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  • 151.
    Karlsson, Henrik
    et al.
    Med radiofysik IMV.
    Angland, Erik
    Linköping University, Department of Medicine and Care.
    Davidsson, Anette
    Linköping University, Faculty of Health Sciences. Linköping University, Department of Medicine and Care, Clinical Physiology. Östergötlands Läns Landsting, Heart Centre, Department of Clinical Physiology.
    Gustafsson, Agneta
    Linköping University, Faculty of Health Sciences. Linköping University, Department of Medicine and Care, Radiation Physics. Östergötlands Läns Landsting, Centre of Surgery and Oncology, Department of Radiation Physics.
    Pettersson, Håkan
    Linköping University, Faculty of Health Sciences. Linköping University, Department of Medicine and Care, Radiation Physics. Östergötlands Läns Landsting, Centre of Surgery and Oncology, Department of Radiation Physics.
    Measurements of airborne 99mTc to technologists during technegas ventilation studies2006In: EANM,2006, 2006Conference paper (Other academic)
  • 152.
    Karlsson, Matts
    et al.
    Linköping University, The Institute of Technology. Linköping University, Department of Biomedical Engineering, Biomedical Modelling and Simulation .
    Engvall, Jan
    Linköping University, Faculty of Health Sciences. Linköping University, Department of Medicine and Care, Clinical Physiology. Östergötlands Läns Landsting, Heart Centre, Department of Clinical Physiology.
    Ask, Per
    Linköping University, The Institute of Technology. Linköping University, Department of Biomedical Engineering, Physiological Measurements.
    Wranne, Bengt
    Linköping University, Faculty of Health Sciences. Linköping University, Department of Medicine and Care, Clinical Physiology. Östergötlands Läns Landsting, Heart Centre, Department of Clinical Physiology.
    Loyd, Dan
    Linköping University, The Institute of Technology. Linköping University, Department of Mechanical Engineering, Applied Thermodynamics and Fluid Mechanics.
    Orifice flow in stenotic and regurgitant valve lesions - Modelling and computer simulations1994In: Biofluid mechanics, Southhampton: Computational Mechanics Publications , 1994Chapter in book (Other academic)
  • 153.
    Kihlberg, Johan
    et al.
    Linköping University, Center for Medical Image Science and Visualization (CMIV). Linköping University, Department of Medical and Health Sciences, Radiology. Linköping University, Faculty of Health Sciences.
    Fransson, Sven-Göran
    Linköping University, Department of Medical and Health Sciences, Radiology. Linköping University, Faculty of Health Sciences. Östergötlands Läns Landsting, Centre for Medical Imaging, Department of Radiology in Linköping.
    Engvall, Jan
    Linköping University, Center for Medical Image Science and Visualization (CMIV). Linköping University, Department of Medical and Health Sciences, Physiology. Linköping University, Faculty of Health Sciences. Östergötlands Läns Landsting, Heart Centre, Department of Clinical Physiology.
    Maret, Eva
    Linköping University, Center for Medical Image Science and Visualization (CMIV). Linköping University, Department of Medical and Health Sciences, Clinical Physiology. Linköping University, Faculty of Health Sciences.
    Warntjes, Marcel
    Linköping University, Center for Medical Image Science and Visualization (CMIV). Linköping University, Department of Medical and Health Sciences, Clinical Physiology. Linköping University, Faculty of Health Sciences. Östergötlands Läns Landsting, Heart Centre, Department of Clinical Physiology.
    Rommel, Franz
    Östergötlands Läns Landsting, Centre of Surgery and Oncology, Department of Haematology UHL.
    Ackumulering av överskottsjärn kan bestämmas med MR2009In: Ackumulering av överskottsjärn kan bestämmas med MR, 2009Conference paper (Refereed)
    Abstract [sv]

    Järnöverskott kan vara toxiskt i kroppen. Järnöverskott ses fr a efter multipla blodtransfusioner vid vissa blodsjukdomar. Internationellt är den vanligaste orsaken thalassemi. Antalet patienter med denna problematik är i Sverige ännu begränsat. Järnöverskott kan leda till allvarlig, svårbehandlad hjärtsvikt man kan behandlas med chelaterande perorala läkemedel och styrs då i allmänhet utifrån ferritin/s. Vår hypotes var att överensstämmelsen mellan järnöverskott och transferrin är låg, att järnöverskott bättre karaktäriseras med MR som också kan differentiera mellan järnöverskott i  hjärta respektive lever.

  • 154.
    Kindberg, Katarina
    et al.
    Linköping University, Department of Management and Engineering, Applied Thermodynamics and Fluid Mechanics . Linköping University, The Institute of Technology.
    Carlhäll, Carljohan
    Linköping University, Department of Medicine and Health Sciences, Clinical Physiology . Linköping University, Faculty of Health Sciences. Östergötlands Läns Landsting, Heart Centre, Department of Clinical Physiology.
    Karlsson, Matts
    Linköping University, Department of Management and Engineering, Applied Thermodynamics and Fluid Mechanics . Linköping University, The Institute of Technology.
    Nguyen, T C
    Stanford University.
    Cheng, A
    Stanford University.
    Langer, F
    Stanford University.
    Rodriguez, F
    Stanford University.
    Daughters, G T
    Stanford University.
    Miller, D C
    Stanford University.
    Jr Ingels, N B
    Stanford University.
    Transmural Strains in the Ovine Left Ventricular Lateral Wall During Diastolic Filling2009In: JOURNAL OF BIOMECHANICAL ENGINEERING-TRANSACTIONS OF THE ASME, ISSN 0148-0731, Vol. 131, no 6Article in journal (Refereed)
    Abstract [en]

    Rapid early diastolic left ventricular (LV) filling requires a highly compliant chamber immediately after systole, allowing inflow at low driving pressures. The transmural LV deformations associated with such filling are not completely understood. We sought to characterize regional transmural LV strains during diastole, with focus on early filling, in ovine hearts at 1 week and 8 weeks after myocardial marker implantation. In seven normal sheep hearts, 13 radiopaque markers were inserted to silhouette the LV chamber and a transmural beadset was implanted into the lateral equatorial LV wall to measure transmural strains. Four-dimensional marker dynamics were obtained 1 week and 8 weeks thereafter with biplane videofluoroscopy in closed-chest, anesthetized animals. LV transmural strains in both cardiac and fiber-sheet coordinates were studied from filling onset to the end of early filling (EOEF, 100 ms after filling onset) and at end diastole. At the 8 week study, subepicardial circumferential strain (E-CC) had reached its final value already at EOEF, while longitudinal and radial strains were nearly zero at this time. Subepicardial E-CC and fiber relengthening (E-ff) at EOEF were reduced to 1 compared with 8 weeks after surgery (E-CC:0.02 +/- 0.01 to 0.08 +/- 0.02 and E-ff:0.00 +/- 0.01 to 0.03 +/- 0.01, respectively, both P < 0.05). Subepicardial E-CC during early LV filling was associated primarily with fiber-normal and sheet-normal shears at the 1 week study, but to all three fiber-sheet shears and fiber relengthening at the 8 week study. These changes in LV subepicardial mechanics provide a possible mechanistic basis for regional myocardial lusitropic function, and may add to our understanding of LV myocardial diastolic dysfunction.

  • 155.
    Kindberg, Katarina
    et al.
    Linköping University, Department of Management and Engineering, Applied Thermodynamics and Fluid Mechanics . Linköping University, The Institute of Technology.
    Haraldsson, Henrik
    Linköping University, Department of Medicine and Health Sciences, Clinical Physiology . Linköping University, Faculty of Health Sciences. Östergötlands Läns Landsting, Heart Centre, Department of Clinical Physiology.
    Sigfridsson, Andreas
    Linköping University, Department of Medicine and Health Sciences, Clinical Physiology . Linköping University, Faculty of Health Sciences. Östergötlands Läns Landsting, Heart Centre, Department of Clinical Physiology.
    Engvall, Jan
    Linköping University, Department of Medicine and Health Sciences, Clinical Physiology . Linköping University, Faculty of Health Sciences. Östergötlands Läns Landsting, Heart Centre, Department of Clinical Physiology.
    Ingels, Neil B.
    dDepartment of Cardiothoracic Surgery, School of Medicine, Stanford University, Stanford, CA 94305, USA.
    Ebbers, Tino
    Linköping University, Department of Medicine and Health Sciences, Clinical Physiology . Linköping University, Faculty of Health Sciences. Östergötlands Läns Landsting, Heart Centre, Department of Clinical Physiology.
    Karlsson, Matts
    Linköping University, Department of Management and Engineering, Applied Thermodynamics and Fluid Mechanics . Linköping University, The Institute of Technology.
    Myocardial strains from 3D DENSE magnetic resonance imagingManuscript (preprint) (Other academic)
    Abstract [en]

    The ability to measure and quantify myocardial motion and deformation provides a useful tool to assist in the diagnosis, prognosis and management of heart disease. The recent development of magnetic resonance imaging methods, such as harmonic phase and displacement encoding with stimulated echoes (DENSE), make detailed non-invasive 3D transmural kinematic analyses of human myocardium possible in the clinic and for research purposes. As data acquisition technologies improve, quantification methods for cardiac kinematics need to be adapted and validated on the new types of data. In the present paper, a previously presented polynomial method for cardiac strain quantification is extended to quantify 3D strains from DENSE magnetic resonance imaging data. The method yields accurate results when validated against an analytical standard, and is applied to in vivo data from a healthy  human heart. The polynomial field is capable of resolving the measured material positions from the in vivo data, and the obtained in vivo strains agree

  • 156.
    Kindberg, Katarina
    et al.
    Linköping University, Department of Management and Engineering, Applied Thermodynamics and Fluid Mechanics. Linköping University, The Institute of Technology. Linköping University, Center for Medical Image Science and Visualization, CMIV.
    Haraldsson, Henrik
    Linköping University, Department of Medical and Health Sciences, Clinical Physiology. Linköping University, Faculty of Health Sciences. Östergötlands Läns Landsting, Heart Centre, Department of Clinical Physiology. Linköping University, Center for Medical Image Science and Visualization, CMIV.
    Sigfridsson, Andreas
    Linköping University, Department of Medical and Health Sciences, Clinical Physiology. Linköping University, Faculty of Health Sciences. Östergötlands Läns Landsting, Heart Centre, Department of Clinical Physiology. Linköping University, Center for Medical Image Science and Visualization, CMIV.
    Sakuma, Hajime
    Department of Radiology, Mie University, 2-174 Edobashi, Tsu, Mie 514-8507, Japan.
    Ebbers, Tino
    Linköping University, Department of Medical and Health Sciences, Clinical Physiology. Linköping University, Faculty of Health Sciences. Östergötlands Läns Landsting, Heart Centre, Department of Clinical Physiology. Linköping University, Center for Medical Image Science and Visualization, CMIV.
    Karlsson, Matts
    Linköping University, Department of Management and Engineering, Applied Thermodynamics and Fluid Mechanics. Linköping University, The Institute of Technology. Linköping University, Center for Medical Image Science and Visualization, CMIV.
    Temporal 3D Lagrangian strain from 2D slice followed cine DENSE MRI2012In: Clinical Physiology and Functional Imaging, ISSN 1475-0961, E-ISSN 1475-097X, Vol. 32, no 2, p. 139-144Article in journal (Refereed)
    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.

