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Hansen, Tomas
Publications (10 of 22) Show all publications
Ekström, M. P., Blomberg, A., Bergstrom, G., Brandberg, J., Caidahl, K., Engstrom, G., . . . Lindberg, E. (2019). The association of body mass index, weight gain and central obesity with activity-related breathlessness: the Swedish Cardiopulmonary Bioimage Study. Thorax, 74(10), 958-964
Open this publication in new window or tab >>The association of body mass index, weight gain and central obesity with activity-related breathlessness: the Swedish Cardiopulmonary Bioimage Study
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2019 (English)In: Thorax, ISSN 0040-6376, E-ISSN 1468-3296, Vol. 74, no 10, p. 958-964Article in journal (Refereed) Published
Abstract [en]

Introduction Breathlessness is common in the population, especially in women and associated with adverse health outcomes. Obesity (body mass index (BMI) >30 kg/m2) is rapidly increasing globally and its impact on breathlessness is unclear.

Methods This population-based study aimed primarily to evaluate the association of current BMI and self-reported change in BMI since age 20 with breathlessness (modified Research Council score ≥1) in the middle-aged population. Secondary aims were to evaluate factors that contribute to breathlessness in obesity, including the interaction with spirometric lung volume and sex.

Results We included 13 437 individuals; mean age 57.5 years; 52.5% women; mean BMI 26.8 (SD 4.3); mean BMI increase since age 20 was 5.0 kg/m2; and 1283 (9.6%) reported breathlessness. Obesity was strongly associated with increased breathlessness, OR 3.54 (95% CI, 3.03 to 4.13) independent of age, sex, smoking, airflow obstruction, exercise level and the presence of comorbidities. The association between BMI and breathlessness was modified by lung volume; the increase in breathlessness prevalence with higher BMI was steeper for individuals with lower forced vital capacity (FVC). The higher breathlessness prevalence in obese women than men (27.4% vs 12.5%; p<0.001) was related to their lower FVC. Irrespective of current BMI and confounders, individuals who had increased in BMI since age 20 had more breathlessness.

Conclusion Breathlessness is independently associated with obesity and with weight gain in adult life, and the association is stronger for individuals with lower lung volumes.

Place, publisher, year, edition, pages
BMJ PUBLISHING GROUP, 2019
Keywords
dyspnoea, sex, weight, lung function, lung volume
National Category
Respiratory Medicine and Allergy
Identifiers
urn:nbn:se:uu:diva-395787 (URN)10.1136/thoraxjnl-2019-213349 (DOI)000487508000008 ()31434752 (PubMedID)
Funder
Swedish Heart Lung FoundationKnut and Alice Wallenberg FoundationSwedish Research CouncilVinnovaSwedish Heart Lung FoundationSwedish Society of Medicine
Available from: 2019-10-28 Created: 2019-10-28 Last updated: 2019-10-28Bibliographically approved
Hansen, T., Kilander, L., Ahlström, H. & Lind, L. (2018). Total atherosclerotic burden measured by magnetic resonance imaging is related to five-year decline in cognitive function. Clinical Physiology and Functional Imaging, 38(3), 373-377
Open this publication in new window or tab >>Total atherosclerotic burden measured by magnetic resonance imaging is related to five-year decline in cognitive function
2018 (English)In: Clinical Physiology and Functional Imaging, ISSN 1475-0961, E-ISSN 1475-097X, Vol. 38, no 3, p. 373-377Article in journal (Refereed) Published
Abstract [en]

Objective: The aim of this study was to explore whether total atherosclerotic burden is related to future decline in performance on cognitive tests.

Methods: The total atherosclerotic burden (TAS) was assessed by whole‐body magnetic resonance angiography (WBMRA) in 305 subjects at age 70 in the study Prospective Investigation of Vasculature in Uppsala Seniors (PIVUS). The mini‐mental state examination (MMSE) and trail making tests (TMT) A and B were evaluated at ages 75 and 80 in 190 of those subjects. No subject with a diagnosis of dementia was included in the sample.

Results: MMSE did not change during the 5 years of follow‐up, while TMT A and B increased by 4 and 7 s, respectively. TAS at age 70 was significantly related to the individual change in TMT B (P<0·0001) between age 75 and 80, when adjusted for sex, education level, TMT B at age 75 and Framingham score at age 70. No such relationship was seen for the change in TMT A (P = 0·10). The relationship between TAS and the change in MMSE was of borderline significance (P = 0·025).

Conclusion: A relationship was found between the total atherosclerotic burden and future decline in performance on TMT B, highlighting a role of global atherosclerosis in the cognitive decline seen during ageing.

