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

Direct link
BETA
Zachrisson, Helene
Publications (10 of 48) Show all publications
Zachrisson, H., Nelzén, O., Lassvik, C. & Skoog, J. (2019). Estimation of Superficial Venous Reflux with Duplex Ultrasound and Foot Volumetry. Juniper Online Journal of Case Studies, 10(1), 1-5, Article ID 555776.
Open this publication in new window or tab >>Estimation of Superficial Venous Reflux with Duplex Ultrasound and Foot Volumetry
2019 (English)In: Juniper Online Journal of Case Studies, ISSN 2476-1370, Vol. 10, no 1, p. 1-5, article id 555776Article in journal (Refereed) Published
Abstract [en]

Objective: To evaluate quantitative duplex ultrasound (DUS) parameters of reflux in patients with isolated great saphenous vein insufficiency.

Methods: 20 limbs were studied. DUS derived reflux time (RT, sec), peak reflux velocity (PRV, cm/s) and reflux volume flow (ml/min) were evaluated and related to expelled volume (EV, ml) and half refilling time (T50, sec) measured by water-based foot volumetry with and without compression of superficial veins.

Results: Reflux volume flow correlated significantly to all hemodynamic parameters assessed by foot volumetry, i.e., EV (p = 0.003), ΔEV (p = 0.006), T50 (p = 0.004) and ΔT50 (p = 0.011). PRV displayed a weaker correlation to foot volumetry parameters EV (p = 0.027) and T50 (p = 0.008). No significant correlation was found between RT and foot volumetry.

Conclusion: These results indicate that reflux volume flow may be a potential parameter in future attempts to quantify reflux using DUS in patients with isolated great saphenous vein insufficiency.

Place, publisher, year, edition, pages
Juniper Publishers, 2019
Keywords
Venous insufficiency; Foot volumetry; Duplex ultrasound; Pathophysiology; Anatomical distribution
National Category
Clinical Medicine
Identifiers
urn:nbn:se:liu:diva-160695 (URN)10.19080/JOJCS.2019.10.555776 (DOI)
Available from: 2019-10-02 Created: 2019-10-02 Last updated: 2019-10-09Bibliographically approved
Zachrisson, H., Svensson, C., Lassvik, C. & Eriksson, P. (2018). An extended High frequency ultrasound protocol for detection of vessel wall inflammation.. In: : . Paper presented at Charing Cross venous workshop strain-gauge plethysmography.
Open this publication in new window or tab >>An extended High frequency ultrasound protocol for detection of vessel wall inflammation.
2018 (English)Conference paper, Oral presentation only (Refereed)
National Category
Clinical Medicine
Identifiers
urn:nbn:se:liu:diva-152725 (URN)
Conference
Charing Cross venous workshop strain-gauge plethysmography
Available from: 2018-11-18 Created: 2018-11-18 Last updated: 2018-11-23
Zachrisson, H. (2018). Biomedicinska analytiker är nyckelspelare. Dagens medicin
Open this publication in new window or tab >>Biomedicinska analytiker är nyckelspelare
2018 (Swedish)In: Dagens medicin, ISSN 1104-7488Article in journal (Other academic) Published
Abstract [sv]

Snabbspår med ultraljudsundersökning är långt ifrån standard, trots att metoden visat sig vara viktig för att snabbt ställa diagnosen jättecellsarterit. I Linköping har man redan infört en fungerande modell.

