Scandinavian Cardiovascular Journal (SCAND CARDIOVASC J )

Publisher: Taylor & Francis


Formerly Scandinavian Journal of Thoracic and Cardiovascular Surgery, Scandinavian Cardiovascular Journal is published by the Society for the Publication of the Key Foundation, Sweden. As of 1997, it is promoted in collaboration between the Scandinavian Societies of Cardiology in Denmark, Finland, Iceland, Norway and Sweden and the Scandinavian Association for Thoracic Surgery, which all have adopted the journal as their official organ. The principal aim of the journal is to promote cardiovascular research that crosses the borders between disciplines. The journal is a forum for the entire field of cardiovascular research, basic and clinical, thoracic surgery, transplantation, interventional cardiology and extracorporeal technology. Manuscripts will be reviewed for possible publication on the understanding that they have not been published, simultaneously submitted or accepted for publication elsewhere. Instructions for authors should be strictly followed. The journal is published in English, with six issues a year.

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    Scandinavian cardiovascular journal (Online)
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Taylor & Francis

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Publications in this journal

  • [Show abstract] [Hide abstract]
    ABSTRACT: Objective: To assess the relationship between hematological inflammatory signs, cardiovascular risk (CV) factors and prognosis in patients presenting with acute myocardial infarction (AMI) and coronary artery ectasia (CAE). Design: We investigated 3321 AMI patients who required urgent primary percutaneous intervention, in two centres in the United Kingdom between January 2009 and August 2012. Thirty patients with CAE were compared with 60 age- and gender-matched controls. Blood was collected within 2 hours of the onset of chest pain. CV risk factors were assessed from the records. Major acute cardiac events and/or mortality (MACE) over two years were documented. Results: CAE occurred in 2.7 % and more often affected the right (RCA) (p= 0.001) and left circumflex artery (LCx) (0.0001). Culprit lesions were more frequently related to atherosclerosis in non-CAE patients (p=0.001). Yet, CV risk factors failed to differentiate between the groups, except diabetes, which was less frequent in CAE (p= 0.02). CRP was higher in CAE (p=0.006), whereas total leucocyte, neutrophil counts and neutrophil/lymphocyte ratio (N/L ratio) were lower (p=0.002, 0.002 and 0.032, respectively) than among non-CAE. This also was the case in diffuse vs. localized CAE (p=0.02, 0.008 and 0.03, respectively). The MACE incidence did not differ between CAE and non-CAE (p=0.083) patients, and clinical management and MACE were unrelated to the inflammatory markers. Conclusion: In AMI, patients with CAE commonly have aneurysmal changes in RCA and LCx, and their inflammatory responses differ from those with non-CAE. These differences did not have prognostic relevance, and do not suggest different management.
    Scandinavian Cardiovascular Journal 03/2014;
  • Scandinavian Cardiovascular Journal 01/2011; 45:14.
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    ABSTRACT: In an in vitro study, extracorporeal circuits equipped with either a leukocyte-depleting filter (n = 5) or a standard arterial-line filter (n = 5) were perfused for 120 minutes with fresh human whole blood. Leukocyte activation, leukocyte and platelet counts and complement activation were studied. Significant reduction of leukocyte and platelet counts and significant activation of leukocytes and of platelets were found in both groups, but without significant intergroup difference for any parameter after 120 minutes of perfusion. The leukocyte-depleting filters, however, were somewhat more effective in removing leukocytes during the initial 30 minutes of circulation.
    Scandinavian Cardiovascular Journal 07/2009; 31(2):73-77.
