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  • 251.
    Johansson, Peter
    et al.
    Östergötlands Läns Landsting, Hjärtcentrum, Kardiologiska kliniken. Linköpings universitet, Institutionen för medicin och hälsa, Omvårdnad. Linköpings universitet, Hälsouniversitetet.
    Alehagen, Urban
    Linköpings universitet, Institutionen för medicin och hälsa, Kardiologi. Östergötlands Läns Landsting, Hjärtcentrum, Kardiologiska kliniken. Linköpings universitet, Hälsouniversitetet.
    Svanborg, Eva
    Linköpings universitet, Institutionen för klinisk och experimentell medicin, Klinisk neurofysiologi. Linköpings universitet, Hälsouniversitetet. Östergötlands Läns Landsting, Rekonstruktionscentrum, Neurofysiologiska kliniken US.
    Dahlström, Ulf
    Linköpings universitet, Institutionen för medicin och hälsa, Kardiologi. Linköpings universitet, Hälsouniversitetet. Östergötlands Läns Landsting, Hjärtcentrum, Kardiologiska kliniken.
    Broström, Anders
    Linköpings universitet, Institutionen för medicin och hälsa, Omvårdnad. Östergötlands Läns Landsting, Närsjukvården i centrala Östergötland, Neurologiska kliniken. Linköpings universitet, Hälsouniversitetet.
    Sleep disordered breathing in an elderly community-living population - relationship to cardiac function, insomnia symptoms and daytime sleepiness2009Konferensbidrag (Refereegranskat)
  • 252.
    Johansson, Peter
    et al.
    Linköpings universitet, Institutionen för medicin och hälsa, Kardiologi. Linköpings universitet, Hälsouniversitetet. Östergötlands Läns Landsting, Hjärtcentrum, Kardiologiska kliniken.
    Alehagen, Urban
    Linköpings universitet, Institutionen för medicin och hälsa, Kardiologi. Linköpings universitet, Hälsouniversitetet. Östergötlands Läns Landsting, Hjärtcentrum, Kardiologiska kliniken.
    Svanborg, Eva
    Linköpings universitet, Institutionen för klinisk och experimentell medicin, Klinisk neurofysiologi. Linköpings universitet, Hälsouniversitetet. Östergötlands Läns Landsting, Rekonstruktionscentrum, Neurofysiologiska kliniken US.
    Dahlström, Ulf
    Linköpings universitet, Institutionen för medicin och hälsa, Kardiologi. Linköpings universitet, Hälsouniversitetet. Östergötlands Läns Landsting, Hjärtcentrum, Kardiologiska kliniken.
    Broström, Anders
    Linköpings universitet, Institutionen för medicin och hälsa, Omvårdnad. Linköpings universitet, Hälsouniversitetet.
    Sleep disordered breathing in an elderly community-living population: Relationship to cardiac function, insomnia symptoms and daytime sleepiness2009Ingår i: Sleep Medicine, ISSN 1389-9457, E-ISSN 1878-5506, Vol. 10, nr 9, s. 1005-1011Artikel i tidskrift (Refereegranskat)
    Abstract [en]

    Introduction: The relationship between sleep disordered breathing (SDB), systolic function/heart failure in elderly people living in community has not been investigated, nor has insomnia and excessive daytime sleepiness (EDS).

    Aim: To describe the prevalence of SDB and its relationship to systolic function, the different insomnia symptoms as well as EDS.

    Method: 331 subjects (71-87 years) underwent echocardiographic examinations and sleep respiratory recordings. Questionnaires were used to evaluate insomnia symptoms and EDS.

    Results: Mild SDB (AHI 5-15), was found in 32%. Moderate SDB (AHI 15-30) occurred in 16%, and 7% had severe SDB (AHI >30). Median AHI was significantly higher (p<0.001) in those with mild impaired systolic function (AHI 11.7) and moderate impaired systolic function (AHI 10.9) compared to those with normal systolic function (AHI 5.0). Mild and moderate impaired systolic function was also independently associated to SDB as indicated by an AHI≥10. Concerning insomnia symptoms and EDS, only difficulties in initiating sleep correlated significantly (p<0.05) with AHI.

    Conclusion: SDB is common among the elderly and may be related to impaired systolic function/heart failure. However, detection of SDB in such population may be problematic since insomnia symptoms and EDS correlated poorly with SDB.

  • 253.
    Johansson, Peter
    et al.
    Linköpings universitet, Institutionen för medicin och hälsa, Kardiologi. Linköpings universitet, Hälsouniversitetet. Östergötlands Läns Landsting, Hjärtcentrum, Kardiologiska kliniken.
    Arestedt, Kristoffer
    University of Kalmar.
    Alehagen, Urban
    Linköpings universitet, Institutionen för medicin och hälsa, Kardiologi. Linköpings universitet, Hälsouniversitetet. Östergötlands Läns Landsting, Hjärtcentrum, Kardiologiska kliniken.
    Svanborg, Eva
    Linköpings universitet, Institutionen för klinisk och experimentell medicin, Klinisk neurofysiologi. Linköpings universitet, Hälsouniversitetet. Östergötlands Läns Landsting, Rekonstruktionscentrum, Neurofysiologiska kliniken US.
    Dahlström, Ulf
    Linköpings universitet, Institutionen för medicin och hälsa, Kardiologi. Linköpings universitet, Hälsouniversitetet. Östergötlands Läns Landsting, Hjärtcentrum, Kardiologiska kliniken.
    Broström, Anders
    Linköpings universitet, Institutionen för medicin och hälsa, Omvårdnad. Linköpings universitet, Hälsouniversitetet.
    Sleep disordered breathing, insomnia, and health related quality of life - A comparison between age and gender matched elderly with heart failure or without cardiovascular disease2010Ingår i: European Journal of Cardiovascular Nursing, ISSN 1474-5151, E-ISSN 1873-1953, Vol. 9, nr 2, s. 108-117Artikel i tidskrift (Refereegranskat)
    Abstract [en]

    Aims: The aims of this study are (I) to compare the prevalence of sleep disordered breathing (SDB) and insomnia between elderly with heart failure (HF) and age and gender matched elderly without cardiovascular disease (CVD), and (II) to examine the association between HF, SDB and insomnia, as well as their impact on health related quality of life (Hr-QoL). Methods: Three hundred and thirty-one elderly (71-87 years) community-living individuals underwent sleep recordings and echocardiography. Questionnaires assessed insomnia and Hr-QoL. Comparisons were made between age and gender matched individuals with HF (n=36) and without CVD (n=36). Results: The HF group had higher mean apnoea-hypopnoea index (17.6 vs. 6.3, pless than0.001). Moderate/severe SDB was found in 42% of those with HF vs. 8% in those without CVD (p=0.001). Those with HF had more difficulties maintaining sleep (DMS) (72% vs. 50%, p=0.05) and excessive daytime sleepiness (EDS) (25% vs. 8%, p=0.05) and scored worse Hr-QoL in five of eight SF-36 domains. In regression analysis SDB had no association to Hr-QoL. DMS associated to the physical-, and non restorative sleep to the mental domain of Hr-QoL. SDB had no correlations to insomnia or EDS. Conclusions: SDB, DMS and EDS are more common in elderly with HF. SDB is not an obvious cause for sleep complaints or poor Hr-QoL in elderly.

  • 254.
    Johansson, Peter
    et al.
    Linköpings universitet, Institutionen för medicin och hälsa, Kardiologi. Linköpings universitet, Hälsouniversitetet. Östergötlands Läns Landsting, Hjärtcentrum, Kardiologiska kliniken.
    Broström, Anders
    Linköpings universitet, Institutionen för medicin och hälsa, Omvårdnad. Linköpings universitet, Hälsouniversitetet.
    Sleep disturbances - A significant problem for cardiovascular nurses in practice and/or research?2010Ingår i: European Journal of Cardiovascular Nursing, ISSN 1474-5151, E-ISSN 1873-1953, Vol. 9, nr 2, s. 75-76Artikel i tidskrift (Övrigt vetenskapligt)
  • 255.
    Johansson, Peter
    et al.
    Linköpings universitet, Hälsouniversitetet. Linköpings universitet, Institutionen för medicin och vård, Kardiologi. Östergötlands Läns Landsting, Hjärtcentrum, Kardiologiska kliniken.
    Broström, Anders
    Linköpings universitet, Hälsouniversitetet. Linköpings universitet, Institutionen för nervsystem och rörelseorgan, Klinisk Neurofysiologi.
    Alehagen, Urban
    Linköpings universitet, Hälsouniversitetet. Linköpings universitet, Institutionen för medicin och vård, Kardiologi. Östergötlands Läns Landsting, Hjärtcentrum, Kardiologiska kliniken.
    Svanborg, Eva
    Linköpings universitet, Hälsouniversitetet. Linköpings universitet, Institutionen för nervsystem och rörelseorgan, Klinisk Neurofysiologi. Östergötlands Läns Landsting, Rekonstruktionscentrum, Neurofysiologiska kliniken US.
    Dahlström, Ulf
    Linköpings universitet, Hälsouniversitetet. Linköpings universitet, Institutionen för medicin och vård, Kardiologi. Östergötlands Läns Landsting, Hjärtcentrum, Kardiologiska kliniken.
    Sleep disturbances, daytime sleepiness and depressive symptomatology in elderly. The corokind study2006Ingår i: 18th Congress of the European Sleep Research Society,2006, 2006, s. 114-114Konferensbidrag (Övrigt vetenskapligt)
  • 256.
    Johansson, Peter
    et al.
    Linköpings universitet, Institutionen för medicin och hälsa, Kardiologi. Linköpings universitet, Hälsouniversitetet. Östergötlands Läns Landsting, Hjärtcentrum, Kardiologiska kliniken.
    Broström, Anders
    Linköpings universitet, Institutionen för medicin och hälsa, Omvårdnad. Linköpings universitet, Hälsouniversitetet.
    Dahlström, Ulf
    Linköpings universitet, Institutionen för medicin och hälsa, Kardiologi. Linköpings universitet, Hälsouniversitetet. Östergötlands Läns Landsting, Hjärtcentrum, Kardiologiska kliniken.
    Alehagen, Urban
    Linköpings universitet, Institutionen för medicin och hälsa, Kardiologi. Linköpings universitet, Filosofiska fakulteten. Östergötlands Läns Landsting, Hjärtcentrum, Kardiologiska kliniken.
    Global perceived health and health-related quality of life in elderly primary care patients with symptoms of heart failure2008Ingår i: European Journal of Cardiovascular Nursing, ISSN 1474-5151, E-ISSN 1873-1953, Vol. 7, nr 4, s. 269-276Artikel i tidskrift (Refereegranskat)
    Abstract [en]

