation and reduces variability in evaluation of LVDF. The large inter-rater variation in classification in this study also underscores the usefulness of tools to support a standardized evaluation.

Place, publisher, year, edition, pages
John Wiley & Sons, 2018
Keywords
Diastolic function; echocardiography; left ventricular function
National Category
Endocrinology and Diabetes
Identifiers
urn:nbn:se:liu:diva-156004 (URN)10.14814/phy2.13815 (DOI)000442995200006 ()30125045 (PubMedID)2-s2.0-85052538225 (Scopus ID)
Available from: 2019-04-01 Created: 2019-04-01 Last updated: 2019-10-15Bibliographically approved
Malin, S., Edelbring, S. & Tamás, É. (2018). Färdighetsträning i simulerad miljö: Undervisning av praktiska färdigheter på Clinicum, Läkarutbildning, Stadium III, Termin 9. Linköping: Linköping University Electronic Press
Open this publication in new window or tab >>Färdighetsträning i simulerad miljö: Undervisning av praktiska färdigheter på Clinicum, Läkarutbildning, Stadium III, Termin 9
2018 (Swedish)Report (Other academic)
Abstract [sv]

Från och med 2009 erbjuds praktiska färdighetsövningar på Clinicum där läkarstudenter under handledning går genom teoretisk bakgrund och övar genomförande av praktiska färdigheter kopplade till mål inom cirkulation, respiration och ortopedi på anatomiska modeller. En observationsstudie genomfördes med fokus på studentcentrerat lärande, meningsfullhet och relevans, samt lärande i samarbete med andra. Det konstaterades att lärmomentet genomförs i enlighet med grundläggande principer för PBL, är stark kopplat till den kliniska praktiken, samt att det bjuder in till att lära i samarbete med andra.

Förbättringsmöjligheter identifierades i tillgänglighet av referensmaterial om teoretisk bakgrund före utbildningsmomentet för att underlätta undervisningens anpassning till studenternas aktuella kunskaper. Att dessutom göra det möjligt att skicka frågor till lärarna som förberedelse skulle bidra till ökad individualisering och effektivisering av utbildningsmomenten.

Place, publisher, year, edition, pages
Linköping: Linköping University Electronic Press, 2018. p. 11
Keywords
medical simulation, undergraduate education, technical skills
National Category
Medical and Health Sciences
Identifiers
urn:nbn:se:liu:diva-155102 (URN)
Available from: 2019-03-19 Created: 2019-03-19 Last updated: 2019-03-19Bibliographically approved
Allvin, R., Berndtzon, M., Carlzon, L., Edelbring, S., Hult, H., Hultin, M., . . . Tamás, É. (2017). Confident but not theoretically grounded: experienced simulation educators perceptions of their own professional development. Advances in Medical Education and Practice, 8, 99-108
Open this publication in new window or tab >>Confident but not theoretically grounded: experienced simulation educators perceptions of their own professional development
Show others...
2017 (English)In: Advances in Medical Education and Practice, ISSN 1179-7258, E-ISSN 1179-7258, Vol. 8, p. 99-108Article in journal (Refereed) Published
Abstract [en]

Background: Medical simulation enables the design of learning activities for competency areas (eg, communication and leadership) identified as crucial for future health care professionals. Simulation educators and medical teachers follow different career paths, and their education backgrounds and teaching contexts may be very different in a simulation setting. Although they have a key role in facilitating learning, information on the continuing professional development (pedagogical development) of simulation educators is not available in the literature.

Objectives: To explore changes in experienced simulation educators’ perceptions of their own teaching skills, practices, and understanding of teaching over time.

Methods: A qualitative exploratory study. Fourteen experienced simulation educators participated in individual open-ended interviews focusing on their development as simulation educators. Data were analyzed using an inductive thematic analysis.

Results: Marked educator development was discerned over time, expressed mainly in an altered way of thinking and acting. Five themes were identified: shifting focus, from following to utilizing a structure, setting goals, application of technology, and alignment with profession. Being confident in the role as an instructor seemed to constitute a foundation for the instructor’s pedagogical development.

Conclusion: Experienced simulation educators’ pedagogical development was based on self-confidence in the educator role, and not on a deeper theoretical understanding of teaching and learning. This is the first clue to gain increased understanding regarding educational level and possible education needs among simulation educators, and it might generate several lines of research for further studies.

