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Karp, Kjell
Publications (10 of 16) Show all publications
Wahlin, B., Fasth, A. E., Karp, K., Lejon, K., Södergren, A. & Wållberg-Jonsson, S. (2017). Cd8+cd28- t-lymphocytes are associated with subclinical atherosclerosis in patients with rheumatoid arthritis. Paper presented at Annual European Congress of Rheumatology, JUN 14-17, 2017, Madrid, SPAIN. Annals of the Rheumatic Diseases, 76, 250-250
Open this publication in new window or tab >>Cd8+cd28- t-lymphocytes are associated with subclinical atherosclerosis in patients with rheumatoid arthritis
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2017 (English)In: Annals of the Rheumatic Diseases, ISSN 0003-4967, E-ISSN 1468-2060, Vol. 76, p. 250-250Article in journal, Meeting abstract (Other academic) Published
Place, publisher, year, edition, pages
BMJ PUBLISHING GROUP, 2017
National Category
Rheumatology and Autoimmunity
Identifiers
urn:nbn:se:umu:diva-142290 (URN)10.1136/annrheumdis-2017-eular.4364 (DOI)000413181400665 ()
Conference
Annual European Congress of Rheumatology, JUN 14-17, 2017, Madrid, SPAIN
Available from: 2017-11-29 Created: 2017-11-29 Last updated: 2018-06-09Bibliographically 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)
Available from: 2016-06-16 Created: 2016-06-16 Last updated: 2018-06-07Bibliographically approved
Leijon-Sundqvist, K., Tegner, Y., Olsson, F., Karp, K. & Lehto, N. (2017). Relation between dorsal and palmar hand skin temperatures during a cold stress test. Journal of Thermal Biology, 66, 87-92
Open this publication in new window or tab >>Relation between dorsal and palmar hand skin temperatures during a cold stress test
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2017 (English)In: Journal of Thermal Biology, ISSN 0306-4565, E-ISSN 1879-0992, Vol. 66, p. 87-92Article in journal (Refereed) Published
Abstract [en]

Hand skin temperature measurements have previously been performed on either dorsal or palmar sides and it is possible to find arguments for the advantage of both locations. Therefore, the aim of this study was to use dynamic infrared (IR) imaging to examine the relationship between dorsal and palmar hand skin temperature. The palmar and dorsal hand skin temperature before and after a cold stress test was measured with IR thermography in 112 healthy participants. Calculation of surface average temperature was made from nine regions of interest on each hand's dorsal and palmar side. Temperature values were recorded at baseline, directly after immersion of hands in vinyl gloves for one minute in water at 20 +/- 0.5 degrees C (gloves removed), and after eight minutes rewarming. Results showed that: a) the skin temperatures on the dorsal and palmar sides of the hand are strongly correlated; b) the correlation is stronger on the fingers than on the carpometacarpal (CMC) area; c) the palmar side of the CMC area is warmer than the dorsal side, but this is reversed in the fingers so that the nail bed is warmer than the finger pad; and d) the temperature difference Delta T between the dorsal and palmar sides of the fingers is independent of the skin temperature, though Delta T on the CMC area of the hand is temperature dependent. Such differences can be important in detailed investigations of thermal phenomena in the hand. In conclusion, results showed a strong correlation between the dorsal and palmar temperatures. If both sides cannot be measured, the purpose of the investigation should determine which side of the hand should be measured.

Keywords
Opisthenar, Volar, CST, Vascular response, Peripheral circulation, Thermoregulation
National Category
Philosophy
Identifiers
urn:nbn:se:umu:diva-136339 (URN)10.1016/j.jtherbio.2017.04.003 (DOI)000401388300012 ()28477914 (PubMedID)
Available from: 2017-06-19 Created: 2017-06-19 Last updated: 2018-06-09Bibliographically approved
Södergren, A., Karp, K., Bengtsson, C., Möller, B., Rantapää-Dahlqvist, S. & Wållberg-Jonsson, S. (2015). Is Lipoprotein-Associated Phospholipase A2a Link between Inflammation and Subclinical Atherosclerosis inRheumatoid Arthritis?. BioMed Research International, Article ID 673018.
Open this publication in new window or tab >>Is Lipoprotein-Associated Phospholipase A2a Link between Inflammation and Subclinical Atherosclerosis inRheumatoid Arthritis?
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2015 (English)In: BioMed Research International, ISSN 2314-6133, E-ISSN 2314-6141, article id 673018Article in journal (Refereed) Published
Abstract [en]

