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  • 1.
    Ahlander, Britt-Marie
    et al.
    Department of Radiology, Ryhov County Hospital, Jönköping.
    Maret, Eva
    Department of Radiology, Ryhov County Hospital, Jönköping / Department of Clinical Physiology, Karolinska University Hospital, Stockholm.
    Brudin, Lars
    Department of Clinical Physiology, Kalmar County Hospital, Kalmar.
    Starck, Sven-Åke
    Department of Natural Science and Biomedicine, School of Health Sciences, Jönköping University / Department of Oncology, Hospital Physics, Ryhov County Hospital, Jönköping.
    Engvall, Jan
    Linköpings universitet, Institutionen för medicin och hälsa, Avdelningen för kardiovaskulär medicin. Linköpings universitet, Centrum för medicinsk bildvetenskap och visualisering, CMIV. Linköpings universitet, Medicinska fakulteten. Region Östergötland, Hjärt- och Medicincentrum, Fysiologiska kliniken US.
    An echo-planar imaging sequence is superior to a steady-state free precession sequence for visual as well as quantitative assessment of cardiac magnetic resonance stress perfusion2017Inngår i: Clinical Physiology and Functional Imaging, ISSN 1475-0961, E-ISSN 1475-097X, Vol. 37, nr 1, s. 52-61Artikkel i tidsskrift (Fagfellevurdert)
    Abstract [en]

    Background To assess myocardial perfusion, steady-state free precession cardiac magnetic resonance (SSFP, CMR) was compared with gradient-echo–echo-planar imaging (GRE-EPI) using myocardial perfusion scintigraphy (MPS) as reference. Methods Cardiac magnetic resonance perfusion was recorded in 30 patients with SSFP and in another 30 patients with GRE-EPI. Timing and extent of inflow delay to the myocardium was visually assessed. Signal-to-noise (SNR) and contrast-to-noise (CNR) ratios were calculated. Myocardial scar was visualized with a phase-sensitive inversion recovery sequence (PSIR). All scar positive segments were considered pathologic. In MPS, stress and rest images were used as in clinical reporting. The CMR contrast wash-in slope was calculated and compared with the stress score from the MPS examination. CMR scar, CMR perfusion and MPS were assessed separately by one expert for each method who was blinded to other aspects of the study. Results Visual assessment of CMR had a sensitivity for the detection of an abnormal MPS at 78% (SSFP) versus 91% (GRE-EPI) and a specificity of 58% (SSFP) versus 84% (GRE-EPI). Kappa statistics for SSFP and MPS was 0·29, for GRE-EPI and MPS 0·72. The ANOVA of CMR perfusion slopes for all segments versus MPS score (four levels based on MPS) had correlation r = 0·64 (SSFP) and r = 0·96 (GRE-EPI). SNR was for normal segments 35·63 ± 11·80 (SSFP) and 17·98 ± 8·31 (GRE-EPI), while CNR was 28·79 ± 10·43 (SSFP) and 13·06 ± 7·61 (GRE-EPI). Conclusion GRE-EPI displayed higher agreement with the MPS results than SSFP despite significantly lower signal intensity, SNR and CNR.

  • 2.
    Aneq Åström, Meriam
    et al.
    Linköpings universitet, Institutionen för medicin och hälsa, Klinisk fysiologi. Linköpings universitet, Hälsouniversitetet. Östergötlands Läns Landsting, Hjärt- och Medicincentrum, Fysiologiska kliniken US.
    Nylander, Eva
    Linköpings universitet, Institutionen för medicin och hälsa, Klinisk fysiologi. Linköpings universitet, Hälsouniversitetet. Östergötlands Läns Landsting, Hjärt- och Medicincentrum, Fysiologiska kliniken US.
    Ebbers, Tino
    Linköpings universitet, Centrum för medicinsk bildvetenskap och visualisering, CMIV. Linköpings universitet, Institutionen för medicin och hälsa, Fysiologi. Linköpings universitet, Hälsouniversitetet. Linköpings universitet, Institutionen för ekonomisk och industriell utveckling, Mekanisk värmeteori och strömningslära.
    Engvall, Jan
    Linköpings universitet, Institutionen för medicin och hälsa, Klinisk fysiologi. Linköpings universitet, Hälsouniversitetet. Östergötlands Läns Landsting, Hjärt- och Medicincentrum, Fysiologiska kliniken US.
    Determination of right ventricular volume and function using multiple axially rotated MRI slices2011Inngår i: Clinical Physiology and Functional Imaging, ISSN 1475-0961, E-ISSN 1475-097X, Vol. 31, nr 3, s. 233-239Artikkel i tidsskrift (Fagfellevurdert)
    Abstract [en]

    Pandgt;Background: The conventional magnetic resonance imaging (MRI) method for right ventricular (RV) volume and motion, using short-axis (SA) orientation, is limited by RV anatomy and shape. We suggest an orientation based on six slices rotated around the long axis of the RV, rotated long axis (RLA). Materials and methods: Three phantoms were investigated in SA and RLA using cine balanced steady-state free precession MRI. Volumes were calculated based on segmentation and checked against true volumes. In 23 healthy male volunteers, we used six long-axis planes from the middle of the tricuspid valve to the RV apex, rotated in 30 degrees increments. For comparison, short-axis slices were acquired. Imaging parameters were identical in both acquisitions. Results: Right ventricular end-diastolic (EDV), end-systolic (ESV) and stroke volumes (SV) determined in the RLA 179 center dot 1 +/- 29 center dot 3; 80 center dot 1 +/- 17 center dot 1; 99 center dot 3 +/- 16 center dot 9 ml and in the SA were 174 center dot 0 +/- 21 center dot 1; 78 center dot 8 +/- 13 center dot 6; 95 center dot 3 +/- 14 center dot 5 ml with P-values for the difference from 0 center dot 17 to 0 center dot 64 (ns). Interobserver variability ranged between 3 center dot 2% and 6 center dot 6% and intraobserver variability between 2 center dot 8% and 6 center dot 8%. In SA views, consensus for the definition of the basal slice was necessary in 39% of the volunteers for whom the average volume change was 20% in ESV and 10% in EDV. Conclusions: The RLA method results in better visualization and definition of the RV inflow, outflow and apex. Accurate measurement of RV volumes for diagnosis and follow-up of cardiac diseases are enhanced by the RLA orientation, even though additional acquisition time is required.

  • 3.
    Blomstrand, Peter
    et al.
    County Hospital Ryhov, Jököping, Sweden.
    Maret, Eva
    Linköpings universitet, Institutionen för medicin och hälsa, Klinisk fysiologi. Linköpings universitet, Hälsouniversitetet.
    Ohlsson, Jan
    County Hospital Ryhov, Jönköping, Sweden.
    Scheike, Morten
    Linköpings universitet, Institutionen för medicin och hälsa, Klinisk fysiologi. Linköpings universitet, Hälsouniversitetet.
    Karlsson, Jan-Erik
    County Hospital Ryhov, Jönköping, Sweden.
    Säfström, Kåge
    Linköpings universitet, Institutionen för medicin och hälsa, Kardiologi. Linköpings universitet, Hälsouniversitetet. Östergötlands Läns Landsting, Hjärtcentrum, Kardiologiska kliniken.
    Swahn, Eva
    Linköpings universitet, Institutionen för medicin och hälsa, Kardiologi. Linköpings universitet, Hälsouniversitetet.
    Engvall, Jan
    Linköpings universitet, Institutionen för medicin och hälsa, Klinisk fysiologi. Linköpings universitet, Hälsouniversitetet.
    Pulsed tissue Doppler imaging for the detection of myocardial ischaemia, a comparison with myocardial perfusion SPECT2004Inngår i: Clinical Physiology and Functional Imaging, ISSN 1475-0961, E-ISSN 1475-097X, Vol. 24, nr 5, s. 289-295Artikkel i tidsskrift (Fagfellevurdert)
    Abstract [en]

    In order to compare the diagnostic ability of pulsed tissue Doppler and myocardial perfusion Single Photon Emission Computed Tomography (SPECT) in patients with a history of unstable coronary artery disease, CAD, 26 patients, 22 men and four women, age 47-76 years, were investigated in a prospective study, 5-10 day after an episode of unstable angina. Tissue Doppler and two-dimensional echocardiography were performed during dobutamine stress testing and myocardial scintigraphy after bicycle exercise and at rest. Patients with a normal SPECT had higher peak systolic velocity during dobutamine infusion, 18.9 +/- 4.1 cm s(-1), than patients with ischaemia, 12.2 +/- 3.8 cm s(-1) (P<0.001) or scar, 8.8 +/- 3.0 cm s(-1) (P<0.01). In a territorial analysis the difference in peak systolic velocity between areas with a normal and abnormal SPECT was less apparent. Failure to achieve >/=13 cm s(-1) in mean-peak systolic velocity was the most accurate criterion for detection of significant CAD on SPECT. We conclude that pulsed tissue Doppler can be used for objective quantification of left ventricular wall motion during dobutamine stress testing and for identification of patients with CAD on SPECT but not for identification of regional ischaemia.

  • 4.
    Brolin, Gustav
    et al.
    Lund University, Sweden.
    Edenbrandt, Lars
    EQUALIS AB, Sweden; Lund University, Sweden.
    Granerus, Göran
    Linköpings universitet, Institutionen för medicin och hälsa, Avdelningen för kardiovaskulär medicin. Linköpings universitet, Hälsouniversitetet. Region Östergötland, Hjärt- och Medicincentrum, Fysiologiska kliniken US.
    Olsson, Anna
    Linköpings universitet, Medicinska fakulteten. Linköpings universitet, Institutionen för medicin och hälsa, Avdelningen för radiologiska vetenskaper.
    Afzelius, David
    EQUALIS AB, Sweden.
    Gustafsson, Agneta
    EQUALIS AB, Sweden; Karolinska University Hospital, Sweden.
    Jonsson, Cathrine
    EQUALIS AB, Sweden; Karolinska University Hospital, Sweden.
    Hagerman, Jessica
    EQUALIS AB, Sweden; Skåne University Hospital, Sweden.
    Johansson, Lena
    EQUALIS AB, Sweden; Central Hospital Karlstad, Sweden.
    Riklund, Katrine
    EQUALIS AB, Sweden; Umeå University, Sweden.
    Ljungberg, Michael
    Lund University, Sweden.
    The accuracy of quantitative parameters in Tc-99m-MAG3 dynamic renography: a national audit based on virtual image data2016Inngår i: Clinical Physiology and Functional Imaging, ISSN 1475-0961, E-ISSN 1475-097X, Vol. 36, nr 2, s. 146-154Artikkel i tidsskrift (Fagfellevurdert)
    Abstract [en]

    Assessment of image analysis methods and computer software used in Tc-99m-MAG3 dynamic renography is important to ensure reliable study results and ultimately the best possible care for patients. In this work, we present a national multicentre study of the quantification accuracy in Tc-99m-MAG3 renography, utilizing virtual dynamic scintigraphic data obtained by Monte Carlo-simulated scintillation camera imaging of digital phantoms with time-varying activity distributions. Three digital phantom studies were distributed to the participating departments, and quantitative evaluation was performed with standard clinical software according to local routines. The differential renal function (DRF) and time to maximum renal activity (T-max) were reported by 21 of the 28 Swedish departments performing Tc-99m-MAG3 studies as of 2012. The reported DRF estimates showed a significantly lower precision for the phantom with impaired renal uptake than for the phantom with normal uptake. The T-max estimates showed a similar trend, but the difference was only significant for the right kidney. There was a significant bias in the measured DRF for all phantoms caused by different positions of the left and right kidney in the anterior-posterior direction. In conclusion, this study shows that virtual scintigraphic studies are applicable for quality assurance and that there is a considerable uncertainty associated with standard quantitative parameters in dynamic Tc-99m-MAG3 renography, especially for patients with impaired renal function.

  • 5.
    Brudin, Lars
    et al.
    Linköpings universitet, Institutionen för medicin och hälsa, Avdelningen för kardiovaskulär medicin. Linköpings universitet, Hälsouniversitetet.
    Jorfeldt, L.
    Karolinska Institute, Sweden Karolinska University Hospital, Sweden .
    Pahlm, O.
    Skåne University Hospital, Sweden .
    Comparison of two commonly used reference materials for exercise bicycle tests with a Swedish clinical database of patients with normal outcome2014Inngår i: Clinical Physiology and Functional Imaging, ISSN 1475-0961, E-ISSN 1475-097X, Vol. 34, nr 4, s. 297-307Artikkel i tidsskrift (Fagfellevurdert)
    Abstract [en]

    Background: Reference values for working capacity, blood pressure, heart rate, perceived exertion, etc. during bicycle exercise tests have been sought after for many years. This is because earlier commonly used reference values for physical work capacity have been either too low or too high when compared to the clinical experience of several Swedish departments of clinical physiology. The aim of the study was to compare two commonly used reference materials with normal outcomes from a clinical database. Methods: Data from a clinical database of standardized exercise tests in Kalmar, Sweden, between 2004 and 2012, and having been judged as normal, were divided into 5-year categories of 5-10 to 75-80 years of age covering people from 7 to 80 years of age. Results: Maximal working capacity (W-max), maximal heart rate, maximal systolic blood pressure and maximal perceived exertion are presented for each of the 15 age categories. Regression equations are also presented for each sex with age and height as independent predictors. Quantitative comparisons of W-max are calculated for the three materials and possible explanations discussed. Conclusions: Values of W-max lie between the two reference materials most commonly used in Sweden. In addition, the present material covers subjects aged 7-19 years.