  • 157.
    Kristenson, Margareta
    et al.
    Linköping University, Faculty of Health Sciences. Linköping University, Department of health and environment. Östergötlands Läns Landsting, FHVC - Folkhälsovetenskapligt centrum, Förebygg.med.
    Lassvik, Claes
    Linköping University, Faculty of Health Sciences. Linköping University, Department of Medicine and Care, Clinical Physiology. Östergötlands Läns Landsting, Heart Centre, Department of Clinical Physiology.
    Bergdahl, Björn
    Linköping University, Faculty of Health Sciences. Linköping University, Department of Medicine and Care, Cardiology. Östergötlands Läns Landsting, Heart Centre, Department of Cardiology.
    Kucinskiene, Z
    Aizieniene, L
    Ziedén, Bo
    Linköping University, Faculty of Health Sciences. Linköping University, Department of Medicine and Care, Internal Medicine. Östergötlands Läns Landsting, MKC-2, GE: endomed.
    Schäfer Elinder, Liselott
    Olsson, Anders
    Linköping University, Faculty of Health Sciences. Linköping University, Department of Medicine and Care, Internal Medicine. Östergötlands Läns Landsting, MKC-2, GE: endomed.
    Ultrasound determined carotid and femoral atherosclerosis in Lithuanian and Swedish men: The LiVicordia study2000In: Atherosclerosis, ISSN 0021-9150, E-ISSN 1879-1484, Vol. 151, no 2, p. 501-508Article in journal (Refereed)
    Abstract [en]

    Coronary heart disease mortality is four times higher in Lithuanian compared to Swedish middle-aged men. Using the same equipment (Acuson XP10 with 5 MHz linear transducer) and staff, we compared the amount of atherosclerosis in carotid and femoral arteries in 100 randomly sampled 50-year-old men in each of the cities Vilnius, Lithuania and Linköping, Sweden. Atherosclerotic plaques were more abundant in Vilnius men compared to Linköping men (53 versus 28% in the common carotid artery, 73 versus 37% in the common femoral artery, P<0.001 for both). Plaques were thicker and more extended in arteries of Vilnius men, and an ultrasound atherosclerosis score was higher in both carotid and femoral arteries (P<0.001 for all). More Vilnius men had a maximal intima-media thickness of the common femoral artery above 1 mm (P<0.005). Stiffness in the common carotid artery was higher in Vilnius men (P<0.001). In a linear regression model of the pooled material, after adjustment for city was made, smoking, systolic blood pressure, low density lipoprotein cholesterol and β-carotene (inversely) significantly contributed to a high total ultrasound score (r2=0.32). These findings show that the higher coronary mortality noted in Lithuanian men goes together with a higher prevalence of early peripheral atherosclerosis.

  • 158.
    Kukulski, T
    et al.
    Linköping University, Faculty of Health Sciences. Linköping University, Department of Medicine and Care, Clinical Physiology.
    Hübbert, Laila
    Linköping University, Faculty of Health Sciences. Linköping University, Department of Medicine and Care, Cardiology. Östergötlands Läns Landsting, Heart Centre, Department of Cardiology.
    Arnold, Martina
    Linköping University, Faculty of Health Sciences. Linköping University, Department of Medicine and Care, Clinical Physiology.
    Wranne, Bengt
    Linköping University, Faculty of Health Sciences. Linköping University, Department of Medicine and Care, Clinical Physiology. Östergötlands Läns Landsting, Heart Centre, Department of Clinical Physiology.
    Hatle, L
    Linköping University, Faculty of Health Sciences. Linköping University, Department of Medicine and Care, Clinical Physiology.
    Sutherland, George
    Linköping University, Faculty of Health Sciences. Linköping University, Department of Medicine and Care, Clinical Physiology.
    Normal regional right ventricular function and its change with age: a Doppler myocardial imaging study2000In: Journal of the American Society of Echocardiography, ISSN 0894-7317, E-ISSN 1097-6795, Vol. 13, p. 194-204Article in journal (Refereed)
  • 159.
    Kukulski, T
    et al.
    Linköping University, Faculty of Health Sciences. Linköping University, Department of Medicine and Care, Clinical Physiology.
    Voigt, JU
    Linköping University, Faculty of Health Sciences. Linköping University, Department of Medicine and Care, Clinical Physiology.
    Wilkenshoff, Ursula
    Linköping University, Faculty of Health Sciences. Linköping University, Department of Medicine and Care, Internal Medicine.
    Strotmann, JM
    Linköping University, Faculty of Health Sciences. Linköping University, Department of Medicine and Care, Clinical Physiology.
    Wranne, Bengt
    Linköping University, Faculty of Health Sciences. Linköping University, Department of Medicine and Care, Clinical Physiology. Östergötlands Läns Landsting, Heart Centre, Department of Clinical Physiology.
    Hatle, L
    Linköping University, Faculty of Health Sciences. Linköping University, Department of Medicine and Care, Clinical Physiology.
    Sutherland, GR
    Linköping University, Faculty of Health Sciences. Linköping University, Department of Medicine and Care, Clinical Physiology.
    A comparison of regional myocardial velocity information derived by pulsed and color: an in vitro and in vivo stydy2000In: Echocardiography, ISSN 0742-2822, E-ISSN 1540-8175, Vol. 17, p. 639-951Article in journal (Refereed)
  • 160.
    Kvikliene, Adriana
    et al.
    Institute of Biomedical Engineering, Kaunas University of Technology, K. Donelaicio st. 73, Kaunas LT-3006, Lithuania.
    Jurkonis, Rytis
    Institute of Biomedical Engineering, Kaunas University of Technology, K. Donelaicio st. 73, Kaunas LT-3006, Lithuania.
    Ressner, Marcus
    Linköping University, The Institute of Technology. Linköping University, Department of Biomedical Engineering, Physiological Measurements.
    Hoff, Lars
    Faculty of Science and Engineering, Vestfold University College, P.O. Box 2243, N-3103 Tønsberg, Norway.
    Jansson, Tomas
    Department of Electrical Measurements, Lund University, P.O. Box 118, SE-221 00, Lund, Sweden.
    Janerot Sjöberg, Birgitta
    Linköping University, Faculty of Health Sciences. Linköping University, Department of Medicine and Health Sciences, Clinical Physiology. Östergötlands Läns Landsting, Heart Centre, Department of Clinical Physiology.
    Lukosevicius, Arunas
    Institute of Biomedical Engineering, Kaunas University of Technology, K. Donelaicio st. 73, Kaunas LT-3006, Lithuania.
    Ask, Per
    Linköping University, The Institute of Technology. Linköping University, Department of Biomedical Engineering, Physiological Measurements.
    Modelling of nonlinear effects and the response of ultrasound contrast micro bubbles: simulation and experiment2004In: Ultrasonics, ISSN 0041-624X, E-ISSN 1874-9968, Vol. 42, no 01-Sep, p. 301-307Article in journal (Refereed)
    Abstract [en]

    The propagation of diagnostic ultrasonic imaging pulses in tissue and their interaction with contrast micro bubbles is a very complex physical process, which we assumed to be separable into three stages: pulse propagation in tissue, the interaction of the pulse with the contrast bubble, and the propagation of the scattered echo. The model driven approach is used to gain better knowledge of the complex processes involved. A simplified way of field simulation is chosen due to the complexity of the task and the necessity to estimate comparative contributions of each component of the process. Simulations are targeted at myocardial perfusion estimation. A modified method for spatial superposition of attenuated waves enables simulations of low intensity pulse pressure fields from weakly focused transducers in a nonlinear, attenuating, and liquid-like biological medium. These assumptions enable the use of quasi-linear calculations of the acoustic field. The simulations of acoustic bubble response are carried out with the Rayleigh-Plesset equation with the addition of radiation damping. Theoretical simulations with synthesised and experimentally sampled pulses show that the interaction of the excitation pulses with the contrast bubbles is the main cause of nonlinear scattering, and a 2-3 dB increase of second harmonic amplitude depends on nonlinear distortions of the incident pulse. (C) 2004 Elsevier B.V. All rights reserved.

  • 161.
    Kvitting, John-Peder Escobar
    et al.
    Linköping University, Department of Medicine and Health Sciences, Thoracic Surgery. Östergötlands Läns Landsting, Heart Centre, Department of Thoracic and Vascular Surgery. Linköping University, Faculty of Health Sciences.
    Dyverfeldt, Petter
    Linköping University, Department of Medicine and Health Sciences, Clinical Physiology . Östergötlands Läns Landsting, Heart Centre, Department of Clinical Physiology. Linköping University, Faculty of Health Sciences.
    Carlhäll, Carljohan
    Linköping University, Department of Medicine and Health Sciences, Thoracic Surgery. Östergötlands Läns Landsting, Heart Centre, Department of Clinical Physiology. Linköping University, Faculty of Health Sciences.
    Sigfridsson, Andreas
    Linköping University, Department of Medicine and Health Sciences, Clinical Physiology . Östergötlands Läns Landsting, Heart Centre, Department of Clinical Physiology. Linköping University, Faculty of Health Sciences.
    Bolger, Ann F
    Linköping University, Department of Medicine and Care, Clinical Physiology. Linköping University, Faculty of Health Sciences. Östergötlands Läns Landsting, Heart Centre, Department of Clinical Physiology.
    Ebbers, Tino
    Linköping University, Department of Medicine and Health Sciences, Clinical Physiology . Östergötlands Läns Landsting, Heart Centre, Department of Clinical Physiology. Linköping University, Faculty of Health Sciences.
    Engvall, Jan
    Linköping University, Department of Medicine and Health Sciences, Clinical Physiology . Östergötlands Läns Landsting, Heart Centre, Department of Clinical Physiology. Linköping University, Faculty of Health Sciences.
    Magnetresonanstomografi ger unika möjligheter att bedöma blodflödet och dess inverkan på hjärt och kärlsystemet.2009In: Läkartidningen, ISSN 0023-7205, E-ISSN 1652-7518, Vol. 106, p. 1901-1904Article in journal (Other academic)
  • 162.
    Kvitting, J.P.
    et al.
    Linköping University, Department of Medicine and Health Sciences, Clinical Physiology . Linköping University, Faculty of Health Sciences. Östergötlands Läns Landsting, Heart Centre, Department of Thoracic and Vascular Surgery.
    Sigfridsson, A.
    Linköping University, Department of Medicine and Health Sciences, Clinical Physiology . Linköping University, Faculty of Health Sciences. Östergötlands Läns Landsting, Heart Centre, Department of Clinical Physiology.
    Wigström, L.
    Linköping University, Department of Medicine and Health Sciences, Clinical Physiology . Linköping University, Faculty of Health Sciences.
    Bolger, A.F.
    Linköping University, Department of Medicine and Care, Clinical Physiology. Linköping University, Faculty of Health Sciences.
    Karlsson, Matts
    Linköping University, Department of Management and Engineering, Applied Thermodynamics and Fluid Mechanics . Linköping University, The Institute of Technology.
    Analysis of human myocardial dynamics using virtual markers based on magnetic resonance imaging2010In: Clinical Physiology and Functional Imaging, ISSN 1475-0961, E-ISSN 1475-097X, Vol. 30, no 1, p. 23-29Article in journal (Refereed)
    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.

