Ulf Dahlström

Heart Failure research group

Ulf Dahlström, professor, project leader

Urban Alehagen, assoc. Professor

Peter Johansson RN, PhD

Liza Ljungberg, Anders Bergström, Björn Agvall, Patric Karlström and Åsa Jonsson PhD Students

Anette Gylling, Malin Huss Research Nurses

Heart failure is a highly prevalent and serious chronic condition with high mortality, morbidity and poor quality of life. The prevalence of Heart failure is expected to increase over the next 10 years due to an increasing aging population and improved health care in ischemic heart disease. Modern treatment according to guidelines has been shown to reduce mortality and morbidity and improve quality of life. However despite these evidences studies have revealed that not all patients with heart failure receive treatment with recommended drugs and if so not always in optimal dosages demonstrated to be effective in randomized controlled trials. One way to improve this is to have structured follow-up at nurse led heart failure clinics (this concept started in Europe in Linkoping 1990 by Ulf Dahlström and have since then been spread in Sweden as well as in Europe) with management programmes which has been shown to affect mortality, morbidity and quality of life in a beneficial way. However, not all patients are referred to those heart failure clinics and this is a problem.
Moreover, since the number of heart failure patients is increasing and since heart failure is one of the most common causes for hospitalization in elderly patients the extent to which heart failure effect resource utilization and costs will substantially increase.
Our research in this area has been focussed on several areas.
In a large cohort study in elderly starting already in the mid 90:s it has been possibly to follow a large number of patients with reduced cardiac function with or without heart failure and healthy individuals over more than 10 years and study mortality, morbidity, quality of life and the value of several biomarkers with an emphasis on the natriuretic peptides regarding assessment of diagnosis and prediction of prognosis. These studies have been performed in close collaboration with researchers at Rigshospitalet in Copenhagen and the department of clinical chemistry. These studies have so far generated more than 20 published papers.
Another area has been to develop equipment for distance remote control and monitoring of our heart failure patients and these studies are performed in collaboration with researchers in the Technical faculty at Linkoping University and researchers at the departments of Theoretical Physics and Medical Technics. In this project we are also developing new biomarkers for heart failure.
A third area is registry studies based on the national heart failure registry. This registry was started 2003 by Ulf Dahlström, who is still responsible for the running of the registry and also chairman of the Swedish heart failure foundation, directed for research in heart failure and development of biobanks connected to the heart failure registry. Just now there is more than 15 ongoing research projects connected to the registry and the total number of patients registered is more than 30 000. We are also in close collaboration with ESC about running a European Heart failure registry as a pilot in 12 countries in Europe (UD is board member of the executive steering committee).
A new area we have recently started is to perform mechanistic translational studies in different types of heart failure and also link those to differences in peripheral cardiovascular system, imaging and immunological changes. Recently we have found in our BNP-guided study that responders behave in another way as non-responders even if the epidemiological characteristics are quite similar and therefore we have recently started a large multicentre study aiming at looking on genetic differences linked to differences in biomarkers in patients defined as responders vs those defined as non-responders. This study is performed in close collaboration with the department of Molecular Medicine at the Karolinska Institute in Stockholm. Several hospitals in Sweden are going to be included in this large multicentre study.
Finally we also have a track directed more to caring and focussed on studies on quality of life, sleep disturbances, depression and also health economics.

Since UD for the moment I a boardmember of the European Heart Failure Association (HFA) of ESC and also chairman of the HFA cie on the National Heart Failure Societies we have great possibilities to extend our research collaboration with Heart Failure experts in Europe and for the moment we participate in one of the large EU-projects in RP7 regarding heart failure and in another investigator initiated large multicentre study focussed on heart failure in Primary Care

UD is also actively acting as an academic teacher in the educational programme for Medical Students at Linkoping University and is responsible for the final exam for those students. UD is also author of many chapters in different textbooks of medicine and has recently written a brand new textbook in Cardiovascular Medicine including a detailed websection with short questions and problembased cases. This work has been performed in close collaboration with Lena Jonasson and Fredrik Nyström.

Ulf Dahlström¿s publications in DIVA(publication database).