Keywords
Atherosclerosis, dementia, magnetic resonance angiography, mild cognitive impairment, mini-mental state examination, trail making tests
National Category
Physiology
Identifiers
urn:nbn:se:uu:diva-322144 (URN)10.1111/cpf.12423 (DOI)000430103100005 ()28402078 (PubMedID)
Funder
Swedish Research CouncilAstraZeneca
Available from: 2017-05-16 Created: 2017-05-16 Last updated: 2018-06-19Bibliographically approved
Batista Borges, J., Hansen, T., Larsson, A. & Hedenstierna, G. (2017). The "normal" ventilated airspaces suffer the most damaging effects of mechanical ventilation. Intensive Care Medicine, 43(7), 1057-1058
Open this publication in new window or tab >>The "normal" ventilated airspaces suffer the most damaging effects of mechanical ventilation
2017 (English)In: Intensive Care Medicine, ISSN 0342-4642, E-ISSN 1432-1238, Vol. 43, no 7, p. 1057-1058Article in journal, Editorial material (Other academic) Published
National Category
Radiology, Nuclear Medicine and Medical Imaging
Identifiers
urn:nbn:se:uu:diva-333825 (URN)10.1007/s00134-017-4708-1 (DOI)000404020100016 ()28204859 (PubMedID)
Available from: 2017-11-29 Created: 2017-11-29 Last updated: 2017-11-29Bibliographically approved
Hagström, E., Michaëlsson, K., Melhus, H., Hansen, T., Ahlström, H., Johansson, L., . . . Arnlöv, J. (2014). Plasma-Parathyroid Hormone Is Associated With Subclinical and Clinical Atherosclerotic Disease in 2 Community-Based Cohorts. Arteriosclerosis, Thrombosis and Vascular Biology, 34(7), 1567-73
Open this publication in new window or tab >>Plasma-Parathyroid Hormone Is Associated With Subclinical and Clinical Atherosclerotic Disease in 2 Community-Based Cohorts
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2014 (English)In: Arteriosclerosis, Thrombosis and Vascular Biology, ISSN 1079-5642, E-ISSN 1524-4636, Vol. 34, no 7, p. 1567-73Article in journal (Refereed) Published
Abstract [en]

OBJECTIVE: Cardiovascular risk factors have different impact on different arterial territories. Diseases with elevated circulating parathyroid hormone (PTH) such as primary hyperparathyroidism and chronic renal failure have been shown to be associated with an increased risk of cardiovascular disease, predominantly heart or cerebrovascular diseases. However, data on the associations between circulating PTH and peripheral atherosclerosis are limited.

APPROACH AND RESULTS: Two prospective, community-based studies were used. In 306 men and women, who were 70 years old, from the Prospective investigation of the vasculature in Uppsala seniors (PIVUS) study, cross-sectional relations between PTH and atherosclerotic burden assessed by whole-body magnetic resonance angiography were investigated. In 998 men, who were 71 years old, from the Uppsala longitudinal study of adult men (ULSAM) study, the association between PTH concentration and risk of subsequent nonfatal atherosclerotic disease (excluding coronary or cerebrovascular disease) was investigated. Adjusting for established vascular risk factors, PTH was associated with burden of atherosclerosis (increase in total atherosclerotic score per SD PTH increase: 0.04, 0.003-0.08; P=0.03) in the PIVUS study. During follow-up in the ULSAM study (median 16.7 years), 89 men were diagnosed with nonfatal atherosclerotic disease. In Cox-regression analyses adjusting for established vascular risk factors and mineral metabolism, higher PTH was associated with an increased risk of nonfatal atherosclerotic disease (hazard ratio for 1 SD increase of PTH: 1.55, 1.33-1.88; P<0.0001). Results were similar when including fatal atherosclerotic disease in the outcome.

CONCLUSIONS: In 2 independent community-based cohorts, PTH was associated to the degree of atherosclerosis and risk of clinically overt atherosclerotic disease, respectively. Our data confirm and extend previous studies supporting a role for PTH in the development of atherosclerotic disease.