Place, publisher, year, edition, pages
Stockholm: Bonnier Business Media AB, 2018
National Category
Medical Biotechnology
Identifiers
urn:nbn:se:liu:diva-152726 (URN)
Available from: 2018-11-18 Created: 2018-11-18 Last updated: 2018-11-21Bibliographically approved
Svensson, C., Lassvik, C. & Zachrisson, H. (2018). Nutcracker Syndrome, vascular imaging with ultrasound. Cardiovasc Pharm Open Access, 7(2), Article ID 1000235.
Open this publication in new window or tab >>Nutcracker Syndrome, vascular imaging with ultrasound
2018 (English)In: Cardiovasc Pharm Open Access, ISSN 2329-6607, Vol. 7, no 2, article id 1000235Article in journal (Refereed) Published
Abstract [en]

Nutcracker Syndrome (NCS) or Left Renal Vein (LRV) entrapment is rare and may be caused by compression of the vein between the aorta and the Superior Mesenteric Artery (SMA). LRV hypertension may lead to varicosities. The syndrome is characterized by a complex of symptoms with substantial variations, the diagnosis is difficult and therefor often delayed. The diagnosis may be settled by many imaging methods, such as renal angiography, retrograde phlebography, Computed Tomography (CT), Magnetic Resonance Imaging (MRI) and Doppler Ultrasonography (DUS). The degree of stenosis may be detected measuring Doppler flow velocities by DUS.

A 50-year old female with Crohn´s disease treated by ileocecal resection, performed 20 years ago, and symptomatic epilepsy treated by a vagal stimulator, had newly added symptoms of abdominal pain, weight loss, dizziness, irregular bowel movements, and increasing fatigue. Blood parameters and physical examination were normal. CT showed no signs of active Crohn´s disease. The left renal veins and the left ovarian vein were dilated and the aorto-mesenteric angle was only 22 degrees.

DUS (Siemens S2000, 6 and 9 MHz transducers) performed one month later confirmed the findings of the CT with typical findings of NCS. DUS will play a crucial role in Nutcracker syndrome considering flow velocity, diameter measurement, anatomy and aorto-mesenteric angle. DUS is a non-invasive, cheap modality that gives a very good resolution that can define vessel walls and evaluate flow velocity conditions. This patient had mild symptoms that led to a conservative treatment whereas epilepsy and Crohn ́s disease was the main problem. If severe symptoms occur different kinds of treatments are available, such as stenting of LRV, open surgical interventions, ablation of collateral pelvic veins and coil embolization.

Place, publisher, year, edition, pages
Los Angeles, CA, United States: Omics Publishing Group, 2018
Keywords
Vascular; Nutcracker syndrome; Anatomy; Cardiovascular
National Category
Medical and Health Sciences Radiology, Nuclear Medicine and Medical Imaging
Identifiers
urn:nbn:se:liu:diva-152728 (URN)10.4172/2329-6607.1000235 (DOI)
Available from: 2018-11-18 Created: 2018-11-18 Last updated: 2019-11-11Bibliographically approved
Nelzén, O., Skoog, J., Länne, T. & Zachrisson, H. (2018). Residual reflux despite technical successful treatment of Great Saphenous Vein Incompetence?. In: Charing Cross Venous Workshop strain gauge plethysmography 2018: . Paper presented at Charing Cross Venous Workshop strain gauge plethysmography.
Open this publication in new window or tab >>Residual reflux despite technical successful treatment of Great Saphenous Vein Incompetence?
2018 (English)In: Charing Cross Venous Workshop strain gauge plethysmography 2018, 2018Conference paper, Oral presentation only (Other academic)
National Category
Clinical Medicine
Identifiers
urn:nbn:se:liu:diva-152724 (URN)
Conference
Charing Cross Venous Workshop strain gauge plethysmography
Available from: 2018-11-18 Created: 2018-11-18 Last updated: 2018-11-23
Hasib, L., Lundberg, A., Zachrisson, H., Ernerudh, J. & Jonasson, L. (2016). Functional and homeostatic defects of regulatory T cells in patients with coronary artery disease. Journal of Internal Medicine, 279(1), 63-77
Open this publication in new window or tab >>Functional and homeostatic defects of regulatory T cells in patients with coronary artery disease
Show others...
2016 (English)In: Journal of Internal Medicine, ISSN 0954-6820, E-ISSN 1365-2796, Vol. 279, no 1, p. 63-77Article in journal (Refereed) Published
Abstract [en]