Objective. Lipoprotein-associated phospholipase A2 (Lp-PLA2), a marker of vascular inflammation, is associated with cardiovascular disease. This prospective study of an inception cohort aimed to investigate whether the level of Lp-PLA2 is associated with subclinical atherosclerosis in patients with rheumatoid arthritis (RA). Methods. Patients from northern Sweden diagnosed with early RA were consecutively recruited into an ongoing prospective study. From these, all patients <= 60 years (n = 71) were included for measurements of subclinical atherosclerosis at inclusion (T0) and five years later (T5). Forty age-and sex-matched controls were included. The patients were clinically assessed, SCORE, Reynolds Risk Score, and Larsen score were calculated, and blood samples were drawn from all individuals at T0 and T5. Results. There was no significant difference in the level of Lp-PLA2 between patients with RA and controls (p > 0.05). In simple linear regression models among patients with RA, Lp-PLA2 at T0 was significantly associated with intima media thickness (IMT) at T0 and T5, flow mediated dilation (FMD) at T0 and T5, ever smoking, male sex, HDL-cholesterol (inversely), non-HDL-cholesterol, SCORE, Reynolds Risk Score, and Larsen score (p < 0.05). Conclusion. In this cohort of patients with early RA, the concentration of Lp-PLA2 was associated with both subclinical atherosclerosis and disease severity.

Place, publisher, year, edition, pages
Hindawi Publishing Corporation, 2015
Keywords
phospholipase, cardiovascular disease, Lp-PLA2
National Category
Rheumatology and Autoimmunity
Identifiers
urn:nbn:se:umu:diva-111521 (URN)10.1155/2015/673018 (DOI)000363154200001 ()26504820 (PubMedID)
Available from: 2015-12-03 Created: 2015-11-13 Last updated: 2018-06-07Bibliographically approved
Södergren, A., Karp, K., Bengtsson, C., Moller, B., Rantapää-Dahlqvist, S. & Wållberg-Jonsson, S. (2015). The Extent of Subclinical Atherosclerosis Is Partially Predicted by the Inflammatory Load: A Prospective Study over 5 Years in Patients with Rheumatoid Arthritis and Matched Controls. Journal of Rheumatology, 42(6), 935-942
Open this publication in new window or tab >>The Extent of Subclinical Atherosclerosis Is Partially Predicted by the Inflammatory Load: A Prospective Study over 5 Years in Patients with Rheumatoid Arthritis and Matched Controls
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2015 (English)In: Journal of Rheumatology, ISSN 0315-162X, E-ISSN 1499-2752, Vol. 42, no 6, p. 935-942Article in journal (Refereed) Published
Abstract [en]

Objective. This prospective followup study investigated subclinical atherosclerosis in relation to traditional cardiovascular disease (CVD) risk factors and inflammation in patients with rheumatoid arthritis (RA) recruited at diagnosis compared with controls. Methods. Patients diagnosed with early RA were consecutively recruited into a prospective study. From these, a subgroup aged <= 60 years (n = 71) was consecutively included for ultrasound measurement of intima-media thickness (IMT) and flow-mediated dilation (FMD) at inclusion (T0) and after 5 years (T5). Age-and sex-matched controls (n = 40) were also included. Results. In the Wilcoxon signed-rank test, both IMT and FMD were significantly aggravated at T5 compared to baseline in patients with RA, whereas only IMT was significantly increased in controls. In univariate linear regression analyses among patients with RA, the IMT at T5 was significantly associated with age, systolic blood pressure (BP), cholesterol, triglycerides, Systematic Coronary Risk Evaluation (SCORE), and Reynolds Risk Score at baseline (p < 0.05). Similarly, FMD at T5 was significantly inversely associated with age, smoking, systolic BP, SCORE, and Reynolds Risk Score (p < 0.05). A model with standardized predictive value from multiple linear regression models including age, smoking, BP, and blood lipids at baseline significantly predicted the observed value of IMT after 5 years. When also including the area under the curve for the 28-joint Disease Activity Score over 5 years, the observed value of IMT was predicted to a large extent. Conclusion. This prospective study identified an increased subclinical atherosclerosis in patients with RA. In the patients with RA, several traditional CVD risk factors at baseline significantly predicted the extent of subclinical atherosclerosis 5 years later. The inflammatory load over time augmented this prediction.

