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  • 1.
    Bonapace, Stefano
    et al.
    Osped Sacro Cuore Don Calabria, Italy.
    Rossi, Andrea
    Univ Verona, Italy.
    Laroche, Cecile
    European Soc Cardiol, France.
    Crespo-Leiro, Maria G.
    Complexo Hosp Univ A Coruna, Spain; Inst Invest Biomed, Spain; Univ A Coruna, Spain; Ctr Invest Red Enfermedades Cardiovasc, Spain.
    Piepoli, Massimo F.
    AUSL Piacenza, Italy.
    Coats, Andrew J. S.
    San Raffaele Pisana Sci Inst, Italy.
    Dahlström, Ulf
    Linköping University, Department of Medical and Health Sciences, Division of Cardiovascular Medicine. Linköping University, Faculty of Medicine and Health Sciences. Region Östergötland, Heart and Medicine Center, Department of Cardiology in Linköping.
    Malek, Filip
    Na Homolce Hosp Cardiovasc Ctr, Czech Republic.
    Macarie, Cezar
    Inst Urgenta Pentru Boli Cardiovasc CC Iliescu, Romania.
    Temporelli, Pier Luigi
    Ist Ricovero and Cura Carattere Sci, Italy.
    Maggioni, Aldo P.
    European Soc Cardiol, France; ANMCO Res Ctr, Italy.
    Tavazzi, Luigi
    GVM CareandRes, Italy.
    Brachial pulse pressure in acute heart failure. Results of the Heart Failure Registry2019In: ESC Heart Failure, E-ISSN 2055-5822, Vol. 6, no 6, p. 1167-1177Article in journal (Refereed)
    Abstract [en]

    Aims To investigate the still uncertain independent prognostic impact of pulse pressure (PP) in acute heart failure (HF), in particular across the left ventricular ejection fraction (EF) phenotypes, and the potential contribution of PP in outlining the individual phenotypes. Methods and results We prospectively evaluated 1-year death and rehospitalization in 4314 patients admitted for acute HF grouped by EF and stratified by their PP level on admission. In HF with reduced (amp;lt; 40%) EF (HFrEF), the highest quartiles of PP had the lowest unadjusted [hazard ratio (HR) 0.77, 95% confidence interval (CI) 0.61-0.98] and adjusted (HR 0.64 0.50-0.82) risk of 1 year all cause death compared to the lowest quartile. Its prognostic impact was partially mediated by systolic blood pressure (SBP). In HF with preserved (amp;gt;= 50%) EF (HFpEF), the intermediate quartile of PP showed the lowest 1 year all cause mortality in unadjusted (HR 0.598, CI 0.416-0.858) and adjusted (HR 0.55, 95% CI 0.388-0.801) models with no relationship with SBP. In a receiver operating characteristic analysis, a combination of PP amp;gt; 60 mmHg and SBP amp;gt; 140 mmHg was associated to a preserved EF with a high performance value. No prognostic significance of PP was found in the HF with mid-range EF subgroup. Conclusions In acute HFrEF, there is an almost linear inverse relation between mortality and PP, partly mediated by SBP. In HFpEF, a J-shaped relationship between mortality and PP was present with a better prognosis at the nadir. A combination of PP amp;gt; 60 mmHg with SBP amp;gt; 140 mmHg may be clinically helpful as marker of a preserved left ventricular EF.

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  • 2.
    Jaarsma, Tiny
    Linköping University, Department of Social and Welfare Studies, Division of Nursing Science. Linköping University, Faculty of Medicine and Health Sciences.
    Reply to Sexual function of patients with heart failure: distinct phenotypes distinct sexual function? by Konstantinos Koutsampasopoulos in ESC heart failure, vol 4, issue 3, pp 3202017In: ESC Heart Failure, E-ISSN 2055-5822, Vol. 4, no 3Article in journal (Other academic)
    Abstract [en]

    n/a

  • 3.
    Jaarsma, Tiny
    et al.
    Linköping University, Department of Social and Welfare Studies, Division of Nursing Science. Linköping University, Faculty of Medicine and Health Sciences. Univ Med Ctr Utrecht, Netherlands.
    Strömberg, Anna
    Linköping University, Department of Medical and Health Sciences, Division of Nursing Science. Linköping University, Faculty of Medicine and Health Sciences. Region Östergötland, Heart and Medicine Center, Department of Cardiology in Linköping.
    We told you so: knowledge is not enough to improve heart failure self-care behaviour2019In: ESC Heart Failure, E-ISSN 2055-5822, Vol. 21, no 11, p. 1443-1444Article in journal (Other academic)
    Abstract [en]