    Background: The aim was to examine whether a single question about global perceived health (GPH) is associated with the domains of health-related quality of life (HR-QoL) as assessed by the SF-36, and whether the scores in these domains differ from the different scores of the GPH in relation to left ventricular ejection fraction (LVEF).

    Method: The study included 412 elderly outpatients with symptoms of heart failure (HF). Echocardiography was used to determine their LVEF, and GPH was assessed by the first question on the SF-36.

    Results: The correlations between GPH and the different domains in SF-36 ranged from 0.33 to 0.64 in patients with LVEF ≥ 50% and was between 0.29 and 0.59 in patients with LVEF < 40%. Regression analyses revealed GPH to be the strongest predictor of HR-QoL. Patients with LVEF < 40% rating poor GPH differed significantly (p < 0.05) from those with good or moderate GPH in six of the eight HR-QoL domains.

    Conclusion: One question about GPH gives a good general description of HR-QoL and may therefore be used as a simple tool to assess HR-QoL in elderly outpatients with clinical symptoms of HF.

  • 257.
    Johansson, Peter
    et al.
    Linköpings universitet, Institutionen för medicin och hälsa, Kardiologi. Linköpings universitet, Hälsouniversitetet. Östergötlands Läns Landsting, Hjärtcentrum, Kardiologiska kliniken.
    Broström, Anders
    Linköpings universitet, Institutionen för medicin och hälsa, Omvårdnad. Linköpings universitet, Hälsouniversitetet.
    Dahlström, Ulf
    Linköpings universitet, Institutionen för medicin och hälsa, Kardiologi. Linköpings universitet, Hälsouniversitetet. Östergötlands Läns Landsting, Hjärtcentrum, Kardiologiska kliniken.
    Alehagen, Urban
    Linköpings universitet, Institutionen för medicin och hälsa, Kardiologi. Linköpings universitet, Hälsouniversitetet. Östergötlands Läns Landsting, Hjärtcentrum, Kardiologiska kliniken.
    Global perceived health and ten-year cardiovascular mortality in elderly primary care patients with possible heart failure2008Ingår i: European Journal of Heart Failure, ISSN 1388-9842, E-ISSN 1879-0844, Vol. 10, nr 10, s. 1040-1047Artikel i tidskrift (Refereegranskat)
    Abstract [en]

    Introduction: Although multi-item health-related quality of life (HRQoL) instruments provide prognostic information, they are rarely used in routine clinical practice.

    Aim: To examine whether a single question about global perceived health (GPH) was a prognostic indicator of cardiovascular (CV) mortality over 10 years of follow-up in elderly patients with possible heart failure (HF) in primary care.

    Method: GPH was measured using the first question on the Short-Form-36 concerning current health status. Of the 510 patients who underwent baseline evaluation, 448 patients were included.

    Results: Cox proportional regression hazard analysis controlled for age, sex, NYHA class, diabetes, ischaemic heart disease, left ventricular ejection fraction and B-type natriuretic peptide plasma concentrations, showed that patients with GPH rated as “poor” or “good” were at four (HR 4.1 CI 95% 1.8–9.4) and three times (HR 3.4 CI 95% 1.4–7.8) the risk of CV mortality, respectively.

    Conclusion: GPH is an independent predictor of CV mortality in elderly patients with possible HF. As a complement to clinical factors when evaluating severity of HF, GPH could be an important tool for identifying patients at risk of adverse CV events and in need of improved treatment.

  • 258.
    Johansson, Peter
    et al.
    Linköpings universitet, Institutionen för medicin och hälsa, Kardiologi. Linköpings universitet, Hälsouniversitetet. Östergötlands Läns Landsting, Hjärtcentrum, Kardiologiska kliniken.
    Dahlström, Ulf
    Linköpings universitet, Institutionen för medicin och hälsa, Kardiologi. Linköpings universitet, Hälsouniversitetet. Östergötlands Läns Landsting, Hjärtcentrum, Kardiologiska kliniken.
    Alehagen, Urban
    Linköpings universitet, Institutionen för medicin och hälsa, Kardiologi. Linköpings universitet, Hälsouniversitetet. Östergötlands Läns Landsting, Hjärtcentrum, Kardiologiska kliniken.
    Depressive symptoms and six-year cardiovascular mortality in elderly patients with and without heart failure2007Ingår i: Scandinavian Cardiovascular Journal, ISSN 1401-7431, E-ISSN 1651-2006, Vol. 41, nr 5, s. 299-307Artikel i tidskrift (Refereegranskat)
    Abstract [en]

    Objectives: To evaluate whether depressive symptoms (DS) in elderly patients with heart failure (HF) in the community is associated with increased mortality.

    Design: A cohort of 510 elderly patients (65-82 years) in a primary healthcare setting with symptoms associated with HF underwent a clinical and echocardiographic examination. A left ventricular ejection fraction (LVEF) <40% indicated HF. The mental health index scale was used to screen for DS. Cardiovascular and all-cause mortality was registered over 6 years.

    Results: After adjustments those with DS had an increased risk (HR) of 3.0 (CI 95% 1.6-5.5, p=0.0001) and 2.2 (CI 95% 1.3-3.7, p=0.0004) of cardiovascular and all-cause mortality, respectively. Patients with HF and DS had the highest risk of cardiovascular mortality, HR 15.7 (CI 95% 4.8-52.2) compared to patients with HF without DS and those with LVEF ≥50% and normal left ventricular diastolic function with and without DS.

    Conclusion: DS in elderly patients with HF is independently associated with increased mortality. Screening for DS is recommended as part of the clinical routine in managing patients with HF.

  • 259.
    Johansson, Peter
    et al.
    Linköpings universitet, Hälsouniversitetet. Linköpings universitet, Institutionen för medicin och vård, Kardiologi. Östergötlands Läns Landsting, Hjärtcentrum, Kardiologiska kliniken.
    Dahlström, Ulf
    Linköpings universitet, Hälsouniversitetet. Linköpings universitet, Institutionen för medicin och vård, Kardiologi. Östergötlands Läns Landsting, Hjärtcentrum, Kardiologiska kliniken.
    Broström, Anders
    Linköpings universitet, Hälsouniversitetet. Linköpings universitet, Institutionen för nervsystem och rörelseorgan, Klinisk Neurofysiologi.
    Consequences and predictors of depression in patients with chronic heart failure: implications for nursing care and future research.2006Ingår i: Progress in Cardiovascular Nursing, ISSN 0889-7204, E-ISSN 1751-7117, Vol. 21, nr 4, s. 202-211Artikel i tidskrift (Refereegranskat)
    Abstract [en]

    Depression is common among patients with chronic heart failure (HF) and leads to more symptoms of HF, decreased quality of life, and an increased risk for premature death. Depressed HF patients also use more health care resources, which increases the economic burden on the health care system. The assessment of risk factors of depression such as age younger than 60-65 years, poor physical functioning, previous depression, poor self-efficacy, living alone, and distressful relationships, in combination with the use of depression instruments, can be helpful in detecting depression in HF patients. Unfortunately, interventions on how to relieve depression in patients with HF have not been investigated thoroughly, however, depression agents as well as HF education, social support, exercise therapy, stress management, and relaxation have been shown to be useful interventions. Because of poor outcomes, studies that examine the effectiveness and/or side effects of pharmacologic as well as nonpharmacologic interventions on depressed patients with HF are needed.

