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142
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Introduction
Research in advanced echocardiographic parameters with a focus on the diastolic function. Long-term follow-up prospective cohort studies, case-control studies and RCT's. Currently working on a large prospective cohort study of hospitalized COVID-19 patients (the ECHOVID-19 study)
Skills and Expertise
Current institution
Publications
Publications (142)
Background
Influenza infection has been associated with multiple cardiac complications including acute heart failure and myocardial infarction. The FluHeart study aims to uncover the potential effect of influenza infection on cardiac structure and function as assessed by echocardiography during hospitalization.
Methods
This prospective cohort stud...
Importance
Cardiovascular disease is the leading cause of death in the US. However, it remains unclear how the burden of cardiovascular events in the US compares with that of other high-income countries with distinct health care systems like Denmark, both overall and by income.
Objective
To compare cardiovascular hospitalization rates (acute myoca...
Background and Aims
Individuals with heart failure (HF), other forms of cardiovascular disease, or kidney disease are at increased risk for the development and adverse health effects of diabetes. As such, prevention or delay of diabetes is an important treatment priority in these groups. The aim of this meta-analysis was to determine the effect of...
Background
Despite evidence demonstrating that influenza vaccination is associated with reduced risk of cardiovascular events and all-cause mortality in individuals with diabetes mellitus (DM), vaccine uptake remains suboptimal.
Objectives
The purpose of this study was to assess the effectiveness of electronically delivered nudges on influenza vac...
Background
Left ventricular mechanical dyssynchrony (LVMD) has shown to predict many cardiovascular outcomes including ventricular arrhythmias. Our hypothesis is that LVMD can reveal early atrial dysfunction.
Purpose
The aim of this study was to investigate whether LVMD can be used to predict atrial fibrillation (AF) and adverse outcomes following...
Background
Cystic fibrosis (CF) is an autosomal recessive disease affecting multiple organs. Emerging evidence indicates an elevated risk of cardiovascular complications in people with CF (pwCF), with some studies implicating CF-related cardiomyopathy as an underlying mechanism. Whether screening for cardiac symptoms and N-terminal pro B-type natri...
Background
The use of glucagon-like peptide-1 receptor agonsists (GLP-1 RA) continues to rise and is increasingly important in the treatment of type-2 diabetes mellitus (T2DM). Though the use of GLP-1 RA continues to increase, persistence and adherence to therapy remains suboptimal.
Purpose
We aimed to assess the level of adherence and persistence...
Background
Cystic fibrosis (CF) is an autosomal recessive disease affecting multiple organs, however the extent of cardiac involvement in CF is yet to be determined. The remarkable therapeutic advancements with new highly effective CF transmembrane conductance regulator (CFTR) modulator treatment and subsequent increase in life expectancy substanti...
Background
B-lines on lung ultrasound (LUS) are non-specific signs of increased density within lung tissue, which can be secondary to pulmonary congestion, pneumonia, or fibrosis. LUS is recommended for managing acute heart failure (HF); however, its value in non-HF populations is less clear.
Purpose
To identify clinical, laboratory, and echocardi...
Background
Despite evidence demonstrating that influenza vaccination is associated with reduced risk of adverse cardiovascular events and all-cause mortality, influenza vaccine uptake remains suboptimal in persons with diabetes mellitus (DM).
Purpose
In this prespecified analysis of the NUDGE-FLU-CHRONIC trial we assessed the effectiveness of elec...
Aims
To assess the level of adherence to glucagon‐like peptide‐1 receptor agonist (GLP‐1RA) treatment using real‐world data and to investigate the sociodemographic and clinical factors associated with discontinuation of GLP‐1RAs.
Methods
First‐time users of GLP‐1RAs with type 2 diabetes mellitus (T2DM), aged ≥18 years, in the period 2007 to 2020,...
Objectives
Whether vaginal estradiol use is associated with an increased risk of recurrent venous thromboembolism (VTE) in women with prior VTE is unknown. We sought to evaluate the association between vaginal estradiol use and recurrent VTE in women with prior VTE.
Methods
We performed a nationwide nested case–control study among 44 024 women age...
