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Waldenström, Anders
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Publications (10 of 79) Show all publications
Engström, G., Lampa, E., Dekkers, K., Lin, Y.-T., Ahlm, K., Ahlström, H., . . . Sundström, J. (2024). Pulmonary function and atherosclerosis in the general population: causal associations and clinical implications. European Journal of Epidemiology
Open this publication in new window or tab >>Pulmonary function and atherosclerosis in the general population: causal associations and clinical implications
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2024 (English)In: European Journal of Epidemiology, ISSN 0393-2990, E-ISSN 1573-7284Article in journal (Refereed) Epub ahead of print
Abstract [en]

Reduced lung function is associated with cardiovascular mortality, but the relationships with atherosclerosis are unclear. The population-based Swedish CArdioPulmonary BioImage study measured lung function, emphysema, coronary CT angiography, coronary calcium, carotid plaques and ankle-brachial index in 29,593 men and women aged 50–64 years. The results were confirmed using 2-sample Mendelian randomization. Lower lung function and emphysema were associated with more atherosclerosis, but these relationships were attenuated after adjustment for cardiovascular risk factors. Lung function was not associated with coronary atherosclerosis in 14,524 never-smokers. No potentially causal effect of lung function on atherosclerosis, or vice versa, was found in the 2-sample Mendelian randomization analysis. Here we show that reduced lung function and atherosclerosis are correlated in the population, but probably not causally related. Assessing lung function in addition to conventional cardiovascular risk factors to gauge risk of subclinical atherosclerosis is probably not meaningful, but low lung function found by chance should alert for atherosclerosis.

Place, publisher, year, edition, pages
Springer Nature, 2024
Keywords
Atherosclerosis, Coronary heart disease, Emphysema, Spirometry
National Category
Cardiac and Cardiovascular Systems Respiratory Medicine and Allergy
Identifiers
urn:nbn:se:umu:diva-219309 (URN)10.1007/s10654-023-01088-z (DOI)001132630700001 ()38165527 (PubMedID)2-s2.0-85181226926 (Scopus ID)
Funder
EU, European Research Council, ERC-2018-STG-801965Swedish Research Council, 2019-01471Swedish Heart Lung Foundation, 20200173Swedish Heart Lung Foundation, 20190505Göran Gustafsson Foundation for Research in Natural Sciences and MedicineAxel och Signe Lagermans donationsstiftelseKnut and Alice Wallenberg FoundationVinnovaUniversity of GothenburgKarolinska InstituteRegion StockholmLinköpings universitetLund UniversityUmeå UniversityUppsala University
Available from: 2024-01-15 Created: 2024-01-15 Last updated: 2024-01-15
Kreiner, M., Okeson, J., Tanco, V., Waldenström, A. & Isberg, A. (2020). Orofacial Pain and Toothache as the Sole Symptom of an Acute Myocardial Infarction Entails a Major Risk of Misdiagnosis and Death. Journal of Oral & Facial Pain and Headache, 34(1), 53-60
Open this publication in new window or tab >>Orofacial Pain and Toothache as the Sole Symptom of an Acute Myocardial Infarction Entails a Major Risk of Misdiagnosis and Death
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2020 (English)In: Journal of Oral & Facial Pain and Headache, ISSN 2333-0384, Vol. 34, no 1, p. 53-60Article in journal (Refereed) Published
Abstract [en]

Aims: To provide an update of knowledge regarding the clinical presentation and neurophysiologic aspects of orofacial pain of cardiac origin in the form of a literature review. Methods: The peer-reviewed databases Scopus/Embase, NCBI (PubMed), and Science Direct were searched up to December 2018. Results: Patients with myocardial infarction presenting without chest pain run a higher risk of death due to missed diagnosis and subsequently a significantly greater delay between the onset of symptoms and arrival at the hospital. During myocardial ischemia, orofacial pain is reported by 4 in 10 patients and described as oppressive and/or burning. Up to 4% of myocardial infarction patients experience pain solely in the orofacial structures, women more often than men. Orofacial pain during myocardial ischemia is associated with ischemia within the inferior wall of the heart, suggesting the involvement of the vagal system. Conclusion: The clinician’s awareness of the full spectrum of clinical characteristics of a myocardial infarction constitutes a key factor in accurate diagnosis. Health care professionals and the general public should be aware of the possibility of myocardial infarction presenting with orofacial pain, toothache, or ear/temporomandibular joint pain as the only symptom.

