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Grönlund, Christer
Publications (10 of 36) Show all publications
Jashari, F., Ibrahimi, P., Bajraktari, G., Grönlund, C., Wester, P. & Henein, M. Y. (2016). Carotid plaque echogenicity predicts cerebrovascular symptoms: a systematic review and meta-analysis. European Journal of Neurology, 23(7), 1241-1247.
Open this publication in new window or tab >>Carotid plaque echogenicity predicts cerebrovascular symptoms: a systematic review and meta-analysis
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2016 (English)In: European Journal of Neurology, ISSN 1351-5101, E-ISSN 1468-1331, Vol. 23, no 7, 1241-1247 p.Article in journal (Refereed) Published
Abstract [en]

Background and purpose: Many reports have shown an association between hypoechoic (echolucent) carotid atherosclerotic plaques and unstable features. In this meta-analysis our aim was to determine the role of carotid plaque echogenicity in predicting future cerebrovascular (CV) symptoms.

Methods: Electronic databases (PubMed, MEDLINE, EMBASE and Cochrane Center Register) up to September 2015 were systematically searched. Studies with ultrasound-based characterization of carotid artery plaque echogenicity and its association with focal neurological symptoms of vascular origin were eligible for analysis. In the meta-analysis, heterogeneity was measured usingI2 statistics and publication bias was evaluated using the Begg–Mazumdar test. In addition several comparisons between subgroups were performed.

Results: Of 1387 identified reports, eight studies with asymptomatic patients and three studies with symptomatic patients were meta-analyzed. Pooled analysis showed an association between echolucent carotid plaques and future CV events in asymptomatic patients [relative risk 2.72 (95% confidence interval 1.86–3.96)] and recurrent symptoms in symptomatic patients [relative risk 2.97 (95% confidence interval 1.85–4.78)]. The association was preserved for all stenosis degrees in asymptomatic patients, whilst patients with echolucent plaques and severe stenosis were at higher risk of future events. Also, computer-assisted methods for assessment of carotid plaque echogenicity and studies analyzing ultrasound data collected after the year 2000 showed better prediction.

Conclusions: In asymptomatic and symptomatic patients, analysis of carotid plaque echogenicity could identify those at high risk of CV events.

Keyword
carotid atherosclerosis, cerebrovascular symptoms, grey scale median, plaque echogenicity, trasound
National Category
Public Health, Global Health, Social Medicine and Epidemiology
Identifiers
urn:nbn:se:umu:diva-124230 (URN)10.1111/ene.13017 (DOI)000378431100022 ()27106563 (PubMedID)
Available from: 2016-08-01 Created: 2016-07-28 Last updated: 2017-11-28Bibliographically approved
Lindkvist, M. & Grönlund, C. (2015). Absolute quantifications of oxy- and deoxyhemoglobin concentrations by combination of differentially resolved spectroscopy and spatially resolved spectroscopy [Letter to the editor]. Spectroscopy Letters, 48(3), 170-172.
Open this publication in new window or tab >>Absolute quantifications of oxy- and deoxyhemoglobin concentrations by combination of differentially resolved spectroscopy and spatially resolved spectroscopy
2015 (English)In: Spectroscopy Letters, ISSN 0038-7010, E-ISSN 1532-2289, Vol. 48, no 3, 170-172 p.Article in journal, Letter (Refereed) Published
Abstract [en]

This letter proposes a theoretical framework to calculate absolute concentrations of oxy- and deoxyhemoglobin using continuous-wave near-infrared spectroscopy. While previous methods on this topic require assumptions on constant blood volume, the proposed method does not. Equations for the absolute concentrations were derived from a combination of the modified Beer-Lambert equation and the theory of diffusion of photons in turbid media. The method has an advantage over and is theoretically consistent with previous methods. It needs yet to be evaluated in an experimental study.

Place, publisher, year, edition, pages
Taylor & Francis, 2015
Keyword
NIRS, absolute quantification, differential spectroscopy, spatially resolved spectroscopy
National Category
Biomedical Laboratory Science/Technology
Identifiers
urn:nbn:se:umu:diva-96484 (URN)10.1080/00387010.2013.867887 (DOI)000343807900003 ()
Available from: 2014-12-01 Created: 2014-11-21 Last updated: 2017-12-05Bibliographically approved
Gustavsson, S., Granåsen, G., Grönlund, C., Wiklund, U., Mörner, S., Henein, M., . . . Lindqvist, P. (2015). Can echocardiography and ECG discriminate hereditary transthyretin V30M amyloidosis from hypertrophic cardiomyopathy?. Amyloid: Journal of Protein Folding Disorders, 22(3), 163-170.
Open this publication in new window or tab >>Can echocardiography and ECG discriminate hereditary transthyretin V30M amyloidosis from hypertrophic cardiomyopathy?
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2015 (English)In: Amyloid: Journal of Protein Folding Disorders, ISSN 1350-6129, E-ISSN 1744-2818, Vol. 22, no 3, 163-170 p.Article in journal (Refereed) Published
Abstract [en]

