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Biomedical subjects

E Henriksen

Publications and source records attributed to E Henriksen.

At least 19 recordsLinked to original sources
PubMed2004

Left ventricular volumes during exercise in endurance athletes assessed by contrast echocardiography.

AIM: The objective was to assess left ventricular (LV) volumes at rest and during upright submaximal exercise in endurance athletes to see whether changes in heart volume could explain the large predicted increase in cardiac output in endurance athletes. METHOD: Contrast echocardiography was used to assess changes in LV volumes during upright bicycle exercise in 24 healthy male endurance athletes. Maximal oxygen uptake and oxygen pulse were measured by using cardiopulmonary exercise testing. RESULTS: From rest to exercise at a heart rate of 160 beats min(-1) end-diastolic volume increased by 18% (P < 0.001) and end-systolic volume decreased by 21% (P = 0.002). Stroke volume showed an almost linear increase during exercise (45% increase, P < 0.001). The increase in end-diastolic volume contributed to 73% of the increase in stroke volume. No significant differences were observed between stroke volume calculated from LV volumes with contrast echocardiography and stroke volume calculated from oxygen pulse at heart rates of 130 and 160 beats min(-1). Using the linear regression equation between oxygen uptake and cardiac output assessed by echocardiography during exercise (r=0.87, P=0.002), cardiac output at maximal exercise was estimated at 33 +/- 3 L min(-1), with an estimated increase in stroke volume by 69% from rest to maximal exercise. CONCLUSION: By using contrast echocardiography, a large increase in stroke volume in endurance athletes could be explained by an almost linear increase in end-diastolic volume and an initial small decrease in end-systolic volume during incremental upright exercise.

Adult↗
PubMed2003

Can we bridge the gap between goals and practice through a common vision? A study of politicians and managers' understanding of the provisions of elderly care services.

The objective of this study was to identify and describe how local politicians and managers experience and understand problems and goals regarding the structures and processes involved in the care of the elderly. Qualitative methodology of a conceptual modelling workshop was used. Participants were health care politicians, local municipal politicians, and executive care managers. The main result was that all participants agreed on four key visions for the health care of the elderly: see the person, see the individual's resources, see the encounter, and see yourself. Other findings indicated that (a) care of older persons was governed by diverse interests, (b) the organisation lacked clear leadership and comprehensive goals, (c) the organisation was fragmented, and (d) there was a lack of skilled staff members to meet patient needs. Older persons were regarded as passive receivers of care or as objects that did not take an active part in health care decisions that affect them.

Aged↗
PubMed2003

Understanding cardiac follow-up services--a qualitative study of patients, healthcare professionals, and managers.

The study explores the experience and understanding of stakeholders involved in follow-up services after a cardiovascular event. A multimethod approach was used consisting of questionnaires, telephone surveys, and in-depth, face-to-face interviews. Five themes were identified: patients wished to be seen in their total context, patients should do as told; healthcare professionals perform check-ups and control cardiac risk factors; healthcare professionals are in charge of the care processes; and the structure and processes of the healthcare organization. Results indicate that healthcare professionals have considerable difficulty in understanding the patient's situation and to collaborate between different levels of care. Furthermore, the total healthcare organization lacked comprehensive and practical structures in the follow-up process, rehabilitation, and secondary preventive services.

Aftercare↗
PubMed2003

Left ventricular volume changes during supine exercise in young endurance athletes.

AIM: The primary objective of the study was to measure the relative left ventricular volumes and the changes in left ventricular ejection fraction during supine position from rest to exercise in young endurance athletes. The secondary objective was to examine if there were gender differences regarding the volume reply and ejection fraction with exercise. METHOD: Sixty-five (35 female and 30 males) young healthy Swedish orienteers participated in the study. Left ventricular volume and ejection fraction changes between rest and submaximal supine bicycle exercise were measured with radionuclide ventriculography. RESULTS: The mean left ventricular end-diastolic volume increased by 13% (P < 0.001) but there was no change in end-systolic volume. Stroke volume was found to increase by 21% (P < 0.001). Left ventricular ejection fraction increased significantly (>0.04 units) in 54% of the athletes from rest to exercise; 5% of the athletes showed a decrease in ejection fraction. A negative correlation was found between ejection fraction at rest and the difference in ejection fraction from rest to exercise (r = -0.38, P = 0.002). There were no gender differences in the left ventricular volume changes or ejection fraction. CONCLUSION: During submaximal supine exercise, the adjustments in cardiac volumes in endurance athletes were small. There were no gender disparities concerning the left ventricular volume reply during exercise.