Place, publisher, year, edition, pages
QUINTESSENCE PUBLISHING, 2020
Keywords
cardiac ischemia, cardiac pain, myocardial infarction, orofacial pain, toothache
National Category
Cardiac and Cardiovascular Systems
Identifiers
urn:nbn:se:umu:diva-167610 (URN)10.11607/ofph.2480 (DOI)000507518000006 ()31465031 (PubMedID)2-s2.0-85077943360 (Scopus ID)
Available from: 2020-02-07 Created: 2020-02-07 Last updated: 2021-05-11Bibliographically approved
Hagström, L., Henein, M. Y., Karp, K., Waldenström, A. & Lindqvist, P. (2017). Impact of age and sex on normal left heart structure and function. Clinical Physiology and Functional Imaging, 37(6), 759-766
Open this publication in new window or tab >>Impact of age and sex on normal left heart structure and function
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2017 (English)In: Clinical Physiology and Functional Imaging, ISSN 1475-0961, E-ISSN 1475-097X, Vol. 37, no 6, p. 759-766Article in journal (Refereed) Published
Abstract [en]

BACKGROUND: Accurate age- and sex-related normal reference values of ventricular structure and function are important to determine the level of dysfunction in patients. The aim of this study therefore was to document normal age range sex-related measurements of LV structural and functional measurements to serve such purpose.

METHODS: We evaluated left ventricular structure and function in 293 healthy subjects between 20 and 90 years with equally distributed gender. Doppler echocardiography was used including measure of both systolic and diastolic functions.

RESULTS: Due to systolic LV function, only long axis function correlated with age (r = 0·55, P<0·01) and the correlation was stronger in females. Concerning diastolic function, there was a strong age correlation in all parameters used (r = 0·40-0·74, P<0·001). Due to LV structural changes over age, females showed a larger reduction in end-diastolic volumes, but no or trivial difference in wall thickness after the age of 60 years.

CONCLUSION: Age is associated with significant normal changes in left ventricular structure and function, which should be considered when deciding on normality. These changes are related to systemic arterial changes as well as body stature, thus reflecting overall body ageing process. Furthermore, normal cardiac ageing in females might partly explain the higher prevalence of heart failure with preserved ejection in females.

Place, publisher, year, edition, pages
John Wiley & Sons, 2017
Keywords
age, cardiac function, sex
National Category
Cardiac and Cardiovascular Systems Physiology
Identifiers
urn:nbn:se:umu:diva-122375 (URN)10.1111/cpf.12371 (DOI)000413678400030 ()27283123 (PubMedID)2-s2.0-84976871519 (Scopus ID)
Available from: 2016-06-16 Created: 2016-06-16 Last updated: 2023-03-23Bibliographically approved
Kreiner, M., lvarez, R., Michelis, V., Waldenström, A. & Isberg, A. (2016). Craniofacial pain can be the sole prodromal symptom of an acute myocardial infarction: an interdisciplinary study. Acta odontológica latinoamericana : AOL, 29(1), 23-28
Open this publication in new window or tab >>Craniofacial pain can be the sole prodromal symptom of an acute myocardial infarction: an interdisciplinary study
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2016 (English)In: Acta odontológica latinoamericana : AOL, ISSN 0326-4815, Vol. 29, no 1, p. 23-28Article in journal (Refereed) Published
Abstract [en]

We recently found craniofacial pain to be the sole symptom of an acute myocardial infarction (AMI) in 4% of patients. We hypothesized that this scenario is also true for symptoms of prodromal (pre-infarction) angina. We studied 326 consecutive patients who experienced myocardial ischemia. Intra-individual variability analyses with respect to ECG findings and pain characteristics were performed for those 150 patients who experienced at least one recurrent ischemic episode. AMI patients (n=113) were categorized into two subgroups: "abrupt onset" (n=81) and "prodromal angina" (n=32). Age, gender and risk factor comparisons were performed between groups. Craniofacial pain constituted the sole prodromal symptom of an AMI in 5% of patients. In those who experienced two ischemic episodes, women were more likely than men to experience craniofacial pain in both episodes (p<0.01). There was no statistically significant difference between episodes regarding either ECG findings or the use of the two typical pain quality descriptors "pressure" and "burning". This study is to our knowledge the first to report that craniofacial pain can be the only symptom of a pre-infarction angina. Craniofacial pain constitutes the sole prodromal AMI symptom in one out of 20 AMI patients. Recognition of this atypical symptom presentation is low because research on prodromal AMI symptoms has to date studied only patients with chest pain. To avoid a potentially fatal misdiagnosis, awareness of this clinical presentation needs to be brought to the attention of clinicians, researchers and the general public.