Place, publisher, year, edition, pages
Dove Medical Press, 2017
Keywords
continuing professional development; interviews; medical simulation; pedagogical development; simulation educator
National Category
Social Work
Identifiers
urn:nbn:se:liu:diva-145063 (URN)10.2147/AMEP.S123517 (DOI)28176931 (PubMedID)
Available from: 2018-02-08 Created: 2018-02-08 Last updated: 2018-05-04Bibliographically approved
Edelbring, S., Karlsson, K., Meyer, F. & Tamás, É. (2017). Utvärdering av IPL-simulering på Clinicum: Simuleringsdag ”Akuta situationer” för sistaårsstudenter från sjuksköterske- och läkarprogrammen HT 2016. Linköping: Linköping University Electronic Press
Open this publication in new window or tab >>Utvärdering av IPL-simulering på Clinicum: Simuleringsdag ”Akuta situationer” för sistaårsstudenter från sjuksköterske- och läkarprogrammen HT 2016
2017 (Swedish)Report (Other academic)
Abstract [sv]

En gemensam simuleringsdag för sjuksköterske- och läkarstudenter har utvärderats och diskuteras här i relation till interprofessionellt lärande och simuleringsbaserat lärande.

IPL-simuleringen kännetecknas av ett starkt studentengagemang och upplevs som mycket relevant och kliniskt autentisk. Den simuleringsbaserade satsningen är alltså fortsatt aktuell och har utvecklats till en hög nivå med relevans för lärande och klinisk förberedelse. Innehållet rör såväl kliniska som team­relaterade kunskaper och kompetenser. Simulering som undervisningsform uppskattas högt och simulerings­instruktörens bidrag till lärandet lyfts fram. Ambitionsnivån kan ytterligare höjas på några punkter. Kurskamraternas bidrag i lärandet kan ytterligare stärkas, likaså omvårdnads­innehållet i scenarierna.

IPL-mål adresseras i aktiviteten, i synnerhet ökar teamsamverkan progressivt under dagen. Det inter­professionella lärandet kan stärkas ännu mer  genom att linjera tydligare med övriga IPL-moment samt knyta an till de uttalade IPL-curriculum-målen.

Place, publisher, year, edition, pages
Linköping: Linköping University Electronic Press, 2017. p. 13
Keywords
Simulering, interprofessionellt lärande, professionell utbildning
National Category
Pedagogy
Identifiers
urn:nbn:se:liu:diva-139799 (URN)
Available from: 2017-08-16 Created: 2017-08-16 Last updated: 2018-03-28Bibliographically approved
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
Show others...
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: 2019-08-28Bibliographically 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
Show others...
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: 2019-08-28
Rönnerfalk, M. & Tamas, E. (2015). Structure and function of the tricuspid and bicuspid regurgitant aortic valve: an echocardiographic study. Interactive Cardiovascular and Thoracic Surgery, 21(1), 71-76
Open this publication in new window or tab >>Structure and function of the tricuspid and bicuspid regurgitant aortic valve: an echocardiographic study
2015 (English)In: Interactive Cardiovascular and Thoracic Surgery, ISSN 1569-9293, E-ISSN 1569-9285, Vol. 21, no 1, p. 71-76Article in journal (Refereed) Published
Abstract [en]

OBJECTIVES: The emerging new treatment options for aortic valve disease call for more sophisticated diagnostics. We aimed to describe the echocardiographic pathophysiology and characteristics of the purely regurgitant aortic valve in detail.

METHODS: Twenty-nine men, with chronic aortic regurgitation without concomitant heart disease referred for aortic valve intervention, underwent 2D transoesophageal echocardiographic (TEE) examination prior to surgery according to a previously published matrix. Measurements of the aortic valve apparatus in long and short axis view were made in systole and diastole and analysed off-line. The aortic valves were grouped as tricuspid (TAV) or bicuspid (BAV), and classified by regurgitation mechanism.

RESULTS: Twenty-four examinations were eligible for analysis of which 13 presented TAV and 11 BAV. The regurgitation mechanism was classified as dilatation of the aorta in 6 cases, as prolapse in 11 cases and as poor cusp tissue quality or quantity in 7 cases. The ventriculo-aortic junction (VAJ) and valve opening were closely related (TAV r = 0.5, BAV r = 0.73) but no correlation was found between the VAJ and the maximal sinus diameter (maxSiD) or the sinotubular junction (STJ). However, the STJ and maxSiD were significantly related (TAV vs BAV: systole r = 0.9, r = 0.8; diastole r = 0.9, r = 0.7), forming an entity. The conjoined BAV cusps were shorter than the anterior cusps when closed (P = 0.002); the inter-commissural distances of the cusps in the BAV group were significantly different (P = 0.001 resp. 0.03) in both systole and diastole.