National Category
Cardiac and Cardiovascular Systems
Identifiers
urn:nbn:se:uu:diva-221246 (URN)10.1161/ATVBAHA.113.303062 (DOI)000337732900033 ()24626438 (PubMedID)
Available from: 2014-03-26 Created: 2014-03-26 Last updated: 2018-11-30
Lundberg, C., Hansen, T., Ahlström, H., Lind, L., Wikström, J. & Johansson, L. (2014). The relationship between carotid intima-media thickness and global atherosclerosis. Clinical Physiology and Functional Imaging, 34(6), 457-462
Open this publication in new window or tab >>The relationship between carotid intima-media thickness and global atherosclerosis
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2014 (English)In: Clinical Physiology and Functional Imaging, ISSN 1475-0961, E-ISSN 1475-097X, Vol. 34, no 6, p. 457-462Article in journal (Refereed) Published
Abstract [en]

BACKGROUND:

The aim of this study was to investigate the relationship between (i) carotid intima-media thickness (CIMT) at baseline as well as (ii) change in CIMT over 5 years (ΔCIMT) and atherosclerotically induced luminal narrowing in non-coronary arterial territories assessed by whole-body magnetic resonance angiography (WBMRA).

METHODS AND RESULTS:

In subgroups of the Prospective Investigation of Vasculature in Uppsala Seniors (PIVUS) study, US measurements of CIMT in the common carotid arteries were analysed at 70 and 75 years and ΔCIMT was calculated (n = 272). WBMRA, assessing arterial stenosis in five different territories by which also a total atherosclerotic score (TAS) was calculated, was performed at 70 years (n = 306).

RESULTS:

Carotid intima-media thickness in the carotid artery at baseline was correlated with TAS (P = 0·0001) when adjusted to a set of traditional risk factors for atherosclerosis, as well as to stenosis in two of the different investigated territories (aorta and lower leg, P = 0·013 and P = 0·004), but there was no significant correlation between ΔCIMT and TAS (P = 0·41).

CONCLUSIONS:

In the present study, CIMT, but not ΔCIMT over 5 years, in the carotid artery was related to overall stenoses in the body, as assessed by WBMRA. These findings support CIMT as a general marker for atherosclerosis.

National Category
Clinical Medicine
Identifiers
urn:nbn:se:uu:diva-221885 (URN)10.1111/cpf.12116 (DOI)000345639300006 ()24405735 (PubMedID)
Available from: 2014-04-07 Created: 2014-04-07 Last updated: 2017-12-05Bibliographically approved
Smekal, D., Hansen, T., Sandler, H. & Rubertsson, S. (2013). Comparison of computed tomography and autopsy in detection of injuries after unsuccessful cardiopulmonary resuscitation. Resuscitation, 84(3), 357-360
Open this publication in new window or tab >>Comparison of computed tomography and autopsy in detection of injuries after unsuccessful cardiopulmonary resuscitation
2013 (English)In: Resuscitation, ISSN 0300-9572, E-ISSN 1873-1570, Vol. 84, no 3, p. 357-360Article in journal (Refereed) Published
Abstract [en]

AIM:

Computed tomography (CT) has been suggested as an aid or even a replacement for autopsy. The aim of this trial was to study the conformity of the two methods in finding injuries in non-surviving patients after unsuccessful cardiopulmonary resuscitation.

METHODS:

In this prospective study, 31 patients were submitted to a CT prior to autopsy after unsuccessful resuscitation attempts. Pathological findings were noted by both the radiologist and the pathologists in a specified protocol. The pathologists and radiologist were blinded from each other's results.

RESULTS:

CT and autopsy revealed rib fractures in 22 and 24 patients respectively (kappa=0.83). In 8 patients, CT revealed more rib fractures than autopsy; and in 12 patients, autopsy revealed more rib fractures than CT. In 7 patients, neither method showed any rib fractures. The mean difference between the two methods in detecting rib fractures was 0.16 (S.D.: ±3.174, limits of agreement: -6.19 to 6.51). The kappa value for sternal fractures was 0.49. A total of 260 pathological findings were noted by CT and 244 by autopsy. The average patient showed a median of 9 injuries (every fracture counted as one injury), independent of the method used in detecting the injuries.

CONCLUSIONS:

There was a strong concordance between the two methods in finding rib fractures but not sternal fractures and these results support the concept of CT as a valuable complement to autopsy in detecting rib fractures after unsuccessful cardiopulmonary resuscitation but not as a replacement. Other injuries did not show the same concordance.