Objective: Hereditary transthyretin (ATTR) amyloidosis with increased left ventricular wall thickness could easily be misdiagnosed by echocardiography as hypertrophic cardiomyopathy (HCM). Our aim was to create a diagnostic tool based on echocardiography and ECG that could optimise identification of ATTR amyloidosis. Methods: Data were analysed from 33 patients with biopsy proven ATTR amyloidosis and 30 patients with diagnosed HCM. Conventional features from ECG were acquired as well as two dimensional and Doppler echocardiography, speckle tracking derived strain and tissue characterisation analysis. Classification trees were used to select the most important variables for differentiation between ATTR amyloidosis and HCM. Results: The best classification was obtained using both ECG and echocardiographic features, where a QRS voltage >30 mm was diagnostic for HCM, whereas in patients with QRS voltage <30 mm, an interventricular septal/posterior wall thickness ratio (IVSt/PWt) >1.6 was consistent with HCM and a ratio <1.6 supported the diagnosis of ATTR amyloidosis. This classification presented both high sensitivity (0.939) and specificity (0.833). Conclusion: Our study proposes an easily interpretable classification method for the differentiation between HCM and increased left ventricular myocardial thickness due to ATTR amyloidosis. Our combined echocardiographic and ECG model could increase the ability to identify ATTR cardiac amyloidosis in clinical practice.

Keyword
cardiac amyloidosis, classification tree, echocardiography, electrocardiography, hypertrophic rdiomyopathy, hypertrophy
National Category
Medical Biotechnology (with a focus on Cell Biology (including Stem Cell Biology), Molecular Biology, Microbiology, Biochemistry or Biopharmacy) Cardiac and Cardiovascular Systems
Identifiers
urn:nbn:se:umu:diva-109962 (URN)10.3109/13506129.2015.1037831 (DOI)000361295200004 ()26104852 (PubMedID)
Available from: 2015-10-09 Created: 2015-10-09 Last updated: 2017-12-01Bibliographically approved
Nyman, E., Grönlund, C., Vanoli, D., Lindqvist, P. & Näslund, U. (2015). Carotid artery plaque assessment within the Västerbotten intervention programme: VIPVIZA. Paper presented at 83rd Congress of the European-Atherosclerosis-Society (EAS), MAR 22-25, 2015, Glasgow, SCOTLAND. Atherosclerosis, 241(1), E159-E159.
Open this publication in new window or tab >>Carotid artery plaque assessment within the Västerbotten intervention programme: VIPVIZA
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2015 (English)In: Atherosclerosis, ISSN 0021-9150, E-ISSN 1879-1484, Vol. 241, no 1, E159-E159 p.Article in journal, Meeting abstract (Other academic) Published
National Category
Cardiac and Cardiovascular Systems
Identifiers
urn:nbn:se:umu:diva-109463 (URN)000360100600527 ()
Conference
83rd Congress of the European-Atherosclerosis-Society (EAS), MAR 22-25, 2015, Glasgow, SCOTLAND
Available from: 2015-10-07 Created: 2015-09-28 Last updated: 2017-10-17Bibliographically approved
Jashari, F., Ibrahimi, P., Johansson, E., Grönlund, C., Wester, P. & Henein, M. Y. (2015). Carotid im-gsm is related to multisite atherosclerosis disease. Paper presented at 83rd Congress of the European-Atherosclerosis-Society (EAS), MAR 22-25, 2015, Glasgow, SCOTLAND. Atherosclerosis, 241(1), E164-E164.
Open this publication in new window or tab >>Carotid im-gsm is related to multisite atherosclerosis disease
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2015 (English)In: Atherosclerosis, ISSN 0021-9150, E-ISSN 1879-1484, Vol. 241, no 1, E164-E164 p.Article in journal, Meeting abstract (Other academic) Published
National Category
Cardiac and Cardiovascular Systems
Identifiers
urn:nbn:se:umu:diva-109462 (URN)000360100600543 ()
Conference
83rd Congress of the European-Atherosclerosis-Society (EAS), MAR 22-25, 2015, Glasgow, SCOTLAND
Note