  • 163. Kvitting, JPE
    et al.
    Ebbers, Tino
    Linköping University, Faculty of Health Sciences. Linköping University, Department of Medicine and Health Sciences, Clinical Physiology . Östergötlands Läns Landsting, Heart Centre, Department of Clinical Physiology.
    Wigström, Lars
    Linköping University, Faculty of Health Sciences. Linköping University, Department of Medicine and Health Sciences, Clinical Physiology . Östergötlands Läns Landsting, Heart Centre, Department of Clinical Physiology.
    Engvall, Jan
    Linköping University, Faculty of Health Sciences. Linköping University, Department of Medicine and Health Sciences, Clinical Physiology . Östergötlands Läns Landsting, Heart Centre, Department of Clinical Physiology.
    Bolger, Ann F
    Linköping University, Faculty of Health Sciences. Linköping University, Department of Medicine and Health Sciences, Clinical Physiology . Östergötlands Läns Landsting, Heart Centre, Department of Clinical Physiology.
    Olin, CL
    Assessment of the 3-D flow pattern in the sinuses of Valsalva2003In: Journal of the American College of Cardiology, ISSN 0735-1097, E-ISSN 1558-3597, Vol. 41, no 6, p. 437A-437AConference paper (Other academic)
  • 164.
    Kühme, Tobias
    et al.
    Linköping University, Department of Medicine and Care. Linköping University, Faculty of Health Sciences.
    Säfström, Kåge
    Linköping University, Faculty of Health Sciences. Linköping University, Department of Medicine and Care, Cardiology. Östergötlands Läns Landsting, Heart Centre, Department of Cardiology.
    Nielsen, Niels Erik
    Linköping University, Faculty of Health Sciences. Linköping University, Department of Medicine and Care, Cardiology. Östergötlands Läns Landsting, Heart Centre, Department of Cardiology.
    Nylander, Eva
    Linköping University, Faculty of Health Sciences. Linköping University, Department of Medicine and Care, Clinical Physiology. Östergötlands Läns Landsting, Heart Centre, Department of Clinical Physiology.
    Olin, Christian
    Rupture of a synthetic VSD patch 28 years after total correction of Fallot's anomaly2006In: Annals of Thoracic Surgery, ISSN 0003-4975, E-ISSN 1552-6259, Vol. 81, no 4, p. 1510-1512Article in journal (Refereed)
    Abstract [en]

    Patients operated on for complex congenital heart malformations need continuous follow-up. We present a male patient born in 1948 with Fallot's anomaly. A total correction was performed when he was 21 years old. Twenty-eight years after the operation, at routine follow-up, he presented with a significant left-to-right shunt because of a new ventricular septal defect. During the operation we found the original patch to be fractured with a central perforation. The patient received a new patch and has been without any clinical symptoms since. © 2006 by The Society of Thoracic Surgeons.

  • 165.
    Kümhe, Tobias
    et al.
    Linköping University, Faculty of Health Sciences. Linköping University, Department of Medicine and Care, Thoracic Surgery. Östergötlands Läns Landsting, Heart Centre, Department of Thoracic and Vascular Surgery.
    Franzén, Stefan
    Linköping University, Faculty of Health Sciences. Linköping University, Department of Medicine and Care, Thoracic Surgery. Östergötlands Läns Landsting, Heart Centre, Department of Thoracic and Vascular Surgery.
    Nylander, Eva
    Linköping University, Faculty of Health Sciences. Linköping University, Department of Medicine and Care, Clinical Physiology. Östergötlands Läns Landsting, Heart Centre, Department of Clinical Physiology.
    The simple solution to a complex case2001In: Journal of Neurology, Neurosurgery and Psychiatry, ISSN 0022-3050, E-ISSN 1468-330X, Vol. 70, no 2, p. 263-Article in journal (Refereed)
  • 166.
    Landtblom, Anne-Marie
    et al.
    Linköping University, Faculty of Health Sciences. Linköping University, Department of Neuroscience and Locomotion. Östergötlands Läns Landsting, Local Health Care Services in Central Östergötland, Department of Neurology.
    Dige, N
    Linköping University, Faculty of Health Sciences. Linköping University, Department of Neuroscience and Locomotion. Östergötlands Läns Landsting, Local Health Care Services in Central Östergötland, Department of Neurology.
    Schwerdt, K
    Linköping University, Faculty of Health Sciences. Linköping University, Department of Neuroscience and Locomotion. Östergötlands Läns Landsting, Local Health Care Services in Central Östergötland, Department of Neurology.
    Säfström, Kåge
    Linköping University, Faculty of Health Sciences. Linköping University, Department of Medicine and Care, Radiology. Östergötlands Läns Landsting, Centre for Medical Imaging, Department of Radiology UHL.
    Granerus, Göran
    Linköping University, Faculty of Health Sciences. Linköping University, Department of Medicine and Care, Clinical Physiology. Östergötlands Läns Landsting, Heart Centre, Department of Clinical Physiology.
    A case of Kleine-Levin syndrome examined with SPECT and neuropsychological testing2002In: Acta Neurologica Scandinavica, ISSN 0001-6314, E-ISSN 1600-0404, Vol. 105, no 4, p. 318-321Article in journal (Refereed)
    Abstract [en]

    A case of Kleine-Levin syndrome with typical periodic hypersomnia and bulemia was diagnosed. On examination with single photo emission tomography (SPECT) (CERETEC«) during a relapse period and 2 weeks later there was marked cortical hypoperfusion of the frontal and temporal lobes, especially on the left side as well as in the right parietal lobe. Neuropsychological testing performed 1 week after a relapse showed a reduction in encoding to memory function of verbal learning indicating neocortical damage of the left fronto-temporal region. A follow-up 2 months later after the patient had spontaneously recovered showed only a slight left fronto-temporal disturbance. CT and MRI of the brain were normal although the MRI showed a large and asymmetric mamillary body. Neuropsychological testing 6 years after recovery showed pronounced reduction in short-time verbal and visual memory. Seven years after recovery SPECT demonstrated a normalized frontal perfusion but still a slight hypoperfusion in the left temporal lobe. Our results correlate to autopsy findings in two cases described previously.

  • 167.
    Landtblom, Anne-Marie
    et al.
    Linköping University, Faculty of Health Sciences. Linköping University, Department of Neuroscience and Locomotion. Östergötlands Läns Landsting, Local Health Care Services in Central Östergötland, Department of Neurology.
    Dige, N
    Schwerdt, K
    Säfström, Kåge
    Linköping University, Faculty of Health Sciences. Linköping University, Department of Medicine and Care, Radiology. Östergötlands Läns Landsting, Centre for Medical Imaging, Department of Radiology UHL.
    Granerus, Göran
    Linköping University, Faculty of Health Sciences. Linköping University, Department of Medicine and Care, Clinical Physiology. Östergötlands Läns Landsting, Heart Centre, Department of Clinical Physiology.
    Short-term memory dysfunction in Kleine-Levin syndrome2003In: Acta Neurologica Scandinavica, ISSN 0001-6314, E-ISSN 1600-0404, Vol. 108, no 5, p. 363-367Article in journal (Refereed)
    Abstract [en]

    Background - A previous investigation at our department of a young man with typical Kleine-Levin syndrome revealed short-term memory dysfunction as well as hypoperfusion of the temporal lobes on single photon emission tomography (SPECT) (CERETECR) examination, 6 and 7 years after recovery, suggesting long lasting or even permanent cerebral dysfunction. Patients and methods - We investigated four cases with classical adolescent Kleine-Levin syndrome characterized by hypersomnia and typical associated symptoms. We used neuropsychological testing and SPECT (CERETECR) of the brain. The results from the previous report related to above is included. Results - Examination with SPECT (CERETECR) during remission revealed hypoperfusion of the temporal lobes and fronto-temporal region in two of four cases. There were normal findings in two. Neuropsychological testing performed during remission showed reduction in the short-term memory capacity in all four cases. Conclusion - It is striking that all the cases investigated showed short-term memory dysfunction. One patient who had recovered from paroxysmal symptoms (hypersomnia attacks and bulimia) 6 years earlier showed progress in the short-term memory dysfunction. A pathologic condition in the temporal lobes may be suspected in Kleine-Levin syndrome.

  • 168.
    Lassvik, Claes
    Linköping University, Faculty of Health Sciences. Linköping University, Department of Medicine and Care, Clinical Physiology. Östergötlands Läns Landsting, Heart Centre, Department of Clinical Physiology.
    Ultraljudsduplex värdefullt redskap i kärldiagnostik.2000In: Läkartidningen, ISSN 0023-7205, E-ISSN 1652-7518, Vol. 97, p. 4983-4990Article in journal (Other academic)
  • 169.
    Lindenberger, Marcus
    et al.
    Linköping University, Faculty of Health Sciences. Linköping University, Department of Medicine and Care, Clinical Physiology.
    Kjellberg, Margareta
    Linköping University, Faculty of Health Sciences. Linköping University, Department of Medicine and Care, Cardiology. Östergötlands Läns Landsting, Heart Centre, Department of Cardiology.
    Karlsson, Erling
    Linköping University, Faculty of Health Sciences. Linköping University, Department of Medicine and Care, Cardiology. Östergötlands Läns Landsting, Heart Centre, Department of Cardiology.
    Wranne, Bengt
    Linköping University, Faculty of Health Sciences. Linköping University, Department of Medicine and Care, Clinical Physiology. Östergötlands Läns Landsting, Heart Centre, Department of Clinical Physiology.
    Pericardiocentesis guided by 2-D echocardiography: The method of choice for treatment of pericardial effusion2003In: Journal of Internal Medicine, ISSN 0954-6820, E-ISSN 1365-2796, Vol. 253, no 4, p. 411-417Article in journal (Refereed)
    Abstract [en]

    Background. Percutaneous pericardiocentesis guided by 2-D echocardiography has been used at Link÷ping Heart Centre since 1983. Aim. To evaluate our experience of this method including a follow-up and also to determine the aetiology of pericardial effusion. Methods. A retrospective study including 120 of 252 consecutive patients punctured. Results. The two most common aetiologies were cardiac surgery (77% valve surgery), followed by malignant disease. The postsurgical effusions became clinically important a median of 12 days after surgery (range 0-56 days). The median survival in the group with malignant disease was 89 days (30-day survival 87%, 1-year survival 10%). Indwelling catheter was used in 93% of the patients. There was no mortality but one patient needed a second pericardiocentesis after an accidental puncture of the right ventricle. Nine patients had rhythm aberrations. Recurring effusion that needed puncture was seen in 8%. Conclusion. Pericardiocentesis guided by 2-D echocardiography is a safe and efficient method to treat pericardial effusion and also valuable as palliative treatment for patients with malignant aetiology of the effusion.