Keywords
facial pain, Myocardial infarction, myocardial ischemia
National Category
Health Sciences Dentistry
Identifiers
urn:nbn:se:umu:diva-43288 (URN)2-s2.0-85029549864 (Scopus ID)
Note

Originally included in thesis in manuscript form. 

Available from: 2011-04-26 Created: 2011-04-26 Last updated: 2023-03-24Bibliographically approved
Svennerholm, K., Rodsand, P., Hellman, U., Waldenström, A., Lundholm, M., Ahrén, D., . . . Haney, M. (2016). DNA content in extracellular vesicles isolated from porcine coronary venous blood directly after myocardial ischemic preconditioning. PLOS ONE, 11(7), Article ID e0159105.
Open this publication in new window or tab >>DNA content in extracellular vesicles isolated from porcine coronary venous blood directly after myocardial ischemic preconditioning
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2016 (English)In: PLOS ONE, E-ISSN 1932-6203, Vol. 11, no 7, article id e0159105Article in journal (Refereed) Published
Abstract [en]

BACKGROUND: Extracellular vesicles (EV) are nano-sized membranous structures released from most cells. They have the capacity to carry bioactive molecules and gene expression signals between cells, thus mediating intercellular communication. It is believed that EV confer protection after ischemic preconditioning (IPC). We hypothesize that myocardial ischemic preconditioning will lead to rapid alteration of EV DNA content in EV collected from coronary venous effluent.

MATERIALS AND METHODS: In a porcine myocardial ischemic preconditioning model, EV were isolated from coronary venous blood before and after IPC by differential centrifugation steps culminating in preparative ultracentrifugation combined with density gradient ultracentrifugation. The EV preparation was validated, the DNA was extracted and further characterized by DNA sequencing followed by bioinformatics analysis.

RESULTS: Porcine genomic DNA fragments representing each chromosome, including mitochondrial DNA sequences, were detected in EV isolated before and after IPC. There was no difference detected in the number of sequenced gene fragments (reads) or in the genomic coverage of the sequenced DNA fragments in EV isolated before and after IPC. Gene ontology analysis showed an enrichment of genes coding for ion channels, enzymes and proteins for basal metabolism and vesicle biogenesis and specific cardiac proteins.

CONCLUSIONS: This study demonstrates that porcine EV isolated from coronary venous blood plasma contain fragments of DNA from the entire genome, including the mitochondria. In this model we did not find specific qualitative or quantitative changes of the DNA content in EV collected immediately after an in vivo myocardial IPC provocation. This does not rule out the possibility that EV DNA content changes in response to myocardial IPC which could occur in a later time frame.

Place, publisher, year, edition, pages
Public Libray Science, 2016
National Category
Cell and Molecular Biology
Identifiers
urn:nbn:se:umu:diva-124283 (URN)10.1371/journal.pone.0159105 (DOI)000380169600033 ()27434143 (PubMedID)2-s2.0-84979231276 (Scopus ID)
Available from: 2016-08-01 Created: 2016-08-01 Last updated: 2023-03-24Bibliographically approved
Haas, J., Frese, K. S., Peil, B., Kloos, W., Keller, A., Nietsch, R., . . . Meder, B. (2015). Atlas of the clinical genetics of human dilated cardiomyopathy. European Heart Journal, 36(18), 1123-U43
Open this publication in new window or tab >>Atlas of the clinical genetics of human dilated cardiomyopathy
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2015 (English)In: European Heart Journal, ISSN 0195-668X, E-ISSN 1522-9645, Vol. 36, no 18, p. 1123-U43Article in journal (Refereed) Published
Abstract [en]