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    ABSTRACT: The significant risk of cerebral embolism during cardiopulmonary bypass (CPB) makes monitoring of embolic events advisable already when developing new operation and coagulation management strategies for example in CPB animal models. The present study therefore evaluated in a porcine CPB model the feasibility of bilateral epicarotid Doppler signal recording and the quality of manual or automatic emboli detection. A total of 42 recordings (e.g. right carotid artery (n =20), left carotid artery (n =22)) were evaluated. The frequency of emboli counts was comparable for both carotid arteries. Automatic emboli detection, however, found significantly more embolic events per pig than did post-hoc manual off-line analysis of the recordings (172±217 vs. 13±10). None of the brains, however, showed any emboli or infarction area either in cross-examination or in histological evaluation. In conclusion, the present study showed the feasibility of using an epicarotid Doppler device for bilateral emboli detection in a porcine CPB model. Automatic on-line emboli detection, however, reported more embolic events than did post hoc, off-line manual analysis. Possible reasons for this discrepancy are discussed.
    Scandinavian Cardiovascular Journal 07/2009; 41(6):411-415.
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    ABSTRACT: Report long-term freedom from ventricular tachycardia (VT), survival, and causes of death in patients with left ventricular aneurysm and VT, who underwent a combined procedure for VT and surgical ventricular restoration (SVR). The primary outcome measures VT, survival, and cause of death, were ascertained by review of patients' records, interrogation of implanted cardioverter-defibrillators and use of national registers. Mean follow-up was 5.2 years. Overall survival was 62% at 5 years and 51% at 9 years. Freedom from spontaneous VT was 89%. In 32 patients who were non-inducible at postoperative testing, there was no occurrence of VT during a mean follow-up of 6.0 years. Causes of death were cardiac in 17 patients, and non-cardiac in 6 patients. No patient died from ventricular arrhythmia. Direct surgery for VT combined with SVR resulted in a very low risk of late recurrence of VT and good long-term survival. Implantation of a cardioverter-defibrillator can safely be withheld in patients who are non-inducible on postoperative programmed electrical stimulation.
    Scandinavian Cardiovascular Journal 07/2008; 42(3):226-32.
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    ABSTRACT: The aim of this nationwide case-control study was to study the epidemiology and identify risk factors of deep sternal wound infections (DSWI) in Iceland. Between 1997-2004, 1 650 adults underwent open cardiac surgery in Iceland. For every infected patient four control subjects were chosen (n =163), matched for time of operation. The groups were compared by multivariable logistic regression analysis. Forty one patients (2.5%) developed DSWI, most often following CABG (76%). The most common pathogens were Staphylococcus aureus (39%) and coagulase-negative staphylococci (24%). All except two patients underwent debridement and rewiring of the sternum. Length of hospital stay was significantly longer in the DSWI group with a trend for increased hospital mortality and significantly greater 1-year mortality (17% vs. 5%, p =0.02). History of stroke (OR 5.12), peripheral arterial disease (OR 5), corticosteroid use (OR 4.25), smoking (OR 3.66) and re-operation for bleeding (OR 4.66) were the strongest independent predictors for DSWI. Incidence of DSWI in Iceland (2.5%) is comparable to other recently published studies, with similar risk factors and significantly reduced survival at one year following the infection.
    Scandinavian Cardiovascular Journal 07/2008; 42(3):208-13.
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    ABSTRACT: To evaluate amiodarone prophylaxis in diabetics and non-diabetics. Further to clarify whether the risk of developing atrial fibrillation is higher for diabetics than non-diabetic patients, and to evaluate whether the diabetic status has any influence on the length of in-hospital stay. Subgroup analysis within a randomized, controlled, double-blinded trial. At 30 days of follow-up atrial fibrillation was equally frequent among diabetics (22%) and non-diabetics (17%) (p =0.41). The length of in-hospital stay for diabetics was prolonged with 25% (9%; 45%). The prophylactic amiodarone was found equally efficient in diabetics and non-diabetics, as the relative risk ratios were 1.2 (0.4-5.4) and 2.0 (0.3-12.5), respectively. Diabetics and non-diabetics had the same effect of the amiodarone prophylaxis regime. Atrial fibrillation developed equally among diabetics and non-diabetics, but the length of stay was prolonged for diabetics.
    Scandinavian Cardiovascular Journal 07/2008; 42(3):173-7.