  • 170.
    Lindenberger, Marcus
    et al.
    Linköping University, Faculty of Health Sciences. Linköping University, Department of Medicine and Health Sciences, Physiology .
    Zachrisson, Helene
    Linköping University, Faculty of Health Sciences. Linköping University, Department of Medicine and Health Sciences, Clinical Physiology . Östergötlands Läns Landsting, Heart Centre, Department of Clinical Physiology.
    Neider, Daniel
    Linköping University, Faculty of Health Sciences. Linköping University, Department of Medicine and Health Sciences, Physiology .
    Länne, Toste
    Linköping University, Faculty of Health Sciences. Linköping University, Department of Medicine and Health Sciences, Physiology . Östergötlands Läns Landsting, Heart Centre, Department of Thoracic and Vascular Surgery.
    Venous compliance and wall distensibility in the venous compartments of the lower limb in man2008In: Experimental Biology,2008, 2008Conference paper (Refereed)
    Abstract [en]

      

  • 171.
    Lund, Eva
    et al.
    Linköping University, Faculty of Health Sciences. Linköping University, Department of Medicine and Care, Radio Physics.
    Kendall, Sally
    Linköping University, Faculty of Health Sciences. Linköping University, Department of Neuroscience and Locomotion, Rehabilitation Medicine. Östergötlands Läns Landsting, Centre for Medicine, Pain and Rehabilitation Centre.
    Janerot-Sjöberg, Birgitta
    Linköping University, Faculty of Health Sciences. Linköping University, Department of Medicine and Care, Clinical Physiology. Östergötlands Läns Landsting, Heart Centre, Department of Clinical Physiology.
    Bengtsson, Ann
    Linköping University, Faculty of Health Sciences. Linköping University, Department of Molecular and Clinical Medicine, Rheumatology. Östergötlands Läns Landsting, Centre for Medicine, Department of Rheumatology in Östergötland.
    Muscle metabolism in fibromyalgia studied by P-31 magnetic resonance spectroscopy during aerobic and anaerobic exercise2003In: Scandinavian Journal of Rheumatology, ISSN 0300-9742, E-ISSN 1502-7732, Vol. 32, no 3, p. 138-145Article in journal (Refereed)
    Abstract [en]

    Objective: To investigate mechanisms underlying the reduced work capacity of fibromyalgia (FM) patients were compared to healthy controls at specified workloads, using P-31 magnetic resonance spectroscopy (MRS). Methods: The forearm flexor muscle group was examined with MRS at rest, at sub maximal and at maximal controlled dynamic work as well as at maximal isometric contraction. Aerobic fitness was determined by bicycle ergonometry. Results: Metabolite concentrations and muscle pH were similar for patients and controls at lower workloads. At maximal dynamic and static contractions the concentration of inorganic phosphate was lower and at static contractions the pH decrease was smaller in patients. The performed work by patients was only 50% compared to controls and the patients experienced more pain. Maximal oxygen uptake was lower in the fibromyalgia group. Expired gas-analysis in this group showed ventilatory equivalents at similar relative levels of maximal work capacity. Conclusion: Fibromyalgia patients seem to utilise less of the energy rich phosphorous metabolites at maximal work despite pH reduction. They seemed to be less aerobic fitted and reached the anaerobic threshold earlier than the controls.

  • 172.
    Lönn, Urban
    et al.
    Thoraxklin Universitetssjukhuset, Linköping.
    Wulff, J
    Keck, K-Y
    Wranne, Bengt
    Linköping University, Faculty of Health Sciences. Linköping University, Department of Medicine and Care, Clinical Physiology. Östergötlands Läns Landsting, Heart Centre, Department of Clinical Physiology.
    Ask, Per
    Linköping University, The Institute of Technology. Linköping University, Department of Biomedical Engineering, Physiological Measurements.
    Peterzén, Bengt
    Linköping University, Faculty of Health Sciences. Linköping University, Department of Medicine and Care, Anaesthesiology. Östergötlands Läns Landsting, Anaesthesiology and Surgical Centre, Department of Intensive Care UHL.
    Ahn, Henrik Casimir
    Linköping University, Faculty of Health Sciences. Linköping University, Department of Medicine and Care, Thoracic Surgery. Östergötlands Läns Landsting, Heart Centre, Department of Thoracic and Vascular Surgery.
    Flow characteristics of the hemopump: An experimental in Vitro study1997In: Annals of Thoracic Surgery, ISSN 0003-4975, E-ISSN 1552-6259, Vol. 63, no 1, p. 162-166Article in journal (Refereed)
  • 173.
    Madler, C.F.
    et al.
    Mädler, C.F., Univ. of Wales College of Medicine, Cardiff, United Kingdom.
    Payne, N.
    Univ. of Wales College of Medicine, Cardiff, United Kingdom.
    Wilkenshoff, U.
    Univ. Hospital Benjamin Franklin, Berlin, Germany.
    Cohen, A.
    Hôpital Saint Antoine, Paris, France.
    Derumeaux, G.A.
    Hôpital Charles Nicolle, Rouen, France.
    Pierard, L.A.
    Piérard, L.A., University Hospital Sart Tilman, Liège, Belgium.
    Engvall, Jan
    Linköping University, Faculty of Health Sciences. Linköping University, Department of Medicine and Health Sciences, Clinical Physiology . Östergötlands Läns Landsting, Heart Centre, Department of Clinical Physiology.
    Brodin, L.-A.
    Brodin, L.-Å., Huddinge University Hospital, Stockholm, Sweden.
    Sutherland, G.R.
    Fraser, A.G.
    Univ. of Wales College of Medicine, Cardiff, United Kingdom, Wales Heart Research Institute, Univ. of Wales College of Medicine, Heath Park, Cardiff CF14 4XN, United Kingdom.
    Non-invasive diagnosis of coronary artery disease by quantitative stress echocardiography: Optimal diagnostic models using off-line tissue Doppler in the MYDISE study2003In: European Heart Journal, ISSN 0195-668X, E-ISSN 1522-9645, Vol. 24, no 17, p. 1584-1594Article in journal (Refereed)
    Abstract [en]

    Aims: To develop optimal methods for the objective non-invasive diagnosis of coronary artery disease, using myocardial Doppler velocities during dobutamine stress echocardiography. Methods and results: We acquired tissue Doppler digital data during dobutamine stress in 289 subjects, and measured myocardial responses by off-line analysis of 11 left ventricular segments. Diagnostic criteria developed by comparing 92 normal subjects with 48 patients with coronary disease were refined in a prospective series of 149 patients referred with chest pain. Optimal diagnostic accuracy was achieved by logistic regression models, using systolic velocities at maximal stress in 7 myocardial segments, adjusting for independent correlations directly with heart rate and inversely with age and female gender (all p<0.001). Best cut-points from receiveroperator curves diagnosed left anterior descending, circumflex and right coronary disease with sensitivities and specificities of 80% and 80%, 91% and 80%, and 93% and 82%, respectively. All models performed better than velocity cut-offs alone (p<0.001). Conclusion: Non-invasive diagnosis of coronary artery disease by quantitative stress echocardiography is best performed using diagnostic models based on segmental velocities at peak stress and adjusting for heart rate, and gender or age. © 2003 Published by Elsevier Ltd on behalf of The European Society of Cardiology.

  • 174.
    Malmgren, Maine
    et al.
    Linköping University, Faculty of Health Sciences. Linköping University, Department of Medicine and Care, Clinical Physiology. Östergötlands Läns Landsting, Heart Centre, Department of Clinical Physiology.
    Hellerström, Sabine
    Linköping University, Faculty of Health Sciences. Linköping University, Department of Medicine and Care, Clinical Physiology. Östergötlands Läns Landsting, Heart Centre, Department of Clinical Physiology.
    Ekberg, Stefan
    Linköping University, Faculty of Health Sciences. Linköping University, Department of Medicine and Care, Radio Physics. Östergötlands Läns Landsting, Centre of Surgery and Oncology, Department of Radiation Physics.
    Gustafsson, A
    Linköping University, Faculty of Health Sciences. Linköping University, Department of Medicine and Care, Radio Physics. Östergötlands Läns Landsting, Centre of Surgery and Oncology, Department of Radiation Physics.
    Practical aspects on patient handling in 18F.FDG studies with dual-head coincidence gamma camera.2000In: Congress of the European Association of Nuclear Medicine, Paris 2000.,2000, 2000Conference paper (Refereed)
  • 175. Malmström, M
    et al.
    Ahlner, Johan
    Linköping University, Faculty of Health Sciences. Linköping University, Department of Medicine and Care, Clinical Pharmacology.
    Carlsson, C
    Schmekel, Birgitta
    Linköping University, Faculty of Health Sciences. Linköping University, Department of Medicine and Care, Clinical Physiology. Östergötlands Läns Landsting, Heart Centre, Department of Clinical Physiology.
    No effect of chinese acupuncture on isocapnic hyperventilation with cold air in asthmatics, measured with impulse oscillometry.2002In: Acupuncture in Medicine, ISSN 0964-5284, Vol. 20, p. 66-73Article in journal (Refereed)
  • 176.
    Maret, Eva
    et al.
    Linköping University, Department of Medicine and Health Sciences. Linköping University, Faculty of Health Sciences.
    Brudin, Lars
    Linköping University, Department of Medicine and Health Sciences. Linköping University, Faculty of Health Sciences.
    Janzon, Magnus
    Linköping University, Faculty of Health Sciences. Linköping University, Department of Medicine and Health Sciences, Cardiology . Östergötlands Läns Landsting, Heart Centre, Department of Cardiology.
    Ohlsson, J
    Linköping University, Department of Medicine and Health Sciences. Linköping University, Faculty of Health Sciences.
    Engvall, Jan
    Linköping University, Department of Medicine and Health Sciences, Clinical Physiology . Linköping University, Faculty of Health Sciences. Östergötlands Läns Landsting, Heart Centre, Department of Clinical Physiology.
    High sensitivity and specificity for detecting transmural infarction with a feature tracking software on cine MRI.2009In: ESC Barcelona 2009, 2009Conference paper (Refereed)
  • 177.
    Maret, Eva
    et al.
    Linköping University, Department of Medicine and Health Sciences, Clinical Physiology . Linköping University, Faculty of Health Sciences.
    Brudin, Lars
    Linköping University, Department of Medicine and Health Sciences, Clinical Physiology . Linköping University, Faculty of Health Sciences.
    Lindström, Lena
    Linköping University, Department of Medicine and Health Sciences, Clinical Physiology . Linköping University, Faculty of Health Sciences.
    Nylander, Eva
    Linköping University, Department of Medicine and Health Sciences, Clinical Physiology . Linköping University, Faculty of Health Sciences. Östergötlands Läns Landsting, Heart Centre, Department of Clinical Physiology.
    Ohlsson, Jan L
    Ryhov City Hospital, Jönköping, Sweden.
    Engvall, Jan
    Linköping University, Department of Medicine and Health Sciences, Clinical Physiology . Linköping University, Faculty of Health Sciences. Östergötlands Läns Landsting, Heart Centre, Department of Clinical Physiology.
    Computer-assisted determination of left ventricular endocardial borders reduces variability in the echocardiographic assessment of ejection fraction2008In: Cardiovascular Ultrasound, ISSN 1476-7120, E-ISSN 1476-7120, Vol. 6, no 55Article in journal (Refereed)
    Abstract [en]