Aims
Cardiovascular‐kidney‐metabolic (CKM) multimorbidity is prevalent among individuals with heart failure (HF), but whether cardiac structure and function, clinical outcomes, and treatment response to sacubitril/valsartan vary in relation to CKM status is unknown.
Methods and results
In this PARAGON‐HF post‐hoc analysis, we evaluated the impact...
IMTRODUCTION: The high-risk population of patients with cardiovascular (CV) disease or risk factors (RF) suffering from COVID-19 is heterogeneous. Several predictors for impaired prognosis have been identified. However, with machine learning (ML) approaches, certain phenotypes may be confined to classify the affected population and to predict outco...
Aims
Type 2 diabetes (T2D) and heart failure (HF) frequently coexist, but whether clinical outcomes and treatment effects of sodium–glucose cotransporter 2 inhibitors (SGLT2i) vary in relation to background glucose‐lowering therapy (GLT) in this population is uncertain.
Methods and results
DELIVER randomized patients with HF and left ventricular e...
Aim
High‐dose quadrivalent influenza vaccine (QIV‐HD) has been shown to be more effective than standard‐dose (QIV‐SD) in reducing influenza infection, but whether diabetes status affects relative vaccine effectiveness (rVE) is unknown. We aimed to assess rVE on change in glycated haemoglobin [HbA1c (∆HbA1c)], incident diabetes, total all‐cause hosp...
To investigate the long-term prognostic value of the left atrial (LA) strain indices – peak atrial longitudinal strain (PALS), peak conduit strain (PCS), and peak atrial contractile strain (PACS) in acute coronary syndrome (ACS) patients in relation to all-cause mortality. This retrospective study included ACS patients treated with percutaneous cor...
Purpose
Layer‐specific global longitudinal strain (GLS) may provide important insights in patients with suspected coronary artery disease (CAD). We aimed to investigate the association between layer‐specific GLS and coronary artery calcium score (CACS) in patients suspected of CAD.
Methods
We performed a retrospective study of patients suspected o...
Arrhythmogenic right ventricular cardiomyopathy is an inherited cardiomyopathy, characterized by abnormal cell adhesions, disrupted intercellular signaling, and fibrofatty replacement of the myocardium. These changes serve as a substrate for ventricular arrhythmias, placing patients at risk of sudden cardiac death, even in the early stages of the d...
Background
The effect of trastuzumab therapy on left atrial (LA) function remains largely unknown. Our aim was to assess the changes in LA strain parameters longitudinally in patients treated with trastuzumab.
Methods
We retrospectively studied 170 patients with stage I‐IV HER2+ breast cancer. All patients had baseline echocardiograms and repeat e...
Aims
3D echocardiographic (3DE) assessment of the left atrium (LA) is a new modality of potential clinical value. Age- and sex-based normative values are needed to benchmark these parameters for clinical use.
Methods and results
Of 4466 participants in the 5th Copenhagen City Heart Study, a prospective longitudinal cohort study on the general popu...
Importance
Influenza vaccination is associated with a reduced risk of mortality in patients with diabetes, but vaccination rates remain suboptimal.
Objective
To assess the effect of electronic nudges on influenza vaccination uptake according to diabetes status.
Design, Setting, and Participants
The NUDGE-FLU (Nationwide Utilization of Danish Gove...
Background
Mitral regurgitation (MR) can be difficult to quantify. We sought to investigate whether the MR jet area to left atrial (LA) area ratio (MR/LA-ratio) method for quantifying MRs can be used to predict incident AF in the general population.
Methods
The study included 4,466 participants from the 5th Copenhagen City Heart Study, a prospecti...
Aims
It is unclear how serial high-sensitivity troponin-I (hsTnI) concentrations affect long-term prognosis in individuals with suspected acute coronary syndrome (ACS).
Methods and results
Subjects who underwent two hsTnI measurements (Siemens TnI Flex® Reagent) separated by 1–7 h, during a first-time hospitalization for myocardial infarction, uns...
