Change search
Refine search result
1 - 33 of 33
CiteExportLink to result list
Permanent link
Cite
Citation style
  • apa
  • ieee
  • modern-language-association-8th-edition
  • vancouver
  • Other style
More styles
Language
  • de-DE
  • en-GB
  • en-US
  • fi-FI
  • nn-NO
  • nn-NB
  • sv-SE
  • Other locale
More languages
Output format
  • html
  • text
  • asciidoc
  • rtf
Rows per page
  • 5
  • 10
  • 20
  • 50
  • 100
  • 250
Sort
  • Standard (Relevance)
  • Author A-Ö
  • Author Ö-A
  • Title A-Ö
  • Title Ö-A
  • Publication type A-Ö
  • Publication type Ö-A
  • Issued (Oldest first)
  • Issued (Newest first)
  • Created (Oldest first)
  • Created (Newest first)
  • Last updated (Oldest first)
  • Last updated (Newest first)
  • Disputation date (earliest first)
  • Disputation date (latest first)
  • Standard (Relevance)
  • Author A-Ö
  • Author Ö-A
  • Title A-Ö
  • Title Ö-A
  • Publication type A-Ö
  • Publication type Ö-A
  • Issued (Oldest first)
  • Issued (Newest first)
  • Created (Oldest first)
  • Created (Newest first)
  • Last updated (Oldest first)
  • Last updated (Newest first)
  • Disputation date (earliest first)
  • Disputation date (latest first)
Select
The maximal number of hits you can export is 250. When you want to export more records please use the Create feeds function.
  • 1.
    Bergström, Göran
    et al.
    Göteborgs universitet.
    Börjesson, Mats
    Swedish School of Sport and Health Sciences, GIH, Department of Sport and Health Sciences, Åstrand Laboratory of Work Physiology, Björn Ekblom's and Mats Börjesson's research group.
    Schmidt, Caroline
    Göteborgs universitet.
    Self-efficacy regarding physical activity is superior to self-assessed activity level, in long-term prediction of cardiovascular events in middle-aged men2015In: BMC Public Health, ISSN 1471-2458, E-ISSN 1471-2458, Vol. 15, article id 820Article in journal (Refereed)
    Abstract [en]

    Background

    Self-efficacy has been determined to be a strong predictor of who will engage in physical activity. We aimed to evaluate the associations between self-efficacy to perform physical activity, self-reported leisure-time physical activity and cardiovascular events in a population-based cohort of middle-aged Swedish men with no previous cardiovascular disease, or treatment with cardiovascular drugs.

    Methods

    Analyses are based on 377 men randomly selected and stratified for weight and insulin sensitivity from a population sample of 58-year-old men (n = 1728) and who had answered a question about their competence to perform exercise (as an assessment of physical self-efficacy). The Saltin-Grimby Physical Activity Level Scale was used to assess self-reported levels of leisure-time physical activity. Cardiovascular events were recorded during 13-years of follow-up.

    Results

    The group with poor self-efficacy to perform physical activity had a significantly higher incidence of cardiovascular events compared with the group with good physical self-efficacy (32.1 % vs 17.1 %, p < 0.01). Multivariate analyses showed that poor physical self-efficacy was associated with an increased relative risk of 2.0 (95 % CI 1.2 to 3.0), of having a cardiovascular event during follow-up also after adjustments for co-variates such as waist to hip ratio, heart rate, fasting plasma glucose, serum triglycerides, systolic blood pressure, apoB/apoA-I ratio and leisure-time physical activity.

    Conclusion

    Self-efficacy to perform physical activity was strongly and independently associated with cardiovascular events and was superior to self-assessed physical activity in predicting cardiovascular events during 13-years of follow-up in a group of middle-aged men, without known CVD or treatment with cardiovascular drugs.

  • 2.
    Börjesson, Mats
    Swedish School of Sport and Health Sciences, GIH, Department of Sport and Health Sciences, Åstrand Laboratory of Work Physiology, Björn Ekblom's and Mats Börjesson's research group.
    The Role Of The Ecg In Cardiovascular Screening Of Athletes2015In: European Journal of Sports Medicine, 3(2015):Suppl. 1 / [ed] Konstantinos Natsis, 2015, Vol. 3, p. 27-28Conference paper (Refereed)
    Abstract [en]

    INTRODUCTION: Sudden cardiac arrest (SCA) in an athlete, is an uncommon event (1/50 000), caused by inherited/congenital cardiovascular disease (in younger athletes, >35 years), while in the older athletes, the cause is most often  underlying coronary artery disease (CAD). Cardiac societies, Sports Medicine Associations and subsequently international sporting bodies have developed cardiac screening programmes to prevent SCA in athletes. In addition, increased  awareness and recommendations regarding arena safety procedures (external automated defibrillators, medical action plans), have been introduced in recent years, to increase the chance of survival in case of a SCA. However, the most appropriate cardiac screening protocol and specifically, the role of the ECG in cardiovascular screening of athletes, is still debated.

    AIM: This talk will discuss the sensitivity and specificity issues, connected with using the ECG or not, as part of cardiovascular screening of athletes.

    MATERIALS AND METHODS: Both the American Heart Association (AHA) and the European Society of Cardiology (ESC) (1) as well as the International Olympic Committee (IOC) recommend regular screening of competitive athletes, including personal and family history and physical examination. However, the AHA does not recommend the routine use of the ECG in screening. In recent years, more evidence has emerged, making it possible to scrutinize the literature regarding sensitivity/specificity for screening with/without ECG.

    RESULTS: Firstly, the available literature show that cardiovascular screening including an ECG will have much superior sensitivity for finding underlying relevant cardiac abnormalities. Traditionally, ECG has been found to also have a large number of false-positives, making the specificity of including the ECG low. However, in recent years, the international consensus-statements on ECG interpretation in athletes, have been repeatedly updated, due to scientific progress, making the specificity of cardiac screening with the ECG much higher, with unchanged high sensitivity (2). On the contrary, cardiac screening without the ECG has been shown to have a very low sensitivity, but more importantly will probably have also a low specificity, since many athletes do have a variety of often diffuse symptoms, which will necessitate further investigation, most readily an ECG. The few available cost-effectiveness studies worldwide, have shown that screening with the ECG is more cost-effective than screening without, but more high quality studies, are needed on cost-effectiveness.

    CONCLUSION: Cardiovascular screening of athletes aims to prevent sudden cardiac arrest (and death) of athletes. The inclusion of an ECG in regular screening, will be accompanied by higher sensitivity, while the specificity using this approach has increased considerably in recent years. All in all, ECG should be an integral part of cardiovascular screening of athletes, and is also recommended by EFSMA in its latest statement on pre-participation examination in sports (3).

  • 3.
    Börjesson, Mats
    et al.
    Swedish School of Sport and Health Sciences, GIH, Department of Sport and Health Sciences, Åstrand Laboratory of Work Physiology, Björn Ekblom's research group.
    Onerup, Aron
    Sahlgrenska universitetssjukhuset, Göteborg.
    Lundqvist, Stefan
    Primärvården Göteborg.
    Dahlöf, Björn
    Sahlgrenska akademin, Göteborg.
    Fysisk aktivitet vid hypertoni2016In: FYSS 2017: fysisk aktivitet i sjukdomsprevention och sjukdomsbehandling, Läkartidningen förlag , 2016, p. 412-425Chapter in book (Other academic)
    Abstract [sv]

    Sammanfattande rekommendation

    Personer med hypertoni bör rekommenderas aerob fysisk aktivitet för att sänka blodtrycket. Måttligt starkt vetenskapligt underlag (evidensstyrka +++).

    Personer med hypertoni kan som tillägg rekommenderas isometrisk träning för att sänka blodtrycket. Begränsat vetenskapligt underlag (evidensstyrka ++).

    Personer med hypertoni bör även rekommenderas muskelstärkande fysisk aktivitet enligt de allmänna rekommendationerna om fysisk aktivitet.

    Personer med hypertoni bör rekommenderas regelbunden fysisk aktivitet som en av flera åtgärder för att sänka blodtrycket.