  • 260.
    Johansson, Peter
    et al.
    Linköpings universitet, Hälsouniversitetet. Linköpings universitet, Institutionen för medicin och vård, Kardiologi. Östergötlands Läns Landsting, Hjärtcentrum, Kardiologiska kliniken.
    Dahlström, Ulf
    Linköpings universitet, Hälsouniversitetet. Linköpings universitet, Institutionen för medicin och vård, Kardiologi. Östergötlands Läns Landsting, Hjärtcentrum, Kardiologiska kliniken.
    Broström, Anders
    Linköpings universitet, Hälsouniversitetet. Linköpings universitet, Institutionen för medicin och vård, Omvårdnad.
    Factors and interventions influencing health-related quality of life in patients with heart failure: A review of the literature2006Ingår i: European Journal of Cardiovascular Nursing, ISSN 1474-5151, E-ISSN 1873-1953, Vol. 5, nr 1Artikel i tidskrift (Refereegranskat)
    Abstract [en]

    Introduction: Because of the lack of a cure for patients with chronic heart failure (HF), there has been a progressive interest in the use of health-related quality of life (Hr-QoL) as complementary end-point to mortality and morbidity. Aim: The aim of this review was from a nursing perspective to describe Hr-QoL and the influencing factors of Hr-QoL, as well as to identify interventions aimed at influencing Hr-QoL in HF patients. Method: Medline, Cinahl and PsycInfo databases were searched from 1995 to 2004. A total of 58 papers were included. Results: HF symptoms and activity status influence Hr-QoL negatively. However, several individual characteristics such as personality, gender and age must also be taken into consideration because different values might exist regarding what constitutes a good Hr-QoL. Nurse led interventions based on education, support and exercise can influence Hr-QoL positively. There is also a need of more studies about the effects of depression, sleep disturbances, support as well as education on Hr-QoL. There is also a need of exercise studies with larger sample sizes and older patients in higher NYHA classes. Conclusion: Several individual factors impact Hr-QoL, therefore, must nursing interventions are individually adapted to the patient's resources. © 2005 European Society of Cardiology. Published by Elsevier B.V. All rights reserved.

  • 261.
    Johansson, Peter
    et al.
    Linköpings universitet, Hälsouniversitetet. Linköpings universitet, Institutionen för medicin och vård, Kardiologi. Östergötlands Läns Landsting, Hjärtcentrum, Kardiologiska kliniken.
    Dahlström, Ulf
    Linköpings universitet, Hälsouniversitetet. Linköpings universitet, Institutionen för medicin och vård, Kardiologi. Östergötlands Läns Landsting, Hjärtcentrum, Kardiologiska kliniken.
    Broström, Anders
    Linköpings universitet, Hälsouniversitetet. Linköpings universitet, Institutionen för medicin och vård, Omvårdnad.
    The measurement and prevalence of depression in patients with chronic heart failure.2006Ingår i: Progress in Cardiovascular Nursing, ISSN 0889-7204, E-ISSN 1751-7117, Vol. 21, nr 1, s. 28-36Artikel i tidskrift (Refereegranskat)
    Abstract [en]

    Chronic heart failure is a common disease accompanied by poor mental health and depression. The diagnosis of depression is based on the presence of affective, cognitive, and somatic symptoms assessed by categoric or dimensional instruments. Depression is prominent and high rates are found with dimensional instruments in hospitalized heart failure patients. Categoric instruments seem to be more reliable but are more complex to use. Because of poor outcomes, attention should also be paid to subthreshold depression. In screening for such cases, dimensional instruments might be preferable because of the risk for underestimation by categoric instruments. Dimensional instruments might also be easier to implement in daily practice but, to reduce bias, cutoff scores might need refinement according to the clinical setting. Therefore, studies that evaluate different cutoff values are needed to find a critical level of burden from a depressive symptomatology on outcomes such as mortality, hospitalizations, and quality of life.

  • 262.
    Johansson, Peter
    et al.
    Linköpings universitet, Institutionen för medicin och hälsa, Kardiologi. Linköpings universitet, Hälsouniversitetet. Östergötlands Läns Landsting, Hjärtcentrum, Kardiologiska kliniken. Linköpings universitet, Institutionen för samhälls- och välfärdsstudier, Hälsa, Aktivitet, Vård (HAV).
    Nieuwenhuis, Maurice
    University of Groningen.
    Lesman-Leegte, Ivonne
    University of Groningen.
    van Veldhuisen, Dirk J
    University of Groningen.
    Jaarsma, Tiny
    Linköpings universitet, Institutionen för samhälls- och välfärdsstudier, Hälsa, Aktivitet, Vård (HAV). Linköpings universitet, Hälsouniversitetet.
    Depression and the delay between symptom onset and hospitalization in heart failure patients.2011Ingår i: European Journal of Heart Failure, ISSN 1388-9842, E-ISSN 1879-0844, Vol. 13, nr 2, s. 214-219Artikel i tidskrift (Refereegranskat)
    Abstract [en]

    AIMS: Heart failure (HF) patients frequently suffer from episodes of deterioration and may need medical treatment. An adequate reaction from the patient is needed to decrease the delay between the onset of deterioration and consulting a medical professional (i.e. consulting behaviour). The aim of the present study was to evaluate whether depressive symptoms are associated with the duration of the delay between the onset of symptoms of worsening HF and hospitalization, and to examine how consulting behaviour correlates to depressive symptoms and delay in HF patients. METHODS AND RESULTS: Data on the time between the onset of symptoms of worsening HF and hospitalization, depressive symptoms, and self-care behaviour were collected in 958 HF patients (37% female; age 71 ± 11 years; New York Heart Association functional class II-IV), using validated questionnaires. The median delay time of the total sample was 72 h (ranging from 0 to 243 days). Patients with depressive symptoms delayed longer compared with those without depressive symptoms (120 vs. 54 h, P= 0.001). Patients with depressive symptoms had a 1.5 times higher risk for a delay of ≥72 h, independent of demographic and clinical variables (P= 0.008). Consulting behaviour did not correlate with depressive symptoms but was weakly associated with delay (r= -0.07, P= 0.03). CONCLUSIONS: Heart failure patients with depressive symptoms have a significantly longer delay between HF deterioration and hospital admission. Interventions designed to improve the consulting behaviour in HF patients with depressive symptoms may have a limited effect on delay. Further research is needed to obtain more insight into the mechanisms underlying the relationship between delay and depression.

  • 263.
    Jonasson, Lena
    Linköpings universitet, Hälsouniversitetet. Linköpings universitet, Institutionen för medicin och vård, Kardiologi. Östergötlands Läns Landsting, Hjärtcentrum, Kardiologiska kliniken.
    Inflammatoriska markörer hos kvinnor2003Övrigt (Övrig (populärvetenskap, debatt, mm))
  • 264.
    Jonasson, Lena
    Linköpings universitet, Hälsouniversitetet. Linköpings universitet, Institutionen för medicin och vård, Kardiologi. Östergötlands Läns Landsting, Hjärtcentrum, Kardiologiska kliniken.
    The possible link between infections and atherosclerosis2007Ingår i: Indian Journal of Medical Sciences, ISSN 0019-5359, E-ISSN 1998-3654, Vol. 61, nr 3, s. 124-126Artikel i tidskrift (Refereegranskat)
    Abstract [en]

    [No abstract available]

  • 265.
    Jonasson, Lena
    et al.
    Linköpings universitet, Hälsouniversitetet. Linköpings universitet, Institutionen för medicin och vård, Kardiologi. Östergötlands Läns Landsting, Hjärtcentrum, Kardiologiska kliniken.
    Backteman, Karin
    Ernerudh, Jan
    Linköpings universitet, Hälsouniversitetet. Linköpings universitet, Institutionen för molekylär och klinisk medicin, Klinisk immunologi. Östergötlands Läns Landsting, Laboratoriemedicinskt centrum, Klinisk immunologi och transfusionsmedicin.
    Loss of natural killer cell activity in patients with coronary artery disease2005Ingår i: Atherosclerosis, ISSN 0021-9150, E-ISSN 1879-1484, Vol. 183, nr 2, s. 316-321Artikel i tidskrift (Refereegranskat)
    Abstract [en]

    Background:: Natural killer (NK) cells are important components of the innate immune system and have a potential role in the regulation of autoimmunity. In the present study, we evaluated the NK cells in patients with coronary artery disease (CAD) and related the findings to clinical and laboratory parameters of the disease. Methods and results:: We studied 45 patients with acute coronary syndrome (ACS), 50 patients with stable angina and angiographically verified CAD (SA) and 50 healthy controls. The distribution of NK cell subsets was determined by flow cytometry and NK cell-mediated cytotoxicity was quantified ex vivo. Both ACS and SA patients had significantly reduced numbers of CD56dim NK cells compared with controls. The patients also exhibited a significant decrease in NK cell activity. The loss in NK cell function was not related to inflammatory activity or metabolic status. Conclusion:: Both stable and unstable conditions of CAD were associated with a redistribution of circulating lymphocytes, comprising a significant reduction of CD56dim NK cells and a concomitant loss of NK cell function. The findings suggest the presence of a persistent immune aberration in CAD patients independent of their clinical setting or systemic inflammatory state. © 2005 Elsevier Ireland Ltd. All rights reserved.