ObjectiveRegulatory T cells (Tregs) are considered atheroprotective, and low levels have been associated with the acute coronary syndrome (ACS), particularly non-ST elevation (NSTE)-ACS. However, the functional properties as well as homeostasis of Tregs are mainly unknown in coronary artery disease (CAD). Here, we investigated the composition and functional properties of naive (n) and memory (m)Tregs in patients with NSTE-ACS and in patients 6-12months post-ACS. MethodsBased on the expression of CD25, FOXP3, CD127, CD45RA, CD39 and CTLA-4, Tregsubsets were defined by flow cytometry in whole blood or isolated CD4(+) T cells. The functional properties of nTregs and mTregs were examined in terms of proliferative capacity and modulation of cytokine secretion. To understand the potential consequences of Treg defects, we also investigated correlations with lipopolysaccharide (LPS)-induced cytokine secretion and ultrasound-defined carotid atherosclerosis. ResultsBoth NSTE-ACS and post-ACS patients exhibited reduced levels of nTregs (P<0.001) compared with healthy control subjects, but without compensatory increases in mTregs. Both nTregs and mTregs from patients showed significantly lower replicative rates and impaired capacity to modulate T-cell proliferation and secretion of interferon-gamma and IL-10. The Treg defect was also associated with LPS-induced cytokine secretion and increased burden of carotid atherosclerosis. ConclusionOur results demonstrate a functional and homeostatic Treg defect in patients with NSTE-ACS and also in stabilized patients 6-12months after ACS. Moreover, this defect was associated with a subclinical proinflammatory and atherogenic state. We believe that the failure to preserve Treg function and homeostasis reflects a need for immune-restoring strategies in CAD.

Place, publisher, year, edition, pages
WILEY-BLACKWELL, 2016
Keywords
acute coronary syndrome; coronary artery disease; immune homeostasis; inflammation; regulatory T cell
National Category
Clinical Medicine
Identifiers
urn:nbn:se:liu:diva-124108 (URN)10.1111/joim.12398 (DOI)000366606200006 ()26260103 (PubMedID)
Note

Funding Agencies|Swedish Medical Research Council; Swedish Heart-Lung Foundation

Available from: 2016-01-25 Created: 2016-01-19 Last updated: 2020-01-16
Skoog, J., Lindenberger, M., Ekman, M., Holmberg, B., Zachrisson, H. & Länne, T. (2016). Reduced venous compliance: an important determinant for orthostatic intolerance in women with vasovagal syncope. American Journal of Physiology. Regulatory Integrative and Comparative Physiology, 310(3), R253-R261
Open this publication in new window or tab >>Reduced venous compliance: an important determinant for orthostatic intolerance in women with vasovagal syncope
Show others...
2016 (English)In: American Journal of Physiology. Regulatory Integrative and Comparative Physiology, ISSN 0363-6119, E-ISSN 1522-1490, Vol. 310, no 3, p. R253-R261Article in journal (Refereed) Published
Abstract [en]

The influence of lower limb venous compliance on orthostatic vasovagal syncope (VVS) is uncertain. The most widespread technique to calculate venous compliance uses a nonphysiological quadratic regression equation. Our aim was therefore to construct a physiologically derived venous wall model (VWM) for calculation of calf venous compliance and to determine the effect of venous compliance on tolerance to maximal lower body negative pressure (LBNP). Venous occlusion plethysmography was used to study calf volume changes in 15 women with VVS (25.5 +/- 1.3 yr of age) and 15 controls (22.8 +/- 0.8 yr of age). The fit of the VWM and the regression equation to the experimentally induced pressure-volume curve was examined. Venous compliance was calculated as the derivative of the modeled pressure-volume relationship. Graded LBNP to presyncope was used to determine the LBNP tolerance index (LTI). The VWM displayed a better fit to the experimentally induced pressure-volume curve (P < 0.0001). Calf blood pooling was similar in the groups and was not correlated to the LTI (r = 0.204, P = 0.30). Venous compliance was significantly reduced at low venous pressures in women with VVS (P = 0.042) and correlated to the LTI (r = 0.459, P = 0.014) in the low pressure range. No correlation was found between venous compliance at high venous pressures and the LTI. In conclusion, the new VWM accurately adopted the curvilinear pressure-volume curve, providing a valid characterization of venous compliance. Reduced venous compliance at low venous pressures may adversely affect mobilization of peripheral venous blood to the central circulation during hypovolemic circulatory stress in women with VVS.