  • 6.
    Carlhäll, Carljohan
    et al.
    Linköpings universitet, Institutionen för medicin och vård, Klinisk fysiologi. Linköpings universitet, Hälsouniversitetet.
    Hatle, L.
    Department of Cardiology, University Hospital Gasthuisberg, Leuven, Belgium.
    Nylander, Eva
    Linköpings universitet, Institutionen för medicin och vård, Klinisk fysiologi. Linköpings universitet, Hälsouniversitetet.
    A novel method to assess systolic ventricular function using atrioventricular plane displacement: a study in young healthy males and patients with heart disease2004Inngår i: Clinical Physiology and Functional Imaging, ISSN 1475-0961, E-ISSN 1475-097X, Vol. 24, nr 4, s. 190-195Artikkel i tidsskrift (Fagfellevurdert)
    Abstract [en]

    Analysis of atrioventricular plane displacement (AVPD) is a well established method for assessment of both systolic and diastolic ventricular function. For several years, AVPD has been a clinical tool and there are many current, as well as potential, areas of application. However, clinical work has shown that the traditional method for evaluation of systolic ventricular function, called total AVPD, does not temporally reflect true systole. Systolic AVPD is a new approach for measuring AVPD to assess ventricular systolic function. We wished to apply this new model in healthy subjects and in patients with different common heart diseases. Twenty-eight young healthy males and 30 patients (aortic stenosis, left sided regurgitant lesions, postmyocardial infarction) were enrolled. AVPD was obtained at the four standard sites by M-mode. Total AVPD was measured in the conventional way and systolic AVPD by identifying true systole, by means of mitral- and aortic valve closure respectively. Ventricular volumes were calculated according to biplane Simpson's rule. The systolic AVPD measurements were significantly lower than the total measurements, at both atrioventricular planes in all groups (P<0·001). This discrepancy was greater at the mitral than at the tricuspid annulus in the patients 24·2% vs. 15·5% (P<0·001), but did not differ in the healthy subjects. At the mitral annulus, this discrepancy also seemed to be more pronounced in the patients than in the healthy subjects 24·2% vs. 10·7%. When assessing ventricular systolic function by AVPD, the conventional method overestimates the amplitude in relation to true systolic function in both patients with heart disease and in young healthy males. Thus, there are uncertainties regarding earlier estimations of AVPD in terms of expression of systolic function and regarding previously presented reference values. We recommend the proposed methodology.

  • 7.
    Carlén, Anna
    et al.
    Linköpings universitet, Medicinska fakulteten. Region Östergötland, Hjärt- och Medicincentrum, Fysiologiska kliniken US. Linköpings universitet, Institutionen för medicin och hälsa, Avdelningen för kardiovaskulär medicin.
    Åström Aneq, Meriam
    Linköpings universitet, Medicinska fakulteten. Region Östergötland, Hjärt- och Medicincentrum, Fysiologiska kliniken US. Linköpings universitet, Institutionen för medicin och hälsa, Avdelningen för kardiovaskulär medicin.
    Nylander, Eva
    Linköpings universitet, Medicinska fakulteten. Region Östergötland, Hjärt- och Medicincentrum, Fysiologiska kliniken US. Linköpings universitet, Institutionen för medicin och hälsa, Avdelningen för kardiovaskulär medicin.
    Gustafsson, Mikael
    Linköpings universitet, Medicinska fakulteten. Region Östergötland, Hjärt- och Medicincentrum, Kardiologiska kliniken US. Linköpings universitet, Institutionen för medicin och hälsa, Avdelningen för kardiovaskulär medicin.
    Loaded treadmill walking and cycle ergometry to assess work capacity: a retrospective comparison in 424 firefighters.2017Inngår i: Clinical Physiology and Functional Imaging, ISSN 1475-0961, E-ISSN 1475-097X, Vol. 37, nr 1, s. 37-44Artikkel i tidsskrift (Fagfellevurdert)
    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.

  • 8.
    Dahlén, Elsa M
    et al.
    Linköpings universitet, Institutionen för medicin och hälsa, Allmänmedicin. Linköpings universitet, Hälsouniversitetet.
    Andreasson, Thomas
    Sahlgrenska University Hospital, Göteborg.
    Cinthio, Magnus
    Nyström, Fredrik
    Linköpings universitet, Institutionen för medicin och hälsa, Internmedicin. Linköpings universitet, Hälsouniversitetet. Östergötlands Läns Landsting, Hjärt- och Medicincentrum, Endokrin- och magtarmmedicinska kliniken US.
    Östgren, Carl Johan
    Linköpings universitet, Institutionen för medicin och hälsa, Allmänmedicin. Linköpings universitet, Hälsouniversitetet. Östergötlands Läns Landsting, Närsjukvården i västra Östergötland, Vårdcentraler.
    Länne, Toste
    Linköpings universitet, Institutionen för medicin och hälsa, Fysiologi. Linköpings universitet, Hälsouniversitetet. Östergötlands Läns Landsting, Hjärt- och Medicincentrum, Thorax-kärlkliniken i Östergötland.
    Is there an underestimation of intima-media thickness based on M-mode ultrasound technique in the abdominal aorta?2012Inngår i: Clinical Physiology and Functional Imaging, ISSN 1475-0961, E-ISSN 1475-097X, Vol. 32, nr 1, s. 1-4Artikkel i tidsskrift (Fagfellevurdert)
    Abstract [en]

    Measuring intima-media thickness (IMT) in the common carotid artery (CCA) is a valuable resource for the evaluation of subclinical atherosclerosis. The main objective of this study was to explore whether a B-mode ultrasound technique, Philips ATL, and an M-mode ultrasound technique, Wall Track System (WTS), show interchangeable results when measured in CCA and the abdominal aorta (AA). A total of 24 healthy, young subjects were examined. IMT and lumen diameter (LD) of the AA and the CCA were measured twice by two skilled ultrasonographers with two different ultrasound equipment B-mode: (Philips, ATL and M-mode: WTS).The intra-observer variability of IMT in CCA and AA using B-mode showed a coefficient of variation 8% and 9%, and with M-mode 11% and 15%, respectively. Interobserver variability of IMT in CCA and AA using B-mode was 6% and 12%, and with M-mode 11% and 18%, respectively. CCA IMT was 0·53 ± 0·07 and 0·53 ± 0·09 mm using B-mode and M-mode, respectively. However, in AA, IMT was 0·61 ± 0·5 and 0·54 ± 0·10 mm using B-mode and M-mode, respectively. Thus, AA IMT was 11·5% thicker using B-mode (P<0·01). We received adequate IMT readings from the carotid artery as well as the AA using two commonly used B-mode and M-mode techniques. B-mode technique seems to show less variability, especially in the AA. More importantly, the two techniques measured different IMT thickness in the aorta, emphasizing the importance of using similar technique when comparing the impact of absolute values of IMT on cardiovascular disease.

  • 9.
    Davidsson, Anette
    et al.
    Linköpings universitet, Institutionen för medicin och hälsa, Avdelningen för kardiovaskulär medicin. Linköpings universitet, Medicinska fakulteten. Region Östergötland, Hjärt- och Medicincentrum, Fysiologiska kliniken US.
    Olsson, Eva
    Linköpings universitet, Institutionen för medicin och hälsa, Avdelningen för kardiovaskulär medicin. Linköpings universitet, Medicinska fakulteten. Region Östergötland, Hjärt- och Medicincentrum, Fysiologiska kliniken US.
    Engvall, Jan
    Linköpings universitet, Institutionen för medicin och hälsa, Avdelningen för kardiovaskulär medicin. Linköpings universitet, Medicinska fakulteten. Region Östergötland, Hjärt- och Medicincentrum, Fysiologiska kliniken US.
    Gustafsson, Agnetha
    Karolinska University Hospital, Huddinge, Stockholm, Sweden.
    Influence of reconstruction algorithms on image quality in SPECT myocardial perfusion imaging2017Inngår i: Clinical Physiology and Functional Imaging, ISSN 1475-0961, E-ISSN 1475-097X, Vol. 37, nr 6, s. 655-662Artikkel i tidsskrift (Fagfellevurdert)
    Abstract [en]

    INTRODUCTION: We investigated if image- and diagnostic quality in SPECT MPI could be maintained despite a reduced acquisition time adding Depth Dependent Resolution Recovery (DDRR) for image reconstruction. Images were compared with filtered back projection (FBP) and iterative reconstruction using Ordered Subsets Expectation Maximization with (IRAC) and without (IRNC) attenuation correction (AC).

    MATERIALS AND METHODS: Stress- and rest imaging for 15 min was performed on 21 subjects with a dual head gamma camera (Infinia Hawkeye; GE Healthcare), ECG-gating with 8 frames/cardiac cycle and a low-dose CT-scan. A 9 min acquisition was generated using five instead of eight gated frames and was reconstructed with DDRR, with (IRACRR) and without AC (IRNCRR) as well as with FBP. Three experienced nuclear medicine specialists visually assessed anonymized images according to eight criteria on a four point scale, three related to image quality and five to diagnostic confidence. Statistical analysis was performed using Visual Grading Regression (VGR).

    RESULTS: Observer confidence in statements on image quality was highest for the images that were reconstructed using DDRR (P<0·01 compared to FBP). Iterative reconstruction without DDRR was not superior to FBP. Interobserver variability was significant for statements on image quality (P<0·05) but lower in the diagnostic statements on ischemia and scar. The confidence in assessing ischemia and scar was not different between the reconstruction techniques (P = n.s.).

    CONCLUSION: SPECT MPI collected in 9 min, reconstructed with DDRR and AC, produced better image quality than the standard procedure. The observers expressed the highest diagnostic confidence in the DDRR reconstruction.

  • 10.
    De Geer, Jakob
    et al.
    Linköpings universitet, Institutionen för medicin och hälsa, Avdelningen för radiologiska vetenskaper. Linköpings universitet, Hälsouniversitetet. Linköpings universitet, Centrum för medicinsk bildvetenskap och visualisering, CMIV. Östergötlands Läns Landsting, Diagnostikcentrum, Röntgenkliniken i Linköping.
    Gjerde, Marcus
    Linköpings universitet, Institutionen för medicin och hälsa, Avdelningen för kardiovaskulär medicin. Linköpings universitet, Hälsouniversitetet. Östergötlands Läns Landsting, Hjärt- och Medicincentrum, Kardiologiska kliniken US. Linköpings universitet, Centrum för medicinsk bildvetenskap och visualisering, CMIV.
    Brudin, Lars
    Linköpings universitet, Institutionen för medicin och hälsa, Avdelningen för kardiovaskulär medicin. Linköpings universitet, Hälsouniversitetet. Department of Clinical Physiology in Kalmar, Linköping University, County Council of Kalmar, Kalmar, Sweden.
    Olsson, Eva
    Linköpings universitet, Institutionen för medicin och hälsa, Avdelningen för kardiovaskulär medicin. Linköpings universitet, Hälsouniversitetet. Östergötlands Läns Landsting, Hjärt- och Medicincentrum, Fysiologiska kliniken US. Linköpings universitet, Centrum för medicinsk bildvetenskap och visualisering, CMIV.
    Persson, Anders
    Linköpings universitet, Centrum för medicinsk bildvetenskap och visualisering, CMIV. Linköpings universitet, Institutionen för medicin och hälsa, Avdelningen för radiologiska vetenskaper. Linköpings universitet, Hälsouniversitetet. Östergötlands Läns Landsting, Diagnostikcentrum, Röntgenkliniken i Linköping.
    Engvall, Jan
    Linköpings universitet, Institutionen för medicin och hälsa, Avdelningen för kardiovaskulär medicin. Linköpings universitet, Hälsouniversitetet. Östergötlands Läns Landsting, Hjärt- och Medicincentrum, Fysiologiska kliniken US.
    Large variation in blood flow between left ventricular segments, as detected by adenosine stress dynamic CT perfusion.2015Inngår i: Clinical Physiology and Functional Imaging, ISSN 1475-0961, E-ISSN 1475-097X, Vol. 35, nr 4, s. 291-300Artikkel i tidsskrift (Fagfellevurdert)
    Abstract [en]

    BACKGROUND: Dynamic cardiac CT perfusion (CTP) is based on repeated imaging during the first-pass contrast agent inflow. It is a relatively new method that still needs validation.

    PURPOSE: To evaluate the variation in adenosine stress dynamic CTP blood flow as compared to (99m) Tc SPECT. Secondarily, to compare manual and automatic segmentation.

    METHODS: Seventeen patients with manifest coronary artery disease were included. Nine were excluded from evaluation for various reasons. All patients were examined with dynamic stress CTP and stress/rest SPECT. CTP blood flow was compared with SPECT on a per segment basis. Results for manual and automated AHA segmentation were compared.

    RESULTS: CTP showed a positive correlation with SPECT, with correlation coefficients of 0·38 and 0·41 for manual and automatic segmentation, respectively (P<0·0001). There was no significant difference between the correlation coefficients of the manual and automated segmentation procedures (P = 0·75). The average per individual global CTP blood flow value for normal segments varied by a factor of 1·9 (manual and automatic segmentation). For the whole patient group, the CTP blood flow value in normal segments varied by a factor of 2·9/2·7 (manual/automatic segmentation). Within each patient, the average per segment blood flow in normal segments varied by a factor of 1·3-2·0/1·2-2·1 (manual/automatic segmentation).

