Publications by authors named "Dixen U"

Background: Oxygen therapy is commonly administered to patients with acute cardiovascular conditions during hospitalisation. Both hypoxaemia and hyperoxia can cause harm, making it essential to maintain oxygen saturation (SpO) within a target range. Traditionally, oxygen administration is manually controlled by nursing staff, guided by intermittent pulse oximetry readings.

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Introduction: Intravenous loop diuretics have been a key component in treating pulmonary oedema since the 1960s and have a Class 1 recommendation in the 2021 guidelines for acute heart failure (AHF). While the diuretic effect of loop diuretics is well established, it remains unclear how furosemide influences pulmonary congestion and cardiac filling pressures in the hyperacute phase before significant diuresis occurs.

Methods: This was a prospective study of adult patients with AHF and objective signs of pulmonary congestion admitted to the cardiac ward.

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Background: Metabolic effects of empagliflozin treatment include lowered glucose and insulin concentrations, elevated free fatty acids and ketone bodies and have been suggested to contribute to the cardiovascular benefits of empagliflozin treatment, possibly through an improved cardiac function. We aimed to evaluate the influence of these metabolic changes on cardiac function in patients with T2D.

Methods: In a randomized cross-over design, the SGLT2 inhibitor empagliflozin (E) was compared with insulin (I) treatment titrated to the same level of glycemic control in 17 patients with type 2 diabetes, BMI of > 28 kg/m, C-peptide > 500 pM.

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Aims: Cardiovascular disease (CVD) is the leading cause of mortality and morbidity in type 1 (T1D) and type 2 diabetes (T2D). Despite diabetes affects the myocardium, risk prediction models do not include myocardial function parameters. Myocardial performance index (MPI) reflects left ventricular function.

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Background: Current recommendations regarding the use of surgical left atrial appendage (LAA) closure to prevent thromboembolisms lack high-level evidence. Patients undergoing open-heart surgery often have several cardiovascular risk factors and a high occurrence of postoperative atrial fibrillation (AF)-with a high recurrence rate-and are thus at a high risk of stroke. Therefore, we hypothesized that concomitant LAA closure during open-heart surgery will reduce mid-term risk of stroke independently of preoperative AF status and CHADS-VASc score.

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Article Synopsis
  • The Danish Atrial Fibrillation trial aims to compare strict versus lenient rate control strategies in patients with persistent or permanent atrial fibrillation to determine the best heart rate target.
  • The primary outcome measure is the physical component score from the SF-36 questionnaire, with 350 participants enrolled to ensure sufficient statistical power.
  • A predefined statistical analysis plan will help minimize bias by determining how outcomes will be assessed before enrollment is complete and data is collected.
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Aims: To evaluate a family-focused intervention for patients with atrial fibrillation (AF) in addition to conventional care and to establish its effect on health-related quality of life (HRQoL), anxiety, depression, AF symptoms, and family support.

Background: AF is a widespread heart disease affecting the well-being of patients and their family members physically and psychologically. Supporting patients and their family members could potentially facilitate regaining family strength and improve HRQoL.

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Patients with non-ischemic systolic heart failure (HF) have increased risk of sudden cardiovascular death (SCD). The initiation and substrate for ventricular arrhythmias remains poorly understood. Our purpose was to describe the relationship between cardiac magnetic resonance (CMR) late gadolinium enhancement (LGE) and Holter recorded ventricular arrhythmic activity.

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Introduction: The COVID-19 pandemic triggered a rapid shift towards telephone consultations (TC) in the out-patient clinic setting with little knowledge of the consequences. The aims of this study were to evaluate patient-centred experiences with TC, to describe patterns in clinical outcomes from TC and to pinpoint benefits and drawbacks associated with this type of consultations.

Methods: This mixed methods study combined an analysis of quantitative and qualitative data.

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Introduction: Type 2 diabetes (T2D) is characterised by elevated plasma glucose, free fatty acid (FFA) and insulin concentrations, and this metabolic profile is linked to diabetic cardiomyopathy, a diastolic dysfunction at first and increased cardiovascular disease (CVD) risk. Shifting cardiac metabolism towards glucose utilisation has been suggested to improve cardiovascular function and CVD risk, but insulin treatment increases overall glucose oxidation and lowers lipid oxidation, without reducing CVD risk, whereas SGLT2 inhibitors (SGLT2i) increase FFA, ketone body concentrations and lipid oxidation, while decreasing insulin concentrations and CVD risk. The aim of the present study is to elucidate the importance of different metabolic profiles obtained during treatment with a SGLT2i versus insulin for myocardial function in patients with T2D.

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  • * Out of 1116 trial participants, women showed lower rates of all-cause and cardiovascular mortality compared to men, yet ICDs did not significantly reduce mortality rates for either sex.
  • * Both men and women had a reduced risk of sudden cardiovascular death with ICDs, but there was no overall survival advantage from ICD implantation in patients with nonischemic systolic heart failure.
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Current evidence base for atrial fibrillation (AF) screening is insufficient. An important finding in the STROKESTOP study was that non-participants had significantly worse outcomes. In a group of potentially non-participants feasibility of opportunistic screening in a domiciliary setting with municipality preventive home visits to citizens ≥75 years was investigated.