CONCLUSIONS: The VAJ was independent of other aortic dimensions and should thereby be considered as a separate entity with influence on valve opening. The detailed 2D TEE measurements of this study add further important information to our knowledge about the function and echocardiographic anatomy of the pathological aortic valve and root either as a stand-alone examination or as a benchmark and complement to 3D echocardiography. This may have an impact on decisions regarding repairability of the native aortic valve.

Place, publisher, year, edition, pages
Oxford University Press (OUP): Policy N / European Association for Cardio-thoracic Surgery, 2015
Keywords
Aortic valve insufficiency; Transoesophageal echocardiography; Tricuspid valve; Bicuspid valve; Cardiac surgery
National Category
Clinical Medicine Cardiac and Cardiovascular Systems
Identifiers
urn:nbn:se:liu:diva-120278 (URN)10.1093/icvts/ivv072 (DOI)000357527800013 ()25840434 (PubMedID)
Note

Funding Agencies|Swedish Heart Lung Foundation [HLF 20120570]; ALF Grants from the County Council of Ostergotland, Sweden [LIO-204141]

Available from: 2015-07-24 Created: 2015-07-24 Last updated: 2017-12-04
Hedman, K., Nylander, E., Henriksson, J., Bjarnegård, N., Brudin, L. & Tamás, É. (2015). The size and shape of the inferior vena cava in trained and untrained females in relation to maximal oxygen uptake.
Open this publication in new window or tab >>The size and shape of the inferior vena cava in trained and untrained females in relation to maximal oxygen uptake
Show others...
2015 (English)Manuscript (preprint) (Other academic)
Abstract [en]

Background. The increase in cardiac dimensions following endurance training is well acknowledged. A few studies report a larger inferior vena cava (IVC) in trained, predominatly male subjects while athlete-control studies upon females are lacking. Previous studies were constrained to long-axis measurements, and there are no reports in the literature on IVC short-axis dimensions and shape in athletes.

Methods and Results. Forty-eight sedentary and 46 endurance trained females (mean age 21±2 years, VO2max 39±5 vs. 52±5 mL×kg-1×min-1, p<0.001) underwent echocardiographic examination including IVC diameter and cross-sectional area measured in the subcostal view. IVC shape was calculated as the ratio of short-axis major-to-minor diameter.

Five out of eight IVC dimensions were larger in trained females, including maximal long-axis diameter (mean 24±3 vs. 20±3 mm, p<0.001) and maximal short-axis area (mean 5.5±1.5 vs. 4.7±1.4 cm2, p=0.022). Both groups presented with a slightly oval IVC with no differences between the groups in IVC shape or inspiratory decrease in any IVC dimension. The IVC long-axis diameter reflected the minor-axis diameter obtained in the short-axis view, during both expiration and inspiration. Positive correlations were seen between maximal IVC long-axis diameter and maximal oxygen uptake (r=0.52, p<0.01), left ventricular end-diastolic volume (r=0.46, p<0.01) and right atrial area (r=0.49, p<0.01).

Conclusion. The IVC was larger in endurance trained than in untrained females but showed similar shape and inspiratory decrease in dimensions. The long-axis IVC diameter was related to maximal oxygen uptake.

Keywords
Inferior Vena Cava, Athlete’s heart, Exercise Training, Sports Cardiology, Maximal Oxygen Uptake
National Category
Cardiac and Cardiovascular Systems
Identifiers
urn:nbn:se:liu:diva-123315 (URN)
Available from: 2015-12-10 Created: 2015-12-10 Last updated: 2019-08-28Bibliographically approved
Forsberg, L. M., Nylander, E. & Tamés, E. (2014). Exercise echocardiography predicts postoperative left ventricular remodeling in aortic regurgitation. SCANDINAVIAN CARDIOVASCULAR JOURNAL, 48(1), 4-12
Open this publication in new window or tab >>Exercise echocardiography predicts postoperative left ventricular remodeling in aortic regurgitation
2014 (English)In: SCANDINAVIAN CARDIOVASCULAR JOURNAL, ISSN 1401-7431, Vol. 48, no 1, p. 4-12Article in journal (Refereed) Published
Abstract [en]