Adult↗
PubMed2003

Contradictions in elderly care: a descriptive study of politicians' and managers' understanding of elderly care.

The care of older people in Sweden has undergone several major reorganisations during the past decade. The healthcare organisation, governed by the county councils, previously had the responsibility of providing care services for elderly people. However, the local municipalities have taken over that duty since 1992. The obligation of the health services is now restricted solely to medical issues. The present study focused on the understanding that politicians and managers have about caring for older people. A section of Stockholm with a population of 320,000 inhabitants was studied. The authors hypothesised that differences in understanding might have an impact on the services of care which older people receive. Interviews were conducted with eight leading politicians and 12 managers responsible for elderly care services. The main focus of inquiry concerned the participants' understanding of caring for older people. The results indicate that politicians and managers in elderly care sometimes have divergent views on how the care should be developed and produced to best serve older people. Five themes of understanding elderly care services and eight contradictory statements among the respondents were identified. A follow-up group session with the respondents was conducted to discuss the results of the interviews. The different ways of understanding elderly care services showed a complex and fragmented organisation lacking clear goals, structures and leadership. However, the authors found a willingness among respondents to collaborate with one another, as well as indications of positive attitudes toward improving healthcare, domiciliary and nursing care of older people.

Aged↗
PubMed2001

Subacute bartonella infection in Swedish orienteers succumbing to sudden unexpected cardiac death or having malignant arrhythmias.

During the period 1979-92, an increasing number of sudden unexpected cardiac deaths (SUCD) occurred in young, Swedish, male elite orienteers. Myocarditis was the most common diagnosis in the 16 victims, and in 4 cases was also associated with fatty infiltration mimicking arrhythmogenic right ventricular cardiomyopathy (ARVC). Tissues from autopsies of 5 orienteers were tested for Bartonella by PCR targeting the gltA (citrate-synthase) gene. The products were then sequenced. Antibodies to B. henselae, B. quintana and B. elizabethae were measured by indirect fluorescence antibody assay. Bartonella spp. DNA was detected in the hearts of 4 deceased orienteers, and in the lung of a fifth deceased case. The sequences were close to B. quintana in 2 cases and identical to B. henselae in 3. Four of these 5 cases, as well as 2 additional cases of elite orienteers with ARVC, indicated antibodies to Bartonella. It is suggested that Bartonella-induced silent subacute myocarditis, eventually leading to electric instability, caused the increased SUCD rate among the Swedish orienteers. It is further suggested that Bartonella infection may be a major pathogenetic factor in the development of ARVC-like disease. Although the mode of transmission is unknown, both zoonotic/vector-borne and parenteral person-to-person transmission may be involved.

Adult↗
PubMed2001

Thallium-201 myocardial imaging at rest in male orienteers and other endurance athletes.

During the period 1979 to 1992, 16 sudden unexpected cardiac deaths were known to have occurred in young Swedish orienteers. Autopsy indicated myocarditis to be the most frequent finding, most often combined with extensive myocardial fibrosis. The aim of the present investigation was to explore whether young male orienteers show a higher frequency than other young elite endurance athletes (controls) in the occurrence of Thallium-201 myocardial perfusion defects at rest, suggestive of fibrosis evoked by myocarditis. Thallium-201 perfusion abnormalities at rest were more frequently found in the controls than in the orienteers (26% vs. 12%, p=0.03). Uneven Tl-201 perfusion was associated with left ventricular mass (r=0.32, r=0.24, p<0.01, p=0.02) and body weight (r=0.30, r=0.31, p<0.01, p=0.03) in orienteers and controls, respectively. Echocardiographic left ventricular wall motion abnormalities were found in 11 athletes (9 orienteers and 2 controls) but only two displayed an abnormal Thallium-201 perfusion scan at rest. Perfusion abnormalities at rest did not occur more frequently in the orienteers but were commonly found in both groups of apparently healthy athletes making it futile to discern abnormals from normals. Thallium-201 perfusion aberrations were not associated with left ventricular wall motion abnormalities obtained by echocardiography.