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  • This study extended the follow-up of the DANISH trial, focusing on how baseline NT-proBNP levels affect the outcomes of implantable cardioverter-defibrillator (ICD) implantation in patients with non-ischemic systolic heart failure.
  • The data showed that patients with lower NT-proBNP levels (below the median) had a significant reduction in all-cause mortality and cardiovascular deaths with ICD compared to standard care, while those with higher levels did not see similar benefits.
  • The findings suggest that lower NT-proBNP levels could help identify patients who are more likely to benefit from ICD implantation in treating their heart failure.
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  • The study investigates how periodic repolarization dynamics (PRD) can identify nonischemic cardiomyopathy patients who might benefit from getting a cardioverter-defibrillator (ICD) implanted as a preventive measure against sudden cardiac events.
  • A post hoc analysis of the DANISH trial included patients with severe heart function issues (LVEF ≤35% and high NT-proBNP levels) to see how baseline PRD, measured using 24-hour Holter monitors, related to their mortality.
  • Results showed that higher PRD was linked to higher mortality in patients not receiving ICDs, while there was no significant link in those with ICDs, suggesting that PRD could help target patients who would benefit most from ICD therapy
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Introduction: Atrial fibrillation is the most common heart arrhythmia with a prevalence of approximately 2% in the western world. Atrial fibrillation is associated with an increased risk of death and morbidity. In many patients, a rate control strategy is recommended.

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  • - Pheochromocytoma is a rare tumor that grows in the adrenal medulla and can cause high blood pressure due to releasing special chemicals called catecholamines.
  • - Diagnosing this condition is tough because its symptoms can come and go, and they can be similar to other, more common problems.
  • - In one case, a young man experienced very high blood pressure and heart issues for 9 years, which got worse after drinking many energy drinks; doctors found the tumor through a scan.
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  • * Researchers analyzed data from 850 patients with severe heart failure, monitoring their heart for 24 hours to find indicators like non-sustained ventricular tachycardia (NSVT) and the burden of premature ventricular contractions (PVCs).
  • * Results showed that while both NSVT and high PVC burden were linked to higher overall mortality and cardiovascular death, they did not help in predicting which patients would benefit from ICD implantation.
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  • Atrial fibrillation (AF) and excessive supraventricular ectopic activity (ESVEA) in patients with nonischemic heart failure (HF) were linked to higher mortality rates, including all-cause and cardiovascular deaths.
  • In a study of 850 patients, 22% had AF and 10% had ESVEA, with both conditions leading to significantly increased risks of death over nearly five years of follow-up.
  • The implantation of a prophylactic implantable cardioverter defibrillator (ICD) did not show any improvement in outcomes for patients with AF or ESVEA, indicating that management strategies may need re-evaluation.
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Background: In patients with paroxysmal atrial fibrillation (PAF) or persistent atrial fibrillation (PeAF) symptom burden and fear of hospital readmission are major causes of reduced quality of life. We attempted to develop a prediction model for future atrial fibrillation hospitalization (AFH) risk in PAF and PeAF patients including all previously experienced AFHs in the analysis, as opposed to time to first event.

Methods: Recurrent event survival analysis was used to model the impact of past AFHs on the risk of future AFHs.

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  • The study investigated the relationship between risk factors, family history of coronary artery disease (CAD), and genetic variants related to CAD and LDL cholesterol levels in patients needing revascularization.
  • In a sample of 1599 patients, a significant family history of CAD correlated with an earlier need for revascularization by about 3.2 years, yet genetic risk scores for CAD and LDL-C were similar between those with and without familial CAD.
  • Results suggested that younger CAD patients had a slightly higher genetic burden for LDL cholesterol-related SNPs, but the overall differences were modest, indicating limited effectiveness of current genetic screening for predicting CAD outcomes.
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Aims: The incidence of atrial fibrillation (AF) has increased significantly over the last decades. Population height is changing in many countries. Height is an important risk factor for AF.

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Background: Atrial fibrillation (AF) is the most common aberrant cardiac arrhythmia. Many AF patients present with symptoms of dyspnea and fatigue, but have normal left ventricular ejection fraction (LVEF).

Purpose: To determine the reproducibility of measurements of global longitudinal strain (GLS) and strain rate in patients with AF and examine if the arrhythmia is associated with abnormal LV strain and strain rate independent of age, sex, heart rate, LVEF and LV mass.

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  • Supraventricular ectopic complexes (SVEC) increase the risk of recurrent atrial fibrillation (AF), but their impact varies by age group, particularly in patients above and below 57 years old.
  • A study with 260 patients examined the effects of antiarrhythmic medication (AAD) and catheter ablation (CA), revealing that older patients (over 57) had a significantly higher rate of AF recurrence after CA compared to younger patients.
  • High SVEC burden within three months post-CA was linked to increased AF recurrence in older patients, whereas no age-related differences were seen in those treated with AAD.
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  • Supraventricular ectopic complexes (SVEC), linked to atrial fibrillation (AF), are more effectively suppressed by antiarrhythmic medications (AAD) compared to catheter ablation (CA) in long-term treatment.
  • In a study involving 260 patients, those on AAD had lower daily SVEC counts compared to those who underwent CA, particularly notable 24 months after treatment.
  • Patients with fewer SVEC exhibited reduced AF occurrences, with AAD showing more stable outcomes over time compared to the initial increase in SVEC burden seen after CA.
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Background: Physical activity at moderate-high intensity is recommended to prevent lifestyle diseases. Patients with atrial fibrillation are at risk of a sedentary lifestyle due to fear of exercise-induced episodes of atrial fibrillation. The burden of arrhythmia can be reduced by physical exercise.

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