Pathological post-systolic shortening as a prognostic marker for major cardiovascular events in patients with type 2 diabetes.

Background: Post-systolic shortening (PSS) has emerged as a method for evaluating left ventricular dysfunction. We aimed to determine whether pathological PSS, alone or in combination with global longitudinal strain (GLS), is a prognostic factor for major adverse cardiovascular events (MACEs) in patients with type 2 diabetes. We prospectively investigated 364 patients with type 2 diabetes aged 55-65 years in the CARDIPP study.

Biomarkers in the Newborn with Fetal Growth Retardation and Early Impairment of Heart Function.

Background Children born with lower birth weight face an increased risk of developing cardiovascular disease later in life. We hypothesize that cardiovascular protein biomarkers in cord blood, associated with birth weight SDS and systolic cardiac function, may reveal mechanisms behind early programming of cardiovascular function. Method We investigated the association between birth weight SDS and plasma levels of 184 circulating proteins determined by Proximity Extension Assay (PEA) in cord blood from 48 children.

4D Flow MRI Velocity and Turbulence Mapping in Mild Valvular Heart Disease.

Background: Valvular heart disease (VHD) commonly leads to the development of turbulent blood flow. Turbulent kinetic energy (TKE), measured with 4D flow MRI, may be a complement to current metrics for early identification of VHD.

Purpose: To investigate TKE as a marker of VHD in relation to flow velocity and cardiovascular geometry.

Plasma copeptin independently predicts cardiovascular events but not all-cause mortality in patients with type 2 diabetes: a prospective observational study.

Background And Aim: Cardiovascular disease (CVD) is the major cause of death in patients with type 2 diabetes mellitus (T2DM), making it of interest to attain efficient methods for prognostic purposes. We aimed to prospectively investigate the association between plasma copeptin and cardiovascular disease (CVD) in individuals with type 2 diabetes mellitus (T2DM), adjusting for mean 24-h ambulatory blood pressure, left ventricular mass index, and traditional cardio-metabolic risk factors.

Methods And Results: A cohort of 523 patients with T2DM with complete data on copeptin, age, sex, body mass index (BMI), smoking, total cholesterol, eGFR, HbA1c, 24-h ambulatory systolic blood pressure (24-h SBP), and left ventricular mass index (LVMI) was derived from the Cardiovascular Risk Factors in Patients with Diabetes - a Prospective Study in Primary Care (CARDIPP) study.

Proteins associated with preserved ratio impaired spirometry.

Background: Preserved ratio impaired spirometry (PRISm) is a spirometry pattern of interest regarding incident airflow obstruction and higher mortality risk. We applied a proteomic approach to gain more insight into the biological mechanisms associated with PRISm.

Methods: From the population-based Swedish Cardiopulmonary Bioimage Study (SCAPIS), participants in the Main (n=4835) and Pilot (n=1054) studies, were included as discovery and replication cohorts.

Chronic cOronary Syndrome in Swedish PRImary care (COSPRI)-a study protocol for a 5-year cluster randomized controlled trial on a novel package versus standard investigation in patients with suspected chronic coronary syndrome referred from primary health care.

Background: This trial aims to assess the effectiveness of a novel diagnostic package in the investigation of symptomatic chronic coronary artery disease (CAD), with a focus on reducing the time to diagnosis and improving risk assessment, compared to the current standard investigation approach. The package investigation is comprised of combined single photon emission computed tomography (SPECT), echocardiography, coronary artery calcification (CAC) scoring, not previously evaluated in Sweden for individual cardiovascular prevention, and CadScore, an acoustic risk score. The standard investigation is comprised of exercise bicycle stress testing and echocardiography.

Low-fibre diet is associated with high-risk coronary plaque features.

Aims: Diet is a determinant of cardiovascular diseases (CVD) with coronary disease as predominant cause of pre-mature death. To analyse how diet was associated with coronary atherosclerosis, including plaque features.

Methods And Results: The cross-sectional population-based study using data from the Swedish CArdioPulmonary BioImage Study (SCAPIS) included 24 079 adults aged 50-64 years, recruited in 2013 to 2018 who were free of clinical cardiovascular disease.

Associations between physical activity and CVD-related metabolomic and proteomic biomarkers.