Adult↗
PubMed2000

Organochlorines in top predators at Svalbard--occurrence, levels and effects.

Alarmingly high polychlorinated biphenyl (PCB) levels have been found in the top predators such as glaucous gull (Larus hyperboreus) and polar bear (Ursus maritimus) at Svalbard [Gabrielsen, G.W., Skaare, J.U., Polder, A., Bakken, V., 1995. Chlorinated hydrocarbons in glaucous gull (Larus hyperboreus). Sci. Total Environ. 160/161, 337-346; Bernhoft, A., Skaare, J.U., Wiig, O., 1997. Organochlorines in polar bears (Ursus maritimus) at Svalbard. Environ. Pollut. 95, 159-175; Henriksen, E.O., Gabrielsen, G.W., Trudeau, S., Wolkers, H., Sagerup, K., Skaare, J.U., 1999. Organochlorines and possible biochemical effects in glaucous gull (Larus hyperboreus) from Bear Island, the Barents Sea. Arch. Environ. Contam. Toxicol. (in press). ]. Studies of the possible toxic effects, particularly on the immune system and reproduction, of the very high PCB levels in these species are currently being investigated. Data obtained in the field (f.i. reproductive success in polar bears and intestinal nematodes in glaucous gulls), as well as levels of various biochemical and physiological parameters (f.i. thyroid hormones, retinol, EROD activity, CYP1A, IgG), have been coupled with the PCB levels [Skaare, J.U., Wiig, O., Bernhoft, A., 1994. Klorerte organiske miljogifter; Nivâer og effekter i isbjorn. Norwegian Polar Institute Reportseries no. 86, 1-23 (in Norwegian); Bernhoft, A., Skaare, J.U., Wiig, O., 1997. Organochlorines in polar bears (Ursus maritimus) at Svalbard. Environ. Pollut. 95, 159-175; Bernhoft, A., Skaare, J.U., Wiig, O., Derocher, A.E., Larsen, H.J., 2000. Possible immunotoxic effects of organochlorines in polar bears (Ursus maritimus) at Svalbard (in press); Henriksen, E.O., Gabrielsen, G.W., Skaare, J.U., Skjegstad, N., Jensen, B.M., 1998a. Relationship between PCB levels, hepatic EROD activity and plasma retinol in glaucous gull, Larus hyperboreus. Marine Environ. Res. 46, 45-49; Henriksen, E.O., Gabrielsen, G.W., Trudeau, S., Wolkers, H., Sagerup, K., Skaare, J.U. , 1999. Organochlorines and possible biochemical effects in glaucous gull (Larus hyperboreus) from Bear Island, the Barents Sea. Arch. Environ. Contam. Toxicol. (in press); Sagerup, K., Gabrielsen, G.W., Skorping, A., Skaare, J.U., 1998. Association between PCB concentrations and intestinal nematodes in glaucou gulls, Larus hyperboreus, from Bear Island. Organohalogen compounds 39, 449-451; Skaare, J.U., Wiig, O., Bernhoft, A., 1994. Klorerte organiske miljogifter; Nivâer og effekter i isbjorn. Norwegian Polar Institute Reportseries no. 86, 1-23. (in Norwegian)].

Adipose Tissue↗
PubMed2000

Imaging of aortoiliac arterial disease. Duplex ultrasound and MR angiography versus digital subtraction angiography.