    CONCLUSION: A positive but rather weak correlation was found between CTP and (99m) Tc SPECT. Large variations in CTP blood flow suggest that a cut-off value for stress myocardial blood flow is inadequate to detect ischaemic segments. Dynamic CTP is hampered by a limited coverage.

  • 11.
    Ekelund, Ulf
    et al.
    Unit of Preventive Nutrition, Department of Medical Nutrition / Biosciences, Karolinska Institutet, Stockholm, Sweden and Department of Physical Education and Health, Örebro University, Örebro, Sweden.
    Tingström, Pia
    Linköpings universitet, Institutionen för medicin och vård, Kardiologi. Linköpings universitet, Hälsouniversitetet.
    Kamwendo, Kitty
    Department of Caring Sciences, Örebro University, Örebro, Sweden.
    Krantz, Monica
    Linköpings universitet, Hälsouniversitetet.
    Nylander, Eva
    Linköpings universitet, Institutionen för medicin och vård, Klinisk fysiologi. Linköpings universitet, Hälsouniversitetet.
    Sjöström, Michael
    Unit of Preventive Nutrition, Department of Medical Nutrition / Biosciences, Karolinska Institutet, Stockholm, Sweden.
    Bergdahl, Björn
    Linköpings universitet, Institutionen för medicin och vård, Kardiologi. Linköpings universitet, Hälsouniversitetet.
    The validity of the Computer Science and Applications activity monitor for use in coronary artery disease patients during level walking2002Inngår i: Clinical Physiology and Functional Imaging, ISSN 1475-0961, E-ISSN 1475-097X, Vol. 22, nr 4, s. 248-253Artikkel i tidsskrift (Fagfellevurdert)
    Abstract [en]

    The principal aim of the present study was to examine the validity of the Computer Science and Applications (CSA) activity monitor during level walking in coronary artery disease (CAD) patients. As a secondary aim, we evaluated the usefulness of two previously published energy expenditure (EE) prediction equations. Thirty-four subjects (29 men and five women), all with diagnosed CAD, volunteered to participate. Oxygen uptake (VO2) was measured by indirect calorimetry during walking on a motorized treadmill at three different speeds (3·2, 4·8 and 6·4 km h−1). Physical activity was measured simultaneously using the CSA activity monitor, secured directly to the skin on the lower back (i.e. lumbar vertebrae 4–5) with an elastic belt. The mean (±SD) activity counts were 1208 ± 429, 3258 ± 753 and 5351 ± 876 counts min−1, at the three speeds, respectively (P<0·001). Activity counts were significantly correlated to speed (r=0·92; P<0·001), VO2 (ml kg−1 min−1; r=0·87; P<0·001) and EE (kcal min−1; r=0·85, P<0·001). A stepwise linear regression analysis showed that activity counts and body weight together explained 75% of the variation in EE. Predicted EE from previously published equations differed significantly when used in this group of CAD patients. In conclusion, the CSA activity monitor is a valid instrument for assessing the intensity of physical activity during treadmill walking in CAD patients. Energy expenditure can be predicted from body weight and activity counts.

  • 12.
    Farnebo, Simon
    et al.
    Linköpings universitet, Institutionen för klinisk och experimentell medicin, Kirurgi. Linköpings universitet, Hälsouniversitetet. Östergötlands Läns Landsting, Rekonstruktionscentrum, Hand- och plastikkirurgiska kliniken US.
    Samuelsson, A.
    Östergötlands Läns Landsting, Anestesi- och operationscentrum, Intensivvårdskliniken US.
    Henriksson, J.
    Karolinska Inst, Dept Physiol and Pharmacol, Stockholm, Sweden.
    Karlander, Lars-Erik
    Linköpings universitet, Institutionen för klinisk och experimentell medicin, Kirurgi. Linköpings universitet, Hälsouniversitetet. Östergötlands Läns Landsting, Rekonstruktionscentrum, Hand- och plastikkirurgiska kliniken US.
    Sjöberg, Folke
    Linköpings universitet, Institutionen för klinisk och experimentell medicin, Brännskadevård. Linköpings universitet, Hälsouniversitetet. Östergötlands Läns Landsting, Sinnescentrum, Hand- och plastikkirurgiska kliniken US. Östergötlands Läns Landsting, Sinnescentrum, Anestesi- och operationkliniken US.
    Urea clearance: a new method to register local changes in blood flow in rat skeletal muscle based on microdialysis2010Inngår i: Clinical Physiology and Functional Imaging, ISSN 1475-0961, E-ISSN 1475-097X, Vol. 30, nr 1, s. 57-63Artikkel i tidsskrift (Fagfellevurdert)
    Abstract [en]

    Pgreater thanIncreasing evidence suggests that local blood flow should be monitored during microdialysis (MD) as the recovery of analytes is affected by local blood flow. At present ethanol clearance is the standard technique for this purpose, but it is not functional at very low perfusion velocities. Here, we introduce a technique for MD whereby local tissue blood flow is recorded by the use of urea clearance (changes inflow/outflow concentration), in conjunction with measurements of tissue metabolism (glucose, lactate and puruvate). MD probes were inserted into the gracilis muscle of 15 rats and perfused with a medium containing urea (20 mmol l-1). Changes in muscle blood flow were made by addition of noradrenaline (5 mu g ml-1) to the perfusion medium at two perfusion velocities (0 center dot 6 and 0 center dot 4 mu l min-1). The clearance of urea from the perfusion medium was then calculated and examined in relation to the dose of noradrenaline and to the coexisting changes in extracellular metabolites. The results showed reproducible and dose-dependent changes in blood flow that were induced by noradrenaline. These were characterized by dose-dependent changes in the urea clearance as well as blood-flow-specific changes in the MD metabolic markers (reduction in glucose and increase in lactate). The sensitivity for blood flow changes as assessed by urea clearance (MD) was increased at 0 center dot 4 compared with the 0 center dot 6 mu l min-1 perfusion speed. The results indicate that inclusion of urea to the perfusion medium may be used to monitor changes in skeletal muscle blood flow at low perfusion velocities and in parallel assess metabolic variables with a high recovery (greater than 90%).

  • 13.
    Gustafsson, Agneta
    et al.
    Linköpings universitet, Institutionen för medicin och hälsa, Avdelningen för radiologiska vetenskaper. Linköpings universitet, Medicinska fakulteten. Region Östergötland, Centrum för kirurgi, ortopedi och cancervård, Radiofysikavdelningen US.
    Karlsson, Henrik
    Kalmar County Hospital, Sweden.
    Nilsson, Kerstin A.
    Geijer, Hakan
    Örebro University Hospital, Sweden.
    Olsson, Anna
    Linköpings universitet, Institutionen för medicin och hälsa, Avdelningen för radiologiska vetenskaper. Linköpings universitet, Medicinska fakulteten. Linköpings universitet, Centrum för medicinsk bildvetenskap och visualisering, CMIV.
    A visual grading study for different administered activity levels in bone scintigraphy2015Inngår i: Clinical Physiology and Functional Imaging, ISSN 1475-0961, E-ISSN 1475-097X, Vol. 35, nr 3, s. 231-236Artikkel i tidsskrift (Fagfellevurdert)
    Abstract [en]

    IntroductionThe aim of the study is to assess the administered activity levels versus visual-based image quality using visual grading regression (VGR) including an assessment of the newly stated image criteria for whole-body bone scintigraphy. Materials and methodsA total of 90 patients was included and grouped in three levels of administered activity: 400, 500 and 600 MBq. Six clinical image criteria regarding image quality was formulated by experienced nuclear medicine physicians. Visual grading was performed in all images, where three physicians rated the fulfilment of the image criteria on a four-step ordinal scale. The results were analysed using VGR. A count analysis was also made where the total number of counts in both views was registered. ResultsThe administered activity of 600 MBq gives significantly better image quality than 400 MBq in five of six criteria (Pless than005). Comparing the administered activity of 600 MBq to 500 MBq, four criteria of six show significantly better image quality (Pless than005). The administered activity of 500 MBq gives no significantly better image quality than 400 Mbq (Pless than005). The count analysis shows that none of the three levels of administrated activity fulfil the recommendations by the EANM. ConclusionThere was a significant improvement in perceived image quality using an activity level of 600 MBq compared to lower activity levels in whole-body bone scintigraphy for the gamma camera equipment end set-up used in this study. This type of visual-based grading study seems to be a valuable tool and easy to implement in the clinical environment.

  • 14.
    Gölster, Helena
    et al.
    Linköpings universitet, Institutionen för medicin och hälsa, Anestesiologi med intensivvård. Linköpings universitet, Hälsouniversitetet.
    Hyllienmark, Lars
    Department of Clinical Neurophysiology, Karolinska Institute, Karolinska University Hospital, Stockholm.
    Ledin, Torbjörn
    Linköpings universitet, Institutionen för nervsystem och rörelseorgan, Oto-Rhino-Laryngologi. Linköpings universitet, Hälsouniversitetet.
    Ludvigsson, Johnny
    Linköpings universitet, Institutionen för molekylär och klinisk medicin, Pediatrik. Linköpings universitet, Hälsouniversitetet.
    Sjöberg, Folke
    Linköpings universitet, Institutionen för medicin och hälsa, Anestesiologi med intensivvård. Linköpings universitet, Hälsouniversitetet.
    Impaired microvascular function related to poor metabolic control in young patients with diabetes2005Inngår i: Clinical Physiology and Functional Imaging, ISSN 1475-0961, E-ISSN 1475-097X, Vol. 25, nr 2, s. 100-105Artikkel i tidsskrift (Fagfellevurdert)
    Abstract [en]

    The purpose of the present study was to identify whether young patients with type 1 diabetes using modern multiple insulin injection therapy (MIT) have signs of microvascular dysfunction and to elucidate possible correlations with various disease parameters. Skin blood flow on the dorsum of the foot was measured with laser Doppler perfusion imaging in 37 patients (age 10–21 years, disease duration 6·0–16 years) and 10 healthy controls. Measurements were performed at rest, after change in posture (the leg was lowered below heart level) and during postocclusive hyperaemia. Following a change in posture blood flow increased instead of decreased in a majority of the study subjects. Patients with acute HbA1c >7·5% (n = 22) had an increase in skin blood flow at rest and a significantly reduced blood flow when the leg was lowered below heart level as compared with patients with HbA1c <7·5% (0·26 V versus 0·17 V, P<0·01 and 0·12 V versus 0·23 V, P<0·05, respectively) and healthy controls. Following occlusion of the macrocirculation for 3 min a small non-significant decrease in the hyperaemic response was seen in the patients. The postocclusive hyperaemic response and the venoarteriolar reflex were not correlated to duration of disease, long-term metabolic control or electrophysiological signs of peripheral nerve dysfunction. It is concluded that signs of microvascular dysfunction related to poor metabolic control are present in young patients with MIT treatment and rather well-controlled diabetes. Low resting blood flow levels are suggested to contribute to the absence of postural vasoconstrictor response.

  • 15.
    Hedman, Kristofer
    et al.
    Linköpings universitet, Institutionen för medicin och hälsa, Avdelningen för kardiovaskulär medicin. Linköpings universitet, Hälsouniversitetet.
    Tamas, Eva
    Linköpings universitet, Institutionen för medicin och hälsa, Thoraxkirurgi. Linköpings universitet, Hälsouniversitetet. Östergötlands Läns Landsting, Hjärt- och Medicincentrum, Thorax-kärlkliniken i Östergötland.
    Nylander, Eva
    Linköpings universitet, Institutionen för medicin och hälsa, Klinisk fysiologi. Linköpings universitet, Hälsouniversitetet. Östergötlands Läns Landsting, Hjärt- och Medicincentrum, Fysiologiska kliniken US.
    Decreased aerobic capacity 4 years after aortic valve replacement in male patients operated upon for chronic aortic regurgitation2012Inngår i: Clinical Physiology and Functional Imaging, ISSN 1475-0961, E-ISSN 1475-097X, Vol. 32, nr 3, s. 167-171Artikkel i tidsskrift (Fagfellevurdert)
    Abstract [en]

    Exercise testing is underutilized in patients with valve disease. We have previously found a low physical work capacity in patients with aortic regurgitation 6 months after aortic valve replacement (AVR). The aim of this study was to evaluate aerobic capacity in patients 4 years after AVR, to study how their peak oxygen uptake (peakVO2) had changed postoperatively over a longer period of time. Twenty-one patients (all men, 52 +/- 13 years) who had previously undergone cardiopulmonary exercise testing (CPET) pre- and 6 months postoperatively underwent maximal exercise testing 49 +/- 15 months postoperatively using an electrically braked bicycle ergometer. Breathing gases were analysed and the patients physical fitness levels categorized according to angstrom strands and Wassermans classifications. Mean peakVO2 was 22.8 +/- 5.1 ml x kg-1 x min-1 at the 49-month follow-up, which was lower than at the 6-month follow-up (25.6 +/- 5.8 ml x kg-1 x min-1, P = 0.001). All but one patient presented with a physical fitness level below average using angstrom strands classification, while 13 patients had a low physical capacity according to Wassermans classification. A significant decrease in peakVO2 was observed from six to 49 months postoperatively, and the decrease was larger than expected from the increased age of the patients. CPET could be helpful in timing aortic valve surgery and for the evaluation of need of physical activity as part of a rehabilitation programme.