    n/a

  • 4.
    Ketilsdottir, Audur
    et al.
    Landspitali Univ Hosp, Iceland; Univ Iceland, Iceland.
    Ingadottir, Brynja
    Univ Iceland, Iceland; Landspitali Univ Hosp, Iceland.
    Jaarsma, Tiny
    Linköping University, Department of Social and Welfare Studies, Division of Nursing Science. Linköping University, Faculty of Medicine and Health Sciences.
    Self-reported health and quality of life outcomes of heart failure patients in the aftermath of a national economic crisis: a cross-sectional study2019In: ESC Heart Failure, E-ISSN 2055-5822, Vol. 6, no 1, p. 111-121Article in journal (Refereed)
    Abstract [en]

    Aims There are indications that economic crises can affect public health. The aim of this study was to describe characteristics, health status, and socio-economic status of outpatient heart failure (HF) patients several years after a national economic crisis and to assess whether socio-economic factors were associated with patient-reported outcome measures (PROMs). Methods and results In this cross-sectional survey, PROMs were measured with seven validated instruments, as follows: self-care (the 12-item European Heart Failure Self-Care Behaviour scale), HF-related knowledge (Dutch Heart Failure Knowledge Scale), symptoms (Edmonton Symptom Assessment System), sense of security (Sense of Security in Care-Patients evaluation), health status (EQ-5D visual analogue scale), health-related quality of life (HRQoL) (Kansas City Cardiomyopathy Questionnaire), and anxiety and depression (Hospital Anxiety and Depression Scale). Additional data were collected on access and use of health care, household income, demographics, and clinical status. The patients (n = 124, mean age 73 +/- 14.9, 69% male) self-care was low for exercising (53%) and weight monitoring (50%) but optimal for taking medication (100%). HF-specific knowledge was high (correct answers 12 out of 15), but only 38% knew what to do when symptoms worsened suddenly. Patients sense of security was high (amp;gt;70% had a mean score of 5 or 6, scale 1-6). The most common symptom was tiredness (82%); 12% reported symptoms of anxiety, and 18% had symptoms of depression. Patients rated their overall health (EQ-5D) on average at 65.5 (scale 0-100), and 33% had poor or very bad HRQoL. The monthly income per household was amp;lt;sic3900 for 84% of the patients. A total of 22% had difficulties making appointments with a general practitioner (GP), and 5% had no GP. On average, patients paid for six health care-related items, and amp;gt;90% paid for medications, primary care, and visits to hospital and private clinics out of their own pocket. The cost of health care had changed for 71% of the patients since the 2008 economic crisis, and increased out-of-pocket costs were most often explained by a greater need for health care services and medication expenses. There was no significant difference in PROMs related to changes in out-of-pocket expenses after the crisis, income, or whether patients lived alone or with others. Conclusions This Icelandic patient population reported similar health-related outcomes as have been previously reported in international studies. This study indicates that even after a financial crisis, most of the patients have managed to prioritize and protect their health even though a large proportion of patients have a low income, use many health care resources, and have insufficient access to care. It is imperative that access and affordable health care services are secured for this vulnerable patient population.

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  • 5.
    Kissopoulou, Antheia
    et al.
    Linköping University, Department of Medical and Health Sciences, Division of Cardiovascular Medicine. Linköping University, Faculty of Medicine and Health Sciences. Cty Council Jonkoping, Sweden.
    Trinks, Cecilia
    Linköping University, Department of Clinical and Experimental Medicine, Division of Cell Biology. Linköping University, Faculty of Medicine and Health Sciences. Region Östergötland, Center for Diagnostics, Clinical genetics.
    Gréen, Anna
    Linköping University, Department of Clinical and Experimental Medicine, Division of Cell Biology. Linköping University, Faculty of Medicine and Health Sciences. Region Östergötland, Center for Diagnostics, Clinical genetics.
    Karlsson, Jan-Erik
    Linköping University, Department of Medical and Health Sciences, Division of Cardiovascular Medicine. Linköping University, Faculty of Medicine and Health Sciences. Cty Council Jonkoping, Sweden.
    Jonasson, Jon
    Linköping University, Department of Clinical and Experimental Medicine, Division of Cell Biology. Linköping University, Faculty of Medicine and Health Sciences. Region Östergötland, Center for Diagnostics, Clinical genetics.
    Gunnarsson, Cecilia
    Linköping University, Department of Clinical and Experimental Medicine, Division of Cell Biology. Linköping University, Faculty of Medicine and Health Sciences. Region Östergötland, Center for Diagnostics, Clinical genetics. Region Östergötland, Center for Business support and Development.
    Homozygous missense MYBPC3 Pro873His mutation associated with increased risk for heart failure development in hypertrophic cardiomyopathy2018In: ESC Heart Failure, E-ISSN 2055-5822, Vol. 5, no 4, p. 716-723Article in journal (Refereed)
    Abstract [en]