PURPOSE: To evaluate and compare the diagnostic accuracy of duplex ultrasound (US) and MR angiography (MRA) at 1.0 T in aortoiliac arterial disease using digital subtraction angiography (DSA) as the reference standard. In addition, a comparison of the 2D time-of-flight (TOF) and 3D contrast-enhanced MRA (CE MRA) techniques was performed. MATERIAL AND METHODS: Prospectively, 39 patients with symptoms of lower-extremity arterial occlusive disease were examined using US, TOF MRA, CE MRA and DSA. Significant lesions (stenosis > or =50%) and occlusions were evaluated blindly for each method. RESULTS: For all segments, the sensitivity for US, TOF MRA and CE MRA with regard to significant lesions was 0.72, 0.81 and 0.81, respectively, and the specificity for each was 0.97, 0.91 and 0.92, respectively. For significant lesions above the inguinal ligament the corresponding sensitivity was 0.84, 0.89 and 0.94 and the specificity 0.93, 0.82 and 0.73, respectively. The specificity was higher when the two MRA methods were combined. TOF MRA overgraded 7 segments as occluded. In most cases, the length of the occlusions was correctly determined on CE MRA, overestimated on TOF MRA and uncertain on US. CONCLUSION: Neither US nor MRA were sufficiently accurate to fully replace angiography. MRA was preferable to US as a non-invasive test when vascular intervention was contemplated. Although CE MRA was superior to TOF MRA, the most accurate results were achieved when the two methods were combined.

Aged↗
PubMed2000

Doppler transmitral and pulmonary venous flow in young orienteers and sedentary young adults.

Doppler filling indices may provide important information on left ventricular diastole and possibly diastolic adaptation in endurance athletes. We therefore undertook a comparative study to obtain reference values for transmitral and pulmonary venous Doppler flow velocities and to characterize differences between young orienteers and young sedentary adults. Seventy-six elite orienteers (42 female and 34 male; 17-30 years old) and 61 sedentary young subjects (32 female and 29 male; 17-33 years old) underwent echocardiography. No significant differences between the athletes and sedentary controls regarding peak transmitral flow were found, although the athletes had significantly higher peak pulmonary flow velocity during diastole than the sedentary controls (0.69+/-0.13, 0.61+/-0.10, 0.78+/-0.12, and 0.57+/-0.09 m/sec for female athletes, female sedentary controls, male athletes, and male sedentary controls, respectively). Because no significant differences were revealed in the transmitral flow velocities between the athletes and the sedentary subjects, the relative force between the left atrium and the left ventricle should not diverge during early filling. An increase in pulmonary venous pressure or a decrease in left atrial pressure can augment the force between the pulmonary veins and the left atrium. A rise in pulmonary venous pressure is a hemodynamically unlikely adaptation in endurance athletes; therefore, to maintain the same transmitral pressure with an assumed lower left atrial pressure, the data suggest a more rapid relaxation and an improved left ventricular elastic recoil, which would enable the athletes to achieve a more rapid negative left ventricular pressure change during early filling.

Adolescent↗
PubMed1999

Wall motion abnormalities in male elite orienteers are aggravated by exercise.

During the period 1979-92, 16 (15 men and one woman) sudden unexpected cardiac deaths occurred among young Swedish orienteers. This finding indicated a sharp increase in the death rate of orienteers, and necropsy demonstrated that myocarditis was a common histopathological finding. Therefore, an extensive non-invasive cardiac investigation was performed. A total of 59 male élite orienteers (mean age 23 years) and 36 cross-country skiers and middle-distance runners (mean age 22 years), serving as controls, were examined by both echocardiography at rest and radionuclide ventriculography at rest and during exercise. Wall motion abnormalities were found in eight orienteers using echocardiography. The purpose of this study was to examine whether the group of orienteers with wall motion abnormalities found using echocardiography had a smaller increase in ejection fraction from rest to exercise using radionuclide ventriculography than the rest of the orienteers and the controls, indicating an aggravation of the wall motion abnormalities during exercise. There were no significant differences in the ejection fraction at rest between the groups. In the orienteers with wall motion abnormalities (group 1), 62% (five out of eight) had less than a 0.05 unit increase in left ventricular ejection fraction compared with 27% (14 out of 51) of the remaining orienteers (group 2) and 19% (7 out of 36) of the controls (group 3). A comparison of athletes in group 1 with those in groups 2 and 3 combined revealed a statistically significant difference (P < 0.05). The divergent response in left ventricular ejection fraction during exercise suggests an aggravation of the wall motion abnormalities with exercise. Both the echocardiographic and the radionuclide ventriculographic findings indicate that the orienteers in group 1 had concealed left ventricular damage.

Adolescent↗
PubMed1999

An echocardiographic study of right and left ventricular adaptation to physical exercise in elite female orienteers.