  • 266.
    Jonasson, Lena
    et al.
    Linköpings universitet, Hälsouniversitetet. Linköpings universitet, Institutionen för medicin och vård, Kardiologi. Östergötlands Läns Landsting, Hjärtcentrum, Kardiologiska kliniken.
    Ernerudh, Jan
    Linköpings universitet, Hälsouniversitetet. Linköpings universitet, Institutionen för molekylär och klinisk medicin, Klinisk immunologi. Östergötlands Läns Landsting, Laboratoriemedicinskt centrum, Klinisk immunologi och transfusionsmedicin.
    Natural killer cells in coronary artery disease2004Ingår i: Atherosclerosis, ISSN 0021-9150, E-ISSN 1879-1484, Vol. 4, s. 312-312Artikel i tidskrift (Refereegranskat)
  • 267.
    Jonasson, Lena
    et al.
    Linköpings universitet, Hälsouniversitetet. Linköpings universitet, Institutionen för medicin och hälsa, Kardiologi. Östergötlands Läns Landsting, Hjärtcentrum, Kardiologiska kliniken.
    Tompa, A.
    Department of Microbiology, Ryhov Hospital, Jönköping, Sweden.
    Wikby, A.
    Dept. of Nat. Sci. and Biomedicine, School of Health Sciences, Jönköping University, Jönköping, Sweden.
    Expansion of peripheral CD8+ T cells in patients with coronary artery disease: Relation to cytomegalovirus infection2003Ingår i: Journal of Internal Medicine, ISSN 0954-6820, E-ISSN 1365-2796, Vol. 254, nr 5, s. 472-478Artikel i tidskrift (Refereegranskat)
    Abstract [en]

    Objectives. The nature of the immune response in coronary artery disease (CAD) is not fully defined. One pathogen that has been linked to atherogenesis, cytomegalovirus (CMV). is known to exert strong and long-lasting effects on peripheral T cells. In the present study, we investigated the effect of prior CMV infection on the immune system in CAD patients. Subjects. Patients with stable angina and angiographically verified CAD (n = 43) and clinically healthy controls (n = 69) were included. Methods. The expression of CD57 and CD28 on peripheral CD4+ and CD8+ T cells was evaluated with three-colour flow cytometry. The findings were related to serological markers of inflammation, T-cell activation and CMV seropositivity. Results. An expansion of CD8+ T cells expressing CD57 but lacking CD28 was seen in the patient group. The numbers of CD8+CD57+ and CD8+ CD28- T-cell subsets were independently related to CMV seropositivity (P < 0.001) but also to CAD per se (P < 0.05). Serum concentrations of C-reactive protein (CRP) and soluble interleukin-2 receptor (sIL-2R) were elevated in the patients but not related to CMV or CD8 + T-cell subsets. Conclusion. A pronounced shift in peripheral T-cell homeostasis was observed in CAD patients. Primarily CMV infection but also CAD per se contributed to the expansion of CD8+ T-cell subsets. The T-cell changes were not related to a systemic inflammatory response but should rather be considered as markers of a chronic antigen exposure and/or immunosenescence in CAD.

  • 268.
    Jonasson, Lena
    et al.
    Linköpings universitet, Hälsouniversitetet. Linköpings universitet, Institutionen för medicin och hälsa, Kardiologi. Östergötlands Läns Landsting, Hjärtcentrum, Kardiologiska kliniken.
    Wikby, A.
    Dept. of Nat. Sci. and Biomedicine, School of Health Sciences, Jönköping University, Jönköping, Sweden.
    Olsson, Anders
    Linköpings universitet, Hälsouniversitetet. Linköpings universitet, Institutionen för medicin och hälsa, Internmedicin. Östergötlands Läns Landsting, Medicincentrum, Endokrin- och magtarmmedicinska kliniken US.
    Low serum ß-carotene reflects immune activation in patients with coronary artery disease2003Ingår i: NMCD. Nutrition Metabolism and Cardiovascular Diseases, ISSN 0939-4753, E-ISSN 1590-3729, Vol. 13, nr 3, s. 120-125Artikel i tidskrift (Refereegranskat)
    Abstract [en]

    Background and Aim: Low serum levels of antioxidant vitamins are associated with coronary artery disease (CAD). An immunomodulatory effect of antioxidants has been proposed. The aim of the study was to investigate whether an increased immune response in CAD patients was associated with suppressed circulating levels of antioxidant vitamins. Methods and Results: Forty-four men with stable angina and angiographically verified CAD were included as well as 69 healthy controls. T cell subsets in peripheral blood were quantified by 3-colour flow cytometry. C-reactive protein (CRP), soluble interleukin-2 receptor (sIL-2R) and the lipophilic antioxidants a-tocopherol, ß-carotene and lycopene were determined in serum. Compared with controls, patients had signs of an enhanced inflammatory activity assessed by significantly increased levels of CRP, sIL-2R and CD4+CD25+T cell subsets. Patients also had significantly lower ß-carotene and lycopene levels whereas a-tocopherol levels did not differ. The increased inflammatory/immune parameters in patients showed a significant inverse relationship to serum ß-carotene but not to lycopene or a-tocopherol. Conclusions: Low serum ß-carotene in CAD patients reflects activation of the immune system. Inflammation should be considered as an important confounding factor when analysing data on ß-carotene and CAD. © 2003, Medikal Press.

  • 269.
    Jons, Christian
    et al.
    Gentofte University Hospital.
    Steen Hansen, Peter
    Skejby University Hospital.
    Johannessen, Arne
    Gentofte University Hospital.
    Hindricks, Gerhard
    Leipzig University Hospital.
    Raatikainen, Pekka
    Oulo University Hospital.
    Kongstad, Ole
    Lund University Hospital.
    Walfridsson, Håkan
    Linköpings universitet, Institutionen för medicin och hälsa, Kardiologi. Linköpings universitet, Hälsouniversitetet. Östergötlands Läns Landsting, Hjärtcentrum, Kardiologiska kliniken.
    Pehrson, Steen
    Rigshospital.
    Almroth, Henrik
    University Hospital, Örebro.
    Hartikainen, Juha
    Kuopio University Hospital.
    Kirstein Petersen, Anders
    Skejby University Hospital.
    Spange Mortensen, Leif
    Uni C.
    Cosedis Nielsen, Jens
    Skejby University Hospital.
    The Medical ANtiarrhythmic Treatment or Radiofrequency Ablation in Paroxysmal Atrial Fibrillation (MANTRA-PAF) Trial: clinical rationale, study design, and implementation2009Ingår i: EUROPACE, ISSN 1099-5129, Vol. 11, nr 7, s. 917-923Artikel i tidskrift (Refereegranskat)
    Abstract [en]

    No large randomized multicentre trial has evaluated the efficacy of radiofrequency ablation (RFA) vs. anti-arrhythmic drug (AAD) therapy as a first-line treatment of paroxysmal atrial fibrillation (AF). The Medical ANtiarrhythmic Treatment or Radiofrequency Ablation (MANTRA-PAF) trial is a randomized, controlled, parallel group, multicentre study designed to test whether catheter-based RFA is superior to optimized AAD therapy in suppressing relapse within 24 months of symptomatic and/or asymptomatic AF in patients with paroxysmal AF without prior AAD therapy. The primary endpoint is cumulative AF burden on repeated 7 days Holter monitoring. Secondary endpoints are: thromboembolic events, hospitalization due to arrhythmia, pro-arrhythmic events, procedure/treatment-related side effects, health economics, quality of life, and change in left ventricular function. Ten centres in Scandinavia and Germany are participating in the study. Enrolment was started in 2005 and as of November 2008, 260 patients have been enrolled into the study. It is expected that enrolment will end by March 2009, when 300 patients have been included. The MANTRA-PAF trial will determine whether catheter-based RFA is superior to optimized AAD therapy as a first-line treatment in suppressing long-term relapse of symptomatic and/or asymptomatic AF.

  • 270.
    Jonsson, Asa
    et al.
    Ryhov Cty Hosp, Dept Cardiol, Jonkoping, Sweden.
    Edner, Magnus
    Danderyd Hosp, Karolinska Inst, Dept Clin Sci, Stockholm, Sweden.
    Alehagen, Urban
    Linköpings universitet, Institutionen för medicin och hälsa, Kardiologi. Linköpings universitet, Hälsouniversitetet. Östergötlands Läns Landsting, Hjärtcentrum, Kardiologiska kliniken.
    Dahlström, Ulf
    Linköpings universitet, Institutionen för medicin och hälsa, Kardiologi. Linköpings universitet, Hälsouniversitetet. Östergötlands Läns Landsting, Hjärtcentrum, Kardiologiska kliniken.
    Heart failure registry: a valuable tool for improving the management of patients with heart failure2010Ingår i: European Journal of Heart Failure, ISSN 1388-9842, E-ISSN 1879-0844, Vol. 12, nr 1, s. 25-31Artikel i tidskrift (Refereegranskat)
    Abstract [en]

    Guidelines on how to diagnose and treat patients with heart failure (HF) are published regularly. However, many patients do not fulfil the diagnostic criteria and are not treated with recommended drugs. The Swedish Heart Failure Registry (S-HFR) is an instrument which may help to optimize the handling of HF patients. The S-HFR is an Internet-based registry in which participating centres (units) can record details of their HF patients directly online and transfer data from standardized forms or from computerized patient documentation. Up to December 2007, 16 117 patients from 78 units had been included in the S-HFR. Of these, 10 229 patients had been followed for at least 1 year, and 2133 deaths were recorded. Online reports from the registry showed that electrocardiograms were available for 97% of the patients. Sinus rhythm was found in 51% of patients and atrial fibrillation in 38%. Echocardiography was performed in 83% of the patients. Overall, 77% of patients were treated with angiotensin converting enzyme inhibitors or angiotensin II receptor blockers, 80% were on beta-blockers, 34% on aldosterone antagonists, and 83% on diuretics. The S-HFR is a valuable tool for improving the management of patients with HF, since it enables participating centres to focus on their own potential for improving diagnoses and medical treatment, through the online reports provided.

