Publications by authors named "Alex Christensen"

Article Synopsis
  • Palmoplantar keratoderma is a complex skin condition with diverse clinical presentations and genetic factors, making diagnosis challenging and sparking the need for comprehensive genetic testing.
  • This study collected data from 142 patients over several years to understand the different types and genetic causes of palmoplantar keratoderma by examining clinical features and performing genetic sequencing.
  • Results revealed that a significant proportion (83%) of families had identifiable genetic variants, with the most common variant linked to the AAGAB gene, affecting the majority of participants who presented with a punctate subtype of the condition.
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Background: Evidence suggests that prehabilitation interventions, which optimise physical and mental health prior to treatment, can improve outcomes for surgical cancer patients and save costs to the health system through faster recovery and fewer complications. However, robust, theory-based evaluations of these programmes are needed. Using a theory of change (ToC) approach can guide evaluation plans by describing how and why a programme is expected to work.

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This review outlines the workflow for patients and relatives with suspected inherited cardiovascular disease, diagnostic criteria, inheritance patterns, and »red flags« for selected conditions. Evaluation for inherited cardiovascular disease typically includes the index patient (proband) and relatives, emphasizing the importance of assessment at specialized clinics. Most inherited cardiovascular conditions have an autosomal dominant inheritance, but other patterns are seen.

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  • * A 12-week exercise program was studied, showing that those who participated had a significant decrease in pulmonary capillary wedge pressure, indicating better heart performance during mild exercise compared to those who maintained their usual activity.
  • * Additional benefits were observed in the exercise group, including improved peak oxygen consumption, cardiac index, and overall quality of life, suggesting that physical training is effective for enhancing cardiac function and exercise capacity among these patients.
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  • Maternal hypertensive disorders of pregnancy (HDPs), such as preeclampsia and gestational hypertension, may affect the cardiac conduction system of newborns, which is not well studied yet.
  • A study analyzed ECG data from 11,826 newborns, comparing those exposed to HDPs (441 preeclampsia and 320 gestational hypertension) with those unexposed.
  • Results indicated that infants exposed to preeclampsia had longer QRS durations and lower R-wave amplitudes, while those exposed to gestational hypertension showed prolonged QT intervals, suggesting a potential impact on cardiac health.
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  • Regular exercise is beneficial for patients with chronic heart failure, but its impact on those with genetic dilated cardiomyopathy (DCM) is less understood, prompting a study on vigorous cycling for DCM caused by truncating titin variants (TTNtv).
  • The study involved 14 participants completing an 8-week exercise training program that led to significant improvements in peak oxygen uptake (VO) and other cardiac functions without any adverse events.
  • Key findings showed that exercise training resulted in a 10% increase in peak VO, enhancements in cardiac output and blood volume, and a trend towards improved left ventricular function, highlighting the potential benefits of vigorous exercise for DCM patients.
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  • Electrocardiographic abnormalities are common in patients with arrhythmogenic right ventricular cardiomyopathy and were analyzed over the long term in a study involving 353 patients and almost 7,000 ECGs.
  • The study found that over time, there were notable changes in QRS voltage, R- and T-wave amplitudes, as well as increases in QRS duration, terminal activation duration, and QTc interval, indicating a progressive worsening of the condition.
  • T-wave inversions observed before diagnosis were linked to a higher risk of future ventricular arrhythmias, suggesting these ECG abnormalities could serve as early indicators of the disease even if they don't meet the full diagnostic criteria.
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Background: Left ventricular noncompaction (LVNC) is characterized by excessive trabeculations of the left ventricular (LV) wall.

Objectives: The authors aimed to examine changes in LV function and morphology in 2 to 4-year-old children with and without LVNC at birth and to describe the prevalence of LVNC in first-degree relatives.

Methods: Echocardiograms in children with and without LVNC (matched 1:4) were performed at 2 to 4 years and in first-degree relatives.

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Aims: The treatment of atrial fibrillation (AF) in hypertrophic cardiomyopathy (HCM) can be challenging since AF aggravates symptoms and increases the risk of stroke. Which factors contribute to the development of AF and stroke in HCM remains unknown. The aim of this study was to determine the incidence of AF and stroke in HCM patients and identify the risk factors.

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Background: Cardiac involvement represents a major cause of morbidity and mortality in patients with myotonic dystrophy type 1 (DM1) and prevention of sudden cardiac death (SCD) is a central part of patient care. We investigated the natural history of cardiac involvement in patients with DM1 to provide an evidence-based foundation for adjustment of follow-up protocols.

Methods: Patients with genetically confirmed DM1 were identified.

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To evaluate QRS complex features during the first month of life and the association with echocardiographic measurements of left ventricular mass in neonates. Prospective cohort study of neonates with electrocardiography (ECG) and echocardiography performed during the first month of life. Left ventricular mass index (LVMI) was determined by echocardiography and the correlation with electrocardiographic markers of LVMI outliers (≥ 98th percentile) were analyzed.