BACKGROUND: A considerable body of echocardiographic studies has described how athletic training induces morphological adaptation of the left ventricle in male endurance athletes, but only a few studies have described left ventricular adaptation in female endurance athletes. In contrast to changes in the left ventricle far less attention has been directed towards right ventricular changes due to extensive physical exercise. The purpose of this study was to obtain normal values and to determine if there are any differences in right and left ventricular cavity and wall dimensions between female orienteers and females with a mainly sedentary lifestyle. METHODS: Echocardiography was performed in 42 highly trained elite female orienteers and 32 healthy female students with a predominantly sedentary lifestyle. The 74 females had no history of cardiac disease, a normal electrocardiogram and showed no echocardiographic abnormalities. M-mode and two-dimensional measurements of the right and left ventricular cavity and wall were obtained in elite orienteers and sedentary females. For the right ventricle and wall, multiple cross-sections were used and measurements were obtained from the right ventricular inflow and outflow tract. RESULTS: The left ventricular end-diastolic cavity dimension and the left ventricular wall thickness were significantly greater in the athletes compared with the sedentary controls. The right ventricular inflow tract measurements were all significantly greater in the orienteers compared with the controls but the right ventricular outflow tract measurements were comparable in the study groups. The right ventricular wall thickness, calculated as the mean of three different wall measurements was an average of 13% greater in the athletes compared with the sedentary controls. CONCLUSION: This study suggests symmetrical cardiac enlargement with a concomitant increase in both the right and left ventricular wall, probably reflecting the increased haemodynamic loading in the female athletes.

Adaptation, Physiological↗
PubMed1998

Menopause is associated with the stiffness of the common carotid artery in 50-year-old women.

To determine if menopause has an effect on the elasticity of the arteries, the stiffness index of the common carotid artery was studied in 84 premenopausal and 139 post-menopausal women. The study group was age-homogeneous, all women being 50 years of age. There were no significant differences between pre- and post-menopausal women regarding atherosclerosis, when measured as the number of subjects with plaques or intimal-medial thickness. The diameter of the common carotid artery was significantly larger in post-menopausal women. The diameter was correlated to measurements of body size which did not, however, differ between the two groups. The mean stiffness indexes were 4.99 +/- 1.02 and 5.38 +/- 1.21 in the pre- and post-menopausal groups respectively (P < 0.05). In a multivariate analysis, menopause (P < 0.05), and also serum insulin levels (P < 0.01) and smoking (P < 0.05) were found to have independent significant associations to the stiffness index. In conclusion, menopause is associated with reduced elasticity of the carotid arteries in 50-year-old women.

Arteriosclerosis↗
PubMed1998

An echocardiographic study of right ventricular adaptation to physical exercise in elite male orienteers.

Considerably more publications appear on left ventricular morphology than on the right ventricle. The reasons for this imbalance are related to the complex shape of the right ventricular cavity and its position beneath the sternum, making imaging, measurement and functional assessment much more complex than the left ventricular chamber. Little attention has been directed towards right ventricular changes because of training, therefore the present study was designed to assess right ventricular changes due to extensive training by comparing cavity and wall dimensions in 29 sedentary men (mean age 23 years) and 82 elite male orienteers (mean age 22 years). The elite orienteers had on average significantly larger right ventricular outflow (10%) and right ventricular inflow (12%) tract 2 and 3 dimensions. The right ventricular wall measurements were on average 13% larger in the orienteers than the sedentary men. The right ventricular enlargement in endurance athletes probably reflects the increased haemodynamic loading that is caused by prolonged and extensive physical training. The thicker right ventricular wall in endurance athletes increases the contractile reserve and decreases wall stress in the right ventricle.

Adolescent↗
PubMed1997

Doppler indexes of left ventricular filling after exercise in 50-year-old healthy persons.