Keywords
Rheumatoid Arthritis, Cardiovascular Disease, Inflammation, Atherosclerosis, Prospective
National Category
Rheumatology and Autoimmunity
Identifiers
urn:nbn:se:umu:diva-106500 (URN)10.3899/jrheum.140694 (DOI)000355543300006 ()25877503 (PubMedID)
Available from: 2015-07-16 Created: 2015-07-14 Last updated: 2018-06-07Bibliographically approved
Wahlin, B., Meedt, T., Jonsson, F., Karp, K., Henein, M. & Wållberg-Jonsson, S. (2014). Prediction of coronary artery calcification and association with inflammation in rheumatoid arthritis: a follow-up study. Paper presented at 15th Annual European Congress of Rheumatology (EULAR), JUN 11-14, 2014, Paris, FRANCE. Annals of the Rheumatic Diseases, 73, 634-635
Open this publication in new window or tab >>Prediction of coronary artery calcification and association with inflammation in rheumatoid arthritis: a follow-up study
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2014 (English)In: Annals of the Rheumatic Diseases, ISSN 0003-4967, E-ISSN 1468-2060, Vol. 73, p. 634-635Article in journal, Meeting abstract (Other academic) Published
National Category
Rheumatology and Autoimmunity
Identifiers
urn:nbn:se:umu:diva-106400 (URN)10.1136/annrheumdis-2014-eular.5907 (DOI)000346919803319 ()
Conference
15th Annual European Congress of Rheumatology (EULAR), JUN 11-14, 2014, Paris, FRANCE
Note

Supplement: 2, Meeting Abstract: SAT0122

Available from: 2015-07-14 Created: 2015-07-14 Last updated: 2018-06-07Bibliographically approved
Wållberg-Jonsson, S., Karp, K., Boman, K., Eriksson, C., Lundstrom, E., Smedby, T., . . . Södergren, A. (2012). Progression of subclinical atherosclerosis over 5 years in patients with early rheumatoid arthritis. Paper presented at 32nd European Workshop for Rheumatology Research, FEB 23-25, 2012, Stockholm, SWEDEN. Annals of the Rheumatic Diseases, 71, A92-A92
Open this publication in new window or tab >>Progression of subclinical atherosclerosis over 5 years in patients with early rheumatoid arthritis
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2012 (English)In: Annals of the Rheumatic Diseases, ISSN 0003-4967, E-ISSN 1468-2060, Vol. 71, p. A92-A92Article in journal, Meeting abstract (Other academic) Published
Identifiers
urn:nbn:se:umu:diva-55385 (URN)10.1136/annrheumdis-2011-201239.16 (DOI)000302323600211 ()
Conference
32nd European Workshop for Rheumatology Research, FEB 23-25, 2012, Stockholm, SWEDEN
Available from: 2012-05-29 Created: 2012-05-14 Last updated: 2018-06-08Bibliographically approved
Rönn, F., Kesek, M., Karp, K., Henein, M. & Jensen, S. M. (2011). Right ventricular lead positioning does not influence the benefits of cardiac resynchronization therapy in patients with heart failure and atrial fibrillation.. Europace, 13(12), 1747-1752
Open this publication in new window or tab >>Right ventricular lead positioning does not influence the benefits of cardiac resynchronization therapy in patients with heart failure and atrial fibrillation.
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2011 (English)In: Europace, ISSN 1099-5129, E-ISSN 1532-2092, Vol. 13, no 12, p. 1747-1752Article in journal (Refereed) Published
Abstract [en]