  • 16.
    Jakobsson, Per
    et al.
    Linköpings universitet, Hälsouniversitetet. Linköpings universitet, Institutionen för medicin och vård, Lungmedicin. Östergötlands Läns Landsting, Kirurgi- och onkologicentrum, Lungmedicinska kliniken US.
    Jorfeldt, Lennart
    Stockholm.
    Oxygen supplementation increases glucose tolerance during euglycaemic hyperinsulinaemic glucose clamp procedure in patients with severe COPD and chronic hypoxaemia2006Inngår i: Clinical Physiology and Functional Imaging, ISSN 1475-0961, E-ISSN 1475-097X, Vol. 26, nr 5, s. 271-274Artikkel i tidsskrift (Fagfellevurdert)
    Abstract [en]

    Investigations in chronic obstructive pulmonary disease (COPD) patients have shown impaired glucose tolerance in hypoxic COPD patients, compared with COPD patients with normal arterial blood gases. In healthy subjects, hypoxaemia or stay at altitude, have been shown to alter glucose metabolism. At altitude the effect seems to be dependent on duration of stay. A short stay is associated with insulin resistance, a longer stay gives rise to increased glucose uptake. The euglycaemic hyperinsulinaemic glucose clamp technique is a method to study glucose tolerance and enables determinations of glucose clearance in peripheral tissues. We investigated six COPD patients [forced expiratory volume in 1 s 0.7 ± 0.2 l (mean ± SD)] with chronic hypoxaemia (PaO2 7.9 ± 0.6 kPa at rest, breathing air), with and without oxygen supplementation, using the glucose clamp technique. Net peripheral glucose uptake was 5.5 ± 1.2 and 7.1 ± 1.6 mg (kg*min)-1 (+29%) breathing air and supplemental oxygen, respectively (P = 0.03). The tissue sensitivity to insulin increased 32% (P = 0.03) with oxygen supplementation. The results indicate that normalization of oxygen saturation in COPD patients with chronic hypoxaemia may have an immediate effect on glucose tolerance and tissue sensitivity to insulin in these patients. © 2006 Blackwell Publishing Ltd.

  • 17.
    Jogestrand, Tomas
    et al.
    Karolinska Institute, Sweden; Karolinska University Hospital, Sweden.
    Freden-Lindqvist, Johan
    Sahlgrens University Hospital, Sweden.
    Lindqvist, Madeleine
    Karolinska University Hospital, Sweden.
    Lundgren, Susanne
    Blekingesjukhuset, Sweden.
    Tillman, Ann-Sofie
    Region Östergötland, Diagnostikcentrum, Fysiologiska kliniken ViN.
    Zachrisson, Helene
    Linköpings universitet, Institutionen för medicin och hälsa, Avdelningen för kardiovaskulär medicin. Linköpings universitet, Hälsouniversitetet. Region Östergötland, Hjärt- och Medicincentrum, Fysiologiska kliniken US. Linköpings universitet, Centrum för medicinsk bildvetenskap och visualisering, CMIV.
    Discrepancies in recommended criteria for grading of carotid stenosis with ultrasound2016Inngår i: Clinical Physiology and Functional Imaging, ISSN 1475-0961, E-ISSN 1475-097X, Vol. 36, nr 4, s. 326-329Artikkel i tidsskrift (Fagfellevurdert)
    Abstract [en]

    The accuracy of duplex ultrasound for grading of internal carotid artery stenosis has been widely tested and shown to be high. However, different methods for measurement of the degree of carotid stenosis with the golden standard conventional angiography have been used in the different studies. This, together with other factors, has led to some confusion regarding the relation between the ultrasonographically measured flow velocity and the angiographically measured degree of stenosis. The ultrasound criteria that are used in Sweden (and in Germany) differ in an important way from the criteria recommended in North America and the United Kingdom for the same degree of angiographic stenoses. Possible reasons for the discrepancies are discussed in this article. The authors recommend absolute agreement locally whether ECST or NASCET criteria shall be used in the communication between radiologists, clinical physiologists, vascular surgeons, neurologists and other physicians involved in patient management decisions. Angle-dependent ultrasound criteria should be used and flow velocity measurements with ultrasound should be combined with assessment of plaque burden on 2D picture.

  • 18.
    Jönsson, Björn
    et al.
    Linköpings universitet, Institutionen för medicin och vård, Kärlkirurgi. Linköpings universitet, Hälsouniversitetet.
    Lindberg, Lars-Göran
    Linköpings universitet, Institutionen för medicinsk teknik. Linköpings universitet, Hälsouniversitetet.
    Skau, Tommy
    Linköpings universitet, Institutionen för medicin och vård, Kärlkirurgi. Linköpings universitet, Hälsouniversitetet.
    Thulesius, Olav
    Linköpings universitet, Institutionen för medicin och vård, Klinisk fysiologi. Linköpings universitet, Hälsouniversitetet.
    Is oscillometric ankle pressure reliable in leg vascular disease?2001Inngår i: Clinical Physiology and Functional Imaging, ISSN 1475-0961, E-ISSN 1475-097X, Vol. 21, nr 2, s. 155-163Artikkel i tidsskrift (Fagfellevurdert)
    Abstract [en]

    The objective of the study was to evaluate the validity of oscillometric systolic ankle pressure in symptomatic leg arterial occlusive disease. Ankle pressure measurements using oscillometric curves obtained using a standard 12-cm cuff with a specially designed device for signal processing were validated against the continuous wave (CW) Doppler technique. Thirty-four subjects without signs or symptoms of peripheral vascular disease (68 legs) and 47 patients with leg ischaemia (85 legs) varying from moderate claudication to critical ischaemia were examined. The oscillometric curves were analysed using several algorithms reported in the literature, based on the assumption that maximum oscillations are recorded near mean arterial pressure. In normals, reasonable agreement between CW Doppler and oscillometric methods was seen. When an algorithm that determined the lowest cuff pressure at which maximum oscillations occurred, and a characteristic ratio for systolic pressure of 0·52 was used, the mean difference between CW Doppler and oscillometry was 1·7 mmHg [range −19 to +27, limits of agreement (2 SD) 21·1 mmHg]. In ischaemic legs, oscillometry overestimated systolic ankle pressure by a mean of 28·8 mmHg [range –126 to +65, limits of agreement 82·8 mmHg]. The difference was more pronounced among patients with critical ischaemia compared with claudicants, and also more evident among diabetics. The error of oscillometric pressure determination in subjects with leg arterial disease inversely increased with CW Doppler ankle pressure. In 39% of the recordings in legs with a CW Doppler systolic pressure below 100 mmHg, the oscillometric mean arterial pressure was higher than the recorded CW Doppler systolic pressure. In conclusion, the oscillometric method to determine systolic ankle pressure, based on the concept of maximum cuff oscillations occurring near mean arterial pressure, is not reliable in leg arterial disease, usually overestimating ankle pressure.

  • 19.
    Kajiura, M.
    et al.
    Department of Pediatrics, Osaka Medical College, 2-7 Daigakumachi, Takatsuki, Osaka, Japan.
    Tanaka, H.
    Department of Pediatrics, Osaka Medical College, 2-7 Daigakumachi, Takatsuki, Osaka, Japan.
    Borres, M.
    Linköpings universitet, Institutionen för medicin och hälsa, Klinisk fysiologi. Linköpings universitet, Hälsouniversitetet. Östergötlands Läns Landsting, Hjärtcentrum, Fysiologiska kliniken.
    Thulesius, O.
    Linköpings universitet, Institutionen för klinisk och experimentell medicin, Pediatrik. Linköpings universitet, Hälsouniversitetet. Östergötlands Läns Landsting, Barn- och kvinnocentrum, Barn- och ungdomskliniken i Linköping.
    Yamaguchi, H.
    Department of Pediatrics, Osaka Medical College, 2-7 Daigakumachi, Takatsuki, Osaka, Japan.
    Tamai, H.
    Department of Pediatrics, Osaka Medical College, 2-7 Daigakumachi, Takatsuki, Osaka, Japan.
    Variant autonomic regulation during active standing in Swedish and Japanese junior high school children2008Inngår i: Clinical Physiology and Functional Imaging, ISSN 1475-0961, E-ISSN 1475-097X, Vol. 28, nr 3, s. 174-181Artikkel i tidsskrift (Fagfellevurdert)
    Abstract [en]

    The present investigation is about cardiovascular responses and relevant autonomic function in Swedish and Japanese pubertal children on active standing using non-invasive continuous beat-to-beat finger arterial pressure (FAP) monitoring and power spectral analysis. Examined were 54 Swedish and 57 Japanese children (13-15 years). FAP and heart rate (HR) was continuously recorded in the supine position and during standing. Supine FAP was significantly higher in Swedish compared with Japanese children (121/62 versus 103/53 mmHg, P < 0.001). Swedish children showed a higher increase in arterial pressure and HR upon uprising, resulting in a higher vasoconstrictor index (5.04 ± 0.22 versus 2.31 ± 0.11 mmHgs-1, P < 0.001, respectively). There were also higher increases in arterial pressure and HR in the following steady state period (1-7min) between the two groups. These differences were also found after adjustment of body weight and height. Frequency domain analysis of HR and arterial pressure variability indicated significantly higher low/high frequency power of HR and low frequency power of arterial pressure. These results suggest that Swedish pubertal children have higher basal blood pressure and enhanced cardiovascular sympathetic responses. These differences in the two cohorts might be caused by genetic factors. © 2008 The Authors Journal compilation © 2008 Scandinavian Society of Clinical Physiology and Nuclear Medicine.

  • 20.
    Kindberg, Katarina
    et al.
    Linköpings universitet, Institutionen för ekonomisk och industriell utveckling, Mekanisk värmeteori och strömningslära. Linköpings universitet, Tekniska högskolan. Linköpings universitet, Centrum för medicinsk bildvetenskap och visualisering, CMIV.
    Haraldsson, Henrik
    Linköpings universitet, Institutionen för medicin och hälsa, Klinisk fysiologi. Linköpings universitet, Hälsouniversitetet. Östergötlands Läns Landsting, Hjärtcentrum, Fysiologiska kliniken. Linköpings universitet, Centrum för medicinsk bildvetenskap och visualisering, CMIV.
    Sigfridsson, Andreas
    Linköpings universitet, Institutionen för medicin och hälsa, Klinisk fysiologi. Linköpings universitet, Hälsouniversitetet. Östergötlands Läns Landsting, Hjärtcentrum, Fysiologiska kliniken. Linköpings universitet, Centrum för medicinsk bildvetenskap och visualisering, CMIV.
    Sakuma, Hajime
    Department of Radiology, Mie University, 2-174 Edobashi, Tsu, Mie 514-8507, Japan.
    Ebbers, Tino
    Linköpings universitet, Institutionen för medicin och hälsa, Klinisk fysiologi. Linköpings universitet, Hälsouniversitetet. Östergötlands Läns Landsting, Hjärtcentrum, Fysiologiska kliniken. Linköpings universitet, Centrum för medicinsk bildvetenskap och visualisering, CMIV.
    Karlsson, Matts
    Linköpings universitet, Institutionen för ekonomisk och industriell utveckling, Mekanisk värmeteori och strömningslära. Linköpings universitet, Tekniska högskolan. Linköpings universitet, Centrum för medicinsk bildvetenskap och visualisering, CMIV.
    Temporal 3D Lagrangian strain from 2D slice followed cine DENSE MRI2012Inngår i: Clinical Physiology and Functional Imaging, ISSN 1475-0961, E-ISSN 1475-097X, Vol. 32, nr 2, s. 139-144Artikkel i tidsskrift (Fagfellevurdert)
    Abstract [en]

    A quantitative analysis of myocardial mechanics is fundamental to the understanding of cardiac function, diagnosis of heart disease and assessment of therapeutic intervention. In the clinical situation, where limited scan time often is important, a detailed analysis of the myocardium in a specific region might be more applicable than a full 3D measurement of the entire left ventricle. This paper presents a method to obtain temporal evolutions of transmural 3D Lagrangian strains from two intersecting 2D planes of slice followed cine displacement encoding with stimulated echoes (DENSE) data using a bilinear-cubic polynomial element to resolve strain from the displaced myocardial positions. The method demonstrates accurate results when validated in an analytical model, and has been applied to in vivo data acquired on a 3 T magnetic resonance (MR) system from a healthy volunteer to quantify systolic strains at the anterior-basal region of left ventricular myocardium. The in vivo results agree within experimental accuracy with values reported in the literature.