  • 271.
    Josefsson, Ann
    et al.
    Linköpings universitet, Institutionen för klinisk och experimentell medicin, Obstetrik och gynekologi. Linköpings universitet, Hälsouniversitetet. Östergötlands Läns Landsting, Barn- och kvinnocentrum, Kvinnokliniken i Linköping.
    Kernell, K
    Linköpings universitet, Institutionen för klinisk och experimentell medicin, Obstetrik och gynekologi. Linköpings universitet, Hälsouniversitetet.
    Nielsen, Niels Erik
    Linköpings universitet, Institutionen för medicin och hälsa, Kardiologi. Linköpings universitet, Hälsouniversitetet. Östergötlands Läns Landsting, Hjärtcentrum, Kardiologiska kliniken.
    Bladh, Marie
    Linköpings universitet, Institutionen för klinisk och experimentell medicin, Obstetrik och gynekologi. Linköpings universitet, Hälsouniversitetet.
    Sydsjö, Gunilla
    Linköpings universitet, Institutionen för klinisk och experimentell medicin, Obstetrik och gynekologi. Linköpings universitet, Hälsouniversitetet. Östergötlands Läns Landsting, Barn- och kvinnocentrum, Kvinnokliniken i Linköping.
    Reproductive Pattern and Pregnancy Outcome in Women with Congenital Heart Disease: A Swedish Population-Based Study in JOURNAL OF WOMENS HEALTH, vol 19, issue 3, pp 619-6192010Ingår i: JOURNAL OF WOMENS HEALTH, Mary Ann Liebert, Inc. , 2010, Vol. 19, nr 3, s. 619-619Konferensbidrag (Refereegranskat)
    Abstract [en]

    n/a

  • 272.
    Järemo, P
    et al.
    Linköpings universitet, Hälsouniversitetet. Linköpings universitet, Institutionen för medicin och vård, Kardiologi. Östergötlands Läns Landsting, Hjärtcentrum, Kardiologiska kliniken.
    Lindahl, Tomas
    Linköpings universitet, Hälsouniversitetet. Linköpings universitet, Institutionen för biomedicin och kirurgi, Klinisk kemi.
    Fransson, Sven Göran
    Linköpings universitet, Hälsouniversitetet. Linköpings universitet, Institutionen för medicin och vård, Radiologi. Östergötlands Läns Landsting, Hjärtcentrum, Kardiologiska kliniken.
    Richter, Arina
    Linköpings universitet, Hälsouniversitetet. Linköpings universitet, Institutionen för medicin och vård, Kardiologi. Östergötlands Läns Landsting, Hjärtcentrum, Kardiologiska kliniken.
    Substantial individual differences of platelet inhibition after clopedogrel loading doses.2001Ingår i: Proccedings of the 4th Int'l Congr on Coronary Artery Disease, Prague 2001,2001, 2001, s. 587-590Konferensbidrag (Refereegranskat)
  • 273. Järemo, P
    et al.
    Richter, Arina
    Linköpings universitet, Hälsouniversitetet. Linköpings universitet, Institutionen för medicin och vård, Kardiologi. Östergötlands Läns Landsting, Hjärtcentrum, Kardiologiska kliniken.
    Chlamydia pneumoniae IgG and the severity of coronary atherosclerosis2004Ingår i: European journal of internal medicine, ISSN 0953-6205, E-ISSN 1879-0828, Vol. 15, nr 8, s. 508-510Artikel i tidskrift (Refereegranskat)
    Abstract [en]

    The aim of this study was to compare Chlamydia pneumoniae IgG and the extent of coronary atherosclerosis. We investigated 92 patients with stable angina pectoris who underwent coronary angiography to assess chest pain. Before angiography, C. pneumoniae IgG was analyzed. The number of major coronary arteries (1-3) having at least one diameter narrowing (≥50%) stenosis was determined. The patients were divided into two groups of equal size, according to C. pneumoniae IgG levels. One group included individuals with C. pneumoniae IgG levels exceeding 46 enzyme-immuno-units (EIU)/L and the other consisted of subjects with IgG concentrations below 46 EIU/L. Subjects with higher antibody concentrations had a more severe disease. The number of diseased arteries was 2.1±0.8 (S.D.) and 1.4±0.6 (S.D.) for the two groups, respectively. The difference is highly significant (p<0.0001). This study suggests a causative relationship between C. pneumoniae IgG and the degree of coronary atherosclerosis. It does not, however, prove causality.

  • 274.
    Järemo, Peter
    et al.
    Linköpings universitet, Hälsouniversitetet. Linköpings universitet, Institutionen för medicin och vård, Kardiologi. Östergötlands Läns Landsting, Hjärtcentrum, Kardiologiska kliniken.
    Lindahl, Tomas
    Linköpings universitet, Hälsouniversitetet. Linköpings universitet, Institutionen för biomedicin och kirurgi, Klinisk kemi. Östergötlands Läns Landsting, Laboratoriemedicinskt centrum, Klinisk kemi.
    Lennmarken, Claes
    Linköpings universitet, Hälsouniversitetet. Linköpings universitet, Institutionen för medicin och vård, Anestesiologi.
    Forsgren, H
    The use of platelet density and volume measurements to estimate the severity of pre-eclampsia.2001Ingår i: European Journal of Clinical Investigation, ISSN 0014-2972, E-ISSN 1365-2362, Vol. 30, s. 1113-1118Artikel i tidskrift (Refereegranskat)
  • 275.
    Järemo, Petter
    Linköpings universitet, Hälsouniversitetet. Linköpings universitet, Institutionen för medicin och vård, Kardiologi. Östergötlands Läns Landsting, Hjärtcentrum, Kardiologiska kliniken.
    Letter concerning: Zeiler et al2001Ingår i: Infusion Therapy and Transfusion Medicine - Infusionstherapie und Transfusionsmedizin, ISSN 1424-5485, E-ISSN 1424-5493, Vol. 28, s. 222-222Artikel i tidskrift (Övrig (populärvetenskap, debatt, mm))
  • 276.
    Järemo, Petter
    Linköpings universitet, Hälsouniversitetet. Linköpings universitet, Institutionen för medicin och vård, Kardiologi. Östergötlands Läns Landsting, Hjärtcentrum, Kardiologiska kliniken.
    Platelet density in essential thrombocythemia and polycythemia vera.1999Ingår i: Platelets, ISSN 0953-7104, E-ISSN 1369-1635, Vol. 10, s. 61-63Artikel i tidskrift (Refereegranskat)
  • 277.
    Järemo, Petter
    Linköpings universitet, Hälsouniversitetet. Linköpings universitet, Institutionen för medicin och vård, Kardiologi. Östergötlands Läns Landsting, Hjärtcentrum, Kardiologiska kliniken.
    Svensk frontlinjeforskning: Patienter med graviditetsförgiftning har betydande trombocytförändringar.2000Ingår i: Läkartidningen, ISSN 0023-7205, E-ISSN 1652-7518, Vol. 97, s. 5291-5291Artikel i tidskrift (Övrig (populärvetenskap, debatt, mm))
  • 278.
    Järemo, Petter
    et al.
    Linköpings universitet, Hälsouniversitetet. Linköpings universitet, Institutionen för medicin och vård, Kardiologi. Östergötlands Läns Landsting, Hjärtcentrum, Kardiologiska kliniken.
    Jungkind, D
    Some characteristics of platelet concentrates contaminated with staphylococeus epidermis.1999Ingår i: Platelets, ISSN 0953-7104, E-ISSN 1369-1635, Vol. 10, s. 338-340Artikel i tidskrift (Refereegranskat)
  • 279.
    Järemo, Petter
    et al.
    Linköpings universitet, Hälsouniversitetet. Linköpings universitet, Institutionen för medicin och vård, Kardiologi. Östergötlands Läns Landsting, Närsjukvården i östra Östergötland, Medicinkliniken ViN.
    Milovanovic, M
    Lindahl, TL
    Richter, Arina
    Linköpings universitet, Hälsouniversitetet. Linköpings universitet, Institutionen för medicin och vård, Kardiologi. Östergötlands Läns Landsting, Hjärtcentrum, Kardiologiska kliniken.
    Elevated platelet reactivity in stable angina pectoris without significant coronary flow obstruction2005Ingår i: Svenskt kardiovaskulärt vårmöte,2005, 2005Konferensbidrag (Övrigt vetenskapligt)
  • 280.
    Järemo, Petter
    et al.
    Linköpings universitet, Hälsouniversitetet. Linköpings universitet, Institutionen för medicin och vård, Kardiologi. Östergötlands Läns Landsting, Närsjukvården i östra Östergötland, Medicinkliniken ViN.
    Milovanovic, M
    Richter, Arina
    Linköpings universitet, Hälsouniversitetet. Linköpings universitet, Institutionen för medicin och vård, Kardiologi. Östergötlands Läns Landsting, Hjärtcentrum, Kardiologiska kliniken.
    Gender and stable angina pectrois: women have greater thrombin-evoked platelet activity but similar ADP-induced platelet responses.2004Ingår i: The 10th Erfurt Conference on Platelets,2004, 2004Konferensbidrag (Övrigt vetenskapligt)
  • 281.
    Järemo, Petter
    et al.
    Linköpings universitet, Hälsouniversitetet. Linköpings universitet, Institutionen för medicin och vård, Kardiologi. Östergötlands Läns Landsting, Närsjukvården i östra Östergötland, Medicinkliniken ViN.
    Milovanovic, M
    Richter, Arina
    Linköpings universitet, Hälsouniversitetet. Linköpings universitet, Institutionen för medicin och vård, Kardiologi. Östergötlands Läns Landsting, Hjärtcentrum, Kardiologiska kliniken.
    In stable angina pectoris females have more reactive platelets than males2004Ingår i: Svenskt kardiovaskulärt vårmöte,2004, 2004Konferensbidrag (Övrigt vetenskapligt)
  • 282.
    Järemo, Petter
    et al.
    Östergötlands Läns Landsting, Närsjukvården i östra Östergötland, Medicinkliniken ViN.
    Milovanovic, Micha
    Linköpings universitet, Institutionen för samhälls- och välfärdsstudier, Hälsa, Aktivitet, Vård (HAV). Linköpings universitet, Hälsouniversitetet.
    Lindahl, Tomas
    Linköpings universitet, Institutionen för klinisk och experimentell medicin, Klinisk kemi. Linköpings universitet, Hälsouniversitetet. Östergötlands Läns Landsting, Laboratoriemedicinskt centrum, Klinisk kemi.
    Richter, Arina
    Linköpings universitet, Institutionen för medicin och vård, Kardiologi. Linköpings universitet, Hälsouniversitetet. Östergötlands Läns Landsting, Hjärtcentrum, Kardiologiska kliniken.
    Elevated platelet reactivity in stable angina pectoris without significant coronary flow obstruction2008Ingår i: Journal of Cardiovascular Medicine, ISSN 1558-2027, Vol. 9, nr 2, s. 129-130Artikel i tidskrift (Refereegranskat)
    Abstract [en]

    BACKGROUND:

    There are many different causes of angina pectoris without significant coronary flow obstruction in major coronary arteries. Examples include Prinzmetal angina and small vessel atherosclerotic disease.