    Background: Left ventricular size and function are important prognostic factors in heart disease. Their measurement is the most frequent reason for sending patients to the echo lab. These measurements have important implications for therapy but are sensitive to the skill of the operator. Earlier automated echo-based methods have not become widely used. The aim of our study was to evaluate an automatic echocardiographic method (with manual correction if needed) for determining left ventricular ejection fraction (LVEF) based on an active appearance model of the left ventricle (syngo (R) AutoEF, Siemens Medical Solutions). Comparisons were made with manual planimetry (manual Simpson), visual assessment and automatically determined LVEF from quantitative myocardial gated single photon emission computed tomography (SPECT).

    Methods: 60 consecutive patients referred for myocardial perfusion imaging (MPI) were included in the study. Two-dimensional echocardiography was performed within one hour of MPI at rest. Image quality did not constitute an exclusion criterion. Analysis was performed by five experienced observers and by two novices.

    Results: LVEF (%), end-diastolic and end-systolic volume/BSA (ml/m(2)) were for uncorrected AutoEF 54 +/- 10, 51 +/- 16, 24 +/- 13, for corrected AutoEF 53 +/- 10, 53 +/- 18, 26 +/- 14, for manual Simpson 51 +/- 11, 56 +/- 20, 28 +/- 15, and for MPI 52 +/- 12, 67 +/- 26, 35 +/- 23. The required time for analysis was significantly different for all four echocardiographic methods and was for uncorrected AutoEF 79 +/- 5 s, for corrected AutoEF 159 +/- 46 s, for manual Simpson 177 +/- 66 s, and for visual assessment 33 +/- 14 s. Compared with the expert manual Simpson, limits of agreement for novice corrected AutoEF was lower than for novice manual Simpson (0.8 +/- 10.5 vs. -3.2 +/- 11.4 LVEF percentage points). Calculated for experts and with LVEF (%) categorized into < 30, 30-44, 45-54 and >= 55, kappa measure of agreement was moderate (0.44-0.53) for all method comparisons (uncorrected AutoEF not evaluated).

    Conclusion: Corrected AutoEF reduces the variation in measurements compared with manual planimetry, without increasing the time required. The method seems especially suited for unexperienced readers.

  • 178.
    Maret, Eva
    et al.
    Linköping University, Department of Medicine and Health Sciences, Clinical Physiology . Linköping University, Faculty of Health Sciences.
    Tödt, Tim
    Linköping University, Department of Medicine and Health Sciences. Linköping University, Faculty of Health Sciences.
    Brudin, Lars
    Linköping University, Department of Medicine and Health Sciences, Clinical Physiology . Linköping University, Faculty of Health Sciences.
    Nylander, Eva
    Linköping University, Department of Medicine and Health Sciences, Clinical Physiology . Linköping University, Faculty of Health Sciences. Östergötlands Läns Landsting, Heart Centre, Department of Clinical Physiology.
    Swahn, Eva
    Linköping University, Department of Medicine and Health Sciences, Cardiology . Linköping University, Faculty of Health Sciences. Östergötlands Läns Landsting, Heart Centre, Department of Cardiology.
    Ohlsson, Jan
    Department of Clinical Physiology, Ryhov County Hospital, SE-55185 Jönköping, Sweden.
    Engvall, Jan
    Linköping University, Department of Medicine and Health Sciences, Clinical Physiology . Linköping University, Faculty of Health Sciences. Östergötlands Läns Landsting, Heart Centre, Department of Clinical Physiology.
    Feature tracking of cine-MRI identifies left ventricular segments with myocardial scarManuscript (preprint) (Other academic)
    Abstract [en]

    Background: The aim of the study was to apply a new feature tracking software (Diogenes MRI, Tomtec GmbH, Unterschliessheim, Germany) on cine-MR images to evaluate its utility and ability to detect infarcted myocardium and to assess the transmural extent of scar without the need for administering intravenous gadolinium-based contrast agents.

    Methods: Thirty patients (3 women and 27 men) were selected based on the presence or absence of extensive myocardial scar in the perfusion area of the left anterior descending coronary artery (LAD) but not in remote areas. Seventeen had a scar transmurality >75% in at least one segment belonging to the LAD area (scar patients) and thirteen had scar <1% in this area or in other parts of the myocardium (non-scar patients). The software tracked the motion of the wall through the entire cardiac cycle using two different techniques. Velocity, displacement and strain were calculated in 48 points in the longitudinal direction, tangential to the endocardial outline, and in the radial direction, perpendicular to the tangent.

    Results: In the scar patients, LAD segments showed lower functional measures than remote segments. The remote segments in the scar group showed, in turn, lower functional measures than the remote segments in the non-scar group. Receiver-operatorcharacteristic (ROC) curves were constructed for all measurements. Best area-undercurve was for radial strain, 0.89, where a cut-off value of 38.8% had 80% sensitivity and 86% specificity for the detection of a segment with scar transmurality >50% in the LAD distribution. As a percentage of the mean, intraobserver variability was for radial measures 16-14-26% for displacement-velocity-strain and for the corresponding interobserver measurements 13-12-18%.

    Conclusions: With the presented method, we show for the first time its ability to detect scar segments with various transmurality already from an analysis of cine-MRI, without the need for the administration of gadolinium-based contrast. The accuracy and repeatability of the radial functional measurements is satisfactory and global measures agree with other aspects of global left ventricular function.

  • 179.
    Maret, Eva
    et al.
    Linköping University, Department of Biomedical Engineering, Center for Medical Image Science and Visualization. Linköping University, Department of Medical and Health Sciences. Linköping University, Faculty of Health Sciences.
    Tödt, Tim
    Linköping University, Department of Medical and Health Sciences, Cardiology. Östergötlands Läns Landsting, Heart Centre, Department of Cardiology. Linköping University, Faculty of Health Sciences.
    Brudin, Lars
    Linköping University, Department of Medical and Health Sciences. Linköping University, Faculty of Health Sciences.
    Nylander, Eva
    Linköping University, Department of Medical and Health Sciences, Physiology. Östergötlands Läns Landsting, Heart Centre, Department of Clinical Physiology. Linköping University, Faculty of Health Sciences.
    Swahn, Eva
    Östergötlands Läns Landsting, Heart Centre, Department of Cardiology. Linköping University, Department of Medical and Health Sciences, Cardiology. Linköping University, Faculty of Health Sciences.
    Ohlsson, Jan
    Linköping University, Department of Medical and Health Sciences, Division of Cardiovascular Medicine. Linköping University, Faculty of Health Sciences.
    Engvall, Jan
    Linköping University, Department of Medical and Health Sciences, Clinical Physiology. Östergötlands Läns Landsting, Heart Centre, Department of Clinical Physiology. Linköping University, Faculty of Health Sciences.
    Functional measurements based on feature tracking of cine magnetic resonance images identify left ventricular segments with myocardial scar.2009In: Cardiovascular Ultrasound, ISSN 1476-7120, E-ISSN 1476-7120, Vol. 7, no 53, p. 1-14Article in journal (Refereed)
    Abstract [en]

    Background

    The aim of the study was to perform a feature tracking analysis on cine magnetic resonance (MR) images to elucidate if functional measurements of the motion of the left ventricular wall may detect scar defined with gadolinium enhanced MR.

    Myocardial contraction can be measured in terms of the velocity, displacement and local deformation (strain) of a particular myocardial segment. Contraction of the myocardial wall will be reduced in the presence of scar and as a consequence of reduced myocardial blood flow.

    Methods

    Thirty patients (3 women and 27 men) were selected based on the presence or absence of extensive scar in the anteroseptal area of the left ventricle. The patients were investigated in stable clinical condition, 4-8 weeks post ST-elevation myocardial infarction treated with percutaneous coronary intervention. Seventeen had a scar area >75% in at least one anteroseptal segment (scar) and thirteen had scar area <1% (non-scar). Velocity, displacement and strain were calculated in the longitudinal direction, tangential to the endocardial outline, and in the radial direction, perpendicular to the tangent.

    Results

    In the scar patients, segments with scar showed lower functional measurements than remote segments. Radial measurements of velocity, displacement and strain performed better in terms of receiver-operator-characteristic curves (ROC) than the corresponding longitudinal measurements. The best area-under-curve was for radial strain, 0.89, where a cut-off value of 38.8% had 80% sensitivity and 86% specificity for the detection of a segment with scar area >50%. As a percentage of the mean, intraobserver variability was 16-14-26% for radial measurements of displacement-velocity-strain and corresponding interobserver variability was 13-12-18%.

    Conclusion

    Feature tracking analysis of cine-MR displays velocity, displacement and strain in the radial and longitudinal direction and may be used for the detection of transmural scar. The accuracy and repeatability of the radial functional measurements is satisfactory and global measures agree.