  • 21.
    Kvitting, J.P.
    et al.
    Linköpings universitet, Institutionen för medicin och hälsa, Klinisk fysiologi. Linköpings universitet, Hälsouniversitetet. Östergötlands Läns Landsting, Hjärtcentrum, Thorax-kärlkliniken.
    Sigfridsson, A.
    Linköpings universitet, Institutionen för medicin och hälsa, Klinisk fysiologi. Linköpings universitet, Hälsouniversitetet. Östergötlands Läns Landsting, Hjärtcentrum, Fysiologiska kliniken.
    Wigström, L.
    Linköpings universitet, Institutionen för medicin och hälsa, Klinisk fysiologi. Linköpings universitet, Hälsouniversitetet.
    Bolger, A.F.
    Linköpings universitet, Institutionen för medicin och vård, Klinisk fysiologi. Linköpings universitet, Hälsouniversitetet.
    Karlsson, Matts
    Linköpings universitet, Institutionen för ekonomisk och industriell utveckling, Mekanisk värmeteori och strömningslära. Linköpings universitet, Tekniska högskolan.
    Analysis of human myocardial dynamics using virtual markers based on magnetic resonance imaging2010Inngår i: Clinical Physiology and Functional Imaging, ISSN 1475-0961, E-ISSN 1475-097X, Vol. 30, nr 1, s. 23-29Artikkel i tidsskrift (Fagfellevurdert)
    Abstract [en]

    Background: Myocardial dynamics are three-dimensional (3D) and time-varying. Cineradiography of surgically implanted makers in animals or patients is accurate for assessing these events, but this invasive method potentially alters myocardial motion. The aim of the study was to quantify myocardial motion using magnetic resonance imaging (MRI) and hence to provide a non-invasive approach to characterize 3D myocardial dynamics.

    Methods: Myocardial motion was quantified in ten normal volunteers by tracking the Lagrangian motion of individual points (i.e. virtual markers), based on time-resolved 3D phase-contrast MRI data and Fourier tracking. Nine points in the myocardium were tracked over the entire cardiac cycle, allowing a wire frame model to be generated and systolic and diastolic events identified.

    Results: Radius of curvature of the left ventricular (LV) wall was calculated from the virtual markers; the ratio between the anterior–posterior (AP) and septal–lateral (SL) walls in the LV shows an oval shape of the apical short axis plane at end systole (ES) and more circular at end diastole (ED). The AP/SL ratio for the basal plane shows an oval shape at ES and ED. We found that the rotation of the basal plane in ES was less compared to the apical plane [−2·0 ± 2·2 versus 4·1 ± 2·6 degrees (P<0·005)]. The apical plane rotated counter clock wise as viewed from the apex.

    Conclusion: This new non-invasive tool, despite current limitations in temporal and spatial resolution, may provide a comprehensive set of virtual myocardial markers throughout the entire LV without the confounding effects introduced by surgical implantation.

  • 22.
    Lindström, Lena
    et al.
    Linköpings universitet, Institutionen för medicin och vård, Klinisk fysiologi. Linköpings universitet, Hälsouniversitetet.
    Nylander, Eva
    Linköpings universitet, Institutionen för medicin och vård, Klinisk fysiologi. Linköpings universitet, Hälsouniversitetet.
    Larsson, Hans
    Linköpings universitet, Institutionen för medicin och vård, Kardiologi. Linköpings universitet, Hälsouniversitetet.
    Wranne, Bengt
    Linköpings universitet, Institutionen för medicin och vård, Klinisk fysiologi. Linköpings universitet, Hälsouniversitetet.
    Left ventricular involvement in arrhythmogenic right ventricular cardiomyopathy: A scintigraphic and echocardiographic study2005Inngår i: Clinical Physiology and Functional Imaging, ISSN 1475-0961, E-ISSN 1475-097X, Vol. 25, nr 3, s. 171-177Artikkel i tidsskrift (Fagfellevurdert)
    Abstract [en]

    Background:  Left ventricular involvement in arrhythmogenic right ventricular cardiomyopathy (ARVC) is a common finding in autopsy studies. In clinical studies using myocardial scintigraphy, MRI and echocardiography, contradictory results have been reported. In this study, we therefore investigated a group of 15 patients with ARVC using thallium-201 (Tl) single-photon emission tomography (SPECT) and echocardiography including assessment of mitral annular motion with M-mode and pulsed tissue Doppler.

    Methods:  Exercise and rest Tl-201 SPECT were performed in 15 patients with ARVC. The time from diagnosis of the disease varied from less than 1–16 years. All patients fulfilled the established diagnostic criteria for ARVC. An echocardiographic examination, including assessment of left and right ventricular motion and measurements of the mitral annulus motion with M-mode and pulsed tissue Doppler was performed in the patients and in 25 normal subjects.

    Results:  Tl-201 uptake defects in the left ventricular myocardium were present in all except one patient (93%). The uptake defects were predominantly located to the anteroseptal and basal posterior segments. Wall motion abnormalities were seen in the same segments, and in addition to this, in the septal area. In line with this, the total amplitude and the peak systolic velocity of mitral annular motion at the septal point were significantly decreased in the patients compared with the control group.

    Conclusions:  Our data show that left ventricular involvement is common in ARVC. Tl-201 SPECT and echocardiographic abnormalities were seen not only in patients with long-lasting symptoms but also in asymptomatic patients and in those with short duration of symptoms.

  • 23.
    Modin, Daniel
    et al.
    Linköpings universitet, Institutionen för medicin och hälsa, Klinisk fysiologi. Linköpings universitet, Hälsouniversitetet.
    Renner, Johan
    Linköpings universitet, Institutionen för ekonomisk och industriell utveckling, Mekanisk värmeteori och strömningslära. Linköpings universitet, Centrum för medicinsk bildvetenskap och visualisering, CMIV. Linköpings universitet, Tekniska högskolan.
    Gårdhagen, Roland
    Linköpings universitet, Institutionen för ekonomisk och industriell utveckling, Mekanisk värmeteori och strömningslära. Linköpings universitet, Centrum för medicinsk bildvetenskap och visualisering, CMIV. Linköpings universitet, Tekniska högskolan.
    Ebbers, Tino
    Linköpings universitet, Institutionen för medicin och hälsa, Klinisk fysiologi. Linköpings universitet, Centrum för medicinsk bildvetenskap och visualisering, CMIV. Linköpings universitet, Hälsouniversitetet. Östergötlands Läns Landsting, Hjärt- och Medicincentrum, Fysiologiska kliniken US.
    Länne, Toste
    Linköpings universitet, Institutionen för medicin och hälsa, Fysiologi. Linköpings universitet, Centrum för medicinsk bildvetenskap och visualisering, CMIV. Linköpings universitet, Hälsouniversitetet. Östergötlands Läns Landsting, Hjärt- och Medicincentrum, Thorax-kärlkliniken i Östergötland.
    Karlsson, Matts
    Linköpings universitet, Institutionen för ekonomisk och industriell utveckling, Mekanisk värmeteori och strömningslära. Linköpings universitet, Centrum för medicinsk bildvetenskap och visualisering, CMIV. Linköpings universitet, Tekniska högskolan.
    Evaluation of Aortic Geometries created by MRI Data in Man2011Inngår i: Clinical Physiology and Functional Imaging, ISSN 1475-0961, E-ISSN 1475-097X, Vol. 31, nr 6, s. 485-491Artikkel i tidsskrift (Fagfellevurdert)
    Abstract [en]

    The development of atherosclerotic plaques has been associated with the patterns of wall shear stress (WSS). However, much is still uncertain with the methods used to calculate WSS. Correct vessel geometries are mandatory to get reliable estimations and the purpose of this study was to evaluate an in vivo method for creating aortic 3D geometry in man based on data from magnetic resonance imaging (MRI) with ultrasound as reference.

    Methods: The aortas of ten healthy males, 23.4 ± 1.6 years of age, were examined with MRI, and 3D geometries were created with manual segmentation of the images. Lumen diameters (LD) were measured in the abdominal aorta (AA) and the thoracic aorta (TA) with non-invasive B-mode ultrasound as a reference.

    Results: The anteroposterior diameter of the AA was 13.6 ± 1.1 mm for the MRI and 13.8 ± 1.3 mm for the ultrasound (NS). Intraobserver variability (CV) for MRI and ultrasound was <0.92% and <0.40% respectively . Interobserver variability MRI and ultrasound was 0.96% and 0.56% respectively. The diameter of the TA was 19.2 ± 1.4 mm for the MRI, and the intraobserver variability (CV) were <0.78% and interobserver variability (CV) were 0.92%.

    Conclusion: Specific arterial geometries can be constructed with a high degree of accuracy using MRI. This indicate that the MRI geometries may be used to create realistic and correct geometries in the calculation of WSS in the aorta of man.

  • 24.
    Naidu Sjöswärd, Kerstin
    et al.
    Linköpings universitet, Institutionen för medicin och vård, Anestesiologi. Linköpings universitet, Hälsouniversitetet.
    Josefsson, Martin
    Linköpings universitet, Institutionen för molekylär och klinisk medicin, Rättsmedicin. Linköpings universitet, Hälsouniversitetet.
    Ahlner, Johan
    Linköpings universitet, Institutionen för molekylär och klinisk medicin, Rättsmedicin. Linköpings universitet, Hälsouniversitetet.
    Schmekel, Birgitta
    Linköpings universitet, Institutionen för medicin och vård, Klinisk fysiologi. Linköpings universitet, Hälsouniversitetet.
    Preserved bronchial dilatation after salbutamol does not guarantee protection against bronchial hyperresponsiveness2003Inngår i: Clinical Physiology and Functional Imaging, ISSN 1475-0961, E-ISSN 1475-097X, Vol. 23, nr 1, s. 14-20Artikkel i tidsskrift (Fagfellevurdert)
    Abstract [en]

    Racemic salbutamol, a β2-adrenoceptor agonist used for dilatation of airways, has recently been shown to induce lessened relaxation of bronchial smooth muscle and partial loss of bronchoprotection, seen as increased hyperresponsiveness, after regular treatment. The racemate undergoes stereo-selective disposition, giving higher plasma levels of S-salbutamol than that of bronchodilating R-salbutamol, thus raising S : R ratios after repeated administration. Our aim was to evaluate whether increased bronchial hyperresponsiveness (BHR) could be found even after 1 day of repeated salbutamol inhalations, with β2-receptor-induced bronchial smooth muscle relaxation remaining and whether this would be associated with plasma levels of either enantiomer. Fifteen patients with stable asthma, aged 19–54 years, were included in a randomized, cross-over study. An indirect bronchial challenge method was used [voluntary isocapnic hyperventilation of cold air (IHCA)], and airway condition tested by means of impulse oscillometry. Racemic salbutamol was inhaled three times during a 6-h period. IHCA was performed and plasma concentrations of enantiomers were measured 4 h after the last dose. Tests were also performed without preceding drug treatment. β2-Agonist-produced bronchial dilatation and protection persisted in the majority of the 15 patients 4 h after repeated inhalations of salbutamol during 1 day. In only two of the 15 patients we could trace increased BHR after salbutamol. Neither dilatation nor protection could be linked to plasma levels of either R- or S-salbutamol. The underlying mechanisms of BHR remain unknown and are dissociated from β2-receptor-mediated dilatation.

  • 25.
    Nielsen, Magnus
    et al.
    Malmö.
    Granerus, Göran
    Linköpings universitet, Hälsouniversitetet. Linköpings universitet, Institutionen för medicin och vård, Klinisk fysiologi. Östergötlands Läns Landsting, Hjärtcentrum, Fysiologiska kliniken.
    Ohlsson, Mattias
    Holst, Holger
    Thorsson, Ola
    Edenbrandt, Lars
    Interpretation of captopril renography using artificial neural networks2005Inngår i: Clinical Physiology and Functional Imaging, ISSN 1475-0961, E-ISSN 1475-097X, Vol. 25, nr 5, s. 293-296Artikkel i tidsskrift (Fagfellevurdert)
    Abstract [en]

    The purpose of this study was to develop a method based on artificial neural networks for interpretation of captopril renography tests for the detection of renovascular hypertension caused by renal artery stenosis and to assess the value of different measurements from the test. A total of 250 99mTc-MAG3 captopril renography tests were used in the study. The material was collected from two different patient groups. One group consisted of 101 patients who also had undergone a renal angiography. The angiographies, which were used as gold standard, showed a significant renal artery stenosis in 53 of the 101 cases. The second group consisted of 149 patients, who's captopril renography tests all were interpreted as not compatible with significant renal artery stenosis by an experienced nuclear medicine physician. Artificial neural networks were trained for the diagnosis of renal artery stenosis using eight measures from each renogram. The neural network was then evaluated in separate test groups using an eightfold cross validation procedure. The performance of the neural networks, measured as the area under the receiver operating characteristic curve, was 0.93. The sensitivity was 91% at a specificity of 90%. The lowest performance was found for the network trained without use of a parenchymal transit measure, indicating the importance of this feature. Artificial neural networks can be trained to interpret captopril renography tests for detection of renovascular hypertension caused by renal artery stenosis. The result almost equals that of human experts shown in previous studies. © 2005 Blackwell Publishing Ltd.