  • 4.
    Börjesson, Mats
    et al.
    Swedish School of Sport and Health Sciences, GIH, Department of Sport and Health Sciences, Åstrand Laboratory of Work Physiology, Björn Ekblom's research group.
    Solberg, Erik Ekker
    Diakonhjemmets sykehus, Oslo.
    Nylander, Eva
    Universitetssjukhuset Linköping.
    Plötslig hjärtdöd vid fysisk aktivitet2016In: FYSS 2017: fysisk aktivitet i sjukdomsprevention och sjukdomsbehandling, Läkartidningen förlag , 2016, p. 241-249Chapter in book (Other academic)
    Abstract [sv]

    Sammanfattning

    Regelbunden fysisk aktivitet har positiva effekter på såväl riskfaktorer för hjärtkärlsjukdom som etablerad hjärt-kärlsjukdom. Aerob fysisk aktivitet på måttlig intensitet rekommenderas allmänt. Mer fysisk aktivitet på hög intensitet har potentiellt ännu större effekt, men kan också medföra ökade risker för personer med bakomliggande hjärt-kärlsjukdom.

    Plötslig hjärtdöd i samband med fysisk aktivitet bland individer > 35 år orsakas nästan uteslutande av kranskärlssjukdom. För äldre idrottare (> 35 år), liksom för icke elitaktiva, saknas i dag svenska rekommendationer om hjärtscreening. Självskattningsformulär, i utvalda fall kompletterat med hjärtundersökning hos ordinarie läkare, har föreslagits kunna minska risken i denna grupp.

    Plötsliga dödsfall under idrottsutövning bland unga (< 35 år) beror vanligen på tidigare odiagnostiserade medfödda eller ärftliga hjärtsjukdomar. Riksidrottsförbundet (RF) och Socialstyrelsen rekommenderar riktade hjärtkontroller av unga elitidrottare från 16 års ålder, bestående av familjehistoria, symtom, fysikalisk undersökning och vilo-EKG.

  • 5.
    Börjesson, Mats
    et al.
    Swedish School of Sport and Health Sciences, GIH, Department of Sport and Health Sciences, Åstrand Laboratory of Work Physiology, Björn Ekblom's and Mats Börjesson's research group.
    Vanhees, Luc
    Leuven University.
    Cardiovascular evaluation of middle-aged/senior leisure time athletes2013In: Cardiac Electrophysiology Clinics, ISSN 1877-9182, Vol. 5, no 1, p. 33-42Article, review/survey (Refereed)
  • 6. Calbet, J A L
    et al.
    Mortensen, S P
    Munch, G D W
    Curtelin, D
    Boushel, Robert
    Swedish School of Sport and Health Sciences, GIH, Department of Sport and Health Sciences, Åstrand Laboratory of Work Physiology.
    Constant infusion transpulmonary thermodilution for the assessment of cardiac output in exercising humans.2016In: Scandinavian Journal of Medicine and Science in Sports, ISSN 0905-7188, E-ISSN 1600-0838, Vol. 26, no 5, p. 518-527Article in journal (Refereed)
    Abstract [en]

    To determine the accuracy and precision of constant infusion transpulmonary thermodilution cardiac output (CITT-Q) assessment during exercise in humans, using indocyanine green (ICG) dilution and bolus transpulmonary thermodilution (BTD) as reference methods, cardiac output (Q) was determined at rest and during incremental one- and two-legged pedaling on a cycle ergometer, and combined arm cranking with leg pedaling to exhaustion in 15 healthy men. Continuous infusions of iced saline in the femoral vein (n = 41) or simultaneously in the femoral and axillary (n = 66) veins with determination of temperature in the femoral artery were used for CITT-Q assessment. CITT-Q was linearly related to ICG-Q (r = 0.82, CITT-Q = 0.876 × ICG-Q + 3.638, P < 0.001; limits of agreement ranging from -1.43 to 3.07 L/min) and BTD-Q (r = 0.91, CITT-Q = 0.822 × BTD + 4.481 L/min, P < 0.001; limits of agreement ranging from -1.01 to 2.63 L/min). Compared with ICG-Q and BTD-Q, CITT-Q overestimated cardiac output by 1.6 L/min (≈ 10% of the mean ICG and BTD-Q values, P < 0.05). For Q between 20 and 28 L/min, we estimated an overestimation < 5%. The coefficient of variation of 23 repeated CITT-Q measurements was 6.0% (CI: 6.1-11.1%). In conclusion, cardiac output can be precisely and accurately determined with constant infusion transpulmonary thermodilution in exercising humans.

  • 7. Calbet, Jose A L
    et al.
    Boushel, Robert C
    Swedish School of Sport and Health Sciences, GIH, Department of Sport and Health Sciences, Åstrand Laboratory of Work Physiology.
    Assessment of cardiac output with transpulmonary thermodilution during exercise in humans.2015In: Journal of applied physiology, ISSN 8750-7587, E-ISSN 1522-1601, Vol. 118, no 1, p. 1-10Article in journal (Refereed)
    Abstract [en]

    The accuracy and reproducibility of transpulmonary thermodilution (TPTd) to assess cardiac output (Q) in exercising men was determined using indocyanine green (ICG) dilution as a reference method. TPTd has been utilized for the assessment of Q and preload indices of global end-diastolic volume (GEDV) and intrathoracic blood volume (ITBV), as well as extravascular lung water (EVLW) in resting humans. It remains unknown if this technique is also accurate and reproducible during exercise. Sixteen healthy men underwent catheterization of the right femoral vein (for iced saline injection), an antecubital vein (ICG injection) and femoral artery (thermistor) to determine their Q by TPTd and [ICG] during incremental 1 and 2-legged pedaling on a cycle ergometer, and combined arm cranking with leg pedaling to exhaustion. There was a close relationship between Td-Q and ICG-Q (r=0.95, n=151, SEE: 1.452 L/min, P<0.001; mean difference of 0.06 L/min; limits of agreement -2.98 to 2.86 L/min), and TPTd-Q and ICG-Q increased linearly with VO2 with similar intercepts and slopes. Both methods had mean coefficients of variation (CV) close to 5% for Q, GEDV and ITBV. The mean CV of EVLW, assessed with both indicators (ICG and thermal) was 17%, and was sensitive enough as to detect a reduction in EVLW of 107 ml when changing from resting supine to upright exercise. In summary, transpulmonary thermodilution with bolus injection into the femoral vein is an accurate and reproducible method to assess cardiac output during exercise in humans.

  • 8.
    Ek, Amanda
    et al.
    Swedish School of Sport and Health Sciences, GIH, Department of Sport and Health Sciences, Åstrand Laboratory of Work Physiology. Karolinska University Hospital.
    Ekblom, Örjan
    Swedish School of Sport and Health Sciences, GIH, Department of Sport and Health Sciences, Åstrand Laboratory of Work Physiology.
    Hambraeus, Kristina
    Falun Hospital.
    Cider, Åsa
    Gothenburg University and Sahlgrenska University Hospital.
    Kallings, Lena
    Swedish School of Sport and Health Sciences, GIH, Department of Sport and Health Sciences, Åstrand Laboratory of Work Physiology. Uppsala University.
    Börjesson, Mats
    Gothenburg University and Sahlgrenska University Hospital.
    Physical inactivity and smoking after myocardial infarction as predictors for readmission and survival: results from the SWEDEHEART-registry.2019In: Clinical Research in Cardiology, ISSN 1861-0684, E-ISSN 1861-0692, Vol. 108, no 3, p. 324-332Article in journal (Refereed)
    Abstract [en]

    BACKGROUND: Physical activity (PA) and smoking cessation are included in the secondary prevention guidelines after myocardial infarction (MI), but they are still underutilised. This study aims to explore how PA level and smoking status (6-10 weeks post-MI) were associated with 1-year readmission and mortality during full follow-up time, and with the cumulative 5-year mortality.

    METHODS: A population-based cohort of all hospitals providing MI-care in Sweden (SWEDEHEART-registry) in 2004-2014. PA was expressed as the number of exercise sessions of ≥ 30 min in the last 7 days: 0-1 (low), 2-4 (medium) and 5-7 (high) sessions/week. Individuals were categorised as smokers, former smokers or never-smokers. The associations were analysed by unadjusted and adjusted logistic and Cox regressions.

