63 research outputs found
Aspects on implementation of coronary heart disease prevention in clinical practice [Elektronisk resurs]
No full textPrevention of first time disease or recurrence of coronary heart disease (CHD) is a major task for the health service. Guidelines regarding CHD prevention have been issued but studies have shown that treatment goals are inadequately met in clinical practice and there is urgent need for improved methods of implementation of guidelines. There is also a need for better risk stratification tools in order to identify asymptomatic subjects with a high risk for future CHD. This thesis has shown that: A structured, one-year, hospital-based secondary prevention programme after CHD, mainly led by specialist nurses with physician backup, could positively influence the use of lipid-lowering drugs and serum cholesterol levels several years after the end of the programme. A quality control system based on patient empowerment and education with continuous feedback to patients, nurses and physicians seemed to be welcomed by both patients and participating health care professionals. However, our system based onvoluntary participation and report cards did not seem to be feasible at this time due to a high dropout rate. Reasons why targets for serum lipids were not met in the EUROASPIRE II study were that too few patients received lipid-lowering drugs, and that of those who did receive such treatment many were treated with sub-optimal doses. Ambulatory ECG with ST-analysis could add significant information on which healthy subjects with a certain accumulation of risk factors who would suffer from a major coronary event (death, AMI or revascularisation) over a 15-year time period
Aspects on implementation of coronary heart disease prevention in clinical practice
No full textPrevention of first time disease or recurrence of coronary heart disease (CHD) is a major task for the health service. Guidelines regarding CHD prevention have been issued but studies have shown that treatment goals are inadequately met in clinical practice and there is urgent need for improved methods of implementation of guidelines. There is also a need for better risk stratification tools in order to identify asymptomatic subjects with a high risk for future CHD. This thesis has shown that: A structured, one-year, hospital-based secondary prevention programme after CHD, mainly led by specialist nurses with physician backup, could positively influence the use of lipid-lowering drugs and serum cholesterol levels several years after the end of the programme. A quality control system based on patient empowerment and education with continuous feedback to patients, nurses and physicians seemed to be welcomed by both patients and participating health care professionals. However, our system based on voluntary participation and report cards did not seem to be feasible at this time due to a high dropout rate. Reasons why targets for serum lipids were not met in the EUROASPIRE II study were that too few patients received lipid-lowering drugs, and that of those who did receive such treatment many were treated with sub-optimal doses. Ambulatory ECG with ST-analysis could add significant information on which healthy subjects with a certain accumulation of risk factors who would suffer from a major coronary event (death, AMI or revascularisation) over a 15-year time period
Aspects on coronary heart disease prevention in clinical practice
No full textPrevention of first time disease or recurrence of coronary heart disease (CHD) is a major task for the health service. Guidelines regarding CHD prevention have been issued but studies have shown that treatment goals are inadequately met in clinical practice and there is urgent need for improved methods of implementation of guidelines. There is also a need for better risk stratification tools in order to identify asymptomatic subjects with a high risk for future CHD. This thesis has shown that: A structured, one-year, hospital-based secondary prevention programme after CHD, mainly led by specialist nurses with physician backup, could positively influence the use of lipid-lowering drugs and serum cholesterol levels several years after the end of the programme. A quality control system based on patient empowerment and education with continuous feedback to patients, nurses and physicians seemed to be welcomed by both patients and participating health care professionals. However, our system based on voluntary participation and report cards did not seem to be feasible at this time due to a high dropout rate. Reasons why targets for serum lipids were not met in the EUROASPIRE II study were that too few patients received lipid-lowering drugs, and that of those who did receive such treatment many were treated with sub-optimal doses. Ambulatory ECG with ST-analysis could add significant information on which healthy subjects with a certain accumulation of risk factors who would suffer from a major coronary event (death, AMI or revascularisation) over a 15-year time period