Objective. We aimed to investigate if preoperative left ventricular (LV) function assessed by exercise echocardiography could predict late postoperative LV function in aortic regurgitation (AR) patients and to evaluate how LV long-axis function is affected late after aortic valve surgery. Design. A total of 21 male chronic AR patients, aged 49 (12) years, accepted for surgery were examined preoperatively, 6 months-, and 4 years postoperatively, at rest and during exercise. Besides conventional echocardiographic parameters, the atrioventricular plane displacement (AVPD) by M-mode and peak systolic velocity (s) in the basal LV by color tissue Doppler were measured. Results. Preoperatively EFrest and EFexercise, were 55(7)% and 54(9)%, respectively, and Delta EF 0(8)%. LV dimensions and volumes indexed to BSA had decreased at the 6-month follow-up and were stable at late follow-up. s(rest), s(exercise), AVPD(rest), and AVPD(exercise) were unchanged at both the postoperative examinations (all P >= 0.05). Preoperative EFexercise and AVPD(exercise) showed inverse correlation to late postoperative indexed LV enddiastolic volume (r = -0.68, p < 0.004 and r = -0.86, P < 0.001) and indexed LV endsystolic volume (r = -0.68, P = 0.004 and r = -0.81, P < 0.001), while there was no correlation to preoperative EFrest and AVPD(rest) (all r < 0.2). Conclusions. Preoperative exercise echocardiography can detect AR patients with suboptimal LV remodeling late postoperatively.

Place, publisher, year, edition, pages
Informa Healthcare, 2014
National Category
Cardiac and Cardiovascular Systems
Identifiers
urn:nbn:se:liu:diva-81049 (URN)10.3109/14017431.2013.861077 (DOI)000330849500002 ()
Available from: 2012-09-06 Created: 2012-09-06 Last updated: 2015-03-31Bibliographically approved
Wickham, A. M., Islam, M. M., Mondal, D., Phopase, J., Sadhu, V., Tamás, É., . . . Griffith, M. (2014). Polycaprolactone–thiophene-conjugated carbon nanotube meshes as scaffolds for cardiac progenitor cells. Journal of Biomedical Materials Research. Part B - Applied biomaterials, 102(7), 1553-1561
Open this publication in new window or tab >>Polycaprolactone–thiophene-conjugated carbon nanotube meshes as scaffolds for cardiac progenitor cells
Show others...
2014 (English)In: Journal of Biomedical Materials Research. Part B - Applied biomaterials, ISSN 1552-4973, E-ISSN 1552-4981, Vol. 102, no 7, p. 1553-1561Article in journal (Refereed) Published
Abstract [en]

The myocardium is unable to regenerate itself after infarct, resulting in scarring and thinning of the heart wall. Our objective was to develop a patch to buttress and bypass the scarred area, while allowing regeneration by incorporated cardiac stem/progenitor cells (CPCs). Polycaprolactone (PCL) was fabricated as both sheets by solvent casting, and fibrous meshes by electrospinning, as potential patches, to determine the role of topology in proliferation and phenotypic changes to the CPCs. Thiophene-conjugated carbon nanotubes (T-CNTs) were incorporated to enhance the mechanical strength. We showed that freshly isolated CPCs from murine hearts neither attached nor spread on the PCL sheets, both with and without T-CNT. As electrospun meshes, however, both PCL and PCL/T-CNT supported CPC adhesion, proliferation, and differentiation. The incorporation of T-CNT into PCL resulted in a significant increase in mechanical strength but no morphological changes to the meshes. In turn, proliferation, but not differentiation, of CPCs into cardiomyocytes was enhanced in T-CNT containing meshes. We have shown that changing the topology of PCL, a known hydrophobic material, dramatically altered its properties, in this case, allowing CPCs to survive and differentiate. With further development, PCL/T-CNT meshes or similar patches may become a viable strategy to aid restoration of the postmyocardial infarction myocardium.

Place, publisher, year, edition, pages
John Wiley & Sons, 2014
Keywords
topology, carbon nanotubes, polycaprolactone, cardiac progenitor cells, electrospun meshes
National Category
Clinical Medicine Basic Medicine Physical Sciences
Identifiers
urn:nbn:se:liu:diva-111488 (URN)10.1002/jbm.b.33136 (DOI)000342963000020 ()24664884 (PubMedID)
Available from: 2014-10-19 Created: 2014-10-19 Last updated: 2018-01-11Bibliographically approved
Organisations

Search in DiVA

Show all publications