  • 26.
    Nilsson, Henric
    et al.
    Linköpings universitet, Institutionen för medicin och hälsa. Linköpings universitet, Medicinska fakulteten. Region Östergötland, Hjärt- och Medicincentrum, Fysiologiska kliniken US.
    Nylander, Eva
    Linköpings universitet, Institutionen för medicin och hälsa, Avdelningen för kardiovaskulär medicin. Linköpings universitet, Medicinska fakulteten. Region Östergötland, Hjärt- och Medicincentrum, Fysiologiska kliniken US. Linköpings universitet, Centrum för medicinsk bildvetenskap och visualisering, CMIV.
    Borg, Sabina
    Linköpings universitet, Institutionen för medicin och hälsa, Avdelningen för fysioterapi. Linköpings universitet, Medicinska fakulteten.
    Tamas, Eva
    Linköpings universitet, Institutionen för medicin och hälsa, Avdelningen för kardiovaskulär medicin. Linköpings universitet, Medicinska fakulteten. Region Östergötland, Hjärt- och Medicincentrum, Thorax-kärlkliniken i Östergötland.
    Hedman, Kristofer
    Linköpings universitet, Institutionen för medicin och hälsa. Linköpings universitet, Medicinska fakulteten. Region Östergötland, Hjärt- och Medicincentrum, Fysiologiska kliniken US.
    Cardiopulmonary exercise testing for evaluation of a randomized exercise training intervention following aortic valve replacement2019Inngår i: Clinical Physiology and Functional Imaging, ISSN 1475-0961, E-ISSN 1475-097X, Vol. 39, nr 1, s. 103-110Artikkel i tidsskrift (Fagfellevurdert)
    Abstract [en]

    Aortic valve surgery is the definitive treatment for aortic stenosis (AS). No specific recommendation is available on how exercise training should be conducted and evaluated after aortic valve replacement (AVR). This study aimed to examine the effect of aerobic exercise training on exercise capacity following AVR. In addition to our primary outcome variable, peak oxygen uptake (peakVO(2)), the effect on submaximal cardiopulmonary variables including oxygen uptake kinetics (tau), oxygen uptake efficiency slope (OUES) and ventilatory efficiency (VE/VCO2 slope) was evaluated. Following AVR due to AS, 12 patients were randomized to either a group receiving 12 weeks of supervised aerobic exercise training (EX) or a control group (CON). Exercise capacity was assessed by a maximal cardiopulmonary exercise test (CPET). There was a significant increase in peak load (+28%, P = 0 center dot 031) and in peakVO(2) (+23%, P = 0 center dot 031) in EX, corresponding to an increase in achieved percentage of predicted peakVO(2) from 88 to 104% (P = 0 center dot 031). For submaximal variables, there were only non-statistically significant trends in improvement between CPETs in EX. In CON, there were no significant differences in any maximal or submaximal variable between CPETs. We conclude that 12 weeks of supervised aerobic exercise training induces significant adaptations in cardiopulmonary function following AVR, especially in regard to maximal variables including peakVO(2). In addition, we provide novel data on the effect on several submaximal variables following exercise training in this group of patients.

  • 27.
    Renner, Johan
    et al.
    Linköpings universitet, Institutionen för ekonomisk och industriell utveckling, Mekanisk värmeteori och strömningslära. Linköpings universitet, Tekniska högskolan. Linköpings universitet, Centrum för medicinsk bildvetenskap och visualisering, CMIV.
    Nadali Najafabadi, Hossein
    Linköpings universitet, Institutionen för ekonomisk och industriell utveckling, Mekanisk värmeteori och strömningslära. Linköpings universitet, Tekniska högskolan.
    Modin, Daniel
    Linköpings universitet, Institutionen för medicin och hälsa, Klinisk fysiologi. Linköpings universitet, Hälsouniversitetet.
    Länne, Toste
    Linköpings universitet, Institutionen för medicin och hälsa, Fysiologi. Linköpings universitet, Hälsouniversitetet. Östergötlands Läns Landsting, Hjärt- och Medicincentrum, Thorax-kärlkliniken i Östergötland. Linköpings universitet, Centrum för medicinsk bildvetenskap och visualisering, CMIV.
    Karlsson, Matts
    Linköpings universitet, Institutionen för ekonomisk och industriell utveckling, Mekanisk värmeteori och strömningslära. Linköpings universitet, Tekniska högskolan. Linköpings universitet, Centrum för medicinsk bildvetenskap och visualisering, CMIV.
    Subject-specific aortic wall shear stress estimations using semi-automatic segmentation2012Inngår i: Clinical Physiology and Functional Imaging, ISSN 1475-0961, E-ISSN 1475-097X, Vol. 32, nr 6, s. 481-491Artikkel i tidsskrift (Fagfellevurdert)
    Abstract [en]

    Atherosclerosis development is strongly believed to be influenced by hemodynamic forces such as wall shear stress (WSS). To estimate such an entity in-vivo in humans, image-based computational fluid dynamics (CFD) is a useful tool. In this study, we use a combination of magnetic resonance imaging (MRI) and CFD to estimate WSS. In such method, a number of steps are included. One important step is the interpretation of images into 3D models, named segmentation. The choice of segmentation method can influence the resulting WSS distribution in the human aorta. This is studied by comparing WSS results gained from the use of two different segmentation approaches: manual and semi-automatic, where the manual approach is considered to be the reference method. The investigation is performed on a group of eight healthy male volunteers. The different segmentation methods give slightly different geometrical depictions of the human aorta (difference in the mean thoracic Aorta lumen diameter were 0.7% Pandlt;0.86). However, there is a very good agreement between the resulting WSS distribution for the two segmentation approaches. The small differences in WSS between the methods increase in the late systole and early diastolic cardiac cycle time point indicating that the WSS is more sensitive to local geometric differences in these parts of the cardiac cycle (correlation coefficient is 0.96 at peak systole and 0.68 at early diastole). We can conclude that the results show that the semi-automatic segmentation method can be used in future to estimate relevant aortic WSS.

  • 28.
    Reske, A.
    et al.
    Östergötlands Läns Landsting, Anestesi- och operationscentrum, Intensivvårdskliniken US.
    Seiwerts, M.
    Department of Diagnostic Radiology, University Hospital Leipzig, Liebigstrasse 20, D-04103 Leipzig, Germany.
    Reske, A.
    Surgical Intensive Care Unit, University Hospital Leipzig, Liebigstrasse 20, D-04103 Leipzig, Germany.
    Gottschaldt, U.
    Department of Anaesthesiology and Intensive Care Medicine, University Hospital Leipzig, Liebigstrasse 20, D-04103 Leipzig, Germany.
    Schreiter, D.
    Surgical Intensive Care Unit, University Hospital Leipzig, Liebigstrasse 20, D-04103 Leipzig, Germany.
    Early recovery from post-traumatic acute respiratory distress syndrome2006Inngår i: Clinical Physiology and Functional Imaging, ISSN 1475-0961, E-ISSN 1475-097X, Vol. 26, nr 6, s. 376-379Artikkel i tidsskrift (Fagfellevurdert)
    Abstract [en]

    Background: To present and discuss the rationale and possible benefits of timely alveolar recruitment in early post-traumatic acute respiratory distress syndrome. Methods: A 17-year-old patient who had sustained blunt thoracic trauma presented with severe hypoxaemia on admission and whole body computed tomography showed pulmonary contusion and substantial bilateral atelectasis. Oxygenation and lung mechanics did not improve with low tidal volume ventilation using high positive end-expiratory pressures (PEEPs). Therefore we applied an alveolar recruitment manoeuvre 7 h after admission. After alveolar recruitment, PEEP was titrated to the lowest level which prevented alveolar derecruitment. Results: Oxygenation and lung compliance improved rapidly and aeration of the entire lung was confirmed by computed tomography 27 h after the recruitment manoeuvre. The patient recovered completely and was discharged after 17 days. Conclusion: Although robust evidence is stilllacking, several lines of evidence suggest potential benefits of timely alveolar recruitment. Patients with early post-traumatic respiratory failure seem to most readily respond to alveolar recruitment manoeuvres and could thus benefit from the gain in functional lung volume and oxygenation. Moreover the probability of ventilator associated complications may be reduced. © 2006 The Authors Journal compilation 2006 Blackwell Publishing Ltd.

  • 29.
    Rosendahl, Lene
    et al.
    Linköpings universitet, Hälsouniversitetet. Linköpings universitet, Institutionen för medicin och hälsa, Klinisk fysiologi.
    Blomstrand, Peter
    Ryhovs sjukhus Jönköping.
    Heiberg, Einar
    Lunds universitet Lund.
    Ohlsson, Jan
    Ryhovs sjukhus Jönköping.
    Björklund, Per-Gunnar
    Ryhovs sjukhus Jönköping.
    Ahlander, Britt-Marie
    Ryhovs sjukhus Jönköping.
    Engvall, Jan
    Linköpings universitet, Hälsouniversitetet. Linköpings universitet, Institutionen för medicin och hälsa, Klinisk fysiologi. Östergötlands Läns Landsting, Hjärtcentrum, Fysiologiska kliniken.
    Computer-assisted calculation of myocardial infarct size shortens the evaluation time of contrast-enhanced cardiac MRI2008Inngår i: Clinical Physiology and Functional Imaging, ISSN 1475-0961, E-ISSN 1475-097X, Vol. 28, nr 1Artikkel i tidsskrift (Fagfellevurdert)
    Abstract [en]

    Background: Delayed enhancement magnetic resonance imaging depicts scar in the left ventricle which can be quantitatively measured. Manual segmentation and scar determination is time consuming. The purpose of this study was to evaluate a software for infarct quantification, to compare with manual scar determination, and to measure the time saved. Methods: Delayed enhancement magnetic resonance imaging was performed in 40 patients where myocardial perfusion single photon emission computed tomography imaging showed irreversible uptake reduction suggesting a myocardial scar. After segmentation, the semi-automatic software was applied. A scar area was displayed, which could be corrected and compared with manual delineation. The different time steps were recorded with both methods. Results: The software shortened the average evaluation time by 12.4min per cardiac exam, compared with manual delineation. There was good correlation of myocardial volume, infarct volume and infarct percentage (%) between the two methods, r = 0.95, r = 0.92 and r = 0.91 respectively. Conclusions: A computer software for myocardial volume and infarct size determination cut the evaluation time by more than 50% compared with manual assessment, with maintained clinical accuracy. © 2007 The Authors Journal compilation 2007 Blackwell Publishing Ltd.

  • 30.
    Rundqvist, Louise
    et al.
    Jonkoping Univ, Sweden.
    Engvall, Jan
    Linköpings universitet, Institutionen för medicin och hälsa, Avdelningen för kardiovaskulär medicin. Linköpings universitet, Medicinska fakulteten. Region Östergötland, Hjärt- och Medicincentrum, Fysiologiska kliniken US. Linköpings universitet, Centrum för medicinsk bildvetenskap och visualisering, CMIV.
    Faresjo, Maria
    Jonkoping Univ, Sweden; Reg Jonkoping Cty, Sweden.
    Blomstrand, Peter
    Jonkoping Univ, Sweden; Reg Jonkoping Cty, Sweden.
    Left ventricular diastolic function is enhanced after peak exercise in endurance-trained adolescents as well as in their non-trained controls2018Inngår i: Clinical Physiology and Functional Imaging, ISSN 1475-0961, E-ISSN 1475-097X, Vol. 38, nr 6, s. 1054-1061Artikkel i tidsskrift (Fagfellevurdert)
    Abstract [en]

    The aims of the study were to explore the temporal change of cardiac function after peak exercise in adolescents, and to investigate how these functional changes relate to maximal oxygen uptake (VO2max). The cohort consisted of 27 endurance-trained adolescents aged 13-19years, and 27 controls individually matched by age and gender. Standard echocardiography and colour tissue Doppler were performed at rest, and immediately after as well as 15min after a maximal cardio pulmonary exercise test (CPET) on a treadmill. The changes in systolic and diastolic parameters after exercise compared to baseline were similar in both groups. The septal E/e-ratio increased immediately after exercise in both the active and the control groups (from 9amp;lt;boldamp;gt;amp;lt;/boldamp;gt;2 to 11amp;lt;boldamp;gt;amp;lt;/boldamp;gt;0; Pamp;lt;0amp;lt;boldamp;gt;amp;lt;/boldamp;gt;001, and from 8amp;lt;boldamp;gt;amp;lt;/boldamp;gt;7 to 10amp;lt;boldamp;gt;amp;lt;/boldamp;gt;2; P=0amp;lt;boldamp;gt;amp;lt;/boldamp;gt;008, respectively). In a comparison between the two groups after CPET, the septal E/e-ratio was higher in the active group both immediately after exercise and 15min later compared to the control group (P=0amp;lt;boldamp;gt;amp;lt;/boldamp;gt;007 and P=0amp;lt;boldamp;gt;amp;lt;/boldamp;gt;006, respectively). We demonstrated a positive correlation between VO2max and cardiac function including LVEF and E/e immediately after CPET, but the strongest correlation was found between VO2max and LVEDV (r=0amp;lt;boldamp;gt;amp;lt;/boldamp;gt;67, Pamp;lt;0amp;lt;boldamp;gt;amp;lt;/boldamp;gt;001) as well as septal E/e (r=0amp;lt;boldamp;gt;amp;lt;/boldamp;gt;34, P=0amp;lt;boldamp;gt;amp;lt;/boldamp;gt;013). Enhanced diastolic function was found in both groups, but this was more pronounced in active adolescents. The cardiac functional response to exercise, in terms of LVEF and E/e, correlates with the increase in VO2 uptake. These findings in trained as well as un-trained teenagers have practical implications when assessing cardiac function.