Aim: Habitual physical activity (PA) affects metabolism and homeostasis in various tissues and organs. However, detailed knowledge of associations between PA and cardiovascular disease (CVD) risk markers is limited. We sought to identify associations between accelerometer-assessed PA classes and 183 proteomic and 154 metabolomic CVD-related biomarkers.

Referenceless 4D flow cardiovascular magnetic resonance with deep learning.

Background: Despite its potential to improve the assessment of cardiovascular diseases, four-dimensional (4D) flow cardiovascular magnetic resonance (CMR) is hampered by long scan times. 4D flow CMR is conventionally acquired with three motion encodings and one reference encoding, as the three-dimensional velocity data are obtained by subtracting the phase of the reference from the phase of the motion encodings. In this study, we aim to use deep learning to predict the reference encoding from the three motion encodings for cardiovascular 4D flow.

Coronary computed tomography angiography in primary care patients with chest pain or dyspnea - a cross-sectional study.

Aims: Coronary Computed Tomography Angiography (CCTA) is recommended as a first-line investigation to exclude significant coronary artery stenosis in case of low to intermediate pre-test probability (PTP). The aim was to investigate CCTA findings in relation to the PTP of patients referred directly from primary health care centres.

Methods/results: In this retrospective cohort study consecutive primary care CCTA referrals in a Swedish county 1st of June 2021 until 30th Nov.

Impact of diabetes and glycemic status on ventricular-arterial coupling in the general population.

Background/aims: Ventricular-arterial coupling (VAC) plays a crucial role in cardiovascular physiology, affecting cardiac function and arterial properties for optimal organ perfusion. Considering that diabetes mellitus (DM) is a known risk factor for incident heart disease and vascular damage, this study aims to investigate whether changes in VAC due to DM occur earlier, even before the onset of clinically evident cardiovascular disease in the general population.

Methods: This retrospective study included 2,884 participants (mean age 57 years, 48% male) of the Swedish CArdioPulmonary BioImage Study (SCAPIS), where data on echocardiography and Pulse wave velocity (PWV) were available.

Prevalence and Common Cardiovascular Risk Factors in Aortic Valve Calcification in the Middle-aged General Population.

Aim: Aortic valve calcification (AVC) is an underlying pathophysiological mechanism for aortic stenosis which is common in the elderly, but less is known in younger individuals. The aim was to study the prevalence and associated characteristics of AVC in a middle-aged general population.

Methods: Data were obtained from the Swedish CArdioPulmonary bioImage Study (SCAPIS) comprising 30,154 individuals 50 to 64 years from the general population recruited in Sweden between 2013-2018.

Follow-up of incidentally detected mild to moderate ascending aortic dilation and risk factors for rapid progression in a Swedish middle-aged population.

Background: Thoracic aortic aneurysm is a life-threatening disease due to the risk for acute aortic syndromes, and subjects with dilated ascending aortas are recommended surveillance imaging to assess the need for preventive surgery. Our objectives were to investigate the progression of dilated ascending aortas and risk factors for rapid progression in a prospectively enrolled general population-based cohort of subjects aged 50-65 years.

Methods: From the 5058 subjects prospectively enrolled in the general population-based Swedish CArdioPulmonary bioImage Study (SCAPIS) in Linköping, we followed all 74 subjects (22% female, mean age 59±4 years) with ascending aortic dilation (≥40 mm) identified by CT angiography, thoracic CT or transthoracic echocardiography.

Impaired microcirculation in the skin and subclinical atherosclerosis in individuals with dysglycaemia in a large population-based cohort.

Background And Aim: Dysglycaemia is a known risk factor for cardiovascular disease and microcirculatory dysfunction is associated with an increased cardiovascular disease risk. The aim of this study was to investigate the prevalence of impaired microcirculation, coronary atherosclerosis, and arterial stiffness in individuals with normo- and dysglycaemia.

Methods: The study included 3,300 participants with microcirculatory measurements and information on glycaemic status, aged 50-65 years, from the Linköping site of the Swedish CArdio-Pulmonary bioImage Study (SCAPIS).

Evaluating the Stress State and the Load-Bearing Fraction as Predicted by an In Vivo Parameter Identification Method for the Abdominal Aorta.

Arterial mechanics are crucial to cardiovascular functionality. The pressure-strain elastic modulus often delineates mechanical properties. Emerging methods use non-linear continuum mechanics and non-convex minimization to identify tissue-specific parameters in vivo.