Background
Early recognition of cardiac dysfunction in patients with chronic obstructive pulmonary disease (COPD) may prevent future cardiac impairment and improve prognosis. Quantitative assessment of subsegmental and segmental vessel volume by Computed Tomographic (CT) imaging can provide a surrogate of pulmonary vascular remodeling. We aimed to...
Aim
To promote the implementation of right ventricular (RV) longitudinal strain in clinical practice, we sought to propose normal values for RV free wall (RVFWLS) and four-chamber longitudinal strain (RV4CLS) and investigate the association with clinical and echocardiographic parameters in participants from the general population.
Methods and Resu...
The ratio of early transmitral filling velocity to early diastolic strain rate (E/SRe) has been proposed as a new non-invasive measurement of left ventricular filling pressure. We aimed to investigate the ability of E/SRe to predict atrial fibrillation (AF) after ST-elevation myocardial infarction (STEMI). This was a prospective cohort study of pat...
Background
Right ventricular (RV) longitudinal strain (RVLS) is a predictor of many cardiovascular outcomes including ventricular arrhythmias. However, the prognostic value of RVLS in predicting incident atrial fibrillation (AF) in participants from the general population is currently unknown.
Purpose
The aim of this study was to investigate if RV...
Background
Left ventricular diastolic dysfunction is frequent in chronic kidney disease (CKD) and is suspected to be linked to a worse renal prognosis.
Purpose
To investigate the association between the ratio of early mitral inflow velocity to early diastolic tissue velocity (E/e') measured by Doppler echocardiography and development of end-stage...
Background
The presence of aortic valve (AV) sclerosis and non-severe aortic stenosis has been a suggested marker of cardiovascular risk, but whether AV sclerosis and non-severe AV stenosis is independently associated with increased cardiovascular risk or a marker of coexistent risk factors remains to be clarified.
Objective
We examined clinical c...
Introduction
Speckle-tracking echocardiography has gained widespread use, and strain parameters such as global longitudinal strain (GLS) and strain rates are strongly associated with risk of heart failure and cardiovascular death. Such strain measures, however, only represent limited features of the complete longitudinal strain (LS) curve. Thus, in...
Background
Postsystolic shortening (PSS) have demonstrated to be a valuable predictor of contractile dysfunction in the myocardium. Our objective was to investigate the prognostic value of PSS, assessed by two-dimensional speckle tracking echocardiography (2DSTE), in relation to cardiovascular morbidity and mortality in a large general population s...
Background
The association between impaired lung function and cardiovascular disease is well known. However, it is not fully understood how a decline in lung function affects the development of cardiovascular disease including heart failure (HF).
Purpose
We aimed to investigate the association between declining lung function and changes in cardiac...
Background
The recently introduced Universal Definition of Heart Failure (HF)(1) considers abnormal cardiac structure or function in the absence of signs/symptoms of HF to be "pre-HF" (stage B), yet lacks clear direction regarding the specific structural abnormalities that may most strongly forecast incident HF and cardiovascular death (CV death)....
Background
Heart failure (HF) is a frequent comorbidity among patients with chronic kidney disease (CKD). Echocardiography allows for simple, non-invasive evaluation of structural and functional heart disease that could potentially classify patients at high risk of HF.
Purpose
This study aimed to assess the prevalence of HF stages A-D defined by t...
Aims
Pressure-strain loop (PSL) analysis is a novel echocardiographic tool capable of assessing myocardial work non-invasively. In this study, we aim to evaluate the prognostic value of myocardial work indices in the general population.
Methods and results
This was a prospective community-based cohort study (n = 4466). PSL analyses were performed...
Background:
Right ventricular free wall (RVFWLS) and four-chamber longitudinal strain (RV4CLS) are associated with adverse events in various patient populations including patients with heart failure (HF). We sought to investigate the prognostic value of RVFWLS and RV4CLS for the development of incident HF in participants from the general populatio...
Background
Color tissue Doppler imaging (TDI) M-mode can be used to measure the cardiac time intervals including the isovolumic contraction time (IVCT), the left ventricular ejection time (LVET), the isovolumic relaxation time (IVRT), and the combination of all the cardiac time intervals in the myocardial performance index (MPI) defined as [(IVCT +...