    RESULTS: During follow-up (M = 3.58 years), a total of 1702 deaths occurred among 30 644 individuals (14.1 cases per 1000 person-years). For medium and high PA, the hazard ratios (HRs) for mortality were 0.39 and 0.36, respectively, compared with low PA. For never-smokers, the HR was 0.45 and former smokers 0.56 compared with smokers. Compared with low PA, the odds ratios (ORs) for readmission in medium PA were 0.65 and 0.59 for CVD and non-CVD causes, respectively. For high PA, the corresponding ORs were 0.63 and 0.55. The association remained in adjusted models. There were no associations between smoking status and readmission.

    CONCLUSIONS: The PA level and smoking status are strong predictors of mortality post-MI and the PA level also predicts readmission, highlighting the importance of adherence to the secondary prevention guidelines.

  • 9.
    Ek, Amanda
    et al.
    Swedish School of Sport and Health Sciences, GIH, Department of Sport and Health Sciences, Åstrand Laboratory of Work Physiology, Björn Ekblom's research group.
    Ekblom, Örjan
    Swedish School of Sport and Health Sciences, GIH, Department of Sport and Health Sciences, Åstrand Laboratory of Work Physiology, Björn Ekblom's research group.
    Kallings, Lena
    Swedish School of Sport and Health Sciences, GIH, Department of Sport and Health Sciences, Åstrand Laboratory of Work Physiology, Björn Ekblom's research group.
    Hambraeus, Kristina
    Cardiologkliniken, Falu lasarett.
    Börjesson, Mats
    Göteborgs Universitet.
    Association between physical activity level and risk of all-cause mortality after myocardial infarction2017In: European Journal of Preventive Cardiology, Vol 24, Issue 1 Suppl, April 2017: Abstract Book EuroPrevent 2017 Malaga, Spain, 2017, Vol. 24, article id 45Conference paper (Refereed)
    Abstract [en]

    Background/Introduction: There is little knowledge of the association between physical activity (PA) level and the mortality risk post myocardial infarction (MI). Steffen/Batey et al (2000), concluded in a smaller study, that individuals who remained active or increased their level of PA after MI had a lower risk of death. However, in order to confirm this and adjust for confounders larger studies are needed.

    Purpose: Explore any association between PA level after MI and all-cause mortality during follow-up in a large MI-cohort.

    Methods: A national cohort study including all patients <75 years of age, with a diagnosis of MI between 1991-2014 (Swedish MI register SWEDEHEART). From the register self-reported PA, 6-10 weeks post MI, (i.e. number of sessions during the past seven days with moderate and/or vigorous PA lasting ≥30 minutes) was obtained. The answers were grouped into 0-1 sessions (inactive), 2-4 sessions (moderately active) and 5-7 sessions (regularly active). Associations were first assessed unadjusted, stratified by potential confounders (sex, age, smoking status, ejection fraction, ST-elevation and quality of life). Thereafter, a multiple logistic regression was performed to control for possible confounders.

    Results: Complete data was obtained from 37 655 individuals (median 63 years, 74 % men). A total of 2512 deaths occurred during a mean of 4.1 years of follow-up. The mortality rate was 17.0 cases/1000 person-years. Moderate and regular activity, was associated with a lower risk of all-cause mortality (OR 0,356 95 %, CI 0,320-0,396 and OR 0,334, 95 % CI 0,305-0,366) compared to being physically inactive. The OR´s remained largely unchanged when stratifying for age, sex, NSTEM/STEMI and ejection fraction. However, active smokers had a lower OR, for subsequent death, as had patients with a low EQ5D. The associations persisted in the multiple logistic regression, after adjustment for confounders (Figure 1).

    Conclusion(s): A higher level of physical activity seems to be associated with a lower risk of all-cause mortality. These results suggest that physical activity assessment is important post MI, not least as an important predictor.

     

  • 10.
    Ek, Amanda
    et al.
    Swedish School of Sport and Health Sciences, GIH, Department of Sport and Health Sciences, Åstrand Laboratory of Work Physiology, Björn Ekblom's research group.
    Ekblom, Örjan
    Swedish School of Sport and Health Sciences, GIH, Department of Sport and Health Sciences, Åstrand Laboratory of Work Physiology, Björn Ekblom's research group.
    Kallings, Lena
    Swedish School of Sport and Health Sciences, GIH, Department of Sport and Health Sciences, Åstrand Laboratory of Work Physiology, Björn Ekblom's research group.
    Hambraeus, Kristina
    Cardiologkliniken, Falu lasarett.
    Börjesson, Mats
    Göteborgs Universitet.
    Samband mellan fysisk aktivitetsnivå efter hjärtinfarkt och risken för mortalitet: Association between physical activity level and risk of all-cause mortality after myocardial infarction2017In: Fria föredrag, nr 025, 2017, article id 025Conference paper (Refereed)
    Abstract [en]

    Background: There is little knowledge of the association between physical activity (PA) level and the mortality risk post myocardial infarction (MI)Steffen/Batey et al (2000), concluded in a smaller study, that individuals who remained active or increased their level of PA post-MI had a lower risk of death. This study aimed to explore any association between PA level post-MI and all-cause mortality during follow-up in a large MI-cohort.

    Methods: A national cohort study including patients <75 years of age, with a diagnosis of MI between 2005-2014 (SWEDEHEART, SEPHIA-register). Self-reported PA, 6-10 weeks post-MI, (i.e. number of sessions during the past seven days with moderate and/or vigorous PA lasting ≥30 minutes) was obtained. The answers were grouped into 0-1 sessions (inactive), 2-4 sessions (moderately active) and 5-7 sessions (regularly active). First, stratified unadjusted associations were investigated. Thereafter, a multiple logistic regression was performed to control for possible confounders.

    Results: Complete data was obtained from 37 655 individuals (median age 63 years, 74 % men). A total of 2512 deaths occurred during a mean of 4.1 years of follow-up. The mortality rate was 17.0 cases/1000 person-years. Moderate and regular activity, was associated with a lower risk of all-cause mortality (OR 0.36, 95 % CI: 0.32-0.40 and OR 0.33, 95 % CI: 0.31-0.37) compared to being physically inactive. The OR´s remained largely unchanged when stratifying for age, gender, NSTEM/STEMI and ejection fraction. However, compared to inactive patients, physically active smokers and patients with ≤ 0.85 Eq5D had a higher OR, for subsequent death. The associations persisted in the multiple logistic regression, after adjustment for confounders (Figure 1).

    Conclusions: A higher level of PA, post-MI was associated with a lower risk of all-cause mortality. These results suggest that PA assessment is important post-MI, not least as an important predictor for risk of death.

  • 11.
    Ekblom, Örjan
    et al.
    Swedish School of Sport and Health Sciences, GIH, Department of Sport and Health Sciences, Åstrand Laboratory of Work Physiology.
    Ek, Amanda
    Swedish School of Sport and Health Sciences, GIH, Department of Sport and Health Sciences, Åstrand Laboratory of Work Physiology, Björn Ekblom's research group.
    Cider, Åsa
    University of Gothenburg.
    Hambraeus, Kristina
    Falun Hospital.
    Börjesson, Mats
    University of Gothenburg.
    Increased Physical Activity Post-Myocardial Infarction Is Related to Reduced Mortality; Results From the SWEDEHEART Registry2018In: Journal of the American Heart Association: Cardiovascular and Cerebrovascular Disease, ISSN 2047-9980, E-ISSN 2047-9980, Vol. 7, no 24, article id e010108Article in journal (Refereed)
    Abstract [en]

    Background

    With increasing survival rates among patients with myocardial infarction (MI), more demands are placed on secondary prevention. While physical activity (PA) efforts to obtain a sufficient PA level are part of secondary preventive recommendations, it is still underutilized. Importantly, the effect of changes in PA after MI is largely unknown. Therefore, we sought to investigate the effect on survival from changes in PA level, post‐MI.