Systematic Coronary Risk Evaluation 2 (SCORE2), arterial stiffness, and subclinical coronary atherosclerosis in a population-based study.

Aim: To investigate the association between Systematic Coronary Risk Evaluation 2 (SCORE2) and subclinical damage in two vascular beds: atherosclerosis in the coronary arteries and aortic arterial stiffness, in a large population-based cohort without cardiovascular disease or diabetes.

Methods: A cross-sectional study based on Swedish CArdio Pulmonary bioImaging Study (SCAPIS) data. A population-based cohort of 3087 participants aged 50-64.

The prognostic value of global longitudinal strain in patients with myocardial infarction and preserved ejection fraction: a prespecified substudy of the REDUCE-AMI trial.

Aims: The REDUCE-AMI trial showed that beta-blockers in patients with preserved left ventricular ejection fraction (LVEF) after acute myocardial infarction (AMI) had no effect on mortality or cardiovascular outcomes. The aim of this substudy was to evaluate whether global longitudinal strain (GLS) is a better prognostic marker than LVEF, and if beta-blockers have a beneficial effect in patients with decreased GLS.

Methods And Results: REDUCE-AMI was a registry-based randomized clinical trial.

Sleeping habits and aortic stiffness in middle-aged men and women from the general population: insights from the SCAPIS study.

Background: The relationship between sleeping habits and aortic stiffness remains inconclusive and is not fully explored in the European general population.

Methods: We examined cross-sectionally 8659 participants from the Swedish population-based cohort Swedish CArdioPulmonary bioImage Study (SCAPIS), mean age 57.5 years, 52.

Restrictive Spirometric Pattern and Preserved Ratio Impaired Spirometry in a Population Aged 50-64 Years.

Knowledge regarding the prevalence and shared and unique characteristics of the restrictive spirometric pattern (RSP) and preserved ratio impaired spirometry (PRISm) is lacking for a general population investigated with post-bronchodilator spirometry and computed tomography of the lungs. To investigate shared and unique features for RSP and PRISm. In the Swedish CArdioPulmonary bioImage Study (SCAPIS), a general population sample of 28,555 people aged 50-64 years (including 14,558 never-smokers) was assessed.

Plasma copeptin and markers of arterial disorder in patients with type 2 diabetes, a cross-sectional study.

Objectives: There is currently limited understanding of the relationship between copeptin, the midregional portion of proadrenomedullin (MRproADM) and the midregional fragment of the N-terminal of proatrial natriuretic peptide (MRproANP), and arterial disorders. Toe brachial index (TBI) and aortic pulse wave velocity (aPWV) are established parameters for detecting arterial disorders. This study evaluated whether copeptin, MRproADM, and MRproANP were associated with TBI and aPWV in patients with type 2 diabetes with no history of cardiovascular disease (CVD).

Wall shear stress measured with 4D flow CMR correlates with biomarkers of inflammation and collagen synthesis in mild-to-moderate ascending aortic dilation and tricuspid aortic valves.

Aims: Understanding the mechanisms underlying ascending aortic dilation is imperative for refined risk stratification of these patients, particularly among incidentally identified patients, most commonly presenting with tricuspid valves. The aim of this study was to explore associations between ascending aortic haemodynamics, assessed using four-dimensional flow cardiovascular magnetic resonance imaging (4D flow CMR), and circulating biomarkers in aortic dilation.

Methods And Results: Forty-seven cases with aortic dilation (diameter ≥ 40 mm) and 50 sex-and age-matched controls (diameter < 40 mm), all with tricuspid aortic valves, underwent 4D flow CMR and venous blood sampling.

P-selectin and C-reactive protein in relation to home blood pressure and coronary calcification: a SCAPIS substudy.

Background: Soluble P-selectin (sP-selectin) and high-sensitivity C-reactive protein (hsCRP) have previously been associated with hypertension, but the relation with out-of-office blood pressure (BP) and coronary artery calcification score is unknown. We aimed to examine the relationship between sP-selectin, hsCRP and home BP, as well as coronary artery calcification score and carotid artery plaques.

Methods: In the Swedish CArdioPulmonary bioImage Study (SCAPIS), 5057 randomly selected participants were evaluated with office and home BP using the semi-automatic Omron M10-IT device.