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    ABSTRACT: Symptomatic abdominal aortic aneurysms (AAA) account for up to 20% of patients with unruptured AAA undergoing open repair. This condition is associated with an average postoperative mortality rate after open repair of about 16%. The aim of this study was to evaluate the outcome of a consecutive series of patients who underwent endovascular repair for symptomatic, unruptured AAA. From January 2000 to October 2006, 14 patients underwent endovascular repair of intact AAA within 15 days since admission for AAA-related symptoms. In these patients, a Zenith stent-graft (Cook Incorporated, Bloomington, IN, USA) was deployed at the Oulu University Hospital, Kuopio University Hospital and Helsinki University Hospital, Finland. Stent-grafting was not successful in one patient because of access failure. The procedure was immediately converted to open repair and an aortobifemoral bypass with a Dacron prosthesis was performed. In the remaining 13 patients, bifurcated Zenith stent-grafts were deployed. After the procedure, type II endoleak was observed in three patients. The mean follow-up time was 1.9+/-1.4 years. The 2-year survival rate was 69%. The survival freedom from secondary procedure was 71% as one patient underwent stent-grafting for a distal type I endoleak 5 months after the procedure. Another patient underwent femoro-femoral cross-over bypass surgery because of right limb graft thrombosis which occurred 9 months after the procedure. These preliminary results suggest that endovascular repair of symptomatic, unruptured AAA is feasible and can be associated with a favourable outcome despite a very high operative risk.
    Scandinavian Cardiovascular Journal 07/2008; 42(3):178-81.
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    ABSTRACT: The objective was to evaluate the prevalence of paroxysmal atrial fibrillation (PAF) in patients with heart failure (HF) due to systolic dysfunction. We included 79 patients (age 68 years, LVEF 30%) with HF and sinus-rhythm (SR) referred to a HF outpatient clinic. A 48 hours Holter ECG and a follow-up ECG were performed. RESULTS. One patient had one episode of PAF. Thirty-two (41%) patients had episodes of irregular atrial runs (AR). The numbers of QRS complexes during AR were 7.2+/-2.9 (mean+/-SD). Patients with AR were older than patients with SR, p =0.02 and more often of female sex, p =0.04. Multivariate logistic regression analysis showed that age and female sex were independently correlated with AR with adjusted OR of 1.1 (per year, 95% CI 1.02-1.14, p =0.01) and 4.0 (1.05-15.07, p =0.04), respectively. The presence of AR did not predict development of new-onset AF. Outpatients with HF due to systolic dysfunction did not present with PAF during 48 hours Holter, but had several episodes of AR. The clinical and prognostic importance of AR deserves further investigation.
    Scandinavian Cardiovascular Journal 07/2008; 42(3):202-7.
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    ABSTRACT: To study epicardial microwave ablation of concomitant atrial fibrillation and its effects on heart rhythm and atrial function during follow-up. The study included 20 open-heart surgery patients with concomitant atrial fibrillation. Transthoracic echocardiography with flow and tissue Doppler recordings was performed preoperatively and at 6 months postoperatively. Blood samples were obtained preoperatively and postoperatively for analysis of atrial natriuretic peptide (ANP), brain natriuretic peptide (BNP), and amino terminal precursor of brain natriuretic peptide (NT-proBNP). Fourteen of 19 patients (74%) were in sinus rhythm with no antiarrhythmic drugs at 12 months. All patients in sinus rhythm had preserved left and right atrial-filling waves through atrioventricular valves during atrial contraction. Tissue velocity echocardiography on patients in sinus rhythm showed preserved atrial wall velocities, atrial strain, and atrial strain rate. Levels of natriuretic peptides tended to decrease in patients with stable sinus rhythm at one year compared to patients in atrial fibrillation. Epicardial microwave ablation results in sinus rhythm in a majority of patients and seems to preserve atrial mechanical function.
    Scandinavian Cardiovascular Journal 07/2008; 42(3):192-201.