  • 180. Markowski, Piotr
    et al.
    Baranowska, Irena
    Baranowski, Jacek
    Linköping University, Faculty of Health Sciences. Linköping University, Department of Medicine and Care, Physiology. Östergötlands Läns Landsting, Heart Centre, Department of Clinical Physiology.
    Simultaneous determination of l-arginine and 12 molecules participating in its metabolic cycle by gradient RP-HPLC method. Application to human urine samples2007In: Analytica Chimica Acta, ISSN 0003-2670, E-ISSN 1873-4324, Vol. 605, no 2, p. 205-217Article in journal (Refereed)
    Abstract [en]

    We have developed and described a highly sensitive, accurate and precise reversed-phase high-performance liquid chromatography (RP-HPLC) method for the simultaneous determination of l-arginine and 12 molecules participating in its metabolic cycle in human urine samples. After pre-column derivatization with ortho-phthaldialdehyde (OPA) reagent containing 3-mercaptopropionic acid (3MPA), the fluorescent derivatives were separated by a gradient elution and detected by fluorescence measurement at 338 nm (excitation) and 455 nm (emission). l-Arginine (ARG) and its metabolites: l-glutamine (GLN), NG-hydroxy-l-arginine (NOHA), l-citrulline (CIT), NG-monomethyl-l-arginine (NMMA), l-homoarginine (HARG), asymmetric NG,NG-dimethyl-l-arginine (ADMA), symmetric NG,NG′-dimethyl-l-arginine (SDMA), l-ornithine (ORN), putrescine (PUT), agmatine (AGM), spermidine (SPERMD) and spermine (SPERM) were extracted in a cation-exchange solid-phase extraction (SPE) column and after derivatization separated in a Purospher® STAR RP-18e analytical column. The calibration curves of analysed compounds are linear within the range of concentration: 45-825, 0.2-15, 16-225, 12-285, 0.1-32, 15-235, 0.1-12, 0.1-12, 10-205, 0.02-12, 0.1-24, 0.01-10 and 0.01-8 nmol mL-1 for GLN, NOHA, CIT, ARG, NMMA, HARG, ADMA, SDMA, ORN, PUT, AGM, SPERMD and SPERM, respectively. The correlation coefficients are greater than 0.9980. Coefficients of variation are not higher than 6.0% for inter-day precision. The method has been determined or tested for limits of detection and quantification, linearity, precision, accuracy and recovery. All detection parameters of the method demonstrate that it is a reliable and efficient means of the comprehensive determination of ARG and its 12 main metabolites, making this approach suitable for routine clinical applications. The levels of analysed compounds in human urine can be successfully determined using this developed method with no matrix effect. © 2007 Elsevier B.V. All rights reserved.

  • 181.
    Naidu Sjöswärd, Kerstin
    et al.
    Linköping University, Department of Medicine and Care. Linköping University, Faculty of Health Sciences.
    Uppugunduri, Srinivas
    Linköping University, Department of Medicine and Care. Linköping University, Faculty of Health Sciences.
    Schmekel, Birgitta
    Linköping University, Department of Medicine and Care, Clinical Physiology. Linköping University, Faculty of Health Sciences. Östergötlands Läns Landsting, Heart Centre, Department of Clinical Physiology.
    Decreased serum levels of P-selectin and eosinophil cationic protein in patients with mild asthma after inhaled salbutamol2004In: Respiration, ISSN 0025-7931, E-ISSN 1423-0356, Vol. 71, no 3, p. 241-245Article in journal (Refereed)
    Abstract [en]

    Background: Asthma is a chronic inflammatory disease of the airways associated with selective recruitment of activated eosinophils. P-selectin, a cell adhesion molecule, may be an important controller of the inflammation by mediating selective eosinophil cell influx to the lung. Serum levels of eosinophil cationic protein (ECP) have been used as a marker of eosinophil inflammation, and indirectly as a marker of disease activity of asthma. ECP levels may not be elevated in some patients with asthma, and this fact prompted us to search for additional surrogate markers for monitoring disease activity in asthma. Objectives: To evaluate whether repeated inhalations of salbutamol, a ß-2-receptor agonist used for bronchodilation, would lead to reduced serum levels of P-selectin and/or ECP. Methods: Fourteen patients with asymptomatic mild stable asthma were enrolled into a randomised crossover study. Salbutamol was inhaled three times every 3 h. Blood was sampled 4 h after the last inhalation. Nine non-treated healthy volunteers served as control subjects. Serum ECP and P-selectin levels were measured using radioimmunoassay and ELISA, respectively. Results: P-selectin and ECP levels in serum obtained from asymptomatic asthmatics were close to those of the volunteers, and inter-day variability tended to be lower for levels of P-selectin than for ECP. Significant decreases of P-selectin (p = 0.01) and ECP (p = 0.03) were recorded after salbutamol inhalation. There was no association between the changes in ECP and P-selectin levels in serum. Conclusions: We conclude that decreases in P-selectin and ECP may have different kinetics, suggesting different pathways of action of salbutamol. We judge that P-selectin may be used as a sensitive marker in mild asthma. Copyright © 2004 S. Karger AG, Basel.

  • 182.
    Naidu-Sjöswärd, Kerstin
    et al.
    Linköping University, Faculty of Health Sciences. Linköping University, Department of Medicine and Care, Anaesthesiology. Östergötlands Läns Landsting, Anaesthesiology and Surgical Centre, Department of Intensive Care UHL.
    Mounira, H
    Davidsson, Anette
    Linköping University, Faculty of Health Sciences. Linköping University, Department of Medicine and Care, Clinical Physiology. Östergötlands Läns Landsting, Heart Centre, Department of Clinical Physiology.
    Söderkvist, Peter
    Linköping University, Faculty of Health Sciences. Linköping University, Department of Biomedicine and Surgery, Division of cell biology.
    Schmekel, Birgitta
    Linköping University, Faculty of Health Sciences. Linköping University, Department of Medicine and Care, Clinical Physiology. Östergötlands Läns Landsting, Heart Centre, Department of Clinical Physiology.
    Single-isomer R-salbutamol is not superior to racemate regarding protection for bronchial hyperresponsiveness2004In: Respiratory Medicine, ISSN 0954-6111, E-ISSN 1532-3064, Vol. 98, no 10, p. 990-Article in journal (Refereed)
    Abstract [en]

    Bronchial hyper-reactivity (BHR) has been suggested to follow cessation of regular medication with racemic salbutamol. This study aimed at investigating the effects from medication with R,S- and R-salbutamol on bronchial response to provocation with isocapnic hyperventilation of cold air (IHCA). Twenty-six patients with mild to moderate asthma were enrolled in a double-blind, randomised, cross-over study. Bronchial response to provocation was measured before and after 1 week's medication. Doses of 0.63 mg R-salbutamol or 1.25 mg R/S-salbutamol were inhaled three times daily during medication-weeks and a wash-out week intervened. Tests were performed 6 h after the last dose of test drug. Impulse oscillometry and forced expiratory volume during one second were methods used to identify bronchial response to provocation. Two patients withdrew from the investigation due to side-effects, one from R- the other from R,S-salbutamol. Comparable resting bronchial conditions were indicated by differences in baseline lung function values of <2% between study days. No statistically significant medication-dependent differences in BHR could be demonstrated between treatment groups. However, 15 patients exhibited higher (P=0.03) post-treatment BHR after pure R-salbutamol than after R,S-salbutamol. Furthermore, plasma concentrations of R-salbutamol tended to be lower (P=0.08) after medication with R- than after R,S-salbutamol despite equal doses of R-salbutamol given during the two separate treatment periods. We also found that considerable amounts of S-salbutamol were retrieved in plasma after medication with pure R-salbutamol. We conclude that we were unable to demonstrate favourable effects of R-salbutamol over R,S-salbutamol regarding response to provocation with IHCA after regular medication of 1 week's duration.

  • 183.
    Neider, Daniel
    et al.
    Linköping University, Faculty of Health Sciences. Linköping University, Department of Medicine and Care, Physiology.
    Hallman, Daniel
    Linköping University, Faculty of Health Sciences. Linköping University, Department of Medicine and Care, Physiology.
    Zachrisson, Helene
    Linköping University, Faculty of Health Sciences. Linköping University, Department of Medicine and Care, Clinical Physiology. Östergötlands Läns Landsting, Heart Centre, Department of Clinical Physiology.
    Lindenberger, Marcus
    Linköping University, Faculty of Health Sciences. Linköping University, Department of Medicine and Care, Physiology.
    Länne, Toste
    Linköping University, Faculty of Health Sciences. Linköping University, Department of Medicine and Care, Physiology. Östergötlands Läns Landsting, Heart Centre, Department of Thoracic and Vascular Surgery.
    Venous compliance in the Superficial Femoral Vein and Greater Saphenous Vein in health males.2007In: Kardiovaskulära vårmötet,2007, 2007Conference paper (Other academic)
    Abstract [en]

      

  • 184.
    Nelson, Nina
    et al.
    Linköping University, Faculty of Health Sciences. Linköping University, Department of Molecular and Clinical Medicine, Pediatrics. Östergötlands Läns Landsting, Centre of Paediatrics and Gynecology and Obstetrics, Barn.
    Janerot-Sjöberg, Birgitta
    Linköping University, Faculty of Health Sciences. Linköping University, Department of Medicine and Care, Clinical Physiology. Östergötlands Läns Landsting, Heart Centre, Department of Clinical Physiology.
    Beat-to-beat changes in stroke volume precede the general circulatory effects of mechanical ventilation: A case report2001Article in journal (Refereed)
    Abstract [en]

    Background: The haemodynamic as well as the ventilatory consequences of mechanical ventilation can be harmful in critically ill neonates. Newly developed ventilatory lung protective strategies are not always available immediately and in an acute situation the haemodynamic changes caused by mechanical ventilation can affect the oxygen delivery considerably. We report the case of a male neonate who was treated with conventional pressure-controlled mechanical ventilation because of respiratory distress and progressive respiratory acidosis resulting from meconium aspiration. Because of poor arterial oxygenation despite 100% inspired oxygen and increased ventilator settings, echocardiography was performed to exclude central haemodynamic reasons for low oxygen delivery. Method: Doppler echocardiography was used for the measurement of stroke volume and cardiac output. Pulse oximetry and aortic blood pressure were monitored continuously. Results: Echocardiography revealed no cardiac malformations or signs of persistent fetal circulation. When inspiratory pressures and duration were increased, beat-to-beat variation in stroke volume preceded decay in cardiac output. Stroke volume variations and oxygen saturation values guided ventilator settings until extracorporal membrane oxygenation could be arranged for. After recovery and discharge 4 weeks later the boy is progressing normally. Conclusion: Because oxygen delivery is dependent on both blood flow and arterial oxygen content, measurement of cardiac output as well as left heart oxygen saturation is a useful guide to optimizing oxygen delivery. This case report demonstrates how Doppler echocardiographic monitoring of beat-to-beat changes in stroke volume can be used to detect early negative haemodynamic effects of increased mechanical ventilation settings before cardiac output is affected.