  • 31. Rydén Ahlgren, Å
    et al.
    Sundkvist, G
    Sandgren, T
    Länne, Toste
    Linköpings universitet, Hälsouniversitetet. Linköpings universitet, Institutionen för medicin och vård, Kärlkirurgi. Östergötlands Läns Landsting, Hjärtcentrum, Thorax-kärlkliniken.
    Female gender increases stiffness of elastic but not of muscular arteries in type I diabetic patients2002Inngår i: Clinical Physiology and Functional Imaging, ISSN 1475-0961, E-ISSN 1475-097X, Vol. 22, nr 6, s. 409-415Artikkel i tidsskrift (Fagfellevurdert)
    Abstract [en]

    The reason for the particularly increased risk for cardiovascular complications in diabetic women is still unclear. We have previously found decreased distensibility of elastic arteries in type I diabetic women, indicating increased cardiac load, not seen in type I diabetic men, which might be one contributing factor. Whether the effect of gender is different in muscular arteries in type I diabetic patients has not been assessed. As estimates of arterial distensibility we measured stiffness (▀) and pressure strain elastic modulus (Ep) in the muscular common femoral artery using echotracking sonography in 30 women (mean age 34 years, range 20-61) and 26 men (mean age 38 years, range 22-56) with type I diabetes. The results were compared with those of 89 healthy individuals of corresponding age and gender and with previously published results from elastic arteries in these patients obtained at the same occasion. The internal common femoral diameter was significantly decreased in both diabetic men and women. In sharp contrast to the highly significant decreased distensibility of the elastic abdominal aorta and common carotid artery in the type I diabetic women, the distensibility of the common femoral artery did not clearly differ between patients and controls, neither for women nor for men. Thus, the gender difference in changes of arterial distensibility found in elastic arteries was absent or far less obvious in the femoral artery. In conclusion, female gender seems to affect the mechanical properties of elastic, but not of large muscular arteries in type I diabetic patients. Thus, putative gender differences in arterial changes in type I diabetes are to be sought in elastic rather than muscular arteries.

  • 32.
    Schmekel, Birgitta
    et al.
    Linköpings universitet, Institutionen för medicin och hälsa, Klinisk fysiologi. Linköpings universitet, Hälsouniversitetet. Östergötlands Läns Landsting, Hjärt- och Medicincentrum, Fysiologiska kliniken US.
    Blomstrand, Peter
    County Hospital Ryhov, Sweden .
    Venge, Per
    Uppsala University, Sweden .
    Serum lysozyme a surrogate marker of pulmonary microvascular injury in smokers?2013Inngår i: Clinical Physiology and Functional Imaging, ISSN 1475-0961, E-ISSN 1475-097X, Vol. 33, nr 4, s. 307-312Artikkel i tidsskrift (Fagfellevurdert)
    Abstract [en]

    Progression rate of disease processes in smoke-induced lung injuries varies greatly. Diverse pathophysiological mechanisms may trigger these divergences. The aim of this study was to evaluate whether circulating markers of monocytes/macrophages and/or neutrophil [i.e. lysozyme (LZM) or myeloperoxidase (MPO)] were associated with reduced values of diffusion capacity (DL,CO), which is considered to serve as a mirror of pulmonary microvascular derangement and an early sign of tissue remodelling in smokers. Data obtained from 134 smokers (GOLD stage 1) and 24 matched healthy non-smoking volunteers were evaluated in a cross-sectional study design. Lung function tests as well as single breath test of DL,CO were assessed according to ATS/ERS guidelines. Biomarkers were measured in serum by means of sensitive immunoassays. A subgroup of smokers with normal lung function was created to minimize confounding, by excluding datasets showing significant airflow limitation and abnormally high values of carboxy haemoglobin (COHb), the latter indicating recent smoking. The capacity of serum lysozyme to correctly identify abnormally low values of DL,CO (i.e. andlt;1 center dot 9SD units), tended to be higher than that of Myeloperoxidase as assessed by analyses of receiver operated curves (ROC; AUC 0 center dot 81, 95%CI: 0 center dot 690 center dot 89 versus AUC 0 center dot 67, 95%CI: 0 center dot 600 center dot 81). It is concluded that serum levels of lysozyme, reflecting mainly activated monocytes/macrophages but also neutrophils, were significantly associated with isolated decrements of DL,CO in smokers with normal lung function tests. This suggests monocytes/macrophages to have a significant mechanistic role in early phases of the disease process and/or pulmonary microvascular damage.

  • 33. Sparring Björkstén, Karin
    et al.
    Ekberg, Stefan
    Linköpings universitet, Hälsouniversitetet. Linköpings universitet, Institutionen för medicin och vård, Medicinsk radiofysik. Östergötlands Läns Landsting, Kirurgi- och onkologicentrum, Radiofysikavdelningen.
    Säfström, Pia
    Linköpings universitet, Hälsouniversitetet. Linköpings universitet, Institutionen för medicin och vård, Medicinsk radiologi. Östergötlands Läns Landsting, Bildmedicinskt centrum, Avdelningen för radiologi US.
    Dige, N
    Granerus, Göran
    Linköpings universitet, Hälsouniversitetet. Linköpings universitet, Institutionen för medicin och vård, Klinisk fysiologi. Östergötlands Läns Landsting, Hjärtcentrum, Fysiologiska kliniken.
    A computerized human reference brain for rCBF/SPET technetium-99m exametazime (HMPAO) investigation of elderly2004Inngår i: Clinical Physiology and Functional Imaging, ISSN 1475-0961, E-ISSN 1475-097X, Vol. 24, nr 4, s. 196-204Artikkel i tidsskrift (Fagfellevurdert)
    Abstract [en]

    Using the bull's eye approach, a reference brain from the single photon emission tomography (SPET) images of 10 subjects aged 62-81 years with excellent mental and physical health was constructed. SPET images were acquired twice, 1 week apart, using a single detector rotating gamma camera collecting 64 planar images over a 360° orbit. The centre of each transaxial slice was first defined with an automatic edge detecting algorithm applied to an anterior-posterior and a side profile of the brain. Each slice was divided into 40 sectors. Maximum counts/pixel in each sector was picked. The 40 maximum count values from one transaxial slice were allowed to form a horizontal row in a new parametric image on the x-axis and slice number from the vertex to the basal parts of the brain on the y-axis. This new image was scaled to a 64 × 16 pixel matrix by interpolation, which meant a normalization of all studies to the same size. The parametric image in each subject was scaled with regard to intensity by a factor calculated by a normalization procedure using the least squares analysis. Mean and SD for each pixel were calculated, thereby constructing a 'mean parametric image', and a 'SD parametric image'. These two images are meant to be used as the reference brain for evaluation of patient studies. This method can be used for objective measurements of diffuse brain changes and for pattern recognition in larger groups of patients. Statistical multifactorial analysis of parameters used for acquisition and data processing is possible. © 2004 Blackwell Publishing Ltd.

  • 34.
    Svensson, Christina
    et al.
    Linköpings universitet, Institutionen för medicin och hälsa, Avdelningen för kardiovaskulär medicin. Linköpings universitet, Medicinska fakulteten.
    Eriksson, Per
    Linköpings universitet, Institutionen för klinisk och experimentell medicin, Avdelningen för neuro- och inflammationsvetenskap. Linköpings universitet, Medicinska fakulteten. Region Östergötland, Hjärt- och Medicincentrum, Reumatologiska kliniken i Östergötland.
    Zachrisson, Helene
    Linköpings universitet, Institutionen för medicin och hälsa, Avdelningen för kardiovaskulär medicin. Linköpings universitet, Medicinska fakulteten. Region Östergötland, Hjärt- och Medicincentrum, Fysiologiska kliniken US.
    Vascular ultrasound for monitoring of inflammatory activity in Takayasu arteritis2019Inngår i: Clinical Physiology and Functional Imaging, ISSN 1475-0961, E-ISSN 1475-097XArtikkel i tidsskrift (Fagfellevurdert)
    Abstract [en]

    Background Takayasu arteritis (TA) is a rare large-vessel arteritis that primarily affects the aorta and its major branches. The aim of this study was to describe the value of high frequency ultrasound for monitoring of inflammatory activity. Methods Twenty-five patients, range 11-71 years, diagnosed with TA were investigated with duplex ultrasound (DUS) including follow-up studies. Twenty-five healthy controls were also investigated. Nine patients had newly diagnosed active TA. Sixteen patients had stable/inactive disease at baseline DUS, and TA was diagnosed median 4 center dot 5 years previously. Intima-media thickness (IMT), vessel and lumen diameter were measured in the carotid arteries, central neck arteries and the aortic arch. The vessel walls were studied qualitatively. The Takayasu ultrasound index was created for inflammatory activity scoring. Results Intima-media thickness in common carotid artery (CCA) was (median and 25-75 percentile parenthetic) 2 center dot 3 mm (1 center dot 7-2 center dot 9) in clinically active TA, 1 center dot 2 mm (1 center dot 1-1 center dot 6) in clinically stable TA (Pamp;lt;0 center dot 001) and 0 center dot 5 mm (0 center dot 5-0 center dot 6) in healthy controls (Pamp;lt;0 center dot 001). Clinically active TA had prominent increase in IMT and/or increased vessel diameter, and/or intramural arteries, and/or hypoechogenic areas interpreted as oedema in the vessel wall. TA in clinical remission was characterized by increased IMT with medium to high echogenicity with or without fibrotic stripes. The Takayasu ultrasound index was higher in patients with active disease versus treated disease, 2 center dot 55 (1 center dot 60-3 center dot 05) versus 1 center dot 30 (1 center dot 00-1 center dot 58), (P = 0 center dot 003). Conclusion DUS is an excellent tool to monitor inflammatory changes in the vessel wall in TA. Further DUS studies in larger patient populations are warranted.

  • 35.
    Tamás, Éva
    et al.
    Linköpings universitet, Institutionen för medicin och hälsa, Thoraxkirurgi. Linköpings universitet, Hälsouniversitetet.
    Nielsen, Niels Erik
    Linköpings universitet, Institutionen för medicin och hälsa, Kardiologi. Linköpings universitet, Hälsouniversitetet.
    Vanhanen, Ingemar
    Linköpings universitet, Institutionen för medicin och hälsa, Thoraxkirurgi. Linköpings universitet, Hälsouniversitetet.
    Nylander, Eva
    Linköpings universitet, Institutionen för medicin och hälsa, Klinisk fysiologi. Linköpings universitet, Hälsouniversitetet.
    Measurement of physical work capacity in patients with chronic aortic regurgitation: A potential improvement in patient management2009Inngår i: Clinical Physiology and Functional Imaging, ISSN 1475-0961, E-ISSN 1475-097X, Vol. 29, nr 6, s. 453-457Artikkel i tidsskrift (Fagfellevurdert)
    Abstract [en]

    BACKGROUND: Timing of surgery in aortic regurgitation (AR) is important. Exercise testing is recommended upon uncertainty about functional limitations but reports on cardiopulmonary exercise testing (CPET) in populations with pure chronic AR are scarce. METHOD: Twenty-eight patients referred for surgery because of chronic AR (13 in NYHA I, 10 in NYHA II and five in NYHA III) were tested by CPET pre- and 6 months postoperatively. Echocardiography, with measurement of left ventricular ejection fraction (LVEF), diameters (LVED, LVES) and volumes (LVEDV, LVESV) was also performed. RESULTS: The patients had normal LVEF pre- and postoperatively. LV diameters and volumes diminished significantly postoperatively (LVED from 67 to 57, LVES from 49 to 41 mm; P < 0.001). The majority of the patients had a 'low' physical work capacity, none of them performed better than 'average' according to Astrand's classification preoperatively and there was no significant postoperative improvement. The mean peak oxygen uptake (VO(2peak)) was 25 ml kg(-1) min(-1) both pre- and postoperatively, and six of the 28 patients had a VO(2peak) of less than 20 ml kg(-1) min(-1). VO(2peak) was not significantly related to NYHA class. CONCLUSION: LVEF, diameters and volumes at rest did not fulfil the criteria for surgery in most of our AR patients, of whom 46% were asymptomatic. However, many had a remarkably low work capacity, which was neither improved 6 months postoperatively nor correlated to echocardiographic LV dimensions. CPET predicted the postoperative work capacity and may, therefore, be a useful complement for timing of surgery in patients with chronic AR.

  • 36.
    Wester, T.
    et al.
    Department of Cardio-thoracic surgery, Oslo Unversity Hospital and University of Oslo, Oslo, Norway.
    Häggblad, Erik
    Linköpings universitet, Institutionen för medicinsk teknik, Biomedicinsk instrumentteknik. Linköpings universitet, Tekniska högskolan.
    Awan, ZA.
    Department of Cardio-thoracic surgery, Oslo Unversity Hospital and University of Oslo, Oslo, Norway.
    Barratt-Due, A.
    Institute of Immunology, Oslo Unversity Hospital and University of Oslo, Oslo, Norway.
    Kvernebo, M.
    Department of Dermatology, Oslo Unversity Hospital and University of Oslo, Oslo, Norway.
    Halvorsen, PS.
    The Interventional Centre, Oslo Unversity Hospital and University of Oslo, Oslo, Norway.
    Mollnes, TE.
    Institute of Immunology, Oslo Unversity Hospital and University of Oslo, Oslo, Norway.
    Kvernebo, K.
    Department of Cardio-thoracic surgery, Oslo Unversity Hospital and University of Oslo, Oslo, Norway.
    Assessment of skin and tongue microcirculation reveals major changes in porcine sepsis2011Inngår i: Clinical Physiology and Functional Imaging, ISSN 1475-0961, E-ISSN 1475-097X, Vol. 31, nr 2, s. 151-158Artikkel i tidsskrift (Fagfellevurdert)
    Abstract [en]

    Aim:  To examine the relation between central hemodynamics, clinical severity and microvascular findings in tongue and skin during sepsis. Materials and methods:  Skin and tongue microcirculation was examined using laser Doppler and video microscopy techniques before and 200 min after inducing sepsis in pigs (n = 6) by inactivated Neisseria meningitides and in two control animals. Results:  All infected pigs developed clinical signs of sepsis. Pericapillary bleedings developed in the tongue in the two pigs with the most severe disease. Capillary density increased in the groin skin in infected pigs after 200 min as compared to baseline (P < 0·02). In the same period, mean capillary flow velocity was reduced in groin skin and tongue in septic pigs (P < 0·02). At 200 min a fraction of capillaries had developed 'no flow' or 'brisk flow', patterns hardly seen at baseline. Laser Doppler perfusion was reduced in ear and tongue after 200 min (P < 0·02 for both). The described pathology was more pronounced in the pigs with the most severe sepsis. Conclusion:  Capillary bleedings may be used as an early indication of severe sepsis. Examination of skin and tongue microcirculations may be used to characterize severity of sepsis and possibly to assess effect of treatment.