Quadricuspid aortic valve not discovered by transthoracic echocardiography
No full textAbstract Background Quadricuspid aortic valve is a rare congenital heart defect. Several different anatomical variations of a quadricuspid aortic valve has been described and aortic regurgitation is the predominant valvular dysfunction associated with quadricuspid aortic valve. Case presentation A 68-year-old woman presented with almost a years history of increasing dyspnoea on exertion. The patient have had two previous transthoracic echocardiographic exams in the last six years and they had only documented moderate aortic regurgitation. Transoesophageal echocardiography displayed a rare case of quadricuspid aortic valve with three cusps of equal size and one larger cusp. The malformation was associated with severe aortic regurgitation. Conclusion Liberal use of transoesophageal echocardiography is often warranted if optimal display of valvular morphology is desired.</p
Relationship between natriuretic peptides and echocardiography parameters in patients with poorly regulated type 2 diabetes
No full textMagnus Dencker1, Martin Stagmo2, Mozhgan Dorkhan31Unit of Clinical Physiology and Nuclear Medicine, Department of Clinical Sciences, 2Division of Cardiology, 3Division of Diabetes and Endocrinology, Malm&ouml; University Hospital, Malm&ouml;, SwedenAbstract: This study evaluated the relationship between natriuretic peptide levels and a wide range of echocardiography parameters in a population of thirty-three patients with poorly regulated type 2 diabetes, and no known heart failure. Natriuretic peptides brain natriuretic peptide (BNP) and N-terminal prohormone BNP (NT-proBNP) were measured. Transthoracic echocardiography was performed and cardiac volumes and ejection fraction were measured. Doppler and tissue Doppler were measured and diastolic function was stratified according to recent guidelines. Very few echocardiography parameters were correlated with BNP or NT-proBNP levels. However, left atrial end-systolic volume indexed for body surface area was correlated with natural logarithm (ln) BNP and ln NT-proBNP (r = 0.62 and r = 0.60; P &lt; 0.05). There were significant differences in ln BNP and ln NT-proBNP levels between those with normal and those with abnormal diastolic function (1.4 vs 3.1; P &lt; 0.001 and 3.4 vs 5.8; P &lt; 0.001). This study showed that very few echocardiography parameters were correlated with BNP or NT-proBNP levels in patients with poorly regulated type 2 diabetes, which in part contradicts previous studies in other diabetic populations. The exception was left atrial end-systolic volume that showed a moderate correlation with BNP or NT-proBNP levels. There were significant differences in BNP and NT-proBNP levels between the group with normal left ventricular diastolic function and the group with abnormal diastolic function.Keywords: type 2 diabetes, natriuretic peptides, echocardiograph
Reported normal values and weighted means for commonly used echocardiography pulsed Doppler and tissue Doppler measurements
No full textPulsed Doppler (PW) and tissue Doppler imaging (TDI) measurements are part of every echocardiography examination for evaluation of left ventricular (LV) diastolic function and filling pressure. The purpose of this study was to summarize published data on normal values for PW and TDI measurements. A PubMed search was performed on the 10th of October 2016 to identify relevant articles. Studies were considered relevant if they included more than 200 healthy individuals. A total of 13 studies were identified. Of these, 13 studies with 7777 subjects reported PW measurement over the mitral valve, six studies with 4082 subjects reported PW measurement in the pulmonary vein and 10 studies with 5988 subjects reported TDI. We also report weighted mean values for 14 different variables. As expected, measurements varied with age. There were no major differences between men and women. In contrast, there was a large difference in reported values between studies, in corresponding age groups. This review therefore raises caution about relying on normal values from just one study
Implementation of the results of outcome trials in clinical practice: current situation and education gap
No full textRight ventricular metastasis of leiomyosarcoma
No full textAbstract Metastatic presentation of leiomyosarcoma in the heart is very rare. We present transthoracic echocardiography and combined PET/CT images of a case with a large right ventricular metastasis of leiomyosarcoma. The patient was placed on cytostatic drugs for palliative purposes, but passed away one month later because of an untreatable ventricular tackycardia.</p
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