  • 185.
    Nelson, Nina
    et al.
    Linköping University, Faculty of Health Sciences. Linköping University, Department of Molecular and Clinical Medicine, Pediatrics. Östergötlands Läns Landsting, Centre of Paediatrics and Gynecology and Obstetrics, Barn.
    Nylander, Eva
    Linköping University, Faculty of Health Sciences. Linköping University, Department of Medicine and Care, Clinical Physiology. Östergötlands Läns Landsting, Heart Centre, Department of Clinical Physiology.
    Neonatal ventricular hypertrophy without cardiac malformations: A retrospective evaluation of 17 infants2001In: Prenatal and Neonatal Medicine, ISSN 1359-8635, E-ISSN 1473-0774, Vol. 6, no 5, p. 318-322Article in journal (Refereed)
    Abstract [en]

    Cardiac hypertrophy in the neonatal period is usually associated with other congenital defects of the circulatory system. Isolated ventricular hypertrophy can be difficult to evaluate and manage. We present 17 neonates with increased ventricular wall thickness without congenital malformations according to echocardiography during the neonatal period. The echocardiographic findings were defined as either concentric or predominantly septal hypertrophy. Doppler signs of ventricular outflow obstruction were found in six babies. The material consisted of preterm infants with steroid-treated bronchopulmonary dysplasia, metabolic disorders, perinatal infections, hypertrophic cardiomyopathy and babies with no identified underlying disorder. Six out of 17 patients died before the age of 8 months: all three babies with hypertrophic cardiomyopathy, one with toxoplasmosis and two out of four infants with steroid-treated bronchopulmonary dysplasia. It was not possible to predict the outcome from the initial clinical examination or from the first echocardiographic investigation. Ventricular wall thickness and outflow obstruction may undergo significant and rapid changes, and thus we recommend repeated echocardiographic examinations.

  • 186.
    Nguyen, Patricia K.
    et al.
    Stanford Univ, Dept Med, Div Cardiovasc Med, Stanford, CA 94305 USA.
    Meyer, Craig
    Univ Virginia, Dept Biomed Engn, Charlottesville, VA 22903 USA.
    Engvall, Jan
    Linköping University, Faculty of Health Sciences. Linköping University, Department of Medicine and Health Sciences, Clinical Physiology . Östergötlands Läns Landsting, Heart Centre, Department of Clinical Physiology.
    Yang, Phillip
    Stanford Univ, Dept Med, Div Cardiovasc Med, Stanford, CA 94305 USA.
    McConnell, Michael V.
    Stanford Univ, Dept Med, Div Cardiovasc Med, Stanford, CA 94305 USA.
    Noninvasive assessment of coronary vasodilation using cardiovascular magnetic resonance in patients at high risk for coronary artery disease2008In: Journal of Cardiovascular Magnetic Resonance, ISSN 1097-6647, E-ISSN 1532-429X, Vol. 10Article in journal (Refereed)
    Abstract [en]

    Background: Impaired coronary vasodilation to both endothelial-dependent and endothelial-independent stimuli have been associated with atherosclerosis. Direct measurement of coronary vasodilation using x-ray angiography or intravascular ultrasound is invasive and, thus, not appropriate for asymptomatic patients or for serial follow-up. In this study, high-resolution coronary cardiovascular magnetic resonance (CMR) was used to investigate the vasodilatory response to nitroglycerine (NTG) of asymptomatic patients at high risk for CAD. Methods: A total of 46 asymptomatic subjects were studied: 13 high-risk patients [8 with diabetes mellitus (DM), 5 with end stage renal disease (ESRD)] and 33 age-matched controls. Long-axis and cross-sectional coronary artery images were acquired pre-and 5 minutes post-sublingual NTG using a sub-mm-resolution multi-slice spiral coronary CMR sequence. Coronary cross sectional area (CSA) was measured on pre-and post-NTG images and % coronary vasodilation was calculated. Results: Patients with DM and ESRD had impaired coronary vasodilation to NTG compared to age-matched controls (17.8 +/- 7.3% vs. 25.6 +/- 7.1%, p = 0.002). This remained significant for ESRD patients alone (14.8 +/- 7.7% vs. 25.6 +/- 7.1%, p = 0.003) and for DM patients alone (19.8 +/- 6.3% vs. 25.6 +/- 7.1%, p = 0.049), with a non-significant trend toward greater impairment in the ESRD vs. DM patients (14.8 +/- 7.7% vs. 19.8 +/- 6.3%, p = 0.23). Conclusion: Noninvasive coronary CMR demonstrates impairment of coronary vasodilation to NTG in high-risk patients with DM and ESRD. This may provide a functional indicator of subclinical atherosclerosis and warrants clinical follow up to determine prognostic significance.

  • 187. Nguyen, TC
    et al.
    Carlhäll, Carljohan
    Linköping University, Faculty of Health Sciences. Linköping University, Department of Medicine and Care, Clinical Physiology. Östergötlands Läns Landsting, Heart Centre, Department of Clinical Physiology.
    Itoh, A
    Oakes, RA
    Ennis, DB
    Boothe, W
    Liang, D
    Daughters, GT
    Ingels, NB
    Miller, DC
    Alterations in transmural myocardial strain: an early marker of left ventricular dysfunction in mitral regurgitation?2007In: Circulation,2007, 2007Conference paper (Refereed)
    Abstract [en]

      116: II-368 

  • 188.
    Nguyen, Tom c.
    et al.
    Stanford University.
    Itoh, Akinobu
    Stanford University.
    Carlhäll, Carljohan
    Linköping University, Faculty of Health Sciences. Linköping University, Department of Medicine and Health Sciences, Clinical Physiology . Östergötlands Läns Landsting, Heart Centre, Department of Clinical Physiology.
    Bothe, Wolfgang
    Stanford University.
    Timek, Tomasz A
    Stanford University.
    Ennis, Daniel B
    Stanford University.
    Oakes, Robert A
    Stanford University.
    Liang, David
    Stanford University.
    Daughters, George T.
    Stanford University.
    Ingels, Neil B
    Stanford University.
    Miller, D. Craig
    Stanford University.
    The effect of pure mitral regurgitation on mitral annular geometry and three-dimensional saddle shape2008In: Journal of Thoracic and Cardiovascular Surgery, ISSN 0022-5223, E-ISSN 1097-685X, Vol. 136, no 3, p. 557-565Article in journal (Refereed)
    Abstract [en]

    Objective: Chronic ischemic mitral regurgitation is associated with mitral annular dilatation in the septal-lateral dimension and flattening of the annular 3-dimensional saddle shape. To examine whether these perturbations are caused by the ischemic insult, mitral regurgitation, or both, we investigated the effects of pure mitral regurgitation (low pressure volume overload) on annular geometry and shape. Methods: Eight radiopaque markers were sutured evenly around the mitral annulus in sheep randomized to control (CTRL, n = 8) or experimental (HOLE, n = 12) groups. In HOLE, a 3.5- to 4.8-mm hole was punched in the posterior leaflet to generate pure mitral regurgitation. Four-dimensional marker coordinates were obtained radiographically 1 and 12 weeks postoperatively. Mitral annular area, annular septal-lateral and commissure-commissure dimensions, and annular height were calculated every 16.7 ms. Results: Mitral regurgitation grade was 0.4 ± 0.4 in CTRL and 3.0 ± 0.8 in HOLE (P < .001) at 12 weeks. End-diastolic left ventricular volume index was greater in HOLE at both 1 and 12 weeks, end-systolic volume index was larger in HOLE at 12 weeks. Mitral annular area increased in HOLE predominantly in the commissure-commissure dimension, with no difference in annular height between HOLE versus CTRL at 1 or 12 weeks, respectively. Conclusion: In contrast with annular septal-lateral dilatation and flattening of the annular saddle shape observed with chronic ischemic mitral regurgitation, pure mitral regurgitation was associated with commissure-commissure dimension annular dilatation and no change in annular shape. Thus, infarction is a more important determinant of septal-lateral dilatation and annular shape than mitral regurgitation, which reinforces the need for disease-specific designs of annuloplasty rings. © 2008 The American Association for Thoracic Surgery.

  • 189.
    Nielsen, Magnus
    et al.
    Malmö.
    Granerus, Göran
    Linköping University, Faculty of Health Sciences. Linköping University, Department of Medicine and Care, Clinical Physiology. Östergötlands Läns Landsting, Heart Centre, Department of Clinical Physiology.
    Ohlsson, Mattias
    Holst, Holger
    Thorsson, Ola
    Edenbrandt, Lars
    Interpretation of captopril renography using artificial neural networks2005In: Clinical Physiology and Functional Imaging, ISSN 1475-0961, E-ISSN 1475-097X, Vol. 25, no 5, p. 293-296Article in journal (Refereed)
    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.

  • 190.
    Nilsson, Kerstin
    et al.
    Linköping University, Faculty of Health Sciences. Linköping University, Department of Medicine and Care, Clinical Physiology. Östergötlands Läns Landsting, Heart Centre, Department of Clinical Physiology.
    Monryd, Lena
    Linköping University, Faculty of Health Sciences. Linköping University, Department of Medicine and Care, Clinical Physiology. Östergötlands Läns Landsting, Heart Centre, Department of Clinical Physiology.
    Granerus, Göran
    Linköping University, Faculty of Health Sciences. Linköping University, Department of Medicine and Care, Clinical Physiology. Östergötlands Läns Landsting, Heart Centre, Department of Clinical Physiology.
    Kidney depth and determination of realtive renal function2002In: European Journal of Nuclear Medicine,2002, 2002, p. 194-194Conference paper (Refereed)
  • 191. Nilsson, S
    et al.
    Engblom, D
    Karlsson, LG
    Mölstad, S
    Jönköping.
    Nylander, Eva
    Linköping University, Faculty of Health Sciences. Linköping University, Department of Medicine and Care, Clinical Physiology. Östergötlands Läns Landsting, Heart Centre, Department of Clinical Physiology.
    Scheike, M
    Åkerlind, Ingemar
    Linköping University, Faculty of Health Sciences. Linköping University, Department of Department of Health and Society, National Centre for Work and Rehabilitation.
    Örtoft, K
    Bröstsmärta och ischemisk hjärtsjukdom i primärvården2002In: Svenska Läkaresällskapets Riksstämma, Göteborg, 2002,2002, 2002Conference paper (Refereed)
  • 192.
    Nilsson, Staffan
    et al.
    Linköping University, Department of Medicine and Health Sciences. Linköping University, Faculty of Health Sciences. Östergötlands Läns Landsting, Local Health Care Services in the East of Östergötland, East County Primary Health Care.
    Scheike, Morten
    Engblom, David
    Linköping University, Department of Clinical and Experimental Medicine, Cell Biology. Linköping University, Faculty of Health Sciences.
    Karlsson, Lars-Göran
    Mölstad, Sigvard
    Linköping University, Department of Medicine and Health Sciences. Linköping University, Faculty of Health Sciences.
    Åkerlind, Ingemar
    Linköping University, Department of Medicine and Health Sciences, Health and Society. Linköping University, Faculty of Health Sciences. Östergötlands Läns Landsting, Local Health Care Services in the West of Östergötland, Unit of Research and Development in Local Health Care, County of Östergötland.
    Örtoft, Kjell
    Nylander, Eva
    Linköping University, Department of Medicine and Health Sciences, Clinical Physiology . Linköping University, Faculty of Health Sciences. Östergötlands Läns Landsting, Heart Centre, Department of Clinical Physiology.
    Chest pain and ischaemic heart disease in primary care2003In: British Journal of General Practice, ISSN 0960-1643, Vol. 53, no 490, p. 378-382Article in journal (Refereed)
    Abstract [en]

    Background: Chest pain is the main symptom of first presentation with ischaemic heart disease (IHD). Little is known about the incidence of IHD among patients consulting the general practitioner (GP) for chest pain.