    Methods and Results

    Data from Swedish national registries were combined, totaling 22 227 patients with MI. PA level was self‐reported at 6 to 10 weeks post‐MI and 10 to 12 months post‐MI. Patients were classified as constantly inactive, increased activity, reduced activity, and constantly active. Proportional hazard ratios were calculated. During 100 502 person‐years of follow‐up (mean follow‐up time 4.2 years), a total of 1087 deaths were recorded. Controlling for important confounders (including left ventricular function, type of MI, medication, smoking, participation in cardiac rehabilitation program, quality of life, and estimated kidney function), we found lower mortality rates among constantly active (hazard ratio: 0.29, 95% confidence interval: 0.21–0.41), those with increased activity (0.41, 95% confidence interval: 0.31–0.55), and those with reduced activity (hazard ratio: 0.56, 95% confidence interval: 0.45–0.69) during the first year post‐MI, compared with those being constantly inactive. Stratified analyses indicated strong effect of PA level among both sexes, across age, MI type, kidney function, medication, and smoking status.

    Conclusions

    The present article shows that increasing the PA level, compared with staying inactive the first year post‐MI, was related to reduced mortality.

  • 12.
    Ekblom-Bak, Elin
    et al.
    Swedish School of Sport and Health Sciences, GIH, Department of Sport and Health Sciences, Björn Ekblom's research group.
    Ekblom, Björn
    Swedish School of Sport and Health Sciences, GIH, Department of Sport and Health Sciences, Björn Ekblom's research group.
    Hellénius, Mai-Lis
    Minskat stillasittande lika viktigt som ökad fysisk aktivitet: [Less sitting as important as increased physical activity]2010In: Läkartidningen, ISSN 0023-7205, E-ISSN 1652-7518, Vol. 107, no 9, p. 587-8Article in journal (Other academic)
    Abstract [en]

    There is clear evidence for the benefits of regular physical activity for several major health diseases. Meanwhile, sedentary behaviour, resulting in limited everyday life nonexercise activity and muscular inactivity, is increasing in Sweden. Recent observational studies suggest that prolonged bouts of sitting and lack of whole body muscular movement are independently of additional regular physical activity, strongly associated with common public health diseases and total mortality. This indicates that we are dealing with two distinct behaviours and their effects; a) the benefits of regular physical activity and b) the risks of too much sitting and limited nonexercise everyday life activity.The focus in clinical practice and for guidelines should be to promote and prescribe regular physical activity as well as avoidance of sedentary behaviour.

  • 13.
    Ekblom-Bak, Elin
    et al.
    Swedish School of Sport and Health Sciences, GIH, Department of Sport and Health Sciences, Björn Ekblom's research group.
    Hellénius, Mai-Lis
    Ekblom, Björn
    Swedish School of Sport and Health Sciences, GIH, Department of Sport and Health Sciences, Björn Ekblom's research group.
    Are we facing a new paradigm of inactivity physiology?2010In: British Journal of Sports Medicine, ISSN 0306-3674, E-ISSN 1473-0480, Vol. 44, no 12, p. 834-5Article in journal (Refereed)
    Abstract [en]

    Evidence for the benefits of regular physical activity for several major health diseases is clear and unanimous. Current public health guidelines are promoting at least 150 minutes per week of moderate to vigorousintensity leisure-time physical activity.

    Recent, observational studies have suggested that prolonged bouts of sitting time and lack of whole-body muscular movement are strongly associated with obesity, abnormal glucose metabolism, diabetes, metabolic syndrome, cardiovascular disease (CVD) risk and cancer, as well as total mortality independent of moderate to vigorous-intensity physical activity.1,–,5 Accordingly, a possible new paradigm of inactivity physiology is suggested, separate from the established exercise physiology, that is, molecular and physiological responses to exercise.6 This new way of thinking emphasises the distinction between the health consequences of sedentary behaviour, that is, limiting everyday life non-exercise activity and that of not exercising. Until now, the expression “sedentary behaviour” has misleadingly been used as a synonym for not exercising. Sedentary time should be defined as the muscular inactivity rather than the absence of exercise.

  • 14.
    Fernberg, Ulrika
    et al.
    Örebro University, Örebro, Sweden.
    Op 't Roodt, Jos
    Maastricht University Medical Center, Maastricht, The Netherlands..
    Fernström, Maria
    Swedish School of Sport and Health Sciences, GIH, Department of Sport and Health Sciences, Åstrand Laboratory of Work Physiology.
    Hurtig-Wennlöf, Anita
    Örebro University, Örebro, Sweden.
    Body composition is a strong predictor of local carotid stiffness in Swedish, young adults - the cross sectional Lifestyle, biomarkers, and atherosclerosis study.2019In: BMC Cardiovascular Disorders, ISSN 1471-2261, E-ISSN 1471-2261, Vol. 19, no 1, article id 205Article in journal (Refereed)
    Abstract [en]

    BACKGROUND: Obesity has nearly tripled worldwide during the last four decades, especially in young adults, and is of growing concern since it is a risk factor for cardiovascular diseases (CVD). We explored how different body composition measurements are associated with intima media thickness (cIMT) and local stiffness in the common carotid artery, in a subsample of healthy, young women and men, from the Swedish Lifestyle, Biomarkers, and Atherosclerosis (LBA) Study.

    METHODS: From the LBA study, a subsample of 220 randomly selected, self-reported healthy individuals, 18-25 years old, were collected for the automatized local stiffness measurements; arterial distensibility, Young's elastic modulus, and β stiffness index. Blood pressure and mean arterial pressure (MAP) was measured using automatic blood pressure equipment. Body mass index (BMI) was calculated, waist circumference was measured, and percentage of body fat assessed using an impedance body composition analyzer. The carotid artery was scanned by ultrasound and analyzed using B-mode edge wall tracking. cIMT was measured and local stiffness measurements were calculated with carotid blood pressure, measured with applanation tonometry.

    RESULTS: No association was found between cIMT and body composition. Local carotid stiffness was associated with body composition, and women had less stiff arteries than men (p < 0.001). Of the local stiffness measurements, arterial distensibility had the strongest associations with body composition measurements in both women and men (p < 0.05). Multiple regression analyses showed that BMI in women and BMI and percentage of body fat in men had the highest impact on arterial distensibility (p < 0.01 in both women and men).

    CONCLUSIONS: Arterial distensibility was the local stiffness measurement with the strongest associations to different body composition measurements, in both women and men. In this age group, body composition measurements seem to be stronger predictors of common carotid arterial stiffness than MAP, and is a convenient way of detecting young adults who need cardiovascular risk follow-up and lifestyle counseling.

  • 15.
    Fernström, Maria
    Swedish School of Sport and Health Sciences, GIH, Department of Sport and Health Sciences, Åstrand Laboratory of Work Physiology.
    Hög aerob uthållighet förenat med låg risk för hjärt-kärlsjukdom hos svenska unga vuxna2018In: BestPractice, no SeptArticle in journal (Other academic)
  • 16.
    Fernström, Maria
    et al.
    Örebro University.
    Fernberg, Ulrika
    Örebro University.
    Eliason, Gabriella
    Örebro University.
    Hurtig-Wennlöf, Anita
    Örebro University.
    Aerobic fitness is associated with low cardiovascular disease risk: the impact of lifestyle on early risk factors for atherosclerosis in young healthy Swedish individuals - the Lifestyle, Biomarker, and Atherosclerosis study.2017In: Vascular Health and Risk Management, ISSN 1176-6344, E-ISSN 1178-2048, Vol. 13, p. 91-99Article in journal (Refereed)
    Abstract [en]

    BACKGROUND: The progression of cardiovascular disease (CVD) and atherosclerosis is slow and develops over decades. In the cross-sectional Swedish Lifestyle, Biomarker, and Atherosclerosis study, 834 young, self-reported healthy adults aged 18.0-25.9 years have been studied to identify early risk factors for atherosclerosis.