Exercise-induced myocardial ischemia has been shown to alter left ventricular (LV) diastolic filling. An abnormal response of Doppler indexes of LV filling during and after exercise testing has been demonstrated to be a sensitive marker of coronary artery disease. A paucity of data is available regarding reference values and the physiological variation in LV filling indexes after exercise in healthy subjects of similar age. We therefore evaluated 77 healthy subjects (33 men and 44 women) aged 50 years by Doppler echocardiography at rest and 15 and 60 minutes after exercise testing. The peak velocity of early diastolic filling (E-wave), the peak velocity of atrial filling (A-wave), the early to atrial peak velocity (E/A) ratio and the deceleration time of early velocity were measured. There was a decrease in the E/A ratio 15 minutes after exercise compared with the E/A ratio at rest in women (1.13 +/- 0.23 vs 1.23 +/- 0.27; p <0.001) and men (1.03 +/- 0.22 vs 1.15 +/- 0.20; p <0.001). The E/A ratio 60 minutes after exercise did not differ significantly from rest in women (1.23 +/- 0.27 vs 1.18 +/- 0.24; p = NS), but men had a lower E/A ratio 60 minutes after than before exercise (1.04 +/- 0.23 vs 1.15 +/- 0.20; p <0.001). There was no difference in deceleration time of the E-wave before and after exercise. Multivariate analysis revealed that the E/A ratio 15 and 60 minutes after exercise was strongly independently associated with the E/A ratio at rest (p <0.001) and heart rate 15 and 60 minutes after exercise (p <0.005) in both women and men. It is concluded that there is a physiological decrease in the E/A ratio 15 minutes after exercise in healthy subjects, and Doppler LV filling indexes after exercise are strongly associated with LV filling indexes at rest and with heart rate.

Analysis of Variance↗
PubMed1997

Association of carotid arterial distensibility with Doppler indices of left ventricular filling in 50-year-old subjects.

Doppler indices of left ventricular diastolic filling are associated with various cardiac and extracardiac factors. Afterload is one of the extracardiac factors influencing left ventricular diastolic filling. The distensibility of the great arteries is one of the components of afterload. In this study, the relation between Doppler indices of left ventricular filling and the distensibility of the common carotid arteries was investigated. We studied 237 subjects at 50 years of age with Doppler echocardiography and ultrasound examination of the common carotid arteries. The following Doppler indices of left ventricular filling were studied: peak early diastolic velocity E-wave, peak atrial diastolic velocity A-wave and early to atrial peak velocity ratio, E/A. Carotid arterial characteristics were: distensibility coefficient, carotid arterial diameter change in systole and fractional change in the carotid arterial diameter. The relation between Doppler indices of left ventricular filling and carotid arterial characteristics was assessed by univariate and multivariate regression analysis. There was a significant univariate, positive association between E/A ratio and carotid arterial distensibility (r = 0.27, P < 0.001), carotid arterial systolic diameter change (r = 0.19, P < 0.005) and fractional change of the carotid arterial diameter (r = 0.20, P < 0.005). In multivariate analysis, E/A ratio was independently associated with carotid arterial distensibility (P < 0.005), after adjusting for heart rate, body mass index and gender. Decreased carotid arterial distensibility was associated with a reduction in E/A ratio, suggesting that arterial distensibility may have an effect on left ventricular diastolic filling or that changes in the arterial elastic properties are associated with corresponding structural changes in the left ventricle.

Blood Pressure↗
PubMed1996

Factors of importance to Doppler indices of left ventricular filling in 50-year-old healthy subjects.

Age is an important determinant of Doppler indices of left ventricular diastolic filling in normal subjects. To define reference values and factors of importance to Doppler indices of left ventricular filling in subjects of similar age, 58 men and 76 women aged 50 years underwent Doppler echocardiography. All those taking part in the study were healthy. When gender was analysed in a multivariate model it showed a significant independent correlation with the peak velocity of early diastolic filling (E wave) (P < 0.001) and the early to atrial peak velocity (E/A) ratio (P < 0.01). The peak E wave velocity was 0.75 +/- 0.11 m.s-1 vs 0.66 +/- 0.10 m.s-1 (P < 0.001) and the E/A ratio was 1.24 +/- 0.25 vs 1.14 +/- 0.20 (P < 0.05) in women and men, respectively. In multivariate analyses, heart rate, diastolic blood pressure and body mass index correlated independently with the E/A ratio in women (P < 0.001 for all), whereas in men, heart rate, diastolic blood pressure, body mass index and left ventricular diameter correlated independently with the E/A ratio (P < 0.001 for all). Doppler measurements of left ventricular filling in 50-year-old healthy subjects showed a wide variation and were significantly associated with heart rate, diastolic blood pressure, body mass index and gender.

Blood Pressure↗