Aim: We were able to show that targeted Next-Generation Sequencing is well suited to be applied in clinical routine diagnostics, substantiating the ongoing paradigm shift from low- to high-throughput genomics in medicine. By means of our atlas of the genetics of human DCM, we aspire to soon be able to apply our findings to the individual patient with cardiomyopathy in daily clinical practice. Numerous genes are known to cause dilated cardiomyopathy (DCM). However, until now technological limitations have hindered elucidation of the contribution of all clinically relevant disease genes to DCM phenotypes in larger cohorts. We now utilized next-generation sequencing to overcome these limitations and screened all DCM disease genes in a large cohort. Methods and results: In this multi-centre, multi-national study, we have enrolled 639 patients with sporadic or familial DCM. To all samples, we applied a standardized protocol for ultra-high coverage next-generation sequencing of 84 genes, leading to 99.1% coverage of the target region with at least 50-fold and a mean read depth of 2415. In this well characterized cohort, we find the highest number of known cardiomyopathy mutations in plakophilin-2, myosin-binding protein C-3, and desmoplakin. When we include yet unknown but predicted disease variants, we find titin, plakophilin-2, myosin-binding protein-C 3, desmoplakin, ryanodine receptor 2, desmocollin-2, desmoglein-2, and SCN5A variants among the most commonly mutated genes. The overlap between DCM, hypertrophic cardiomyopathy (HCM), and channelopathy causing mutations is considerably high. Of note, we find that >38% of patients have compound or combined mutations and 12.8% have three or even more mutations. When comparing patients recruited in the eight participating European countries we find remarkably little differences in mutation frequencies and affected genes. Conclusion: This is to our knowledge, the first study that comprehensively investigated the genetics of DCM in a large-scale cohort and across a broad gene panel of the known DCM genes. Our results underline the high analytical quality and feasibility of Next-Generation Sequencing in clinical genetic diagnostics and provide a sound database of the genetic causes of DCM.

Place, publisher, year, edition, pages
Oxford University Press, 2015
Keywords
cardiomyopathy, genetics, patients, diagnosis
National Category
Cardiac and Cardiovascular Systems
Identifiers
urn:nbn:se:umu:diva-105259 (URN)10.1093/eurheartj/ehu301 (DOI)000354742800015 ()25163546 (PubMedID)2-s2.0-84929617783 (Scopus ID)
Available from: 2015-06-22 Created: 2015-06-22 Last updated: 2023-03-23Bibliographically approved
Kayvanpour, E., Haas, J., Sedaghat-Hamedani, F., Waldenström, A., Monserrat, L., Charron, P. H., . . . Katus, H. A. (2015). Genetic cardiomyopathy overlaps can modify phenotypic features in dilated cardiomyopathy patients - a comprehensive next-generation sequencing (NGS) study. European Heart Journal, 36, 953-954
Open this publication in new window or tab >>Genetic cardiomyopathy overlaps can modify phenotypic features in dilated cardiomyopathy patients - a comprehensive next-generation sequencing (NGS) study
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2015 (English)In: European Heart Journal, ISSN 0195-668X, E-ISSN 1522-9645, Vol. 36, p. 953-954Article in journal, Meeting abstract (Other academic) Published
National Category
Cardiac and Cardiovascular Systems
Identifiers
urn:nbn:se:umu:diva-110581 (URN)000361205106385 ()
Note

Supplement: 1 Meeting Abstract: P5472

Available from: 2015-11-03 Created: 2015-10-23 Last updated: 2018-06-07Bibliographically approved
Svennerholm, K., Rodsand, P., Hellman, U., Lundholm, M., Waldenström, A., Biber, B., . . . Haney, M. (2015). Myocardial ischemic preconditioning in a porcine model leads to rapid changes in cardiac extracellular vesicle messenger RNA content. International Journal of Cardiology Heart and Vasculature, 8, 62-67
Open this publication in new window or tab >>Myocardial ischemic preconditioning in a porcine model leads to rapid changes in cardiac extracellular vesicle messenger RNA content
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2015 (English)In: International Journal of Cardiology Heart and Vasculature, ISSN 2352-9067, Vol. 8, p. 62-67Article in journal (Refereed) Published
Abstract [en]

Background: Extracellular vesicles (EVs) are thought to exert protective effects after ischemic and remote ischemic preconditioning. It is not well understood which EV content factors are most relevant for protective effects. We hypothesize that ischemic preconditioning leads to qualitative changes in EV mRNA content and quantitative changes in EV size and number.