    PURPOSE: The aims of this study were to 1) assess selected cardiometabolic biomarkers, carotid intima-media thickness (cIMT) as a marker of subclinical atherosclerosis, and lifestyle-related indicators (food habits, handgrip strength, and oxygen uptake, VO2 max); 2) analyze the associations between cIMT and lifestyle factors; and 3) identify subjects at risk of CVD using a risk score and to compare the characteristics of subjects with and without risk of CVD.

    METHOD: Blood samples were taken in a fasting state, and food habits were reported through a questionnaire. cIMT was measured by ultrasound, and VO2 max was measured by ergometer bike test. The risk score was calculated according to Wildman.

    RESULT: cIMT (mean ± standard deviation) was 0.50±0.06 mm, and VO2 max values were 37.8±8.5 and 42.9±9.9 mL/kg/min, in women and men, respectively. No correlation was found between aerobic fitness expressed as VO2 max (mL/kg/min) and cIMT. Using Wildman's definition, 12% of the subjects were classified as being at risk of CVD, and 15% had homeostasis model assessment of insulin resistance. A total of 35% of women and 25% of men had lower high-density lipoprotein cholesterol than recommended. Food habits did not differ between those at risk and those not at risk. However, aerobic fitness measured as VO2 max (mL/kg/min) differed; 47% of the subjects at risk had low aerobic fitness compared to 23% of the nonrisk subjects (P<0.001).

    CONCLUSION: High aerobic fitness is associated with low CVD risk in Swedish young adults. The high prevalence of young adults observed with unfavorable levels of high-density lipoprotein cholesterol and homeostasis model assessment of insulin resistance raises concerns about future CVD risk.

  • 17.
    Gripeteg, Lena
    et al.
    University of Gothenburg.
    Arvidsson, Daniel
    University of Gothenburg.
    Johannesson, Elias
    University of Gothenburg.
    Larsson, Christel
    University of Gothenburg.
    Sjöberg, Agneta
    University of Gothenburg.
    Angerås, Oskar
    University of Gothenburg.
    Fagman, Erika
    University of Gothenburg.
    Brandberg, John
    University of Gothenburg.
    Ekblom, Örjan
    Swedish School of Sport and Health Sciences, GIH, Department of Sport and Health Sciences, Åstrand Laboratory of Work Physiology.
    Bergström, Göran
    University of Gothenburg.
    Börjesson, Mats
    University of Gothenburg.
    Concomitant Associations of Healthy Food Intake and Cardiorespiratory Fitness With Coronary Artery Calcium.2018In: American Journal of Cardiology, ISSN 0002-9149, E-ISSN 1879-1913, Vol. 122, no 4, p. 560-564, article id S0002-9149(18)31060-9Article in journal (Refereed)
    Abstract [en]

    Conflicting findings remain regarding associations between lifestyle behaviors and coronary artery calcium (CAC). We investigated concomitant associations of healthy food intake and cardiorespiratory fitness (CRF) with CAC. Data from 706 men and women 50 to 64 years old from the Swedish SCAPIS pilot trial were analyzed. A CAC score was calculated using the Agatston method. A Healthy Food Index (HFI) was established using data from a web-based food frequency questionnaire. CRF was assessed from a bike exercise test. Regression analyses were performed with occurrence of CAC (dichotomous) and level of CAC score in patients with CAC (continuous) as outcomes. 58% had 0 CAC score. HFI was significantly associated with having no CAC (standardized coefficient β = 0.18, p <0.001) but not with level of CAC score (β = -0.09, p = 0.34). CRF showed no significant association with having no CAC (β = -0.08, p = 0.12) or with the level of CAC score (β = -0.04, p = 0.64). However, there was an interaction between HFI and CRF (β = -0.23, p = 0.02); for increasing levels of CRF there was stronger negative association between HFI and level of CAC score, reaching β = -0.48, p = 0.045 for the highest CRF level. In conclusion, these results emphasize the importance of a healthy food intake in combination with higher CRF to counteract CAC development.

  • 18.
    Lidin, Matthias
    et al.
    Karolinska institutet.
    Hellénius, Mai-Lis
    Karolinska institutet.
    Rydell-Karlsson, Monica
    Karolinska institutet.
    Ekblom Bak, Elin
    Swedish School of Sport and Health Sciences, GIH, Department of Sport and Health Sciences, Åstrand Laboratory of Work Physiology.
    Long-term effects on cardiovascular risk of a structured multidisciplinary lifestyle program in clinical practice.2018In: BMC Cardiovascular Disorders, ISSN 1471-2261, E-ISSN 1471-2261, Vol. 18, no 1, article id 59Article in journal (Refereed)
    Abstract [en]

    BACKGROUND: Cardiovascular disease is still the leading cause of premature death world-wide with factors like abdominal obesity, hypertension and dyslipidemia being central risk factors in the etiology. The aim of the present study was to investigate the effects on cardiovascular risk factors and cardiovascular risk after 6 months and 1 year, in individuals with increased cardiovascular risk enrolled in a lifestyle multidisciplinary program in a clinical setting.

    METHOD: Individuals with increased cardiovascular risk were referred from primary health care and hospitals to a program at an outpatient clinic at a department of cardiology. The program consisted of three individual visits including a health check-up with a physical examination and blood sampling, and a person-centered dialogue for support in behavioural change of unhealthy lifestyle habits (at baseline, 6 months and 1 year). Furthermore, five educational group sessions were given at baseline. Cardiovascular risk was assessed according to Framingham cardiovascular risk predicting model.

    RESULTS: One hundred individuals (mean age 59 years, 64% women) enrolled between 2008 and 2014 were included in the study. Waist circumference, systolic and diastolic blood pressure and total cholesterol decreased significantly over 1 year. In parallel, cardiovascular risk according to the cardiovascular risk profile based on Framingham 10-year risk prediction model, decreased with 15%. The risk reduction was seen in both men and women, and in participants with or without previous cardiovascular disease.

    CONCLUSION: Participating in a structured lifestyle program over a year was associated with significant improvement in multiple cardiovascular risk factors and decreased overall cardiovascular risk.

    TRIAL REGISTRATION: The study is registered at www.clinicaltrials.gov (ClinicalTrial.gov ID: NCT02744157 ).

  • 19.
    Lindkvist, Madelene
    et al.
    Örebro university.
    Fernberg, Ulrika
    Örebro university.
    Ljungberg, Liza U
    Örebro university.
    Fälker, Knut
    Örebro university.
    Fernström, Maria
    Örebro university.
    Hurtig-Wennlöf, Anita
    Örebro university.
    Grenegård, Magnus
    Örebro university.
    Individual variations in platelet reactivity towards ADP, epinephrine, collagen and nitric oxide, and the association to arterial function in young, healthy adults.2019In: Thrombosis Research, ISSN 0049-3848, E-ISSN 1879-2472, Vol. 174, p. 5-12, article id S0049-3848(18)30647-9Article in journal (Refereed)
    Abstract [en]

    INTRODUCTION: Platelet aggregation and secretion can be induced by a large number of endogenous activators, such as collagen, adenosine diphosphate (ADP) and epinephrine. Conversely, the blood vessel endothelium constitutively release platelet inhibitors including nitric oxide (NO) and prostacyclin. NO and prostacyclin are also well-known vasodilators and contribute to alterations in local blood flow and systemic blood pressure.

    MATERIALS AND METHODS: In this study we investigated individual variations in platelet reactivity and arterial functions including blood pressure and flow-mediated vasodilation (FMD) in 43 young, healthy individuals participating in the Lifestyle, Biomarkers and Atherosclerosis (LBA) study. Platelet aggregation and dense granule secretion were measured simultaneously by light transmission and luminescence. FMD was measured with ultrasound.

    RESULTS: The platelet function assay showed inter-individual differences in platelet reactivity. Specifically, a sub-group of individuals had platelets with an increased response to low concentrations of ADP and epinephrine, but not collagen. When the NO-donor S-nitroso-N-acetyl-DL-penicillamine (SNAP) was combined with high doses of these platelet activators, the results indicated for sub-groups of NO-sensitive and NO-insensitive platelets. The individuals with NO-sensitive platelets in response to SNAP in combination with collagen had a higher capacity of FMD of the arteria brachialis.

