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  • 1.
    Bay, Annika
    et al.
    Umeå University, Public Health and Clinical Medicine, Umeå, Sweden.
    Berghammer, Malin
    University West, Department of Health Sciences, Section for nursing - graduate level.
    Lamas, K
    Umeå University, Nursing, Umeå, Sweden.
    Sandberg, Camilla
    Umeå University, Public Health and Clinical Medicine, Umeå, Sweden.
    Johansson, Bengt
    Umeå University, Public Health and Clinical Medicine, Umeå, Sweden.
    Facilitators and barriers for physical activity in adults with congenital heart disease2018In: European Heart Journal, ISSN 0195-668X, E-ISSN 1522-9645, Vol. 39, no suppl_1, p. 1120-1121, article id ehy566.P5433Article in journal (Refereed)
    Abstract [en]

    Background: A majority of adults with congenital heart disease (CHD) have reduced exercise capacity and do not reach the recommended level of physical activity. A physically active lifestyle is essential to maintain health and counteract acquired cardiovascular disease. This study illuminates aspects that may be relevant for performing physical activity.Purpose: To describe facilitators and barriers for physical activity in adults with CHD.Methods: Semi-structured interviews were performed individually with fourteen adults (age 19–68 years, women=7) with complex CHD. The interviews were analyzed using qualitative content analysis.Results: Aspects that may enable or inhibit physical activity were found in two domains; Facilitators and Barriers, which both consisted of four categories physical, psychological, psychosocial and environmental aspects (Table 1).

  • 2.
    Berghammer, Malin
    et al.
    University West, Department of Health Sciences, Section for nursing - graduate level.
    Johansson, B.
    Umea University, Department of Public Health and Clinical Medicine, Umea, Sweden.
    Mattson, E.
    Karolinska University Hospital, Department of Cardiology, Stockholm, Sweden.
    Moons, P.
    The Sahlgrenska Academy at Gothenburg University, Institute of health and caring sciences, Gothenburg, Sweden;.
    Dellborg, M.
    University of Gothenburg, Institute of medicine, Sahlgrenska Academy, Gothenburg, Sweden.
    Exploration of disagreement between the patient’s self reported limitations and limitations assessed by caregivers in adults with congenital heart disease2018In: European Heart Journal, ISSN 0195-668X, E-ISSN 1522-9645, Vol. 39, no Suppl 1, article id 2406Article in journal (Refereed)
    Abstract [en]

    Background: The New York Heart Association (NYHA) classification is applied in a wide spectrum of heart diseases including adult patients with congenital heart disease (ACHD). The NYHA-class assessment is often based on the evaluation by the caregiver, but to what extent it correlates with the patient's view of their function is not fully known.Purpose: To investigate the relation between the patient's self-reported physical limitations, symptoms, other heart defect related factors and NYHA-class assessed by the caregiver.Methods: Eligible patients (n=333, age 39.2±13.6 years) were identified and randomly selected from the national registry for CHD. All of the patients completed a standardized questionnaire measuring different PRO-domains. By combing self-reported data with registry data including NYHA-class, analyses of agreement of physical limitations were performed.Results: Almost 30% of the patients rated their limitations higher compared to the NYHA-class estimated by the caregiver. Patients with self-reported limitations and their NYHA-class underestimated by caregivers, more often reported symptoms, anxiety, lower health and worked fewer hours/week compared to other patients with CHD. There were no differences regarding sex, type of symptoms, prescribed medications, or complexity of cardiac lesion. In patients without self-reported limitations agreement with NYHA-class estimated by caregivers was 97%.Conclusion: Adult patients with CHD and self-reported limitations may not be correctly identified by the care-giver. Instruments for patient reported outcomes might improve the assessment of physical limitations and could further improve the correctness in evaluating the patient's status.

  • 3.
    Östman-Smith, Ingegerd
    et al.
    Gothenburg University, Division of Paediatrics, Department of Clinical Sciences, Sahlgrenska Academy.
    Wisten, Aase
    Sunderby Hospital, Luleå, Department of Internal Medicine.
    Nylander, Eva
    Linköping University, Department of Clinical Physiology/CVM, Faculty of Health Science.
    Bratt, Ewa-Lena
    Gothenburg University, Division of Paediatrics, Department of Clinical Sciences, Sahlgrenska Academy.
    de-Wahl Granelli, Anne
    Gothenburg University, Division of Paediatrics, Department of Clinical Sciences, Sahlgrenska Academy.
    Oulhaj, Abderrahim
    University of Oxford, OPTIMA, Department of Physiology, Anatomy and Genetics.
    Ljungström, Erik
    Lund University, Department of Cardiology, University Hospita.
    Electrocardiographic amplitudes: a new risk factor for sudden death in hypertrophic cardiomyopathy.2010In: European Heart Journal, ISSN 0195-668X, E-ISSN 1522-9645, Vol. 31, no 4, p. 439-449Article in journal (Refereed)
    Abstract [en]

    AIMS: Assessment of ECG-features as predictors of sudden death in adults with hypertrophic cardiomyopathy (HCM).

    METHODS AND RESULTS: 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 >or=7.7 mV (odds ratio 18.8, sensitivity 87%, negative predictive value (NPV) 94%, P < 0.0001), 12-lead amplitude-duration product >or=2.2 mV s (odds ratio 31.0, sensitivity 92%, NPV 97%, P < 0.0001), and limb-lead amplitude-duration product >or=0.70 mV s (odds ratio 31.5, sensitivity 93%, NPV 96%, P < 0.0001). Sensitivity in HCM-patients <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 >or=6 gives a sensitivity of 85% but a higher positive predictive value than above measures. Optimal separation between HCM-CA <40 years and athletes is obtained by a risk score >or=6 (odds ratio 345, sensitivity 85%, specificity 100%, P < 0.0001).

    CONCLUSION: Twelve-lead ECG is a powerful instrument for risk-stratification in HCM.

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