    METHODS:

    We investigated individuals with stable angina pectoris subject to elective coronary angiography. To keep the study group as homogeneous as possible, patients with diabetes mellitus were excluded. Subjects with normal coronary angiograms (n = 13) or insignificant (< 50%) coronary flow obstruction(s) (n = 4) were grouped together. The remaining cohort (n = 96) with at least one significant (> or = 50%) flow obstruction in at least one major coronary artery served as controls.

    RESULTS:

    Before angiography, platelet activity in vitro on stimulation with a thrombin-receptor activating peptide (TRAP-6) (57 micromol/l and 74 micromol/l) and ADP (1.7 micromol/l and 8.5 micromol/l) was determined. Angina pectoris individuals without significant flow obstruction in major coronary arteries had enhanced platelet reactivity both when stimulated with TRAP-6 and ADP (P < 0.01 for both TRAP-6 concentrations and P < 0.05 for both ADP concentrations, respectively.

    CONCLUSIONS:

    It is concluded that angina pectoris without significant flow impediment in major epicardial arteries is associated with augmented platelet reactivity.

  • 283.
    Järemo, Petter
    et al.
    Östergötlands Läns Landsting, Närsjukvården i östra Östergötland, Medicinkliniken ViN.
    Milovanovic, Micha
    Linköpings universitet, Institutionen för samhälls- och välfärdsstudier, Hälsa, Aktivitet, Vård (HAV). Linköpings universitet, Hälsouniversitetet. Östergötlands Läns Landsting, Närsjukvården i östra Östergötland, Medicinkliniken ViN.
    Lindahl, Tomas
    Linköpings universitet, Institutionen för klinisk och experimentell medicin, Klinisk kemi. Linköpings universitet, Hälsouniversitetet. Östergötlands Läns Landsting, Laboratoriemedicinskt centrum, Klinisk kemi.
    Richter, Arina
    Linköpings universitet, Institutionen för medicin och hälsa, Kardiologi. Linköpings universitet, Hälsouniversitetet. Östergötlands Läns Landsting, Hjärtcentrum, Kardiologiska kliniken.
    Letter: Elevated platelet density and enhanced platelet reactivity in stable angina pectoris complicated by diabetes mellitus type II2009Ingår i: Thrombosis Research, ISSN 0049-3848, E-ISSN 1879-2472, Vol. 124, nr 3, s. 373-374Artikel i tidskrift (Övrigt vetenskapligt)
    Abstract [en]

    The prognosis of coronary heart disease (CHD) has changed for the better. Type II diabetes mellitus (T2DM) complicates CHD and is associated with less favorable prospects and higher rates of coronary recurrence.

    149 individuals below 75 years of age subject to elective coronary angiography to evaluate chest pain were consented. Patients were eligible if they did not have a history of rheumatic disease. 51 individuals treated medically for T2DM were compared with the remaining subjects (n = 98). Blood samples were obtained before elective coronary angiography.A special designed optical apparatus was used to analyze peak platelet density. Platelet bound fibrinogen after provocation reflecting the activation of the GPIIb-IIIa receptor i.e. platelet reactivity was determined with the use of a flow cytometer.

    T2DM is associated with augmented platelet density (p < 0.001).Diabetic platelets displayed enhanced reactivity when stimulating with higher concentrations ADP (8.5 μmol/l) (p < 0.01) and TRAP-6 (74 μmol/l) (p < 0.001).

    DTII patients with stable angina pectoris showed enhanced platelet density, augmented platelet reactivity and increased MPV. Platelets are more reactive in DTII. More aggressive platelets may offer a explanation as to why DTII has an impact upon the prognosis of CHD.

     

  • 284.
    Järemo, Petter
    et al.
    Linköpings universitet, Hälsouniversitetet. Linköpings universitet, Institutionen för medicin och hälsa, Kardiologi. Östergötlands Läns Landsting, Närsjukvården i östra Östergötland, Medicinkliniken ViN.
    Milovanovic, Micha
    Linköpings universitet, Hälsouniversitetet. Linköpings universitet, Institutionen för samhälls- och välfärdsstudier, Hälsa, Aktivitet, Vård (HAV).
    Richter, Arina
    Linköpings universitet, Hälsouniversitetet. Linköpings universitet, Institutionen för medicin och hälsa, Kardiologi. Östergötlands Läns Landsting, Hjärtcentrum, Kardiologiska kliniken.
    Gender and stable angina pectoris: Women have greater thrombin-evoked platelet activity but similar adenosine diphosphate-induced platelet responses2005Ingår i: Thrombosis and Haemostasis, ISSN 0340-6245, Vol. 94, nr 1, s. 227-228Övrigt (Övrigt vetenskapligt)
  • 285.
    Järemo, Petter
    et al.
    Linköpings universitet, Hälsouniversitetet. Linköpings universitet, Institutionen för medicin och vård, Kardiologi. Östergötlands Läns Landsting, Närsjukvården i östra Östergötland, Medicinkliniken ViN.
    Richter, Arina
    Linköpings universitet, Hälsouniversitetet. Linköpings universitet, Institutionen för medicin och vård, Kardiologi. Östergötlands Läns Landsting, Hjärtcentrum, Kardiologiska kliniken.
    Neutrophils, smoking and coronary heart disease2003Ingår i: Heart, ISSN 1355-6037, E-ISSN 1468-201XArtikel i tidskrift (Övrigt vetenskapligt)
  • 286.
    Järemo, Petter
    et al.
    Linköpings universitet, Hälsouniversitetet. Linköpings universitet, Institutionen för medicin och vård, Kardiologi. Östergötlands Läns Landsting, Närsjukvården i östra Östergötland, Medicinkliniken ViN.
    Starkhammar, C
    Östergötlands Läns Landsting, Folktandvården.
    Lundström, Å
    Östergötlands Läns Landsting, Folktandvården.
    Lindahl, Tomas
    Linköpings universitet, Hälsouniversitetet. Linköpings universitet, Institutionen för biomedicin och kirurgi, Avdelningen för klinisk kemi. Östergötlands Läns Landsting, Laboratoriemedicinskt centrum, Klinisk kemi.
    Richter, Arina
    Linköpings universitet, Hälsouniversitetet. Linköpings universitet, Institutionen för medicin och vård, Kardiologi. Östergötlands Läns Landsting, Hjärtcentrum, Kardiologiska kliniken.
    Inverse relationship between the severity of gingivitis and platelet reactivity in stable angina pectoris [6]2007Ingår i: Journal of Thrombosis and Haemostasis, ISSN 1538-7933, E-ISSN 1538-7836, Vol. 5, nr 2, s. 422-423Artikel i tidskrift (Övrigt vetenskapligt)
    Abstract [en]

    [No abstract available]

  • 287. Jönsson, S
    et al.
    Bergström, I
    Li, Wei
    Linköpings universitet, Institutionen för medicin och vård, Klinisk farmakologi. Linköpings universitet, Hälsouniversitetet.
    Nilsson,
    Jonasson, Lena
    Linköpings universitet, Institutionen för medicin och hälsa, Kardiologi. Linköpings universitet, Hälsouniversitetet. Östergötlands Läns Landsting, Hjärtcentrum, Kardiologiska kliniken.
    Neutrophils- a potential source for increased serum MMP-9 in coronary artery disease.2009Konferensbidrag (Refereegranskat)
  • 288.
    Jönsson, Simon
    et al.
    Linköpings universitet, Institutionen för medicin och hälsa. Linköpings universitet, Hälsouniversitetet.
    Bergström, Ida
    Linköpings universitet, Institutionen för medicin och hälsa. Linköpings universitet, Hälsouniversitetet.
    Li, Wei
    Linköpings universitet, Institutionen för medicin och hälsa. Linköpings universitet, Hälsouniversitetet.
    Nilsson, L
    Linköpings universitet, Institutionen för medicin och hälsa. Linköpings universitet, Hälsouniversitetet.
    Jonasson, Lena
    Linköpings universitet, Institutionen för medicin och hälsa, Kardiologi. Linköpings universitet, Hälsouniversitetet. Östergötlands Läns Landsting, Hjärtcentrum, Kardiologiska kliniken.
    NEUTROPHILS - A POTENTIAL SOURCE FOR INCREASED SERUM MMP-9 IN CORONARY ARTERY DISEASE in ATHEROSCLEROSIS SUPPLEMENTS, vol 10, issue 2, pp2009Ingår i: ATHEROSCLEROSIS SUPPLEMENTS, Elsevier Science B.V., Amsterdam. , 2009, Vol. 10, nr 2Konferensbidrag (Refereegranskat)
    Abstract [en]

    n/a

  • 289.
    K Hansson, Goran
    et al.
    Karolinska Institute.
    Jonasson, Lena
    Linköpings universitet, Institutionen för medicin och hälsa, Kardiologi. Linköpings universitet, Hälsouniversitetet. Östergötlands Läns Landsting, Hjärtcentrum, Kardiologiska kliniken.
    The Discovery of Cellular Immunity in the Atherosclerotic Plaque2009Ingår i: ARTERIOSCLEROSIS THROMBOSIS AND VASCULAR BIOLOGY, ISSN 1079-5642, Vol. 29, nr 11, s. 1714-1717Artikel i tidskrift (Refereegranskat)
    Abstract [en]

    It is now generally accepted that atherosclerosis is an inflammatory/immune disease triggered by LDL accumulation in the artery wall. When discovering T cells and the molecular components of a cellular immune response, we proposed that atherosclerosis is an inflammatory process with an autoimmune component. This notion was met with general skepticism but has gained support from experimental and clinical studies. Here we describe some of the early studies that helped developing this concept.