Place, publisher, year, edition, pages
AMER PHYSIOLOGICAL SOC, 2016
Keywords
vasovagal syncope; orthostatic intolerance; venous compliance; venous capacitance
National Category
Clinical Medicine
Identifiers
urn:nbn:se:liu:diva-125296 (URN)10.1152/ajpregu.00362.2015 (DOI)000369058900005 ()26561647 (PubMedID)
Note

Funding Agencies|Futurum-The Academy of Health Care; Jonkoping County Council; Medical Research Council of Southeast Sweden; Heart and Lung Foundation

Available from: 2016-02-24 Created: 2016-02-19 Last updated: 2019-11-11
Skoog, J., Zachrisson, H., Länne, T. & Lindenberger, M. (2016). Slower Lower Limb Blood Pooling Increases Orthostatic Tolerance in Women with Vasovagal Syncope. Frontiers in Physiology, 7(232)
Open this publication in new window or tab >>Slower Lower Limb Blood Pooling Increases Orthostatic Tolerance in Women with Vasovagal Syncope
2016 (English)In: Frontiers in Physiology, ISSN 1664-042X, E-ISSN 1664-042X, Vol. 7, no 232Article in journal (Refereed) Published
Abstract [en]

Background and Aim: Slower lower limb blood pooling and associated blunted sympathetic activation has been detected in healthy women prone to orthostatic syncope. Whether these findings are true also for patients with vasovagal syncope (WS) is unknown. The aim was to investigate initial blood pooling time (pooling(time), time to 50% of total blood pooling) together with hemodynamic responses and orthostatic tolerance during lower body negative pressure (LBNP) in WS and healthy controls. Methods and Results: Fourteen WS women (25.7 +/- 1.3 years) and 15 healthy women (22.8 +/- 0.8 years) were subjected to single-step and graded LBNP to pre-syncope. Lower limb blood pooling (ml 100 ml(-1)), poolingtime (s), hemodynamic responses and LBNP-tolerance were evaluated. LBNP induced comparable lower limb blood pooling in both groups (controls, 3.1 +/- 0.3; WS, 2.9 +/- 0.3 ml 100 ml(-1), P = 0.70). In controls, shorter pooling(time) correlated to higher LBNP-tolerance (r = -0.550, P amp;lt; 0.05) as well as better maintained stroke volume (r =-0.698, P amp;lt; 0.01) and cardiac output (r = -0.563, P amp;lt; 0.05). In contrast, shorter poolingtime correlated to lower LBNP-tolerance in VVS (r = 0.821, P amp;lt; 0.001) and larger decline in stroke volume (r = 0.611, P 0.05). Furthermore, in controls, shorter poolingtime correlated to baroreflex-mediated hemodynamic changes during LBNP, e.g., increased vasoconstriction (P amp;lt; 0.001). In VVS, poolingtime was not correlated with LBNP-induced baroreceptor unloading, but rather highly correlated to resting calf blood flow (P amp;lt; 0.001). Conclusions: Shorter poolingtime seems to elicit greater sympathetic activation with a concomitant higher orthostatic tolerance in healthy women. The contrasting findings in AS indicate a deteriorated vascular sympathetic control suggesting well-defined differences already in the initial responses during orthostatic stress.

