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Biomedical subjects

K Jensen-Urstad

Publications and source records attributed to K Jensen-Urstad.

25 records · Page 2Linked to original sources

High prevalence of arrhythmias in elderly male athletes with a lifelong history of regular strenuous exercise.

OBJECTIVE: To characterise cardiac arrhythmias and cardiac autonomic function in 11 elderly men (mean (SD) age 73.2 (2.8) years) with a lifelong history of regular very strenuous, exercise. A control group of 12 healthy sedentary or moderately physically active men (74.5 (2.7) years) was also studied. DESIGN: 48 hour ambulatory electrocardiograms were recorded. Cardiac autonomic function was estimated from power spectral analysis of heart rate variability. Maximal oxygen uptake during treadmill exercise testing was 2.91 (0.52) l (41 (7) ml/kg). RESULTS: Nine of 11 athletes had complex ventricular arrhythmias compared with five of 12 controls. Seven athletes but none of the controls had episodes of heart rate below 40 beats/min and two athletes had RR intervals longer than two seconds. Heart rate variability in the athletes was higher than in the controls. CONCLUSIONS: Elderly athletes with a lifelong training history seem to have more complex arrhythmias and profound bradyarrhythmias than do healthy elderly controls, which may increase the risk of sudden cardiac death. In contrast, the age related decrease in heart rate variability seems to be retarded, which has a positive prognostic value and may decrease the risk of life threatening ventricular arrhythmias.

Aged↗

Relationship between intima-media thickness in the common carotid artery and atherosclerosis in the carotid bifurcation.

BACKGROUND AND PURPOSE: An increase in intima-media thickness (IMT) in the common carotid artery (CCA) is commonly used as a marker of atherosclerosis. The purpose of this study was to investigate the relationship between IMT in the CCA and atherosclerosis in the carotid bifurcation. METHODS: 182 consecutive patients (mean age, 67 years) referred for carotid duplex scanning were included. We measured IMT and classified plaques by means of a high-resolution ultrasound technique. RESULTS: IMT was correlated to age, male gender, ischemic heart disease, and presence of plaques or stenoses in any of the carotid bifurcations. In men, IMT was larger on the left than on the right side. Plaques were seen in 163 carotid bifurcations, in 45 of these with > 50% stenosis. On the left side but not on the right, there was a correlation between IMT in the CCA and presence of plaques or stenoses in the carotid bifurcation. Echogenic plaques were more common than echolucent, but the latter caused significantly more stenoses. No relationship was found between plaque echogenicity and IMT. CONCLUSIONS: IMT of the CCA is correlated to the degree of atherosclerosis in the carotid bifurcations in general and on the left side also to the presence of plaques or stenoses in the left carotid bifurcation. Our results support earlier observations suggesting faster development of carotid atherosclerosis on the left than on the right side. Echogenic plaques were more common and generally smaller than echolucent plaques, but there was no correlation between plaque echogenicity and IMT.

Adult↗

Heart rate variability is related to leucocyte count in men and to blood lipoproteins in women in a healthy population of 35-year-old subjects.

OBJECTIVES: To investigate if, in a healthy randomly-selected population of 35-year-old men and women, there already is a relation between decreased heart rate variability and conventional risk factors for cardiovascular disease. BACKGROUND: Analysis of heart rate variability (HRV) has been used for estimating tonic autonomic activity. HRV is reduced in patients with various cardiovascular diseases. If a decreased HRV is a late phenomenon in the progression of cardiovascular disease, or if it parallels or even precedes manifest disease is unknown. DESIGN: Spectral analysis of HRV was made from 24-hour ambulatory electrocardiograms in a randomised population of healthy 35-year-old men (n = 63) and women (n = 70). The different spectral indices of HRV were analysed against gender, leucocyte count (previously described as an independent risk factor for cardiovascular disease), blood lipoproteins, smoking, heredity, body mass index (BMI) and systolic blood pressure. SETTING: A research centre of general medicine and a university hospital. RESULTS: Mean heart rate was lower, total power (TP), very low frequency power (VLF) and low frequency power (LF) were higher in men than in women. In women TP, VLF and LF were negatively correlated to BMI, smoking, triglycerides and positively correlated to HDL cholesterol. TP and VLF were also negatively correlated to risk factor score. High frequency power (HF), a marker of parasympathetic activity, was positively related to HDL cholesterol. In men, at daytime, TP, VLF, LF and HF were negatively correlated to leucocyte count. TP, VLF and LF were also negatively correlated to triglycerides and VLF also to risk factor score. CONCLUSIONS: There are correlations between HRV and known risk factors for cardiovascular disease already in a healthy 35-year-old population. A novel observation is the relationship in men between leucocyte count and heart rate variability.

Adult↗

Heart rate variability in healthy subjects is related to age and gender.