    Hypertrophic cardiomyopathy (HCM) is a primary autosomal-dominant disorder of the myocardium with variable expressivity and penetrance. Occasionally, homozygous sarcomere genetic variants emerge while genotyping HCM patients. In these cases, a more severe HCM phenotype is generally seen. Here, we report a case of HCM that was diagnosed clinically at 39years of age. Initial symptoms were shortness of breath during exertion. Successively, he developed a wide array of severe clinical manifestations, which progressed to an ominous end-stage heart failure that resulted in heart transplantation. Genotype analysis revealed a missense MYBPC3 variant NM_000256.3:c.2618Camp;gt;A,p.(Pro873His) that presented in the homozygous form. Conflicting interpretations of pathogenicity have been reported for the Pro873His MYBPC3 variant described here. Our patient, presenting with two copies of the variant and devoid of a normal allele, progressed to end-stage heart failure, which supports the notion of a deleterious effect of this variant in the homozygous form.

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  • 6.
    Lans, Charlotta
    et al.
    Linköping University, Department of Medical and Health Sciences, Division of Cardiovascular Medicine. Linköping University, Faculty of Medicine and Health Sciences. Department of Physiotherapy, Kalmar County Hospital, Kalmar, Sweden.
    Cider, Åsa
    Department of Health and Rehabilitation/Physiotherapy, Institute of Neuroscience and Physiology, Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden; Occupational Therapy and Physiotherapy, Sahlgrenska University Hospital, Gothenburg, Sweden.
    Nylander, Eva
    Linköping University, Department of Medical and Health Sciences, Division of Cardiovascular Medicine. Linköping University, Faculty of Medicine and Health Sciences. Region Östergötland, Heart and Medicine Center, Department of Clinical Physiology in Linköping.
    Brudin, Lars
    Linköping University, Department of Medical and Health Sciences, Division of Cardiovascular Medicine. Linköping University, Faculty of Medicine and Health Sciences. Department of Clinical Physiology, Kalmar County Hospital, Kalmar, Sweden.
    Peripheral muscle training with resistance exercise bands in patients with chronic heart failure. Long-term effects on walking distance and quality of life; a pilot study2018In: ESC Heart Failure, E-ISSN 2055-5822, Vol. 5, no 2, p. 241-248Article in journal (Refereed)
    Abstract [en]

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

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  • 7.
    Schaufelberger, Maria
    et al.
    Univ Gothenburg, Sweden.
    Ekestubbe, Sofia
    Univ Gothenburg, Sweden.
    Hultgren, Simon
    Univ Gothenburg, Sweden.
    Persson, Hans
    KIDS, Sweden; KIDS, Sweden.
    Reimstad, Ann
    Linköping University, Department of Medical and Health Sciences. Linköping University, Faculty of Medicine and Health Sciences. Region Östergötland, Center for Surgery, Orthopaedics and Cancer Treatment, Department of Respiratory Medicine.
    Schaufelberger, Mattias
    Univ Gothenburg, Sweden.
    Rosengren, Annika
    Univ Gothenburg, Sweden.
    Validity of heart failure diagnoses made in 2000-2012 in western Sweden2020In: ESC Heart Failure, E-ISSN 2055-5822Article in journal (Refereed)
    Abstract [en]

    Aims The aim of this study is to validate a diagnosis of heart failure (HF) according to the European Society of Cardiology (ESC) guidelines among patients hospitalized at Sahlgrenska University Hospital, Gothenburg, Sweden, between 2000 and 2012. Methods and results In Sweden, it is mandatory to report all hospital discharge diagnoses to the Swedish national inpatient register. In total, 27 517 patients were diagnosed with HF at the Sahlgrenska University hospital between 2000 and 2012. Altogether, 1100 records with a primary (n = 550) or contributory (n = 550) diagnosis of HF were randomly selected. The diagnosis was validated according to the ESC guidelines from 1995, 2001, 2005, and 2008, and cases were divided into three groups: definite, probable, and miscoded. In total, 965 cases were validated, while 135 records were excluded for various reasons. Of the 965 records, the diagnosis was validated as definite in 601 (62.3%) and as probable in 310 (32.1%); only 54 (5.6%) of cases had been miscoded. Echocardiography, as an objective evidence of cardiac dysfunction, had been performed in 581 (96.7%) of the definite, 106 (34.2%) of the probable, and 31 (57.4%) of the miscoded cases. Among the probable cases, the main reason they had not been classified as a definitive diagnosis of HF was lack of examination by echocardiography (63.8%). Conclusions The overall validity of HF diagnosis at Sahlgrenska University Hospital is high. This may reflect a high diagnostic validity at the time of diagnosis in the national Swedish patient register, supporting the continued use of this register in epidemiological research.