Place, publisher, year, edition, pages
FRONTIERS MEDIA SA, 2016
Keywords
syncope; blood pooling; orthostatic intolerance; hemodynamics; baroreceptors; veins; sympathetic nervous system
National Category
Physiology
Identifiers
urn:nbn:se:liu:diva-130129 (URN)10.3389/fphys.2016.00232 (DOI)000377761400001 ()27378941 (PubMedID)
Note

Funding Agencies|Futurum-the Academy of Health Care, Jonkoping County Council; Medical Research Council of Southeast Sweden; Heart and Lung Foundation; County Council of Ostergotland

Available from: 2016-07-12 Created: 2016-07-11 Last updated: 2018-01-10
Zachrisson, H., Svensson, C., Dremetsika, A. & Eriksson, P. (2015). An extended high frequency ultrasound protocol for early diagnosis of arteritis.. In: : . Paper presented at Society of Vascular Ultrasound Annual Meeting, Las Vegas, USA.
Open this publication in new window or tab >>An extended high frequency ultrasound protocol for early diagnosis of arteritis.
2015 (English)Conference paper, Poster (with or without abstract) (Refereed)
National Category
Clinical Medicine
Identifiers
urn:nbn:se:liu:diva-118781 (URN)
Conference
Society of Vascular Ultrasound Annual Meeting, Las Vegas, USA
Available from: 2015-06-04 Created: 2015-06-04 Last updated: 2015-06-18
Skoog, J., Zachrisson, H., Lindenberger, M., Ekman, M., Ewerman, L. & Länne, T. (2015). Calf venous compliance measured by venous occlusion plethysmography: methodological aspects.. European Journal of Applied Physiology, 115(2), 245-56
Open this publication in new window or tab >>Calf venous compliance measured by venous occlusion plethysmography: methodological aspects.
Show others...
2015 (English)In: European Journal of Applied Physiology, ISSN 1439-6319, E-ISSN 1439-6327, Vol. 115, no 2, p. 245-56Article in journal (Refereed) Published
Abstract [en]

PURPOSE: Calf venous compliance (C calf) is commonly evaluated with venous occlusion plethysmography (VOP) during a standard cuff deflation protocol. However, the technique relies on two not previously validated assumptions concerning thigh cuff pressure (P cuff) transmission and the impact of net fluid filtration (F filt) on C calf. The aim was to validate VOP in the lower limb and to develop a model to correct for F filt during VOP.

METHODS: Strain-gauge technique was used to study calf volume changes in 15 women and 10 age-matched men. A thigh cuff was inflated to 60 mmHg for 4 and 8 min with a subsequent decrease of 1 mmHg s(-1). Intravenous pressure (P iv) was measured simultaneously. C calf was determined with the commonly used equation [Compliance = β 1 + 2β 2 × P cuff] describing the pressure-compliance relationship. A model was developed to identify and correct for F filt.

RESULTS: Transmission of P cuff to P iv was 100 %. The decrease in P cuff correlated well with P iv reduction (r = 0.99, P < 0.001). Overall, our model showed that C calf was underestimated when F filt was not accounted for (all P < 0.01). F filt was higher in women (P < 0.01) and showed a more pronounced effect on C calf compared to men (P < 0.05). The impact of F filt was similar during 4- and 8-min VOP.

CONCLUSIONS: P cuff is an adequate substitute for P iv in the lower limb. F filt is associated with an underestimation of C calf and differences in the effect of F filt during VOP can be accounted for with the correction model. Thus, our model seems to be a valuable tool in future studies of venous wall function.

National Category
Clinical Medicine
Identifiers
urn:nbn:se:liu:diva-113393 (URN)10.1007/s00421-014-3009-4 (DOI)000347725800003 ()25272971 (PubMedID)
Available from: 2015-01-17 Created: 2015-01-17 Last updated: 2017-12-05
Organisations

Search in DiVA

Show all publications