Aims Little is known about the optimal right ventricular (RV) pacing site in cardiac resynchronization therapy (CRT). This study compares bi-ventricular pacing at the left ventricular (LV) free wall combined with two different RV stimulation sites: RV outflow tract (RVOT+LV) vs. RV-apex (RVA+LV). Methods and results Thirty-three patients (32 males) with chronic heart failure, NYHA class III-IV, optimal drug therapy, QRS-duration ≥150 ms, and chronic atrial fibrillation (AF) received CRT with two different RV leads, in the apex (RVA) or outflow tract (RVOT), together with an LV lead, all connected to a bi-ventricular pacemaker. Randomization to pacing in RVOT+LV or RVA+LV was made 1 month after implantation and cross-over to the alternate pacing configuration occurred after 3 months. The median age of patients was 69 ± 10 years, the mean QRS was 179 ± 23 ms, and 58% of patients had ischaemic heart disease. Seven patients had pacemaker rhythm at inclusion and 60% were treated with atrioventricular-junctional ablation before randomization. In the RVA+LV and RVOT+LV pacing modes, 67 and 63% (nonsignificant) responded symptomatically with a decrease of at least 10 points in the Minnesota Living with Heart Failure score. The secondary end-points (6-min walk test, peak oxygen uptake, N-Terminal fragment of B-type Natriuretic Peptide, and left ventricular ejection fraction) showed significant improvement between baseline and CRT, but not between RVOT+LV and RVA+LV. Conclusion In this randomized controlled study, the exact RV pacing site, either apex or outflow tract, did not influence the benefits of CRT in a group of patients with chronic heart failure and AF. ClinicalTrials.gov ID: NCT00457834.

Place, publisher, year, edition, pages
Oxford University Press, 2011
Keywords
Congestive heart failure, Cardiac resynchronization therapy, Lead placement, Atrial fibrillation, Right ventricular pacing configurations, Cardiac resynchronization, Biventricular pacing, Left ventricular pacing, Right ventricular pacing
National Category
Cardiac and Cardiovascular Systems
Identifiers
urn:nbn:se:umu:diva-49358 (URN)10.1093/europace/eur193 (DOI)21712261 (PubMedID)
Available from: 2011-11-09 Created: 2011-11-09 Last updated: 2018-06-08Bibliographically approved
Johansson, E. P., Ahlqvist, J., Garoff, M., Karp, K., Levring Jäghagen, E. & Wester, P. (2011). Ultrasound screening for asymptomatic carotid stenosis in subjects with calcifications in the area of the carotid arteries on panoramic radiographs: a cross-sectional study. BMC Cardiovascular Disorders, 11(44), 1-9
Open this publication in new window or tab >>Ultrasound screening for asymptomatic carotid stenosis in subjects with calcifications in the area of the carotid arteries on panoramic radiographs: a cross-sectional study
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2011 (English)In: BMC Cardiovascular Disorders, ISSN 1471-2261, E-ISSN 1471-2261, Vol. 11, no 44, p. 1-9Article in journal (Refereed) Published
Abstract [en]

Background: Directed ultrasonic screening for carotid stenosis is cost-effective in populations with > 5% prevalence of the diagnosis. Occasionally, calcifications in the area of the carotid arteries are incidentally detected on odontological panoramic radiographs. We aimed to determine if directed screening for carotid stenosis with ultrasound is indicated in individuals with such calcifications. Methods: This was a cross-sectional study. Carotid ultrasound examinations were performed on consecutive persons, with findings of calcifications in the area of the carotid arteries on panoramic radiography that were otherwise eligible for asymptomatic carotid endarterectomy. Results: Calcification in the area of the carotid arteries was seen in 176 of 1182 persons undergoing panoramic radiography. Of these, 117 fulfilled the inclusion criterion and were examined with carotid ultrasound. Eight persons (6.8%; 95% CI 2.2-11.5%) had a carotid stenosis - not significant over the 5% pre-specified threshold (p = 0.232, Binomial test). However, there was a significant sex difference (p = 0.008), as all stenoses were found in men. Among men, 12.5% (95% CI 4.2-20.8%) had carotid stenosis - significantly over the 5% pre-specified threshold (p = 0.014, Binomial test). Conclusions: The incidental finding of calcification in the area of the carotid arteries on panoramic radiographs should be followed up with carotid screening in men that are otherwise eligible for asymptomatic carotid endarterectomy.