  • 8.
    Silverdal, Jonas
    et al.
    Univ Gothenburg, Sweden.
    Sjoland, Helen
    Univ Gothenburg, Sweden.
    Bollano, Entela
    Univ Gothenburg, Sweden.
    Pivodic, Aldina
    Stat Konsultgrp, Sweden.
    Dahlström, Ulf
    Linköping University, Department of Medical and Health Sciences, Division of Cardiovascular Medicine. Linköping University, Faculty of Medicine and Health Sciences. Region Östergötland, Heart and Medicine Center, Department of Cardiology in Linköping.
    Fu, Michael
    Univ Gothenburg, Sweden.
    Prognostic impact over time of ischaemic heart disease vs. non-ischaemic heart disease in heart failure2020In: ESC Heart Failure, E-ISSN 2055-5822Article in journal (Refereed)
    Abstract [en]

    Aims The aim of this study is to investigate the prognostic impact of ischaemic heart disease (IHD) in heart failure (HF) and its association to age, sex, left ventricular ejection fraction (EF), and HF duration, and furthermore, to evaluate if the impact of IHD has changed over time, in light of improved therapy. Methods and results We studied 30 946 patients with non-valvular HF, by accessing the Swedish Heart Failure Registry, from years 2000 to 2012. The mortality in 17 778 patients with clinical IHD was compared with 13 168 patients without IHD (non-IHD). There was a significantly worse outcome in IHD, with the crude mortality of 41.1% and the event rate per 100 person-years [95% confidence interval (CI)] of 14.8 (14.4-15.1), compared with 28.2% and 9.7 (9.4-10.0) in non-IHD. After multivariable adjustment, the hazard ratio (HR) (95% CI) for mortality, IHD vs. non-IHD, was 1.16 (1.11-1.22; P amp;lt; 0.0001). Subgroup analyses showed significantly increased mortality in IHD, in all age subgroups, in all subgroups with EF amp;lt; 50%, in both men and women, and regardless of heart failure duration more or less than 6 months. Analyses for the combination of age and EF showed the highest HR for time to death in the youngest with the lowest EF, HR (95% CI) 2.05 (1.59-2.64) for patients amp;lt;60 years of age with EF amp;lt; 30%. Although a numerical reduction of the HR for mortality was seen over time, the risk for mortality in IHD, compared with the non-IHD group, was greater throughout the study period. Conclusions In non-valvular heart failure, IHD was associated with significantly increased mortality, compared with non-IHD, in groups of EF below 50%, in all age groups, and regardless of sex or HF duration. The risk increase associated with EF reduction diminished with increasing age. The mortality in IHD, compared with non-IHD, remained significantly higher throughout the 13 year study period.