Meeting Abstract: EAS-0463

Available from: 2015-10-08 Created: 2015-09-28 Last updated: 2017-12-01Bibliographically approved
Ibrahimi, P., Jashari, F., Johansson, E., Grönlund, C., Bajraktari, G., Wester, P. & Henein, M. Y. (2015). Common carotid intima-media features determine distal disease phenotype and vulnerability in asymptomatic patients. International Journal of Cardiology, 196, 22-28.
Open this publication in new window or tab >>Common carotid intima-media features determine distal disease phenotype and vulnerability in asymptomatic patients
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2015 (English)In: International Journal of Cardiology, ISSN 0167-5273, E-ISSN 1874-1754, Vol. 196, 22-28 p.Article in journal (Refereed) Published
Abstract [en]

Objectives: There is a growing awareness of the importance of carotid plaque features evaluation in stroke prediction. Carotid intima-media thickness (IMT) and recently its echogenicity were used for stroke prediction, although their clinical relevance was not well determined. The aim of this study was to assess the relationship between common carotid artery (CCA) ultrasound markers of atherosclerosis and distal, bifurcation and internal carotid artery (ICA), plaque features. Methods: We analyzed 137 carotid arteries in 87 asymptomatic patients with known carotid disease (mean age 69 +/- 6 year, 34.5% females). Intima media thickness (IMT) and its gray scale median (IM-GSM) were measured at the CCA. Plaque textural features including gray scale median (GSM), juxtaluminal black area (JBA-mm(2)) without a visible cap, and plaque coarseness, at bifurcation and ICA were also determined. CCA measurements were correlated with those of the distal plaques. Results: An increased IMT in CCA correlated with plaque irregularities in the bifurcation and ICA (r = 0.53, p < 0.001), while IM-GSM was closely related to plaque echogenicity (GSM) (r = 0.76, p < 0.001), and other textural plaque features. Both, IMT and IM-GSM correlated weakly with stenosis severity (r = 0.27, p = 0.001 and r = -0.18, p = 0.026) respectively. Conclusion: In asymptomatic patients, measurements of CCA reflect distal, bifurcation and ICA disease, with IMT reflecting plaque irregularities and IM-GSM as markers of textural plaque abnormalities. Integrating measurements of both IMT and IM-GSM in a model could be used as a better marker of disease vulnerability over and above each measure individually. 

Keyword
Carotid atherosclerosis, Intima-media thickness, Intima-media-gray scale median, Plaque features, aque vulnerability
National Category
Neurology
Identifiers
urn:nbn:se:umu:diva-107150 (URN)10.1016/j.ijcard.2015.05.168 (DOI)000358314300005 ()26070179 (PubMedID)
Available from: 2015-09-02 Created: 2015-08-19 Last updated: 2017-12-04Bibliographically approved
Ibrahimi, P., Jashari, F., Johansson, E., Grönlund, C., Wester, P. & Henein, M. Y. (2015). Common carotid intima-media measurements determine distal disease structure and vulnerability in asymptomatic patients. Paper presented at 83rd Congress of the European-Atherosclerosis-Society (EAS), MAR 22-25, 2015, Glasgow, SCOTLAND. Atherosclerosis, 241(1), E164-E164.
Open this publication in new window or tab >>Common carotid intima-media measurements determine distal disease structure and vulnerability in asymptomatic patients
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2015 (English)In: Atherosclerosis, ISSN 0021-9150, E-ISSN 1879-1484, Vol. 241, no 1, E164-E164 p.Article in journal, Meeting abstract (Other academic) Published
National Category
Cardiac and Cardiovascular Systems
Identifiers
urn:nbn:se:umu:diva-109461 (URN)000360100600541 ()
Conference
83rd Congress of the European-Atherosclerosis-Society (EAS), MAR 22-25, 2015, Glasgow, SCOTLAND
Available from: 2015-10-08 Created: 2015-09-28 Last updated: 2017-12-01Bibliographically approved
Lindqvist, G., Grönlund, C., Söderberg, S., Gonzalez, M., Henein, M. Y. & Tossavainen, E. (2014). Biventricular dysfunction and their consequences predict mortality in pulmonary arterial hypertension. Paper presented at Congress of the European-Society-of-Cardiology (ESC), AUG 30-SEP 03, 2014, Barcelona, SPAIN. European Heart Journal, 35(Supplement 1, Meeting abstract P492), 78-78.
Open this publication in new window or tab >>Biventricular dysfunction and their consequences predict mortality in pulmonary arterial hypertension
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2014 (English)In: European Heart Journal, ISSN 0195-668X, E-ISSN 1522-9645, Vol. 35, no Supplement 1, Meeting abstract P492, 78-78 p.Article in journal, Meeting abstract (Other academic) Published
Place, publisher, year, edition, pages
Oxford University Press, 2014
National Category
Cardiac and Cardiovascular Systems
Identifiers
urn:nbn:se:umu:diva-97246 (URN)000343001300287 ()
Conference
Congress of the European-Society-of-Cardiology (ESC), AUG 30-SEP 03, 2014, Barcelona, SPAIN
Available from: 2014-12-15 Created: 2014-12-12 Last updated: 2017-12-05Bibliographically approved
Gustafsson, S., Granåsen, G., Wiklund, U., Grönlund, C., Suhr, O. B. & Lindqvist, P. (2014). Discriminating hereditary transthyretin cardiomyopathy from hypertrophic cardiomyopathy using an echocardiographic and ECG based classification tree. Paper presented at Congress of the European-Society-of-Cardiology (ESC), AUG 30-SEP 03, 2014, Barcelona, SPAIN. European Heart Journal, 35(Supplement 1, Meeting abstract P5254), 929-929.
Open this publication in new window or tab >>Discriminating hereditary transthyretin cardiomyopathy from hypertrophic cardiomyopathy using an echocardiographic and ECG based classification tree
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2014 (English)In: European Heart Journal, ISSN 0195-668X, E-ISSN 1522-9645, Vol. 35, no Supplement 1, Meeting abstract P5254, 929-929 p.Article in journal, Meeting abstract (Other academic) Published
Place, publisher, year, edition, pages
Oxford University Press, 2014
National Category
Cardiac and Cardiovascular Systems
Identifiers
urn:nbn:se:umu:diva-97261 (URN)000343001305297 ()
Conference
Congress of the European-Society-of-Cardiology (ESC), AUG 30-SEP 03, 2014, Barcelona, SPAIN
Available from: 2014-12-15 Created: 2014-12-12 Last updated: 2017-12-05Bibliographically approved
Ibrahimi, P., Jashari, F., Johansson, E., Grönlund, C., Bajraktari, G., Wester, P. & Henein, M. Y. (2014). Vulnerable plaques in the contralateral carotid arteries in symptomatic patients: a detailed ultrasound analysis. Atherosclerosis, 235(2), 526-531.
Open this publication in new window or tab >>Vulnerable plaques in the contralateral carotid arteries in symptomatic patients: a detailed ultrasound analysis
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2014 (English)In: Atherosclerosis, ISSN 0021-9150, E-ISSN 1879-1484, Vol. 235, no 2, 526-531 p.Article in journal (Refereed) Published
Abstract [en]