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Introduction: Myocardial development is still transitioning by the time of birth making the cardiomyocyte vulnerable to maternal and perinatal factors. We aimed at investigating the impact of maternal and perinatal factors on the neonatal electrocardiogram.

Methods: In a prospective cohort study, neonates underwent cardiac evaluation with electrocardiograms and echocardiograms (age 0-30 days).

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Background: Genetic variants in titin (TTN) are associated with dilated cardiomyopathy (DCM) and skeletal myopathy. However, the skeletal muscle phenotype in individuals carrying heterozygous truncating TTN variants (TTNtv), the leading cause of DCM, is understudied.

Objectives: This study aimed to assess the skeletal muscle phenotype associated with TTNtv.

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Background And Purpose: Hereditary haemorrhagic telangiectasia (HHT) is a genetic disease with fragile blood vessels and vascular malformations, potentially causing neurological manifestations, including stroke and cerebral abscesses. The study aimed to investigate neurological manifestations in the Danish HHT database, focusing on pulmonary arteriovenous malformations (PAVMs) as a risk factor for cerebral events.

Methods: Retrospective analysis of the Danish HHT database was conducted, cross-referencing neurological outcomes with the Danish Apoplexy Register for accuracy.

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Pathogenic variants in several genes involved in the function or regulation of smooth muscle cells (SMC) are known to predispose to congenital heart disease and thoracic aortic aneurysm and dissection (TAAD). Variants in MYLK are primarily known to predispose to TAAD, but a growing body of evidence points toward MYLK also playing an essential role in the regulation of SMC contraction outside the aorta. In this case report, we present a patient with co-occurrence of persistent ductus arteriosus (PDA) and thoracic aortic dissection.

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Arrhythmias and electrocardiographic (ECG) abnormalities are common among patients with atrial septal defects (ASDs). We studied a large cohort of neonates with ASDs to investigate whether ECG abnormalities are present at this early stage or develop later, secondary to hemodynamic changes. We analyzed the echocardiograms and ECGs from the Copenhagen Baby Heart Study, a population-based cohort study.

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Introduction: Patients triaged as non-urgent in the emergency department constitute a diverse group with a low mortality rate assumed to be able to wait three hours for a physician. Little is known about the causes of death of non-urgent patients who die shortly after admission. We examined whether deaths among non-urgent patients were preventable.

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Article Synopsis
  • Abdominal aortic aneurysm (AAA) has a significant genetic component, with a study identifying 141 genetic associations, including 97 that were previously unknown.
  • The research highlighted key biological pathways related to AAA, such as lipid metabolism, vascular development, and inflammation, indicating how these factors contribute to the disease's progression.
  • The study also suggests that lowering non-high-density lipoprotein cholesterol could be beneficial for AAA patients, advocating for the use of PCSK9 inhibitors based on evidence from a mouse model where PCSK9 loss prevented AAA development.
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Importance: Despite some promising preclinical and clinical data, it remains uncertain whether remote ischemic conditioning (RIC) with transient cycles of limb ischemia and reperfusion is an effective treatment for acute stroke.

Objective: To evaluate the effect of RIC when initiated in the prehospital setting and continued in the hospital on functional outcome in patients with acute stroke.

Design, Setting, And Participants: This was a randomized clinical trial conducted at 4 stroke centers in Denmark that included 1500 patients with prehospital stroke symptoms for less than 4 hours (enrolled March 16, 2018, to November 11, 2022; final follow-up, February 3, 2023).

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Many sequence variants have additive effects on blood lipid levels and, through that, on the risk of coronary artery disease (CAD). We show that variants also have non-additive effects and interact to affect lipid levels as well as affecting variance and correlations. Variance and correlation effects are often signatures of epistasis or gene-environmental interactions.

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Ventricular septal defects (VSD) represent the most common congenital heart defect in newborns. We assessed the electrocardiographic characteristics of newborns with VSDs in a general population sample. The Copenhagen Baby Heart Study is a prospective population-based cohort study offering cardiac evaluation of newborns.

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Familial ST-depression syndrome represents a novel inherited disease characterized by nonischemic ST-segment depressions in multiple leads. The ECG phenotype appears to debut around puberty, while the typical onset of arrhythmias occurs around 50 years of age. Clinical manifestations include supraventricular arrhythmias, fast polymorphic ventricular tachycardia, sudden cardiac death, and left ventricular systolic dysfunction.

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Aims: Wolff-Parkinson-White (WPW) syndrome is a conduction disorder characterized by an accessory electrical pathway between the atria and ventricles, which may predispose to supraventricular tachycardia (SVT) and sudden cardiac death. It can be seen as an isolated finding or associated with structural heart disease. Our aims were to determine the prevalence of a WPW pattern in a large and unselected cohort of neonates and to describe the electro- and echocardiographic characteristics as well as the natural history during early childhood.

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