  • 290. Kalmsten, H
    et al.
    Hugosson, H
    Johansson, Peter
    Linköpings universitet, Hälsouniversitetet. Linköpings universitet, Institutionen för medicin och vård, Kardiologi. Östergötlands Läns Landsting, Hjärtcentrum, Kardiologiska kliniken.
    Broström, Anders
    Linköpings universitet, Hälsouniversitetet. Linköpings universitet, Institutionen för medicin och vård, Omvårdnad.
    Older men with congestive heart failure and their conceptions of quality of life - a qualitative study2005Ingår i: Annual spring meeting of the working group on cardiovascular nursing,2005, 2005Konferensbidrag (Övrigt vetenskapligt)
  • 291. Kaminskas, A
    et al.
    Ziedén, Bo
    Linköpings universitet, Hälsouniversitetet. Linköpings universitet, Institutionen för medicin och vård, Internmedicin. Östergötlands Läns Landsting, MKC-2, GE: endomed.
    Elving, B
    Linköpings universitet, Hälsouniversitetet. Linköpings universitet, Institutionen för hälsa och miljö. Östergötlands Läns Landsting, FHVC - Folkhälsovetenskapligt centrum, Förebygg.med.
    Kristenson, Margareta
    Linköpings universitet, Hälsouniversitetet. Linköpings universitet, Institutionen för hälsa och miljö. Östergötlands Läns Landsting, FHVC - Folkhälsovetenskapligt centrum, Förebygg.med.
    Abaravicius, A
    Bergdahl, Björn
    Linköpings universitet, Hälsouniversitetet. Linköpings universitet, Institutionen för medicin och vård, Kardiologi. Östergötlands Läns Landsting, Hjärtcentrum, Kardiologiska kliniken.
    Olsson, Anders
    Linköpings universitet, Hälsouniversitetet. Linköpings universitet, Institutionen för medicin och vård, Internmedicin. Östergötlands Läns Landsting, MKC-2, GE: endomed.
    Kucinskiene, Z
    Adipose tissue fatty acids in men from two populations with different cardiovascular risk - the LiVicordia study.1999Ingår i: Scandinavian Journal of Clinical and Laboratory Investigation, ISSN 0036-5513, E-ISSN 1502-7686, Vol. 59, s. 227-232Artikel i tidskrift (Refereegranskat)
  • 292. Kamwendo, K
    et al.
    Tingström, Pia
    Linköpings universitet, Hälsouniversitetet. Linköpings universitet, Institutionen för medicin och vård, Internmedicin.
    Bergdahl, Björn
    Linköpings universitet, Hälsouniversitetet. Linköpings universitet, Institutionen för medicin och vård, Kardiologi. Östergötlands Läns Landsting, Hjärtcentrum, Kardiologiska kliniken.
    Svensson, E
    Effect of problem-based learning on stages of change for exercise behaviour in patients with coronary artery disease2004Ingår i: Physiotherapy Research International, ISSN 1358-2267, E-ISSN 1471-2865, Vol. 9, s. 24-32Artikel i tidskrift (Refereegranskat)
  • 293.
    Karlstrom, Patric
    et al.
    Institute for Medicine and Care, Jönköping, Sweden .
    Alehagen, Urban
    Linköpings universitet, Institutionen för medicin och hälsa, Kardiologi. Linköpings universitet, Hälsouniversitetet. Östergötlands Läns Landsting, Hjärtcentrum, Kardiologiska kliniken.
    Boman, Kurt
    Institute for Medicine, Skellefteå, Sweden .
    Dahlström, Ulf
    Linköpings universitet, Institutionen för medicin och hälsa, Kardiologi. Linköpings universitet, Hälsouniversitetet. Östergötlands Läns Landsting, Hjärtcentrum, Kardiologiska kliniken.
    Upstep: A Randomized Study of BNP Guided Management of Systolic Heart Failure in Elderly Patients in CIRCULATION, vol 120, issue 18, pp S729-S7302009Ingår i: CIRCULATION, 2009, Vol. 120, nr 18, s. S729-S730Konferensbidrag (Refereegranskat)
    Abstract [en]

    n/a

  • 294. Knot, J
    et al.
    Widimsky, P
    Wijns, W
    Stenestrand, Ulf
    Linköpings universitet, Institutionen för medicin och hälsa, Kardiologi. Östergötlands Läns Landsting, Hjärtcentrum, Kardiologiska kliniken. Linköpings universitet, Hälsouniversitetet.
    Kristensen, SD
    Van´T Hof, A
    Weidinger, F
    Janzon, Magnus
    Linköpings universitet, Institutionen för medicin och hälsa, Kardiologi. Östergötlands Läns Landsting, Hjärtcentrum, Kardiologiska kliniken. Linköpings universitet, Hälsouniversitetet.
    Nörgaard, BL
    Soerensen, JT
    van de Wetering,
    Thygesen, K
    Bergsten, PA
    Digerfeldt, C
    Potgieter, A
    Tomer, N
    Fajadet,
    How to set up an effective national primary angioplasty network: Lessons learned from five European countries2009Ingår i: EuroIntervention, ISSN 1774-024X, Vol. 3, nr 299, s. 301-309Artikel i tidskrift (Refereegranskat)
    Abstract [en]

    AIMS: Percutaneous coronary interventions (PCI) are used to treat acute and chronic forms of coronary artery disease. While in chronic forms the main goal of PCI is to improve the quality of life, in acute coronary syndromes (ACS) timely PCI is a life-saving procedure - especially in the setting of ST-elevation myocardial infarction (STEMI). The aim of this study was to describe the experience of countries with successful nationwide implementation of PCI in STEMI, and to provide general recommendations for other countries. METHODS AND RESULTS: The European Association of Percutaneous Cardiovascular Interventions (EAPCI) recenty launched the Stent For Life Initiative (SFLI). The initial phase of this pan-European project was focused on the positive experience of five countries to provide the best practice examples. The Netherlands, the Czech Republic, Sweden, Denmark and Austria were visited and the logistics of ACS treatment was studied. Public campaigns improved patient access to acute PCI. Regional networks involving emergency medical services (EMS), non-PCI hospitals and PCI centres are useful in providing access to acute PCI for most patients. Direct transfer from the first medical contact site to the cathlab is essential to minimise the time delays. Cathlab staff work is organised to provide acute PCI services 24 hours a day / seven days a week (24/7). Even in those regions where thrombolysis is still used due to long transfer distances to PCI, patients should still be transferred to a PCI centre (after thrombolysis). The highest risk non-ST elevation acute myocardial infarction patients should undergo emergency coronary angiography within two hours of hospital admission, i.e. similar to STEMI patients. CONCLUSIONS: Three realistic goals for other countries were defined based on these experiences: 1) primary PCI should be used for >70% of all STEMI patients, 2) primary PCI rates should reach >600 per million inhabitants per year and 3) existing PCI centres should treat all their STEMI patients by primary PCI, i.e. should offer a 24/7 service

  • 295.
    Kristenson, Margareta
    et al.
    Linköpings universitet, Hälsouniversitetet. Linköpings universitet, Institutionen för hälsa och miljö. Östergötlands Läns Landsting, FHVC - Folkhälsovetenskapligt centrum, Förebygg.med.
    Kucinskiene, Z
    Bergdahl, Björn
    Linköpings universitet, Hälsouniversitetet. Linköpings universitet, Institutionen för medicin och vård, Kardiologi. Östergötlands Läns Landsting, Hjärtcentrum, Kardiologiska kliniken.
    Tagesson, C
    Orth-Gomer, K
    Olsson, Anders
    Linköpings universitet, Hälsouniversitetet. Linköpings universitet, Institutionen för medicin och vård, Internmedicin. Östergötlands Läns Landsting, MKC-2, GE: endomed.
    Self-rated health and biological mechanisms: experiences from the LiVicordia study.2000Ingår i: Self-rated health in a European perspective / [ed] Peter Nilsson and Kristina Orth-Gomér, Linköping: Linköpings universitet , 2000, s. 167-175Kapitel i bok, del av antologi (Övrigt vetenskapligt)
  • 296.
    Kristenson, Margareta
    et al.
    Linköpings universitet, Hälsouniversitetet. Linköpings universitet, Institutionen för hälsa och miljö.
    Kucinskiene, Zita
    Vilnius, Lithuania.
    Bergdahl, Björn
    Linköpings universitet, Hälsouniversitetet. Linköpings universitet, Institutionen för medicin och vård, Kardiologi. Östergötlands Läns Landsting, Hjärtcentrum, Kardiologiska kliniken.
    Orth-Gomér, Kristina
    Karoliska inst Stockholm.
    Risk factors for coronary heart disease in different socioeconomic groups of Lithuania and Sweden - The LiVicordia study2001Ingår i: Scandinavian Journal of Public Health, ISSN 1403-4948, E-ISSN 1651-1905, Vol. 29, nr 2, s. 140-150Artikel i tidskrift (Refereegranskat)
    Abstract [en]