Background:
The ratio of transmitral early filling velocity to early diastolic strain rate (E/e'sr) has recently emerged as a measure of left ventricular filling pressure. Reference values are needed for this new parameter for it to be used clinically.
Methods:
Healthy participants from a prospective general population study, the 5th Copenhagen...
Background:
Randomized controlled trials (RCTs) enrolling patients with high cardiovascular risk have found that influenza vaccination may reduce the incidence of cardiovascular events. We performed an updated meta-analysis assessing the effect of influenza vaccination on the incidence of cardiovascular events in patients with ischemic heart disea...
Ventricular arrhythmia is one of the main causes of sudden cardiac death. Hence, identifying patients at risk of ventricular arrhythmias and sudden cardiac death is important but can be challenging. The indication for an implantable cardioverter defibrillator as a primary preventive strategy relies on the left ventricular ejection fraction as a mea...
Background:
The cardiac time intervals include the isovolumic contraction time (IVCT), the left ventricular ejection time (LVET), the isovolumic relaxation time (IVRT) and the combination of all the cardiac time intervals in the myocardial performance index (MPI) (defined as [(IVCT+IVRT)/LVET)]. Whether the cardiac time intervals change over time...
Aims:
Left ventricular (LV) systolic deformation is altered early in the ventricular disease process despite normal LV ejection fraction (LVEF). These alterations seem to be characterized by decreased global longitudinal strain (GLS) and augmented global circumferential strain (GCS). This study aimed to investigate the link between myocardial defo...
Aims:
Hypertensive heart disease (HHD) is recognized as a key clinical precursor to heart failure with preserved ejection fraction (HFPEF). However, pathophysiological transition from HHD to HFPEF is not well understood. We sought determine whether regional differences in impaired myocardial function may underlie the greater mechanical dysfunction...
Background:
Global longitudinal (GLS) and global circumferential strain (GCS) have been shown to be impaired in HFpEF.
Objectives:
To assess whether treating HFpEF patients with sacubitril/valsartan would significantly improve GLS and GCS compared to valsartan alone.
Methods:
PARAMOUNT was a phase 2, randomized, parallel-group, double-blind mu...
Background
2-dimensional Speckle-Tracking Echocardiography, to obtain longitudinal layer specific strain (LSS), has recently emerged as a novel and accurate non-invasive imaging technique for diagnosis as well as for prediction of adverse cardiac events. This systematic review and meta-analysis aimed to give an overview of the possible clinical imp...
Background
COVID-19 is associated with subclinical myocardial injury. Exogenous ketone esters acutely improve left myocardial function in healthy participants and patients with heart failure, but the effects have not been investigated in participants previously hospitalized for COVID-19.
Methods
This is a randomized placebo-controlled double-blind...
Objectives:
Diabetes has been reported to be associated with an increased risk of death among patients with COVID-19. However, the available studies lack detail on COVID-19 illness severity and measurement of relevant comorbidities.
Methods:
We conducted a multicentre, retrospective cohort study of patients 18 years of age and older who were hos...
Importance:
A diagnosis of diabetes is considered when a patient has hyperglycemia with a random plasma glucose ≥200 mg/dL. However, in the inpatient setting, hyperglycemia is frequently non-specific, especially among patients who are acutely unwell. As a result, patients with transient hyperglycemia may be incorrectly labeled as having diabetes,...
Introduction:
COVID-19 has spread globally in waves, and Danish treatment guidelines have been updated following the first wave. We sought to investigate whether the prognostic values of echocardiographic parameters changed with updates in treatment guidelines and the emergence of novel severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2)...
Background
It is well known that left atrial (LA) function and size can provide significant information regarding the risk of atrial fibrillation (AF) and heart failure (HF). The ratio of LA volume index and tissue doppler imaging a' (peak myocardial velocity of the left ventricle in late diastole exposing the atrial contraction) provides the LA vo...