Place, publisher, year, edition, pages
BioMed Central, 2011
Keywords
endarterectomy, stroke, emboli, trial, risk
National Category
Cardiac and Cardiovascular Systems
Identifiers
urn:nbn:se:umu:diva-45670 (URN)10.1186/1471-2261-11-44 (DOI)000294287500001 ()21752238 (PubMedID)
Available from: 2011-08-09 Created: 2011-08-09 Last updated: 2018-06-08Bibliographically approved
Södergren, A., Karp, K., Boman, K., Eriksson, C., Lundström, E., Smedby, T., . . . Wållberg-Jonsson, S. (2010). Atherosclerosis in early rheumatoid arthritis: very early endothelial activation and rapid progression of intima media thickness. Arthritis Research & Therapy, 12(4), R158
Open this publication in new window or tab >>Atherosclerosis in early rheumatoid arthritis: very early endothelial activation and rapid progression of intima media thickness
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2010 (English)In: Arthritis Research & Therapy, ISSN 1478-6354, E-ISSN 1478-6362, Vol. 12, no 4, p. R158-Article in journal (Refereed) Published
Abstract [en]

INTRODUCTION : In this study we aimed to investigate whether there are indications of premature atherosclerosis, as measured by endothelial dependent flow-mediated dilation (ED-FMD) and intima media thickness (IMT), in patients with very early RA, and to analyze its relation to biomarkers of endothelial dysfunction, taking inflammation and traditional cardiovascular disease (CVD) risk factors into account.

METHODS : Patients from the three northern counties of Sweden diagnosed with early RA are followed in an ongoing prospective study of CVD co-morbidity. Of these, all patients aged ≤60 years were consecutively included in this survey of CVD risk factors (n = 79). Forty-four age and sex matched controls were included. IMT of common carotid artery and ED-FMD of brachial artery were measured using ultrasonography. Blood was drawn for analysis of lipids, erythrocyte sedimentation rate (ESR), C-reactive protein (CRP), plasminogen activator inhibitor-1 (PAI-1), tissue plasminogen activator (tPA)-mass, VonWillebrand factor (VWF), soluble intercellular adhesion molecule-1 (sICAM), soluble vascular cell adhesion molecule-1 (sVCAM), sE-selectin, sL-selectin and monocyte chemotactic protein-1 (MCP-1). In a subgroup of 27 RA patients and their controls the ultrasound measurements were reanalysed after 18 months.

RESULTS : There were no significant differences between RA patients and controls in terms of IMT or ED-FMD at the first evaluation. However after 18 months there was a significant increase in the IMT among the patients with RA (P < 0.05). Patients with RA had higher levels of VWF, sICAM-1 (P < 0.05) and of MCP-1 (P = 0.001) compared with controls. In RA, IMT was related to some of the traditional CVD risk factors, tPA-mass, VWF (P < 0.01) and MCP-1 and inversely to sL-selectin (P < 0.05). In RA, ED-FMD related to sL-selectin (P < 0.01). DAS28 at baseline was related to PAI-1, tPA-mass and inversely to sVCAM-1 (P < 0.05) and sL-selectin (P = 0.001).

CONCLUSIONS : We found no signs of atherosclerosis in patients with newly diagnosed RA compared with controls. However, in patients with early RA, IMT and ED-FMD were, to a greater extent than in controls, related to biomarkers known to be associated with endothelial dysfunction and atherosclerosis. After 18 months, IMT had increased significantly in RA patients but not in controls.

National Category
Medical and Health Sciences
Identifiers
urn:nbn:se:umu:diva-39670 (URN)10.1186/ar3116 (DOI)20712865 (PubMedID)
Available from: 2011-02-03 Created: 2011-02-03 Last updated: 2018-06-08Bibliographically approved
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