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  • 9.
    Tromp, Jasper
    et al.
    Department of Cardiology, University of Groningen, University Medical Center Groningen, Hanzeplein 1, 9713 GZ, Groningen, The Netherlands; National Heart Centre Singapore, 5 Hospital Drive, Singapore, 169609, Singapore.
    Richards, Arthur Mark
    Cardiovascular Research Institute, National University Heart Centre, Singapore, Singapore; Christchurch Heart Institute, University of Otago, Dunedin, New Zealand.
    Tay, Wan Ting
    National Heart Centre Singapore, 5 Hospital Drive, Singapore, 169609, Singapore.
    Teng, Tiew-Hwa K
    National Heart Centre Singapore, 5 Hospital Drive, Singapore, 169609, Singapore; School of Population Health, University of Western Australia, Nedlands, WA, Australia.
    Yeo, Poh Shuan Daniel
    Tan Tock Seng Hospital, Singapore, Singapore.
    Sim, David
    National Heart Centre Singapore, 5 Hospital Drive, Singapore, 169609, Singapore.
    Jaufeerally, Fazlur
    Duke-NUS Graduate Medical School, Singapore, Singapore.
    Leong, Gerard
    Changi General Hospital, Singapore, Singapore.
    Ong, Hean Yee
    Khoo Teck Puat Hospital, Singapore, Singapore.
    Ling, Lieng Hsi
    Cardiovascular Research Institute, National University Heart Centre, Singapore, Singapore.
    van Veldhuisen, Dirk J
    Department of Cardiology, University of Groningen, University Medical Center Groningen, Hanzeplein 1, 9713 GZ, Groningen, The Netherlands.
    Jaarsma, Tiny
    Linköping University, Department of Social and Welfare Studies, Division of Nursing Science. Linköping University, Faculty of Medicine and Health Sciences.
    Voors, Adriaan A.
    Department of Cardiology, University of Groningen, University Medical Center Groningen, Hanzeplein 1, 9713 GZ, Groningen, The Netherlands.
    van der Meer, Peter
    Department of Cardiology, University of Groningen, University Medical Center Groningen, Hanzeplein 1, 9713 GZ, Groningen, The Netherlands.
    de Boer, Rudolf A.
    Department of Cardiology, University of Groningen, University Medical Center Groningen, Hanzeplein 1, 9713 GZ, Groningen, The Netherlands.
    Lam, Carolyn S. P.
    Cardiovascular Research Institute, National University Heart Centre, Singapore, Singapore; National Heart Centre Singapore, 5 Hospital Drive, Singapore, 169609, Singapore; Duke-National University of Singapore, Singapore, Singapore.
    N-terminal pro-B-type natriuretic peptide and prognosis in Caucasian vs. Asian patients with heart failure2018In: ESC Heart Failure, E-ISSN 2055-5822, Vol. 5, no 2, p. 279-287Article in journal (Refereed)
    Abstract [en]

    N-terminal pro-B-type natriuretic peptide (NT-proBNP) is the most frequently used biomarker in heart failure (HF), but its prognostic utility across ethnicities is unclear.

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  • 10.
    Vellone, Ercole
    et al.
    Univ Roma Tor Vergata, Italy.
    Chiala, Oronzo
    Univ Roma Tor Vergata, Italy.
    Boyne, Josiane
    Maastricht Univ, Netherlands.
    Klompstra, Leonie
    Linköping University, Department of Social and Welfare Studies, Division of Nursing Science. Linköping University, Faculty of Medicine and Health Sciences.
    Evangelista, Lorraine S.
    Univ Calif Irvine, CA USA.
    Bäck, Maria
    Linköping University, Department of Medical and Health Sciences, Division of Physiotherapy. Linköping University, Faculty of Medicine and Health Sciences.
    Ben Gal, Tuvia
    Rabin Med Ctr, Israel; Tel Aviv Univ, Israel.
    Martensson, Jan
    Jonkoping Univ, Sweden.
    Strömberg, Anna
    Linköping University, Department of Medical and Health Sciences, Division of Nursing Science. Linköping University, Faculty of Medicine and Health Sciences. Region Östergötland, Heart and Medicine Center, Department of Cardiology in Linköping.
    Jaarsma, Tiny
    Linköping University, Department of Social and Welfare Studies, Division of Nursing Science. Linköping University, Faculty of Medicine and Health Sciences.
    Cognitive impairment in patients with heart failure: an international study2020In: ESC Heart Failure, E-ISSN 2055-5822Article in journal (Refereed)
    Abstract [en]

    Aims Cognitive impairment (CI) in heart failure (HF) patients has mostly been studied in single countries in specific health care settings. Sociodemographic and clinical predictors of the global CI and CI dimensions are still unclear. We described CI in a diverse HF population recruited in several countries and in different health care settings and investigated sociodemographic and clinical factors associated with the global and specific CI dimensions in HF patients. Methods and results A secondary analysis from the baseline data of the Wii-HF trial. Patients (n = 605) were enrolled in Sweden, Italy, Israel, The Netherlands, Germany, and the United States. We used the Montreal Cognitive Assessment to evaluate CI and the 6 minute walk test (6MWT) to measure exercise capacity. Patients were on average 67 years old (SD, 12), and 86% were in New York Heart Association Class II and III. The mean Montreal Cognitive Assessment score was 24 (SD, 4), and 67% of patients had at least a mild CI. The item evaluating short-term memory had a considerable proportion of low scoring patients (28.1%). Worse CI was associated with patients older age, lower education, and lower 6MWT scores (R-2 = 0.27). CI dimension scores were differently associated with specific clinical and demographic variables, but the 6MWT scores were associated with five out of seven CI dimension scores. Conclusions CI is an important problem in HF patients, with specific challenges in regard to memory. Exercise capacity is a modifiable factor that could be improved in HF patients with the potential to improve cognition and other outcomes in this population.

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