Background
Large randomized controlled trials (RCT) have shown that COVID-19 vaccines are effective at preventing severe COVID-19. However, the RCT's are not powered to detect rare adverse events. It has been reported that the new mRNA based COVID-19 vaccines may increase the risk of thromboembolic and ischemic events. Likewise, thromboembolic and...
Background
Cardiac disease is the most common cause of death in Europe and is a rising problem globally. Recently, a causal relationship between ischemic heart disease and cholesterol remnants has been suggested by genetic studies. Additionally, new studies have shown that cholesterol remnants were independently related to later development of isch...
Background
The aim of the present study was to investigate the impact of cardiovascular risk factors – age, sex, hypertension, hypercholesterolemia, diabetes, smoking and obesity on Tissue Doppler imaging (TDI) measures of systolic and diastolic tissue velocities in the general population over a 10-year period. Identifying risk factors that are ass...
Background
Left atrial (LA) function has shown to be a significant predictor of cardiovascular outcomes. We sought to determine the prognostic value of LA strain in relation to incident heart failure (HF) in the general population.
Methods
The present study includes 3,540 participants from the general population without prevalent atrial fibrillati...
Background
The ratio of early transmitral filling velocity (E) to early diastolic strain rate (e'sr) (E/e'sr) has recently been proposed as a novel non-invasive measure of early LV filling pressure. Using two-dimensional speckle tracking derived e'sr instead of Doppler-derived e' circumvents several of the limitations known to the Doppler-based met...
Background
Right ventricular free wall (RVFWLS) and global longitudinal strain (RV4CLS) have been shown to be prognostic of adverse events in various patient groups including patients with heart failure (HF).
Purpose
We sought to investigate the prognostic value of RVFWLS and RV4CLS for the development of incident HF in participants from the gener...
Background
Recent research suggests that early left ventricular (LV) systolic dysfunction is characterized by compromised longitudinal function and a concomitant augmentation of circumferential deformation expressed as increased global circumferential strain (GCS). It is hypothesized that increased GCS could be used to identify people at higher ris...
Background
Cigarette smoking is the leading preventable cause of death worldwide. Smoking is known to cause coronary artery disease, but studies have also shown that smoking independently is associated with higher risk of heart failure. However, the link between smoking and cardiac structure and function is not yet fully examined.
Purpose
The aim...
Background
Peak atrial longitudinal strain (PALS) has previously been shown to predict cardiovascular morbidity and mortality in the general population. However, the impact of cardiovascular risk factors on PALS over a decade in participants from the general population is unknown.
Purpose
The aim of this study was to investigate the impact of card...
Background
COVID‐19 infection has been hypothesized to affect left ventricular function; however, the underlying mechanisms and the association to clinical outcome are not understood. The global work index (GWI) is a novel echocardiographic measure of systolic function that may offer insights on cardiac dysfunction in COVID‐19. We hypothesized that...
Background
In this study we aimed to assess if a focused lung ultrasound examination predict the need for mechanical ventilation admission to an intensive care unit, high-flow oxygen treatment, death of COVID-19 within 30 days and 30-day all-cause mortality in patients with clinical suspicion of COVID-19 or PCR-verified SARS-CoV-2 infection.
Metho...
Background:
There is wide variation in mortality among patients hospitalized with COVID-19. Whether this is related to patient or hospital factors is unknown.
Objective:
To compare the risk of mortality for patients hospitalized with COVID-19 and to determine whether the majority of that variation was explained by differences in patient characte...
Importance: A diagnosis of diabetes is considered when a patient has hyperglycemia with a random plasma glucose ≥200 mg/dL. However, in the inpatient setting, hyperglycemia is frequently non-specific, especially among patients who are acutely unwell. As a result, patients with transient hyperglycemia may be incorrectly labeled as having diabetes, l...
Aims
Valvular event timing is an integral part of echocardiographic pressure–strain loop (PSL) analyses. The impact that different event timing modalities may have on myocardial work indices is unknown.
Methods and results
A methodological study was performed on 200 subjects, including 50 healthy subjects, 50 with aortic valve sclerosis, 50 with a...