    Aims: Lithuanian middle-aged men have a fourfold higher risk for coronary heart disease (CHD) mortality compared with Swedish men. In Sweden, CHD mortality is twice as high in blue- compared with white-collar workers. Whether the same risk factors that characterized Lithuanian men, compared with Swedish men, could be found in low socioeconomic groups within the cities was investigated. Methods: The LiVicordia study compared both traditional and new possible risk factors for CHD among 150 50-year-old men in Link÷ping, Sweden and Vilnius, Lithuania. A comparison was made of the prevalence of these risk factors in high and low socioeconomic groups within the cities and, after controlling for the city, variations across socioeconomic groups in the total sample. Results: Small differences were found in traditional risk factors between cities. However, Vilnius men were shorter, had lower serum levels of antioxidant vitamins, more psychosocial strain, and lower cortisol response to a standardized laboratory stress test. These characteristics were also found among men in low social classes in both cities. In linear regression models, short stature, low serum ▀-carotene, low social integration, coping and self-esteem, high vital exhaustion, high baseline and low cortisol response to stress were related to low social class. Conclusions: The same set of risk factors, mainly relating to oxidative and psychosocial stress, that characterized Vilnius men was also found in men in low social classes within the cities. The results suggest that a common set of risk factors may help to explain health differences both between and within countries. ⌐ Taylor & Francis 2001.

  • 297.
    Kristenson, Margareta
    et al.
    Linköpings universitet, Hälsouniversitetet. Linköpings universitet, Institutionen för hälsa och miljö. Östergötlands Läns Landsting, FHVC - Folkhälsovetenskapligt centrum, Förebygg.med.
    Lassvik, Claes
    Linköpings universitet, Hälsouniversitetet. Linköpings universitet, Institutionen för medicin och vård, Klinisk fysiologi. Östergötlands Läns Landsting, Hjärtcentrum, Fysiologiska kliniken.
    Bergdahl, Björn
    Linköpings universitet, Hälsouniversitetet. Linköpings universitet, Institutionen för medicin och vård, Kardiologi. Östergötlands Läns Landsting, Hjärtcentrum, Kardiologiska kliniken.
    Kucinskiene, Z
    Aizieniene, L
    Ziedén, Bo
    Linköpings universitet, Hälsouniversitetet. Linköpings universitet, Institutionen för medicin och vård, Internmedicin. Östergötlands Läns Landsting, MKC-2, GE: endomed.
    Schäfer Elinder, Liselott
    Olsson, Anders
    Linköpings universitet, Hälsouniversitetet. Linköpings universitet, Institutionen för medicin och vård, Internmedicin. Östergötlands Läns Landsting, MKC-2, GE: endomed.
    Ultrasound determined carotid and femoral atherosclerosis in Lithuanian and Swedish men: The LiVicordia study2000Ingår i: Atherosclerosis, ISSN 0021-9150, E-ISSN 1879-1484, Vol. 151, nr 2, s. 501-508Artikel i tidskrift (Refereegranskat)
    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.

  • 298.
    Kristofferzon, Marja-Leena
    et al.
    University of Gävle.
    Johansson, Ingela
    Linköpings universitet, Institutionen för medicin och hälsa, Kardiologi. Linköpings universitet, Hälsouniversitetet. Östergötlands Läns Landsting, Hjärtcentrum, Kardiologiska kliniken.
    Brannstrom, Margareta
    Umeå University.
    Arenhall, Eva
    University of Örebro.
    Baigi, Amir
    Halland County Council.
    Brunt, David
    Vaxjö University.
    Fridlund, Bengt
    Vaxjö University.
    Nilsson, Ulrica
    Orebro University Hospital.
    Persson, Sylvi
    Vaxjö University.
    Rask, Mikael
    Vaxjö University.
    Wieslander, Inger
    Halmstad University.
    Ivarsson, Bodil
    Lund University Hospital.
    Evaluation of a Swedish version of the Watts Sexual Function Questionnaire (WSFQ) in persons with heart disease: A pilot study2010Ingår i: EUROPEAN JOURNAL OF CARDIOVASCULAR NURSING, ISSN 1474-5151, Vol. 9, nr 3, s. 168-174Artikel i tidskrift (Refereegranskat)
    Abstract [en]

    Background As part of preparation for a Swedish multicentre study, exploring sexual and married life in patients with myocardial infarction and their partners, a Swedish validated instrument was required Aims The aim of this pilot study was to evaluate the validity and reliability of a Swedish version of the Watts Sexual Function Questionnaire (WSFQ) among persons with a heart disease Methods A convenience sample of 79 persons (47 men and 32 women) living with a heart disease was recruited from the members of the National Association of Heart and Lung Patients They completed a Swedish version of the WSFQ on two occasions Results Two separate factor analyses each revealed a two-factor structure on both occasions "Sexual appetite" and "Sexual expectations" with gender-neutral questions and "Sexual sensitiveness" and "Sexual ability" with gender-specific questions Cronbachs alpha coefficients ranged from 0 48 to 0 86 and test-retest values for all but one question exceeded 0.70 Conclusions The Swedish version of the WSFQ showed good validity and stability and acceptable internal homogeneity Extended evaluations of the questionnaire are recommended

  • 299.
    Kukulski, T
    et al.
    Linköpings universitet, Hälsouniversitetet. Linköpings universitet, Institutionen för medicin och vård, Klinisk fysiologi.
    Hübbert, Laila
    Linköpings universitet, Hälsouniversitetet. Linköpings universitet, Institutionen för medicin och vård, Kardiologi. Östergötlands Läns Landsting, Hjärtcentrum, Kardiologiska kliniken.
    Arnold, Martina
    Linköpings universitet, Hälsouniversitetet. Linköpings universitet, Institutionen för medicin och vård, Klinisk fysiologi.
    Wranne, Bengt
    Linköpings universitet, Hälsouniversitetet. Linköpings universitet, Institutionen för medicin och vård, Klinisk fysiologi. Östergötlands Läns Landsting, Hjärtcentrum, Fysiologiska kliniken.
    Hatle, L
    Linköpings universitet, Hälsouniversitetet. Linköpings universitet, Institutionen för medicin och vård, Klinisk fysiologi.
    Sutherland, George
    Linköpings universitet, Hälsouniversitetet. Linköpings universitet, Institutionen för medicin och vård, Klinisk fysiologi.
    Normal regional right ventricular function and its change with age: a Doppler myocardial imaging study2000Ingår i: Journal of the American Society of Echocardiography, ISSN 0894-7317, E-ISSN 1097-6795, Vol. 13, s. 194-204Artikel i tidskrift (Refereegranskat)
  • 300.
    Kärner, Anita
    et al.
    Linköpings universitet, Institutionen för samhälls- och välfärdsstudier, Hälsa, Aktivitet, Vård (HAV). Linköpings universitet, Hälsouniversitetet.
    Abrandt Dahlgren, Madeleine
    Linköpings universitet, Institutionen för beteendevetenskap och lärande, Avdelningen för studier av vuxenutbildning, folkbildning och högre utbildning (VUFo). Linköpings universitet, Utbildningsvetenskap.
    Bergdahl, Björn
    Linköpings universitet, Institutionen för medicin och hälsa, Kardiologi. Linköpings universitet, Hälsouniversitetet. Östergötlands Läns Landsting, Hjärtcentrum, Kardiologiska kliniken.
    Coronary heart disease: causes and drug treatment - spouses’ conceptions2004Ingår i: Journal of Clinical Nursing, ISSN 0962-1067, Vol. 13, nr 2, s. 167-176Artikel i tidskrift (Refereegranskat)
    Abstract [en]

    Background. Spouses are important in the rehabilitation process of their partner after coronary heart disease event. Their knowledge and attitudes have an impact on their support to the partner concerning lifestyle changes and drug treatment after an event.

    Aims and objectives. To explore spouses' conceptions concerning causes of coronary heart disease and drug treatment 1 year after the partner's cardiac event.

    Design. Qualitative with an empirical and inductive approach.

    Methods. Semi-structured interviews with strategically selected spouses (17 women and eight men) were taped. The transcripts were analysed within the phenomenographic framework.

    Results. Spouses' conceptions about causes of coronary heart disease and its treatment consisted of correct facts, as judged on a lay level, less elaborated conceptions and misconceptions. Among causes of coronary heart disease, the spouses were most knowledgeable about fat intake. They knew less about contributions from inactivity, stress and smoking. Ambivalent feelings were expressed about benefits vs. side effects of drugs. The treatment was conceived as necessary for the heart, but harmful for other organs. Men and women were evenly distributed in most of the derived categories. More women than men considered stress as a cause of coronary heart disease and also misconceived physical exercise to cause the disease.

    Conclusion. A variation of spouses' conceptions was revealed about causes of coronary heart disease and drug treatment. There was a lack of understanding concerning important parts of cardiac rehabilitation activities. These misconceptions may have implications by influencing their partner's co-operative behaviour.

    Relevance to clinical practice. Spouses' pre-existing conceptions of coronary heart disease and its treatment should be considered in the rehabilitation process of their partner. Couples with misconceptions should be given the opportunity to increase qualitatively their knowledge starting from their point of view rather than from that of the professional perspective.

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