Methods: Using an in vivo porcine ischemic preconditioning model, EVs were collected from coronary venous blood, and isolated by differential ultracentrifugations. The presence and purity of EV were verified by electron microscopy and Western blot, and EV number was assessed by nanoparticle tracking analysis. The mRNA EV was identified by microarray.

Results: Gene ontology analysis showed enrichment of EV mRNA coding for proteins associated with regulation of transcription, translation, extracellular matrix, morphogenic development and feeding behavior. There were 11,678 different mRNA transcripts detected in EV, where a total of 1103 was significantly increased or decreased after preconditioning, of which 638 mRNA sequences were up-regulated and/or emerged due to preconditioning. Several of them have known association with ischemic preconditioning. There was no significant difference in EV quantity or size before and after preconditioning.

Conclusions: These findings demonstrate in an in vivo model that myocardial ischemic preconditioning influences the composition of mRNA in EV, including gene transcripts for proteins associated with the protective effect of ischemic preconditioning. The finding that preconditioned parental cells release EV containing mRNA that is qualitatively different from those released by non-preconditioned cells shows the importance of the external milieu on parental cell EV production.

Place, publisher, year, edition, pages
Elsevier, 2015
Keywords
extracellular vesicles, mRNA, transcription, ischemic preconditioning, myocardium
National Category
Cell and Molecular Biology Cardiac and Cardiovascular Systems
Research subject
Cardiology
Identifiers
urn:nbn:se:umu:diva-111217 (URN)10.1016/j.ijcha.2015.05.006 (DOI)000218809300013 ()28785681 (PubMedID)2-s2.0-84930674705 (Scopus ID)
Available from: 2015-11-10 Created: 2015-11-10 Last updated: 2023-03-24Bibliographically approved
Torstensson, I., Blomström-Lundqvist, C., Olsson, S. B., Rydén, L., Swedberg, K. & Waldenström, A. (2015). Strokeprofylax vid förmaksflimmer: välj nya antikoagulantia före warfarin. Läkartidningen, 112(38), Article ID DPPL.
Open this publication in new window or tab >>Strokeprofylax vid förmaksflimmer: välj nya antikoagulantia före warfarin
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2015 (Swedish)In: Läkartidningen, ISSN 0023-7205, E-ISSN 1652-7518, Vol. 112, no 38, article id DPPLArticle in journal (Other (popular science, discussion, etc.)) Published
National Category
Clinical Medicine
Identifiers
urn:nbn:se:umu:diva-212287 (URN)2-s2.0-84942156401 (Scopus ID)
Note

Publicerad på Lakartidningen.se 2015-09-22.

Available from: 2023-07-20 Created: 2023-07-20 Last updated: 2023-07-20Bibliographically approved
Bergström, G., Berglund, G., Blomberg, A., Brandberg, J., Engström, G., Engvall, J., . . . Rosengren, A. (2015). The Swedish CArdioPulmonary BioImage Study: objectives and design.. Journal of Internal Medicine, 278(6), 645-659
Open this publication in new window or tab >>The Swedish CArdioPulmonary BioImage Study: objectives and design.
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2015 (English)In: Journal of Internal Medicine, ISSN 0954-6820, E-ISSN 1365-2796, Vol. 278, no 6, p. 645-659Article in journal (Refereed) Published
Abstract [en]

Cardiopulmonary diseases are major causes of death worldwide, but currently recommended strategies for diagnosis and prevention may be outdated because of recent changes in risk factor patterns. The Swedish CArdioPulmonarybioImage Study (SCAPIS) combines the use of new imaging technologies, advances in large-scale 'omics' and epidemiological analyses to extensively characterize a Swedish cohort of 30 000 men and women aged between 50 and 64 years. The information obtained will be used to improve risk prediction of cardiopulmonary diseases and optimize the ability to study disease mechanisms. A comprehensive pilot study in 1111 individuals, which was completed in 2012, demonstrated the feasibility and financial and ethical consequences of SCAPIS. Recruitment to the national, multicentre study has recently started.

National Category
Cardiac and Cardiovascular Systems
Identifiers
urn:nbn:se:umu:diva-120485 (URN)10.1111/joim.12384 (DOI)000375425100001 ()26096600 (PubMedID)2-s2.0-84983097810 (Scopus ID)
Available from: 2016-05-17 Created: 2016-05-17 Last updated: 2023-05-09Bibliographically approved
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