  • 37.
    Zachrisson, Helene
    et al.
    Linköpings universitet, Institutionen för medicin och hälsa, Klinisk fysiologi. Linköpings universitet, Hälsouniversitetet. Östergötlands Läns Landsting, Hjärt- och Medicincentrum, Fysiologiska kliniken US.
    Fouladiun, Marita
    Sahlgrens Academy.
    Blomstrand, Christian
    Sahlgrens Academy.
    Volkmann, Reinhard
    Sahlgrens Academy.
    Functional assessment of high-grade ICA stenosis with duplex ultrasound and transcranial Doppler2012Inngår i: Clinical Physiology and Functional Imaging, ISSN 1475-0961, E-ISSN 1475-097X, Vol. 32, nr 3, s. 241-246Artikkel i tidsskrift (Fagfellevurdert)
    Abstract [en]

    Background: Duplex ultrasound (DUS) has shown a andgt;90% accuracy compared to angiography, concerning the degree of internal carotid artery (ICA) stenosis. However, uncertainty may occur in a severe stenosis, in which peak systolic velocity (PSV) may decrease owing to high flow resistance or high backward pressure. We investigated intracranial collateral flows using transcranial Doppler (TCD) to further evaluate the hemodynamic significance of high-grade ICA stenosis. Methods: In this retrospective study, 320 consecutive symptomatic patients were examined. The degree of ICA stenosis and collateral capacity in the circle of Willis was investigated by DUS and TCD. In addition, magnetic resonance angiography (MRA) was added in a subgroup of 204 patients. The criterion for hemodynamic significant ICA stenosis was established collateral flow. Results: In 91% of all symptomatic vessels (291 vessels), an ICA stenosis of 70% was found. Established collateral flow always indicated precerebral carotid artery disease of 70%. Furthermore, in 11% of the whole study material, collateral reserve capacity was found despite high-grade (70%) ICA stenosis. PSV in ICA andlt; 2 5 m s) 1 was combined with established collateral flow and MRA stenosis of 70% in 9% (19 arterial systems). In 4%, doubt existed concerning the degree of stenosis after DUS. Conclusion: Transcranial Doppler helps to determine whether an ICA stenosis is of hemodynamic significance and to assess collateral patterns. Established collateral blood flow will help to identify patients with 70% (ECST) carotid artery disease. TCD might be of value when flow velocity criteria combined with plaque assessment by DUS are inclusive. Other diagnostic methods may also be considered.

  • 38.
    Zachrisson, Helene
    et al.
    Linköpings universitet, Institutionen för medicin och hälsa, Klinisk fysiologi. Linköpings universitet, Hälsouniversitetet. Östergötlands Läns Landsting, Hjärt- och Medicincentrum, Fysiologiska kliniken US.
    Lindenberger, Marcus
    Linköpings universitet, Institutionen för medicin och hälsa, Fysiologi. Linköpings universitet, Hälsouniversitetet.
    Hallman, Daniel
    Linköpings universitet, Institutionen för medicin och hälsa, Fysiologi. Linköpings universitet, Hälsouniversitetet.
    Ekman, M.
    Biomed Data AB, Gothenburg, Sweden.
    Neider, Daniel
    Linköpings universitet, Institutionen för medicin och hälsa, Fysiologi. Linköpings universitet, Hälsouniversitetet.
    Länne, Toste
    Linköpings universitet, Institutionen för medicin och hälsa, Fysiologi. Linköpings universitet, Hälsouniversitetet. Östergötlands Läns Landsting, Hjärt- och Medicincentrum, Thorax-kärlkliniken i Östergötland.
    Diameter and compliance of the greater saphenous vein - effect of age and nitroglycerine2011Inngår i: Clinical Physiology and Functional Imaging, ISSN 1475-0961, E-ISSN 1475-097X, Vol. 31, nr 4, s. 300-306Artikkel i tidsskrift (Fagfellevurdert)
    Abstract [en]

    Objectives: The greater saphenous vein (GSV) is commonly used in autologous vein graft surgery. GSV diameter has proven to influence graft patency, and furthermore venous compliance might be of importance. The purpose of the study was to evaluate the effect of age on GSV diameter and compliance, and to evaluate the effect of nitroglycerine (NTG). Methods: The diameter and compliance of the GSV, with and without NTG, were examined with B-mode ultrasound in 12 elderly (70.3 +/- 1.2 year) and 15 young (25.1 +/- 0.6 year) men. The GSV diameter at the thigh and calf level was measured at rest, after 6 min of venous stasis (60 mmHg) and after NTG administration. Pressure-area curves during a linear venous pressure decrease were produced. Venous compliance was calculated using the quadratic regression equation (area) = beta(0) + beta(1) (cuff pressure) + beta(2) (cuff pressure)(2). Results: GVS diameter between the groups showed significant lower diameter in elderly compared to young men (Pless than0.05). Venous occlusion increased GSV diameter in elderly men (Pless than0.01) as well as young men (Pless than0.001). NTG increased GSV diameter in elderly men (Pless than0.01) with an equal trend in young men. During venous occlusion, after administration of NTG, GSV diameter increased further in both elderly (Pless than0.01) and young men (Pless than0.001). GSV compliance was decreased in elderly (beta(1), 0.037 +/- 0019, beta(2), -0.000064 +/- 00017) versus young men (beta(1), 0.128 +/- 0.013, beta(2), -0.00010 +/- 000018) [Pless than0.001 (beta(1)), Pless than0.02 (beta(2))]. Conclusions: Baseline GSV diameter as well as GSV compliance is decreased in elderly men compared to the young subjects. As reduced GSV diameter as well as reduced compliance is related to decreased graft patency, these findings might be of importance for the uses of GSV as graft material in cardiovascular bypass surgery. The clinical value has to be clarified in future studies.

  • 39.
    Zachrisson, Helene
    et al.
    Linköpings universitet, Institutionen för medicin och hälsa, Avdelningen för kardiovaskulär medicin. Linköpings universitet, Medicinska fakulteten. Region Östergötland, Hjärt- och Medicincentrum, Fysiologiska kliniken US.
    Svensson, Christina
    Linköpings universitet, Institutionen för medicin och hälsa, Avdelningen för kardiovaskulär medicin. Linköpings universitet, Medicinska fakulteten. Region Östergötland, Hjärt- och Medicincentrum, Fysiologiska kliniken US.
    Dremetsika, Asimina
    Linköpings universitet, Institutionen för klinisk och experimentell medicin. Linköpings universitet, Medicinska fakulteten. Region Östergötland, Hjärt- och Medicincentrum, Reumatologiska kliniken i Östergötland.
    Eriksson, Per
    Linköpings universitet, Institutionen för klinisk och experimentell medicin, Avdelningen för neuro- och inflammationsvetenskap. Linköpings universitet, Medicinska fakulteten. Region Östergötland, Hjärt- och Medicincentrum, Reumatologiska kliniken i Östergötland.
    An extended high-frequency ultrasound protocol for detection of vessel wall inflammation.2018Inngår i: Clinical Physiology and Functional Imaging, ISSN 1475-0961, E-ISSN 1475-097X, Vol. 38, nr 4, s. 586-594Artikkel i tidsskrift (Fagfellevurdert)
    Abstract [en]

    OBJECTIVE: The aim of this study was to evaluate an extended protocol of the large vessels using high-frequency duplex ultrasound (DUS) for detection of vessel wall inflammation.

    METHODS: Fifty-eight patients performed a DUS examination where arteritis could not be excluded. All DUS examinations were performed using ACUSON S2000 TM ultrasound system (Siemens Medical Solutions USA, Inc.). High-frequency linear transducers were used (18L6 MHz, 9L4MHz) or curve linear for the aortic arch (6C2 MHz). Carotid, vertebral, central neck arteries (subclavian, axillary, innominate) arteries, aortic arch and femoral arteries were studied. Circumferential, homogenous wall thickening, with or without a hyperechogenic stripe lining the innermost layer, were regarded as typical signs of arteritis. Intima-media thickness (IMT) was measured in the patients and a normal control group. The latest clinical updated diagnosis was assessed at least 6 months after DUS.

    RESULTS: The DUS findings showed normal vessels (n = 14), arteritis and atherosclerosis (n = 13), atherosclerosis (n = 15) and arteritis (n = 16). The latter group had a significant increased IMT in the common femoral artery and the common carotid artery (mean 1·0 ±  SD 0·3 mm versus 0·6 ± 0·2 mm in the normal group (n = 37), P<0·00001, 1·2 ± 0·5 mm versus 0·8 ± 0·2 mm in the normal group (n = 40), P<0·00001). In the groups with sonographic signs implying arteritis (n = 29), 20 patients had a clinical diagnosis of arteritis, whereas eight patients had another main diagnosis such as malignancy/other inflammatory or infectious disease complicated by inflammation of the vessel wall. One patient had multiple diagnoses and was not possible to classify.

    CONCLUSION: An extended ultrasound protocol for central neck and leg arteries could be of value for diagnosis of arteritis. In case of atypical vessel wall inflammation, other main diagnoses should be considered.

  • 40.
    Åström Aneq, Meriam
    et al.
    Linköpings universitet, Institutionen för medicin och hälsa, Avdelningen för kardiovaskulär medicin. Linköpings universitet, Medicinska fakulteten. Region Östergötland, Hjärt- och Medicincentrum, Fysiologiska kliniken US.
    Maret, Eva
    Karolinska University Hospital and Karolinska Institutet, Stockholm, Sweden.
    Brudin, Lars
    Department of Clinical Physiology, Kalmar County Hospital, Kalmar, Sweden.
    Svensson, Anneli
    Linköpings universitet, Institutionen för medicin och hälsa, Avdelningen för kardiovaskulär medicin. Linköpings universitet, Medicinska fakulteten. Region Östergötland, Hjärt- och Medicincentrum, Kardiologiska kliniken US.
    Engvall, Jan
    Linköpings universitet, Institutionen för medicin och hälsa, Avdelningen för kardiovaskulär medicin. Linköpings universitet, Medicinska fakulteten. Region Östergötland, Hjärt- och Medicincentrum, Fysiologiska kliniken US.
    Right ventricular systolic function and mechanical dispersion identify patients with arrhythmogenic right ventricular cardiomyopathy.2018Inngår i: Clinical Physiology and Functional Imaging, ISSN 1475-0961, E-ISSN 1475-097X, Vol. 38, nr 5, s. 779-787Artikkel i tidsskrift (Fagfellevurdert)
    Abstract [en]

    PURPOSE: To assess right ventricular (RV) regional and global systolic function using feature tracking (FT) in patients with a definite diagnosis of arrhythmogenic right ventricular cardiomyopathy (ARVC) and to investigate if changes in strain amplitude and mechanical dispersion indicate a propensity for arrhythmia.

    MATERIALS AND METHODS: Twenty-seven patients fulfilling Task Force Criteria for ARVC and 24 healthy volunteers underwent MR at 1·5 Tesla. Steady-state free precession cine of long-axis slices and a short-axis stack of the RV was acquired. Segmental longitudinal systolic strain amplitude and time-to-peak (TTP) strain were measured in the four- and two-chamber views of the RV.

    RESULTS: Compared to controls, patients with ARVC had lower RV ejection fraction (RVEF), (53% vs 57%, P = 0·012) and lower longitudinal strain amplitude in the RV free wall (-20·6 vs -26·3%, P = 0·014) and in the basal part of the RV (-22·8 vs -31·7%, P<0·001). Mechanical dispersion, defined as the standard deviation (SD) of TTP of RV segments, was larger in patients with ARVC (48 ms [21-74] vs 35 ms [13-66 ms], P = 0·02). Patients with ventricular tachycardia (VT) or non-sustained VT had lower RVEF (46% vs 55%, P = 0·008), but did not have significantly lower RV strain amplitude (-19·5% vs 21·0%, P = 0·073) and no signs of mechanical dispersion (49 ms vs 48 ms, P = 0·861) compared to patients without arrhythmia.

    CONCLUSION: ARVC patients had lower longitudinal absolute strain amplitude in basal RV segments and increased mechanical dispersion compared to healthy volunteers, but the presence of mechanical dispersion was not predictive of ventricular arrhythmia.

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