National Category
Clinical Medicine
Identifiers
urn:nbn:se:uu:diva-182251 (URN)10.1016/j.resuscitation.2012.06.023 (DOI)000318164200025 ()22776515 (PubMedID)
Available from: 2012-10-08 Created: 2012-10-08 Last updated: 2017-12-07Bibliographically approved
Lundberg, C., Johansson, L., Ebeling Barbier, C., Lind, L., Ahlström, H. & Hansen, T. (2013). Total atherosclerotic burden by whole body magnetic resonance angiography predicts major adverse cardiovascular events. Atherosclerosis, 228(1), 148-152
Open this publication in new window or tab >>Total atherosclerotic burden by whole body magnetic resonance angiography predicts major adverse cardiovascular events
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2013 (English)In: Atherosclerosis, ISSN 0021-9150, E-ISSN 1879-1484, Vol. 228, no 1, p. 148-152Article in journal (Refereed) Published
Abstract [en]

OBJECTIVE:

The purpose of the present study was to investigate the relationship between the Total Atherosclerotic Score (TAS), a measurement of the overall atherosclerotic burden of the arterial tree by whole body magnetic resonance angiography (WBMRA), and the risk of major adverse cardiovascular events (MACE), defined as cardiac death, myocardial infarction, stroke and/or coronary revascularization, assuming that TAS predicts MACE.

METHODS AND RESULTS:

305 randomly selected 70 year-old subjects (47% women) underwent WBMRA. Their atherosclerotic burden was evaluated and TAS > 0, that is atherosclerotic changes, were found in 68% of subjects. During follow-up (mean 4.8 years), MACE occurred in 25 subjects (8.2%). Adjusting for multiple risk factors, TAS was associated with MACE (OR 8.86 for any degree of vessel lumen abnormality, 95%CI 1.14-69.11, p = 0.037). In addition, TAS improved discrimination and reclassification when added to the Framingham risk score (FRS), and ROC (Receiver Operator Curve) increased from 0.681 to 0.750 (p = 0.0421).

CONCLUSION:

In a population-based sample of 70 year old men and women WBMRA, with TAS, predicted MACE independently of major cardiovascular risk factors.

National Category
Radiology, Nuclear Medicine and Medical Imaging
Identifiers
urn:nbn:se:uu:diva-197476 (URN)10.1016/j.atherosclerosis.2013.02.015 (DOI)000318567000022 ()23474127 (PubMedID)
Available from: 2013-03-26 Created: 2013-03-26 Last updated: 2017-12-06Bibliographically approved
Järhult, S. J., Hansen, T., Ahlström, H., Johansson, L., Sundström, J. & Lind, L. (2012). Brachial artery hyperemic blood flow velocity in relation to established indices of vascular function and global atherosclerosis. Clinical Physiology and Functional Imaging, 32(3), 227-233
Open this publication in new window or tab >>Brachial artery hyperemic blood flow velocity in relation to established indices of vascular function and global atherosclerosis
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2012 (English)In: Clinical Physiology and Functional Imaging, ISSN 1475-0961, E-ISSN 1475-097X, Vol. 32, no 3, p. 227-233Article in journal (Other academic) Published
Abstract [en]

Background

Systolic to diastolic blood flow velocity (SDFV) ratio in the Brachial artery recently proved to be related to cardiovascular risk and Carotid atherosclerosis. We hypothesized that the SDFV ratio was related to established markers of vascular function and global atherosclerosis. 

 

Methods

Established markers of endothelial function in forearm resistance vessels, flow-mediated vasodilation and arterial stiffness were assessed in the Prospective Investigation of the Vasculature in Uppsala Seniors (PIVUS) study including 1016 individuals aged 70. Whole body magnetic resonance angiography was performed in a random 306 of the participants. Atherosclerotic lesions were summarized in a total atherosclerotic score (TAS). Before and during hyperemia of the Brachial artery, systolic and diastolic blood flow velocities were measured by Doppler.

 

Results

The SDFV ratio was positively related to endothelium-independent vasodilatation, while inverse relations to flow-mediated dilation, common carotid artery distensibility and the stroke volume to pulse pressure ratio were found. Endothelium-dependent vasodilatation and total peripheral resistance index were not significantly related to the SDFV ratio.

The SDFV ratio (p=0.015) and the blood flow increase during hyperemia (p= 0.020) were both significantly related to TAS after gender adjustment. When adjusted for the Framingham risk score, both the SDFV ratio (p= 0.057) and blood flow increase (p= 0.078) lost somewhat in significance.

 

Conclusion

The SDFV ratio was related to established markers of both vasodilation and arterial compliance, and to global atherosclerosis. Future larger studies have to evaluate if the SDFV ratio is related to global atherosclerosis independently of traditional risk factors.