    CONCLUSIONS: Platelet reactivity towards ADP, epinephrine and NO differs between young, healthy individuals. Some individuals have a more effective response towards NO, both in the aspect of platelet inhibition ex vivo, as well as vasodilation in vivo.

  • 20.
    Lönnberg, Lena
    et al.
    Uppsala University, Sweden..
    Ekblom Bak, Elin
    Swedish School of Sport and Health Sciences, GIH, Department of Sport and Health Sciences, Åstrand Laboratory of Work Physiology, Björn Ekblom's research group.
    Damberg, Mattias
    Uppsala University, Sweden..
    Improved unhealthy lifestyle habits in patients with high cardiovascular risk: results from a structured lifestyle programme in primary care2019In: Upsala Journal of Medical Sciences, ISSN 0300-9734, E-ISSN 2000-1967Article in journal (Refereed)
    Abstract [en]

    Background. Physical activity, healthful dietary habits, and not smoking are associated with reduced cardiovascular morbidity and mortality. However, few studies have examined how counselling to improve poor lifestyle habits might be carried out in clinical practice. In Swedish primary care, structured lifestyle counselling is still not integrated into everyday clinical practice. The aim of the present study was two-fold: (1) to describe a novel lifestyle intervention programme in primary care; and (2) to evaluate change in unhealthy lifestyle habits over 1 year in men and women with high cardiovascular risk who participated in the lifestyle intervention programme. Method. A single-group study with a 1-year follow-up was carried out. A total of 417 people was enrolled, median age 62 years (54% women), with either hypertension (69%), type 2 diabetes mellitus, or impaired glucose tolerance. The 1-year intervention included five counselling sessions that focused on lifestyle habits, delivered by a district nurse with postgraduate credits in diabetes care and the metabolic syndrome. All patients were offered in-depth counselling for one or more lifestyle habits when needed. Lifestyle habits were assessed by a questionnaire at baseline and 1-year follow-up. Total change was assessed using a nine-factor unhealthy lifestyle habit index. Results. Favourable, significant changes were observed for physical activity, dietary habits, smoking, and stress over 1 year. Similar improvements were seen for both sexes and type of diagnosis. Conclusions. The results support the utility of a multifactorial, structured approach to change unhealthy lifestyle habits for cardiovascular risk prevention in a primary care setting.

  • 21.
    Mattsson, C. Mikael
    Swedish School of Sport and Health Sciences, GIH, Department of Sport and Health Sciences.
    Hjärtats adaptation till träning2016In: Idrott och hjärtat / [ed] Mats Börjesson & Mikael Dellborg, Studentlitteratur AB, 2016, p. 21-36Chapter in book (Other (popular science, discussion, etc.))
    Abstract [sv]

    Boken Idrott och hjärtat beskriver de positiva effekterna av träning och fysisk aktivitet men tar också upp risker förenade med högintensiv aktivitet. Boken ger en god inblick i de grundläggande förändringarna i hjärtats arbete vid träning, på motions- och elitnivå.


    Idrott och hjärtat är uppbyggd i tre delar: ”Det (troligen) friska hjärtat”, ”Det sjuka hjärtat” samt den tredje delen ”Praktiska tillämpningar” vilken beskriver dels undersökningstekniker och utredningsgång, viktiga och vanliga differentialdiagnoser och symtom, allt relaterat till hjärta och idrott.


    Idrott och hjärtat riktar sig till lagläkare och andra idrottsmedicinskt engagerade, till idrottsintresserade specialister inom kardiologi, internmedicin, klinisk fysiologi och allmänmedicin samt till specialintresserade sjuksköterskor och fysioterapeuter.

  • 22.
    Mattsson, C. Mikael
    Swedish School of Sport and Health Sciences, GIH.
    Mysteriet plötslig hjärtdöd2009In: Idrottens olösta gåtor / [ed] Christian Carlsson, Stockholm: SISU Idrottsböcker , 2009, 1, p. 54-65Chapter in book (Other (popular science, discussion, etc.))
  • 23.
    Mattsson, C. Mikael
    Swedish School of Sport and Health Sciences, GIH.
    När hjärtat slutar slå: Plötslig hjärtdöd2009In: Idrott & Kunskap, ISSN 1652-6961, no 4, p. 26-30Article in journal (Other (popular science, discussion, etc.))
    Abstract [sv]

    Det är alltid tragiskt och ofta ett mysterium när en till synes helt frisk idrottsutövare faller död ned på planen mitt under pågående match. I den här artikeln ska vi försöka bena ut begreppet ”plötslig hjärtdöd inom idrotten”: Vad är det? Vad beror det på? Och vad kan man göra för att förhindra det? I början av juli hölls en konferens vid Stanford Universitetet i USA där världsledande experter i ämnet var samlade.

  • 24.
    Mattsson, C. Mikael
    Swedish School of Sport and Health Sciences, GIH, Department of Sport and Health Sciences, Åstrand Laboratory of Work Physiology, Björn Ekblom's and Mats Börjesson's research group.
    Physiology of Adventure Racing: with emphasis on circulatory response and cardiac fatigue2011Doctoral thesis, comprehensive summary (Other academic)
    Abstract [en]

    The overall aims of this thesis were to elucidate the circulatory responses to ultra-endurance exercise (Adventure Racing), and furthermore, to contribute to the clarification of the so called “exercise-induced cardiac fatigue” in relation to said exercise. An Adventure race (AR) varies in duration from six hours to over six days, in which the participants have to navigate through a number of check-points over a pre-set course, using a combination of three or more endurance/outdoor sports, e.g., cycling, running, and kayaking. This thesis is based on the results from four different protocols; 12- and 24-h (n = 8 and 9, respectively) in a controlled setting with fixed exercise intensity, and 53-h and 5-7-day (n = 15 in each) in field setting under race conditions. The subjects in all protocols were experienced adventure racing athletes, competitive at elite level. Study I and II address the circulatory responses and cardiovascular drift, using methods for monitoring heart rate (HR), oxygen uptake (VO2), cardiac output (non-invasive re-breathing) and blood pressure, during ergometer cycling at fixed steady state work rate at periods before, during and after the ultra-endurance exercise. In Study III and IV we examined the possible presence of exercise-induced cardiac fatigue after a 5-7-day AR, from two different perspectives. In Study III analyses were performed with biochemical methods to determine circulating levels of cardiac specific biomarkers (i.e., creatine kinase isoenzyme MB (CK-MB), troponin I, B-type natriuretic peptide (BNP) and N-terminal prohormonal B-type natriuretic peptide (NT-proBNP)). We also made an attempt to relate increases in biomarkers to rated relative performance. In Study IV we used tissue velocity imaging (TVI) (VIVID I, GE VingMed Ultrasound, Norway) to determine whether the high workload (extreme duration) would induce signs of functional cardiac fatigue similar to those that occur in skeletal muscle, i.e., decreased peak systolic velocities. Using conventional echocardiography we also evaluated whether the hearts of experienced ultra-endurance athletes are larger than the normal upper limit. The central circulation changed in several steps in response to ultra-endurance exercise. Compared to initial levels, VO2 was increased at every time-point measured. The increase was attributed to peripheral adaptations, confirmed by a close correlation between change in VO2 and change in arteriovenous oxygen difference. The first step of the circulatory response was typical of normal (early) cardiovascular drift, with increased HR and concomitantly decreased stroke volume (SV) and oxygen pulse (VO2/HR), occurring over the first 4-6 h. The second step, which continued until approximately 12h, included reversed HR-drift, with normalisation of SV and VO2/HR. When exercise continued for 50 h a late cardiovascular drift was noted, characterised by increased VO2/HR, (indicating more efficient energy distribution), decreased peripheral resistance, increased SV, and decreased work of the heart. Since cardiac output was maintained at all-time points we interpret the changes as physiologically appropriate adaptations. Our findings in Study III point towards a distinction between the clinical/pathological and the physiological/exercise-induced release of cardiac biomarkers. The results imply that troponin and CKMB lack relevance in the (healthy) exercise setting, but that BNP, or NT-proBNP adjusted for exercise duration, might be a relevant indicator for impairment of exercise performance. High levels of NTproBNP, up to 2500 ng · l -1 , can be present after ultra-endurance exercise in healthy athletes without any subjective signs or clinical symptoms of heart failure. However, these high levels of NT-proBNP seemed to be associated with decreased relative exercise performance, and might be an indicator of the cardiac fatigue that has previously been described after endurance exercise. Study IV revealed that the sizes of the hearts (left ventricle) of all of our ultra-endurance athletes were within normal limits. The measurements of peak systolic velocities showed (for group average) no signs of cardiac fatigue even after 6 days of continuous exercise. This discrepancy between ours and other studies, involving e.g., marathon or triathlon, might reflect the fact that this type of exercise is performed at relatively low average intensity, suggesting that the intensity, rather than the duration, of exercise is the primary determinant of cardiac fatigue.