BACKGROUND AND AIM: Carotid plaques may represent a generalized atherosclerotic syndrome or a localized disease. The aim of this study was to assess the morphological and textural features of carotid plaques located contralateral to the symptomatic side and compare them with the symptomatic side and with plaques from asymptomatic patients. METHODS: We studied 66 arteries in 39 patients (mean age 70 ± 7 year, 33% females). Arterial plaques were classified as either symptomatic (n = 30), contralateral to symptomatic (n = 25) or asymptomatic (n = 11). We compared several plaque features between these groups including the mean values of the grey scale median (GSM), entropy, juxtaluminal black area (JBA) without visible echogenic cap, GSM of the JBA and surface irregularity. RESULTS: The plaques contralateral to symptomatic arteries had similar morphological and textural features to those in the symptomatic arteries. In contrast, they had more vulnerable morphological and textural features than those in asymptomatic arteries: less smooth plaques (12% vs. 55%) and instead more often mildly irregular (60% vs 36%) or markedly irregular (28% vs. 9%; p = 0.03), lower GSM (26.2 ± 8 vs. 49.4 ± 14, p < 0.001) and lower GSM of the JBA (5.0 ± 3.6 vs. 11.4 ± 2.1, p = 0.008). The frequency of entropy and plaque calcification was similar in all groups. CONCLUSION: Symptomatic patients with carotid artery disease seem to have similar morphological and textural features of vulnerability in the symptomatic and the contralateral carotid arteries, which are profound compared with asymptomatic carotid arteries. These findings support the concept of generalized carotid atherosclerotic pathology rather than incidental unilateral disease, and also emphasize a need for aggressive measures for plaque stabilization, particularly in symptomatic patients.

Place, publisher, year, edition, pages
Elsevier, 2014
Keyword
carotid artery disease, plaque vulnerability, gray scale median, juxtaluminal black area
National Category
Cardiac and Cardiovascular Systems
Identifiers
urn:nbn:se:umu:diva-93540 (URN)10.1016/j.atherosclerosis.2014.05.934 (DOI)000342411000941 ()24953493 (PubMedID)
Available from: 2014-09-24 Created: 2014-09-24 Last updated: 2017-12-05Bibliographically approved
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