The effects of age and gender on heart rate variability as measured by spectral and time domain analysis of 24 h ECG recordings were evaluated in 101 healthy subjects, 49 men and 52 women (20-69 years of age). In the frequency domain, total power, very low-frequency power, low-frequency power and high-frequency power were negatively correlated to age (P < 0.001 for all variables). Total power decreased by 30% between 20-29 and 60-69 years of age. In the time domain, SDNN-index, the mean of the standard deviations of all normal R-R intervals for all 5 min segments of a 24 h ECG recording, was negatively correlated to age (P < 0.001). Total power, very low-frequency power, low-frequency power and the low-frequency/high-frequency ratio were lower in women (P < 0.05, P < 0.05, P < 0.01 and P < 0.01), although the absolute differences were much smaller than for age. There was a pronounced circadian variation; at night total power increased in all age groups (P < 0.01). The results show that age, and to a lesser degree gender, are important determinants of heart rate variability in healthy subjects. Heart rate variability is a valuable tool for risk stratification in cardiovascular disease, but the physiological effects of ageing, with diminishing heart rate variability in older age groups, must also be taken into account.

Adult↗

A methodological study of arterial wall function using ultrasound technique.

We aimed to establish reference values for three important properties of the arterial wall using a conventional ultrasound scanner. We measured: (1) intima-media thickness (IMT) of the carotid arteries with the internal trace function of the ultrasound system; (2) wall stiffness by pulsatile diameter changes in the right common carotid artery assessed by M-mode; and (3) endothelial function expressed as flow-mediated dilatation (FMD) of the brachial artery. IMT and wall stiffness measurements and reproducibility were compared with those obtained by external analysing systems. All variables were obtained in healthy subjects (n = 20), 29-53 years old. IMT increased with age (P < 0.01). There was no difference in IMT between men and women. The inter-operator variability for measuring IMT was 6-9%. The same order of reproducibility was obtained with an external PC-based analysing system. Regarding wall stiffness, no correlation was found with age, nor any difference between men and women. A low intra-operator variability (CV < 10%) was found for measurements of wall stiffness with both M-mode and an external wall tracking system. FMD of the brachial artery diminished with age (P < 0.01). There was a relation between FMD and brachial artery size (P < 0.01) and, therefore, as men have larger arterial diameters (P < 0.01), smaller FMD in men. We conclude that it is possible to characterize arterial wall function non-invasively in an adequately reproducible manner using a conventional ultrasound system in healthy middle-aged men and women.

Adult↗

Vascular function correlates with risk factors for cardiovascular disease in a healthy population of 35-year-old subjects.

OBJECTIVE: To investigate whether, in a healthy, randomly selected population of 35-year-old men and women, there is a relation between vascular function and conventional risk factors for cardiovascular disease such as gender, smoking, elevated blood-lipids, high blood pressure and heredity for cardiovascular disease, and to blood glucose. DESIGN: Basal brachial artery diameter was measured. Endothelial function was measured as flow mediated dilation (FMD) in response to reactive hyperaemia. The nonendothelial dependent dilation was measured after sublingual nitro-glycerine (NTG). SETTING: A research centre of general medicine and a university hospital. SUBJECTS: One hundred men and 100 women all 35 years old, were invited by letter. Sixty-six of the 92 men (72%) living in the community and 74 of the 88 women (84%) participated. RESULTS: Gender had the largest influence on FMD and NTG induced arterial dilation, probably reflecting the larger vessel diameters in the men as FMD and NTG induced dilation is inversely related to basal vessel size (r = -0.55, P < 0.001 and r = -0.40, P < 0.001). In women basal vessel diameter was positively correlated to blood glucose (r = 0.35, P = 0.009) and BMI (r = 0.34, P = 0.012) and negatively correlated to HDL cholesterol (r = -0.43, P = 0.001). FMD and NTG induced arterial dilation correlated with a combined risk factor score (r = -0.32, P = 0.019 and r = -0.31, P = 0.024). The men with the highest risk factor scores had larger vessel size and higher blood flow at rest compared to men without risk factors (4.8 +/- 0.6 mm, 240 +/- 84 mL min-1 and 4.0 +/- 0.8 mm, 139 +/- 72 mL min-1, respectively, P = 0.014 and P = 0.016). FMD or NTG induced dilation did not correlate to any of the risk factors in men. CONCLUSIONS: There are correlations between vascular reactivity and risk factors for IHD in women and correlations between vessel diameter and risk factors for IHD in both men and women already in a healthy population 35-year-old subjects. Further studies are needed to determine if the vessel diameter in itself, in a healthy population, is a sign of attenuated endothelial function.

Adult↗

Pronounced resting bradycardia in male elite runners is associated with high heart rate variability.

Forty-eight hour Holter monitoring was undertaken of 16 male elite middle- and long-distance runners, age 25 +/- 3 years, with peak oxygen uptake 4.83 +/- 0.43 1 O2/min or 73.0 +/- 3.9 ml O2/kg/min. The athletes had pronounced bradycardia during the night-time, with heart rate calculated from four RR intervals < 30 beats/min in five runners. Twelve of 16 runners had RR intervals > 2 s. Of those, 10 runners had sinus pauses exceeding 2 s, the longest being 3.06 s. Three runners had AV block II, two with Mobitz type 1, and one with both Mobitz type 1 and 2. Autonomic function was estimated by time domain and power spectral analysis of heart rate variability. The runners were compared with a control group of 13 sedentary or moderately active subjects. The runners had a mean of 14 b.p.m. lower heart rate at night than the controls. The runners had higher heart rate variability in all spectral bands. In the time domain pNN50 and rMSSD, which are considered to reflect strongly vagal tone, were markedly higher in the runners than the controls. The findings suggest that an increased parasympathetic tone might at least partly explain the pronounced resting sinus bradycardias found in endurance-trained runners.

Bradycardia↗