Keywords
atherosclerosis; brachial; hyperaemic; vascular function
National Category
Cardiac and Cardiovascular Systems
Research subject
Medical Science
Identifiers
urn:nbn:se:uu:diva-132917 (URN)10.1111/j.1475-097X.2011.01117.x (DOI)000302545300010 ()22487158 (PubMedID)
Projects
PIVUS
Available from: 2010-10-28 Created: 2010-10-28 Last updated: 2017-12-12Bibliographically approved
Lind, L., Simon, T., Johansson, L., Kotti, S., Hansen, T., Machecourt, J., . . . Mallat, Z. (2012). Circulating levels of secretory- and lipoprotein-associated phospholipase A2 activities: relation to atherosclerotic plaques and future all-cause mortality. European Heart Journal, 33(23), 2946-54
Open this publication in new window or tab >>Circulating levels of secretory- and lipoprotein-associated phospholipase A2 activities: relation to atherosclerotic plaques and future all-cause mortality
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2012 (English)In: European Heart Journal, ISSN 0195-668X, E-ISSN 1522-9645, Vol. 33, no 23, p. 2946-54Article in journal (Refereed) Published
Abstract [en]

Aims

Secretory- and lipoprotein-associated phospholipases A2 (sPLA2 and Lp-PLA2) are enzymes both suggested to be of importance for atherosclerosis. We investigated relationships between the activities of these enzymes in the circulation and atherosclerosis as well as future clinical events.

Methods and results

The population-based Prospective Investigation of the Vasculature in Uppsala Seniors (PIVUS) study included 1016 randomly selected subjects, all aged 70. The prevalence of carotid artery plaques was recorded by ultrasound (n= 954), and arterial stenosis was assessed by whole-body magnetic resonance angiography (WBMRA, n= 302). Secretory-associated phospholipase A2 [odds ratio 1.23 for 1 SD increase, 95% confidence interval (CI): 1.05-1.44, P= 0.007], but not Lp-PLA2 (P= 0.26), activity was significantly related to carotid atherosclerosis and to the amount of stenosis at WBMRA (P= 0.006) following adjustment for multiple risk factors (waist circumference, serum triglycerides, body mass index, C-reactive protein, high density lipoprotein-C, low density lipoprotein-C, triglycerides, GFR, fasting glucose, blood pressure, statin use, and exercise habits). Secretory-associated phospholipase A2 [hazard ratio (HR) 1.45 for 1 SD increase, 95% CI: 1.15-1.84, P= 0.001], but not Lp-PLA2 (HR 0.95, P= 0.55), activity was a significant risk factor for all-cause mortality (114 had died) during 7.0 years follow-up after adjustment for the risk factors described above. In a sample of 1029 post-myocardial infarction (MI) patients (French registry of Acute ST-elevation and non-ST-elevation Myocardial Infarction), sPLA2 (adjusted HR 1.32 for 1 unit increase, 95% CI: 1.02-1.71, P= 0.036), but not Lp-PLA2 (HR 1.03, P= 0.90), activity predicted death or recurrent MI during 1-year follow-up (n= 136 cases).

Conclusion

sPLA2 activity was related to atherosclerosis and predicted all-cause mortality in a sample of elderly subjects, as well as death or MI in post-MI patients.

National Category
Medical and Health Sciences
Identifiers
urn:nbn:se:uu:diva-183793 (URN)10.1093/eurheartj/ehs132 (DOI)000312107200014 ()22711753 (PubMedID)
Available from: 2012-11-01 Created: 2012-11-01 Last updated: 2017-12-07Bibliographically approved
Torkzad, M. R., Wikström, J., Hansen, T., Bergman, A., Bjerner, T. & Ahlström, H. (2012). The Clinical Perspective on Value of 3D, Thin Slice T2-Weighted Images in 3T Pelvic MRI for Tumors. Current Medical Imaging Reviews, 8(2), 76-81(6)
Open this publication in new window or tab >>The Clinical Perspective on Value of 3D, Thin Slice T2-Weighted Images in 3T Pelvic MRI for Tumors
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2012 (English)In: Current Medical Imaging Reviews, ISSN 1573-4056, Vol. 8, no 2, p. 76-81(6)Article in journal (Refereed) Published
Abstract [en]

Pelvic imaging is undergoing rapid changes due to increased use of 3-Tesla (3T) magnetic resonance imaging (3T MRI). One of the advantages of 3T could be the possibility for thin section 3-dimensional (3D) imaging which could improve accuracy and at the same time reduce the need for multi-planar imaging needed for conventional T2 imaging (TSE). In the following text we review the advantages of 3D thin section imaging for assessment of pelvic tumors.

Keywords
MRI, pelvic neoplasms, imaging three-dimensional
National Category
Radiology, Nuclear Medicine and Medical Imaging
Identifiers
urn:nbn:se:uu:diva-181181 (URN)10.2174/157340512800672243 (DOI)000310573200002 ()
Available from: 2012-09-18 Created: 2012-09-18 Last updated: 2012-12-11Bibliographically approved
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