Background
Chronic low-grade inflammation as in asthma may lead to a higher risk of cardiovascular events. We evaluated if patients with chronic obstructive pulmonary disease (COPD) and asthma have a higher risk of acute cardiovascular events than patients with COPD without asthma.
Methods
Nationwide multi-center retrospective cohort study of Dani...
Importance
Diabetes has been reported to be associated with an increased risk of death among patients with COVID-19. However, available studies lack detail on COVID illness severity and measurement of relevant comorbidities.
Design, Setting, and Participants
We conducted a multicenter, retrospective cohort study of patients over the age of 18 year...
Aims
A pattern of reduced basal longitudinal strain (BLS) is often observed with left ventricular (LV) hypertrophy (LVH). Whether this pattern is associated with poor outcome is unclear. We aimed to evaluate the prognostic value of regional longitudinal strain according to LV geometry.
Methods and results
We investigated participants in the 4th Co...
Background:
Pressure-strain loop analyses is a noninvasive technique capable of evaluating myocardial work. Reference values are needed to benchmark these myocardial work indices for clinical practice.
Methods:
Healthy participants from a general population study were used to establish reference values for global work index (GWI), global constru...
Background:
Atrial fibrillation (AF) is the most common arrythmia following ST-segment elevation myocardial infarction (STEMI) and can lead to stroke and other heart-related diseases. This study aimed to determine the prognostic value of left atrial (LA) strain, obtained by speckle tracking echocardiography (STE), in predicting incident AF outcomes...
Background
Lung ultrasound (LUS) is a useful tool for diagnosis and monitoring in patients with active COVID-19-infection. However, less is known about the changes in LUS findings after a hospitalization for COVID-19.
Methods
In a prospective, longitudinal study in patients with COVID-19 enrolled from non-ICU hospital units, adult patients underwe...
To investigate cross-sectional associations between heavy occupational lifting and cardiac structure and function. Participants from the 5th round of the Copenhagen City Heart Study, aged < 65 years old, answering a questionnaire regarding occupational physical activity, heavy occupational lifting, use of anti-hypertensive and heart medication, and...
Background
Adverse events in COVID-19 are difficult to predict. Risk stratification is encumbered by the need to protect healthcare workers. We hypothesize that AI can help identify subtle signs of myocardial involvement in the 12-lead electrocardiogram (ECG), which could help predict complications.
Objective
Use intake ECGs from COVID-19 patients...
Background:
As lung ultrasound (LUS) has emerged as a diagnostic tool in patients with COVID-19, we sought to investigate the association between LUS findings and the composite in-hospital outcome of ARDS incidence, ICU admission, and all-cause mortality.
Methods:
In this prospective, multi-center, observational study, adults with laboratory-con...
Introduction: The ratio of early mitral inflow velocity to early diastolic strain rate (E/e’sr) is a novel echocardiographic measure to estimate early left ventricular (LV) filling pressure.
Hypothesis: We hypothesize that E/e’sr is a predictor of outcome following coronary artery bypass grafting (CABG) and that it is superior to the conventionally...
Background: In current literature, left atrial (LA) function assessed by 2D speckle tracking echocardiography (2DSTE) has shown increasing clinical and prognostic significance. We sought to establish age- and sex-based normative values of LA strain measures in the general population and to assess the diagnostic and prognostic yield of the predictio...
Introduction: Sectionalized quantification of layer-specific global longitudinal strain (GLS) has recently become available with new technological advancements. We sought to investigate the prognostic value of layer-specific strain in patients undergoing coronary artery bypass grafting (CABG).
Methods: This retrospective cohort study comprised pati...
Introduction: A novel tool to assess myocardial work by echocardiography has recently become available through pressure-strain loop (PSL) analyses. We sought to evaluate the prognostic value of non-invasive myocardial work indices in the general population.
Methods: This was an echocardiographic substudy based on a prospective community-based cohor...
Background
Recent improvements in speckle tracking echocardiography have made sectionalized quantification of layer-specific global longitudinal strain (GLS) possible. Prior studies have reported prognostic value of GLS in several cardiac diseases, however, the use of layer-specific strain has not been investigated in patients undergoing coronary a...