    Aims: To estimate the occurrence of IHD among patients consulting for chest pain, to study the results of the bicycle exercise test, and to estimate the incidence of IHD in the population.

    Design of study: Prospective descriptive study.

    Setting: Three primary health centres in south-eastern Sweden

    Method: All patients without a current IHD diagnosis, aged 20 to 79 years, and consulting for a new episode of chest pain, were included consecutively. The outcome was classified as IHD, possible IHD or not IHD, according to the results of a postal questionnaire, an exercise test or hospital care. Data from the hospital registry on patients with a diagnosis of IHD were analysed retrospectively.

    Results: Out of 38 075 GP consultations, 577 (1.5%) were for chest pain. IHD was diagnosed in 41 (8%) of the chest pain patients, in 41 (83%) the diagnosis was excluded, and in 50 (9%) the diagnosis was judged as being uncertain. Even though the diagnostic criteria were strict, the exercise tests led to a diagnostic conclusion in 77% of the cases, most frequently a normal test result. Combining data from primary and hospital care, the yearly incidence of IHD was 6.5 diagnosed per 1000 inhabitants (aged 20 to 79 years old).

    Conclusion: The incidence of a new episode of chest pain bringing the patient to the GP was low. Eight per cent of the patients received an IHD diagnosis, and in 9% further investigation or clinical assessment is needed.

  • 193.
    Norberg Spaak, L
    et al.
    Östergötlands Läns Landsting, RC - Rekonstruktionscentrum, ÖNH - Öron- Näsa- Halskliniken.
    Granerus, Göran
    Linköping University, Faculty of Health Sciences. Linköping University, Department of Medicine and Care, Clinical Physiology. Östergötlands Läns Landsting, Heart Centre, Department of Clinical Physiology.
    Gustafsson, A
    Linköping University, Faculty of Health Sciences. Linköping University, Department of Medicine and Care, Radio Physics. Östergötlands Läns Landsting, Centre of Surgery and Oncology, Department of Radiation Physics.
    XVII World Congress IFOS Cairo, Egypt 2002Preliminary experiences of gamma camera-PET in patients with head and neck or lung cancer2002In: Rapportklass C eller D samt Impactvärde 0,000 sätts om ISSN inte kan uppges.,2002, 2002Conference paper (Refereed)
  • 194.
    Nylander, Eva
    Linköping University, Faculty of Health Sciences. Linköping University, Department of Medicine and Health Sciences. Östergötlands Läns Landsting, Heart Centre, Department of Clinical Physiology.
    Cardiological screening of athletes2007In: Advanced Course in Sports medicine, Epidemiology and Rehabiliation,2007, 2007Conference paper (Other academic)
    Abstract [en]

      

  • 195.
    Nylander, Eva
    Linköping University, Faculty of Health Sciences. Linköping University, Department of Medicine and Care, Clinical Physiology. Östergötlands Läns Landsting, Heart Centre, Department of Clinical Physiology.
    Svenska riktlinjer (Idrottshjärtat och screening - svenska riktlinjer och hur gör vi?)2007In: IX Svenska Kardiovaskulära vårmötet,2007, 2007Conference paper (Other academic)
  • 196.
    Nylander, Eva
    et al.
    Linköping University, Faculty of Health Sciences. Linköping University, Department of Medicine and Care, Clinical Physiology. Östergötlands Läns Landsting, Heart Centre, Department of Clinical Physiology.
    Dahlin, Lars-Göran
    Linköping University, Faculty of Health Sciences. Linköping University, Department of Medicine and Care, Thoracic Surgery. Östergötlands Läns Landsting, Heart Centre, Department of Thoracic and Vascular Surgery.
    Ebeling, C
    Svedjeholm, Rolf
    Linköping University, Faculty of Health Sciences. Linköping University, Department of Medicine and Care, Thoracic Surgery. Östergötlands Läns Landsting, Heart Centre, Department of Thoracic and Vascular Surgery.
    Vektorkardiografi bättre än skalärt EKG för diagnos av perioperativ hjärtinfarkt2000In: Kardiovaskulära dagarna,2000, 2000Conference paper (Other academic)
  • 197.
    Ohlson, Maria
    et al.
    Linköping University, Faculty of Health Sciences. Linköping University, Department of Medicine and Health Sciences. Östergötlands Läns Landsting, Centre of Surgery and Oncology, Department of Radiation Physics.
    Grétarsdóttir, Jakobína
    Sahlgrenska Universitetssjukhuset.
    Olsson, Eva
    Linköping University, Faculty of Health Sciences. Linköping University, Department of Medicine and Health Sciences. Östergötlands Läns Landsting, Heart Centre, Department of Clinical Physiology.
    Johansson, Lena
    Sahlgrenska Universitetssjukhuset.
    Gustafsson, Agneta
    Linköping University, Faculty of Health Sciences. Linköping University, Department of Medicine and Health Sciences. Östergötlands Läns Landsting, Centre of Surgery and Oncology, Department of Radiation Physics.
    Kartläggning av bildkvalitet vid myokardscintifrafi: en nationell studie2008Report (Other academic)
    Abstract [sv]

     www.ssi.se Statens strålsskyddsinstitut Swedish Radiation Protection Authority.

  • 198.
    Olsson, Anna
    et al.
    Linköping University, Faculty of Health Sciences. Linköping University, Department of Medicine and Care, Radiation Physics.
    Davidsson, Anette
    Linköping University, Faculty of Health Sciences. Linköping University, Department of Medicine and Care, Clinical Physiology. Östergötlands Läns Landsting, Heart Centre, Department of Clinical Physiology.
    Pettersson, Håkan
    Linköping University, Faculty of Health Sciences. Linköping University, Department of Medicine and Care, Radiation Physics. Östergötlands Läns Landsting, Centre of Surgery and Oncology, Department of Radiation Physics.
    Gustafsson, Agneta
    Linköping University, Faculty of Health Sciences. Linköping University, Department of Medicine and Care, Radiation Physics. Östergötlands Läns Landsting, Centre of Surgery and Oncology, Department of Radiation Physics.
    Finger doses from handling radioative isotopes at a Nuclear Medicine department2006In: EANM,2006, 2006Conference paper (Other academic)
  • 199.
    Olsson, Anna
    et al.
    Linköping University, Faculty of Health Sciences. Linköping University, Department of Medicine and Care, Radiation Physics.
    Gustafsson, Agneta
    Linköping University, Faculty of Health Sciences. Linköping University, Department of Medicine and Care, Radiation Physics. Östergötlands Läns Landsting, Centre of Surgery and Oncology, Department of Radiation Physics.
    Hellerström, Sabine
    Klinsik Fysiologi HC.
    Granerus, Göran
    Linköping University, Faculty of Health Sciences. Linköping University, Department of Medicine and Care, Clinical Physiology. Östergötlands Läns Landsting, Heart Centre, Department of Clinical Physiology.
    World Federation of Nuclear Medicine and Biology Santiago, Chile, 20022002In: World Federation of Nuclear Medicine and Biology Santiago, Chile 2002,2002, 2002Conference paper (Other academic)
    Abstract [en]

       

  • 200.
    Ostman-Smith, Ingegerd
    et al.
    Gothenburg University.
    Wisten, Aase
    Sunderby Hospital.
    Nylander, Eva
    Linköping University, Department of Medicine and Health Sciences, Clinical Physiology . Linköping University, Faculty of Health Sciences. Östergötlands Läns Landsting, Heart Centre, Department of Clinical Physiology.
    Bratt, Ewa-Lena
    Gothenburg University.
    de-Wahl Granelli, Anne
    Gothenburg University.
    Oulhaj, Abderrahim
    University Oxford.
    Ljungstrom, Erik
    Lund University.
    Electrocardiographic amplitudes: a new risk factor for sudden death in hypertrophic cardiomyopathy2010In: EUROPEAN HEART JOURNAL, ISSN 0195-668X, Vol. 31, no 4, p. 439-449Article in journal (Refereed)
    Abstract [en]

    Assessment of ECG-features as predictors of sudden death in adults with hypertrophic cardiomyopathy (HCM). ECG-amplitude sums were measured in 44 normals, 34 athletes, a hospital-cohort of 87 HCM-patients, and 29 HCM-patients with sudden death or cardiac arrest (HCM-CA). HCM-patients with sudden death or cardiac arrest had substantially higher ECG-amplitudes than the HCM-cohort for limb-lead and 12-lead QRS-amplitude sums, and amplitude-duration products (P = 0.00003-P = 0.000002). Separation of HCM-CA from the HCM-cohort is obtained by limb-lead QRS-amplitude sum andgt;= 7.7 mV (odds ratio 18.8, sensitivity 87%, negative predictive value (NPV) 94%, P andlt; 0.0001), 12-lead amplitude-duration product andgt;= 2.2 mV s (odds ratio 31.0, sensitivity 92%, NPV 97%, P andlt; 0.0001), and limb-lead amplitude-duration product andgt;= 0.70 mV s (odds ratio 31.5, sensitivity 93%, NPV 96%, P andlt; 0.0001). Sensitivity in HCM-patients andlt; 40 years is 90, 100, and 100% for those ECG-variables, respectively. Qualitative analysis showed correlation with cardiac arrest for pathological T-wave-inversion (P = 0.0003), ST-depression (P = 0.0010), and dominant S-wave in V-4 (P = 0.0048). A risk score is proposed; a score andgt;= 6 gives a sensitivity of 85% but a higher positive predictive value than above measures. Optimal separation between HCM-CA andlt; 40 years and athletes is obtained by a risk score andgt;= 6 (odds ratio 345, sensitivity 85%, specificity 100%, P andlt; 0.0001). Twelve-lead ECG is a powerful instrument for risk-stratification in HCM.

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