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    ABSTRACT: To describe gender differences and factors of importance for outcome in patients referred for sustained ventricular arrhythmias. Two hundred and fifty three patients took part in the survey, 126 (20 women) had sustained monomorphic ventricular tachycardia (VT) and 127 (31 women) had polymorphic VT/ventricular fibrillation. Ischemic heart disease was less common in women than in men (47 vs. 80%). At discharge, an ICD implant was similarly common in women (33%) and men (29%). One hundred and twenty five (65%) men and 37 (79%) women were alive at follow-up, p =0.08 (median follow-up 53 months). Independent predictors of long-term mortality were: 1) PVT/VF as the presenting arrhythmia, 2) a low ejection fraction, 3) increased QRS duration and 4) diabetes mellitus. The lower proportion of women compared to men being referred for evaluation of sustained ventricular arrhythmias may contribute to the lower number of ICD implants in women. The long-term survival in women and men did not differ significantly.
    Scandinavian Cardiovascular Journal 07/2008; 42(3):182-91.
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    ABSTRACT: To investigate the prognostic importance of cardiac troponin I (cTnI) elevation after percutaneous coronary intervention (PCI) in different clinical settings. The study includes 238 patients presenting with acute coronary syndrome (ACS) and 194 patients with stable angina pectoris (SAP). The composite end point of death or hospitalization due to non-fatal myocardial infarction, repeated revascularization or unstable angina, was determined during one year of follow-up. cTnI elevation after PCI was more frequent in ACS patients than SAP patients. ACS patients with cTnI elevation after PCI had significantly higher number of events than patients with unchanged cTnI status after PCI. SAP patients had generally lower event rate than ACS patients. The event rate was also significantly higher among ACS patients than SAP patients at comparable degrees of cTnI elevation after PCI. There was no difference in events among SAP patients with or without cTnI elevation after PCI. cTnI elevation after PCI predicts adverse outcome after one year in patients with ACS, but not in patients with SAP.
    Scandinavian Cardiovascular Journal 07/2008; 42(3):214-21.
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    ABSTRACT: Hypertrophic cardiomyopathy (HCM) represents an important cause of sudden cardiac death particularly in otherwise healthy young individuals. In some families, HCM is caused by distinct mutations of the cardiac beta myosin heavy chain gene (MYH7). We have analyzed the expression of the malignant MYH7Arg453Cys mutation, in cardiac and skeletal muscle, and related it to morphological alterations. Morphological investigation revealed hypertrophic cardiomyocytes but regularly arranged myofibrils. Skeletal muscle showed no sign of structural alterations. Our results indicate that cardiomyocyte hypertrophy is secondary, due to impaired function, and that the mutation causes no structural alteration in myofibrillar structure in cardiac or skeletal muscle.
    Scandinavian Cardiovascular Journal 05/2008; 42(2):153-6.
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    ABSTRACT: Most major defibrillator trials have short follow-up and may neither capture the benefit for those with preserved function nor the progressive nature of advanced heart disease. We intended to investigate the long-term outcome in an unselected population of patients treated with ICD. We followed 124 consecutive patients that received an ICD during 1993-2002 at our institution for a median of 6.1 years. Information about heart disease, index arrhythmia, follow-up and death was extracted from medical records. The crude mortality was 26% (32/124). One- and two-year mortality was 6% and 12%, estimated 5- and 10-year mortality 20% and 33%. The cause of death was heart failure in 75% of deaths. The ejection fraction was below 35% in 91% of the 32 patients who died. We estimated that 28% of the patients received lifesaving therapy. The relative number of saved lives and complications was not related to the ejection fraction. Patients with preserved left ventricular function are excellent candidates for ICD, with life-saving ICD therapies in a substantial proportion, low mortality and good quality of life.
    Scandinavian Cardiovascular Journal 05/2008; 42(2):125-9.