  • 25.
    Mattsson, C. Mikael
    Swedish School of Sport and Health Sciences, GIH, Department of Sport and Health Sciences, Björn Ekblom's research group.
    Så påverkas hjärtat: Nya avhandlingar: Physiology of Adventure Racing - with emphasis on circulatory response and cardiac fatigue2011In: Svensk IdrottsMedicin, ISSN 1103-7652, Vol. 30, no 4, p. 22-27Article in journal (Other academic)
    Abstract [sv]

    Det övergripande målet med denna avhandling är att redogöra för hur den centrala cirkulationen påverkas av ultra-uthållighetsarbete (multisport/Adventure Racing), samt bidra till kartläggningen av den så kallade "arbetsinducerade hjärtutmattningen".

  • 26.
    Mattsson, C. Mikael
    et al.
    Swedish School of Sport and Health Sciences, GIH, Department of Sport and Health Sciences, Åstrand Laboratory of Work Physiology, Björn Ekblom's and Mats Börjesson's research group.
    Berglund, Bo
    Department of Medicine, Internal Medicine Unit, Karolinska Institutet, Karolinska University Hospital Solna, Sweden.
    Ekblom, Björn
    Swedish School of Sport and Health Sciences, GIH, Department of Sport and Health Sciences, Åstrand Laboratory of Work Physiology, Björn Ekblom's and Mats Börjesson's research group.
    Extreme values of NT-proBNP after ultra-endurance exercise in healthy athletes – Related to impaired exercise performance?2011Article in journal (Refereed)
  • 27.
    Mattsson, C. Mikael
    et al.
    Swedish School of Sport and Health Sciences, GIH, Department of Sport and Health Sciences.
    Börjesson, Mats
    Swedish School of Sport and Health Sciences, GIH, Department of Sport and Health Sciences.
    EKG hos idrottare: Ibland svårt, men alltid viktigt2013In: Svensk Idrottsmedicin, ISSN 1103-752, Vol. 32, no 2, p. 11-13Article in journal (Other academic)
    Abstract [sv]

    Få medicinska underökningar har så lång tradition och så stor symbolisk betydelse som ett EKG (elektrokardiogram). Hjärtat är ju själva symbolen för liv, och ett normalt EKG är en viktig del i att man betecknas som hjärtfrisk.

  • 28.
    Mattsson, C. Mikael
    et al.
    Swedish School of Sport and Health Sciences, GIH, Department of Sport and Health Sciences, Björn Ekblom's research group.
    Lind, Britta
    KTH, Skolan för teknik och hälsa.
    Enqvist, Jonas K.
    Swedish School of Sport and Health Sciences, GIH, Department of Sport and Health Sciences, Björn Ekblom's research group.
    Mårtensson, Mattias
    KTH, Skolan för teknik och hälsa.
    Ekblom, Björn
    Swedish School of Sport and Health Sciences, GIH, Department of Sport and Health Sciences, Björn Ekblom's research group.
    Brodin, Lars-Åke
    KTH, Skolan för teknik och hälsa.
    No evidence of cardiac fatigue in tissue velocity curves at rest after 6 days of ultra-endurance exercise2010In: European Heart Journal (2010) 31 (Abstract Supplement), 304-305, Oxford Journals , 2010, Vol. 31, no Abstract supplement, p. 304-305Conference paper (Refereed)
    Abstract [en]

    Purpose: The aim of this study was to investigate if extreme workload would induce signs of cardiac fatigue similar to that in skeletal muscle, e.g. decreased velocity of contraction.

    Methods: The subjects were 12 men and 3 women who participated in the Adventure Racing World Championship, a 5-7 days non-stop competition open for mixed gender teams of four. All subjects were healthy, well-trained ultra-endurance athletes with experince from several years of training and competition at international elite level. Measurements of the heart's contraction velocities were conducted using tissue Doppler imaging (VIVID7) in a resting situation at baseline, immediately after the race, and after 24 hours of recovery.

    Results: Characteristics for the subjects were at baseline (mean ± SD, for men and women): age 30±3 and 27±4; interventricular septal thickness 10.5±0.7 and 8.0±0.0 mm; left ventricular end-diastolic diameter 54.4±3.4 and 45.0±3.0 mm; posterior wall thickness 10.4±0.9 and 8.0±1.0 mm; early to late diastolic filling velocity (E/A) 2.3±0.6 and 2.2±0.2. Exercise duration was approx. 150 hours, and the calculated average work intensity was 40% of respective VO2peak, including time for rest, change of equipment, and food intake. Values of contraction velocities are presented in the table.

    Conclusions: All athletes had normally sized hearts. Based on contraction velocities we found no evidence of cardiac fatigue after ultra-endurance exercise. A difference compared to studies that found cardiac fatigue in other sports (e.g. marathon, triathlon) is that even though our population exercised for an extreme duration the average intensity was low. This might point towards that exercise intensity, not duration, is the primary source for cardiac fatigue.

  • 29.
    Mattsson, C. Mikael
    et al.
    Swedish School of Sport and Health Sciences, GIH, Department of Sport and Health Sciences, Åstrand Laboratory of Work Physiology, Björn Ekblom's and Mats Börjesson's research group.
    Lind, Britta
    School of Technology and Health, Royal Institute of Technology (KTH).
    Enqvist, Jonas K.
    Swedish School of Sport and Health Sciences, GIH, Department of Sport and Health Sciences, Åstrand Laboratory of Work Physiology, Björn Ekblom's and Mats Börjesson's research group.
    Mårtensson, Mattias
    School of Technology and Health, Royal Institute of Technology (KTH).
    Ekblom, Björn
    Swedish School of Sport and Health Sciences, GIH, Department of Sport and Health Sciences, Åstrand Laboratory of Work Physiology, Björn Ekblom's and Mats Börjesson's research group.
    Brodin, Lars-Åke
    School of Technology and Health, Royal Institute of Technology (KTH).
    No evidence of cardiac fatigue in tissue velocity curves at rest after 6 days of ultra-endurance exercise.2011Article in journal (Refereed)
  • 30.
    Mattsson, C. Mikael
    et al.
    Swedish School of Sport and Health Sciences, GIH, Department of Sport and Health Sciences.
    Waggott, Daryl
    Department of Cardiovascular Medicine, School of Medicine, Stanford University, Stanford, CA, USA.
    Wheeler, Matthew
    Department of Cardiovascular Medicine, School of Medicine, Stanford University, Stanford, CA, USA.
    Pavlovic, Aleksandra
    Department of Cardiovascular Medicine, School of Medicine, Stanford University, Stanford, CA, USA.
    Reese, Kristin
    Department of Cardiovascular Medicine, School of Medicine, Stanford University, Stanford, CA, USA.
    Ashley, Euan A.
    Department of Cardiovascular Medicine, School of Medicine, Stanford University, Stanford, CA, USA.
    Informing women’s cardiovascular health through genomic analysis of extreme endurance athletes2015Conference paper (Refereed)
    Abstract [en]

    Cardiovascular health exists as a spectrum of wellness and disease states. We hypothesize that interrogating the tail ends of the distribution for individuals with extreme phenotypes, such as high VO2max in endurance athletes, will inform prevention, cause and treatment of pathogenic conditions. Mounting literature suggests that the physiological path to athletic performance is different among males and females. Traits with published sexual dichotomy include lactate threshold, efficiency, heat management, and fat metabolism. To define the genetic roots of this dichotomy, we propose to investigate sex-specific genetic determinants of VO2max among elite endurance athletes. We have recruited 36 female (VO2max>63 ml/kg; >99.99th percentile) and 129 male (>75 ml/kg) elite athletes (n=167) who have been consented and undergone enhanced whole exome sequencing. Even with differential eligibility, skewed recruitment (1:3.5) is a challenge. We will recruit a total of 100 female and 156 male elite athletes, and analyze these 256 exomes for burden of rare genetic variation that may impact sex-specific determinants of VO2max. We will combine these data with an additional 1850 samples of elite athletes to evaluate for common variants that have sex-specific effects on VO2max. Lastly, we will do a sex specific genetic cohort comparison of endurance athletes with existing collections of cardiovascular disease patients. Our preliminary results show tantalizing evidence for several highly plausible sex specific genes, including androgen receptor (AR) and FTO. The AR is the target of several known performance enhancing drugs, such as testosterone. FTO is associated with numerous aspects of body composition, energy management and even some evidence for age of menarche. While already promising, rigorous analysis, increased sample size and orthogonal replication is required as our next step.

  • 31. Palmefors, Henning
    et al.
    DuttaRoy, Smita
    Rundqvist, Bengt
    Börjesson, Mats
    Swedish School of Sport and Health Sciences, GIH, Department of Sport and Health Sciences, Åstrand Laboratory of Work Physiology, Björn Ekblom's and Mats Börjesson's research group.
    The effect of physical activity or exercise on key biomarkers in atherosclerosis: a systematic review2014In: Atherosclerosis, ISSN 0021-9150, E-ISSN 1879-1484, Vol. 235, no 1, p. 150-61Article, review/survey (Refereed)
    Abstract [en]

    OBJECTIVE: This systematic review aimed to summarize published papers on the effect of physical activity (PA)/exercise on key atherosclerotic factors in patients with risk factors for or established cardiovascular disease (CVD).

    METHODS: Studies involving PA and cytokines, chemokines, adhesion molecules, CRP and angiogenic factors were searched for in Medline and Cochrane library. Original human studies of more than 2 weeks of PA intervention were included. Study quality was assessed according to the GRADE system of evidence.

    RESULTS: Twenty-eight papers fulfilled the inclusion criteria. PA decreases the cytokines, tumor necrosis factor-a (TNF-a), interleukin-6 (IL-6), and interferon-y IFN-y (high, moderate and low evidence, respectively). The effect of PA on chemokines; stromal derived factor-1 (SDF-1), interleukin-8 (IL-8) (insufficient evidence) and monocyte chemoattractant protein-1 (MCP-1) (low evidence) was inconclusive. Aerobic exercise decreased the adhesion molecules, vascular cell adhesion molecule-1 (VCAM-1) and intercellular adhesion molecule-1 (ICAM-1) (moderate and high evidence, respectively), while effects of PA on E- and P-selectin were inconclusive. PA decreases C-reactive protein (CRP) (high evidence). The angiogenic actors, endothelial progenitor cells (EPCs) are increased (high evidence) and VEGF is decreased (moderate evidence) by PA. The effect of PA on these factors seems to depend on the type and duration of exercise intervention and patient factors, such as presence of ischemia.

    CONCLUSION: As presented in this review, there is a high level of evidence that physical activity positively affects key players in atherosclerosis development. These effects could partly explain the scientifically proven anti-atherogenic effects of PA, and do have important clinical implications.

  • 32. Schmied, C
    et al.
    Börjesson, Mats
    Swedish School of Sport and Health Sciences, GIH, Department of Sport and Health Sciences, Åstrand Laboratory of Work Physiology, Björn Ekblom's and Mats Börjesson's research group.
    Sudden cardiac death in athletes.2014In: Journal of Internal Medicine, ISSN 0954-6820, E-ISSN 1365-2796, Vol. 275, no 2, p. 93-103Article in journal (Refereed)
    Abstract [en]

    A 'paradox of sport' is that in addition to the undisputed health benefits of physical activity, vigorous exertion may transiently increase the risk of acute cardiac events. In general, the risk of sudden cardiac death (SCD) approximately doubles during physical activity and is 2- to 3-fold higher in athletes compared to nonathletes. The incidence of SCD in young athletes is in fact very low, at around 1-3 per 100 000, but attracts much public attention. Variations in incidence figures may be explained by the methodology used for data collection and more importantly by differences between subpopulations of athletes. The incidence of SCD in older (≥35 years) athletes is higher and may be expected to rise, as more and older individuals take part in organized sports. SCD is often the first clinical manifestation of a potentially fatal underlying cardiovascular disorder and usually occurs in previously asymptomatic athletes. In the young (<35 years), SCD is mainly due to congenital/inherited cardiac abnormalities, whilst coronary artery disease (CAD) is the most common cause in older athletes. Cardiac screening including family/personal history, physical examination and resting electrocardiogram (ECG) may identify individuals at risk and has the potential to decrease the risk of SCD in young athletes. Screening including the ECG has a high sensitivity for underlying disease in young athletes, but the specificity needs to be improved, whereas the sensitivity of screening without the use of ECG is very low. The screening modality recommended for young athletes is of limited value in older athletes, who should receive individualized screening with cardiac stress testing for patients with high risk of underlying CAD. As cardiovascular screening will never be able to identify all athletes at risk, adequate preparedness is vital in case of a potentially fatal event at the sporting arena/facility. Firstly, we will review the magnitude of the problem of SCD in athletes of different ages, as well as the aetiology. Secondly, we will focus on how to prevent SCD in athletes of all ages, reviewing cardiovascular screening recommendations as well as emergency preparedness and arena safety.

  • 33. Solberg, E E
    et al.
    Börjesson, Mats
    Swedish School of Sport and Health Sciences, GIH, Department of Sport and Health Sciences, Åstrand Laboratory of Work Physiology, Björn Ekblom's and Mats Börjesson's research group.
    Sharma, S
    Papadakis, M
    Wilhelm, M
    Drezner, J A
    Harmon, K G
    Alonso, J M
    Heidbuchel, H
    Dugmore, D
    Panhuyzen-Goedkoop, N M
    Mellwig, K-P
    Carre, F
    Rasmusen, H
    Niebauer, J
    Behr, E R
    Thiene, G
    Sheppard, M N
    Basso, C
    Corrado, D
    Sudden cardiac arrest in sports - need for uniform registration: A Position Paper from the Sport Cardiology Section of the European Association for Cardiovascular Prevention and Rehabilitation.2016In: European Journal of Preventive Cardiology, ISSN 2047-4873, E-ISSN 2047-4881, Vol. 23, no 6, p. 657-667Article in journal (Refereed)
    Abstract [en]

    There are large variations in the incidence, registration methods and reported causes of sudden cardiac arrest/sudden cardiac death (SCA/SCD) in competitive and recreational athletes. A crucial question is to which degree these variations are genuine or partly due to methodological incongruities. This paper discusses the uncertainties about available data and provides comprehensive suggestions for standard definitions and a guide for uniform registration parameters of SCA/SCD. The parameters include a definition of what constitutes an 'athlete', incidence calculations, enrolment of cases, the importance of gender, ethnicity and age of the athlete, as well as the type and level of sporting activity. A precise instruction for autopsy practice in the case of a SCD of athletes is given, including the role of molecular samples and evaluation of possible doping. Rational decisions about cardiac preparticipation screening and cardiac safety at sport facilities requires increased data quality concerning incidence, aetiology and management of SCA/SCD in sports. Uniform standard registration of SCA/SCD in athletes and leisure sportsmen would be a first step towards this goal.

1 - 33 of 33
CiteExportLink to result list
Permanent link
Cite
Citation style
  • apa
  • ieee
  • modern-language-association-8th-edition
  • vancouver
  • Other style
More styles
Language
  • de-DE
  • en-GB
  • en-US
  • fi-FI
  • nn-NO
  • nn-NB
  • sv-SE
  • Other locale
More languages
Output format
  • html
  • text
  • asciidoc
  • rtf