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    ABSTRACT: The most severe forms of acute heart failure have a dismal prognosis despite modern invasive treatment. For some of these patients, improved outcome must relay on early institution of ventricular assist devices (VAD). We aimed to estimate the potential VAD need in acute heart failure. All patients admitted to the ICU or CCU for acute heart failure (AHF) in 2003/04 (n=302) were reviewed. Non-survivors with severe acute heart failure, i.e. cardiogenic shock and postcardiotomy HF, were individually reviewed to assess eligibility for VAD-treatment. Cardiogenic shock and postcardiotomy HF was present in 23% (n=69) and 19% (n=57) of the AHF patients. Overall in hospital mortality in these groups was 38% (n=48). Of these, 15 were less than 75 years of age, without serious comorbidities and thus deemed to be potential candidates for VAD-treatment. This survey indicates that 12% of patients with severe acute heart failure are potential candidates for VAD-treatment. Extending these figures to a national level, indicate that approximately 70 patients per year could be candidates for short-term VAD-treatment in Norway.
    Scandinavian Cardiovascular Journal 05/2008; 42(2):118-24.
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    ABSTRACT: In LQT1 subtype of inherited long QT syndrome, repolarization abnormalities originating from defective I(Ks) render patients vulnerable to ventricular arrhythmia during sudden sympathetic activation. Experimental studies show lower I(Ks) density and longer action potential duration in left (LV) than in right (RV) ventricle. We studied interventricular dispersion of repolarization in patients with I(Ks) defect during autonomic tests. We measured interventricular (difference of QT intervals between LV and RV type leads) and transmural electrocardiographic dispersion of repolarization from 25-lead electrocardiograms in nine asymptomatic KCNQ1 mutation carriers (LQT1) and eight controls during rest, Valsalva maneuver, mental stress, sustained handgrip and supine exercise. LQT1 carriers showed increased interventricular dispersion of repolarization (13+/-9 ms vs. 4+/-4 ms, p=0.03) during all tests. Valsalva strain increased the difference between the study groups. In LQT1 carriers, interventricular dispersion of repolarization correlated weakly with electrocardiographic transmural dispersion of repolarization. Asymptomatic KCNQ1 mutation carriers exhibit increased and by abrupt sympathetic activation augmented interventricular difference in electrocardiographic repolarization times. Interventricular and transmural repolarization dispersion behave similarly in patients with I(Ks) defect.
    Scandinavian Cardiovascular Journal 05/2008; 42(2):130-6.
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    ABSTRACT: In this issue Ibrahim and co-authors report on technical hazards of off-pump (without heart lung machine) coronary surgery 1. Their findings are in line with meta-analyses of randomized trials which indicate that under-grafting and graft-failures are more common after off-pump than after standard operations. The risk that the objectives of coronary bypass surgery are endangered is discussed in relation to evidence based medicine. A moratorium is suggested until conclusive data are available.
    Scandinavian Cardiovascular Journal 05/2008; 42(2):99-101.
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    ABSTRACT: Effects of off-pump CABG on LIMA-LAD anastomotic dimensions vs. on-pump CABG assessed by epicardial ultrasound imaging. LIMA-LAD anastomoses were performed off-pump in 38 patients and on-pump in 12. Intra-operative imaging was by a GE Vivid 7 ultrasound scanner and i13L transducer. Length of the anastomosis (DA), LAD diameters at the toe (D1) and heel (D3) of the anastomosis, the reference downstream LAD (D2) were measured in diastole by two-dimensional imaging (B-mode). Relationships between these dimensions were compared between on- and off-pump patients. In off-pump patients, D3 dimension was smaller than D1 (p=0.004). Both D3 and D1 were smaller than D2 (p<0.01). Ratio D3/D2 was smaller than D1/D2 (p=0.009). In on-pump patients, these ratios were similar. D3/D2 ratio was smaller in off- than in on-pump patients (p=0.01), D1/D2 were similar in the two groups. Off-pump CABG may cause a narrowing of the coronaries, especially at the anastomotic heel. The anastomotic technique at the heel may have to be modified to improve its patency.
    Scandinavian Cardiovascular Journal 04/2008; 42(2):105-9.

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