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Ambulatory cardiac arrhythmias in relation to mild hypokalaemia and prognosis in community dwelling middle-aged and elderly subjects.

https://arctichealth.org/en/permalink/ahliterature281049
Source
Europace. 2016 Apr;18(4):585-91
Publication Type
Article
Date
Apr-2016
Author
Nick Mattsson
Golnaz Sadjadieh
Preman Kumarathurai
Olav Wendelboe Nielsen
Lars Køber
Ahmad Sajadieh
Source
Europace. 2016 Apr;18(4):585-91
Date
Apr-2016
Language
English
Publication Type
Article
Keywords
Age Factors
Aged
Atrial Premature Complexes - etiology - mortality - physiopathology
Biomarkers - blood
Denmark
Disease-Free Survival
Diuretics - therapeutic use
Electrocardiography, Ambulatory
Female
Humans
Hypokalemia - blood - complications - diagnosis - drug therapy - mortality
Independent living
Kaplan-Meier Estimate
Linear Models
Logistic Models
Male
Middle Aged
Multivariate Analysis
Potassium - blood
Predictive value of tests
Proportional Hazards Models
Risk factors
Severity of Illness Index
Tachycardia, Supraventricular - etiology - mortality - physiopathology
Time Factors
Ventricular Premature Complexes - diagnosis - etiology - mortality - physiopathology
Abstract
Severe hypokalaemia can aggravate arrhythmia tendency and prognosis, but less is known about risk of mild hypokalaemia, which is a frequent finding. We examined the associations between mild hypokalaemia and ambulatory cardiac arrhythmias and their prognosis.
Subjects from the cohort of the 'Copenhagen Holter Study' (n = 671), with no history of manifest cardiovascular (CV) disease or stroke, were studied. All had laboratory tests and 48-h ambulatory electrocardiogram (ECG) recording. The median follow-up was 6.3 years. p-Potassium was inversely associated with frequency of premature ventricular complexes (PVCs) especially in combination with diuretic treatment (r = -0.22, P = 0.015). Hypokalaemia was not associated with supraventricular arrhythmias. Subjects at lowest quintile of p-potassium (mean 3.42, range 2.7-3.6 mmol/L) were defined as hypokalaemic. Cardiovascular mortality was higher in the hypokalaemic group (hazard ratio and 95% confidence intervals: 2.62 (1.11-6.18) after relevant adjustments). Hypokalaemia in combination with excessive PVC worsened the prognosis synergistically; event rates: 83 per 1000 patient-year in subjects with both abnormalities, 10 and 15 per 1000 patient-year in those with one abnormality, and 3 per 1000 patient-year in subjects with no abnormality. One variable combining hypokalaemia with excessive supraventricular arrhythmias gave similar results in univariate analysis, but not after multivariate adjustments.
In middle-aged and elderly subjects with no manifest heart disease, mild hypokalaemia is associated with increased rate of ventricular but not supraventricular arrhythmias. Hypokalaemia interacts synergistically with increased ventricular ectopy to increase the risk of adverse events.
PubMed ID
26293625 View in PubMed
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Excessive supraventricular ectopic activity and increased risk of atrial fibrillation and stroke.

https://arctichealth.org/en/permalink/ahliterature97276
Source
Circulation. 2010 May 4;121(17):1904-11
Publication Type
Article
Date
May-4-2010
Author
Zeynep Binici
Theodoros Intzilakis
Olav Wendelboe Nielsen
Lars Køber
Ahmad Sajadieh
Author Affiliation
Department of Cardiology, Copenhagen University Hospital of Amager and Bispebjerg, Bispebjerg Bakke 23, Copenhagen 2400, Denmark. zeynep.binici@dadlnet.dk
Source
Circulation. 2010 May 4;121(17):1904-11
Date
May-4-2010
Language
English
Publication Type
Article
Keywords
Aged
Atrial Fibrillation - diagnosis - mortality
Atrial Premature Complexes - diagnosis - mortality
Denmark - epidemiology
Electrocardiography, Ambulatory
Female
Follow-Up Studies
Hospitalization - statistics & numerical data
Humans
Incidence
Kaplan-Meiers Estimate
Male
Middle Aged
Prevalence
Prognosis
Proportional Hazards Models
Risk factors
Stroke - mortality
Urban Population - statistics & numerical data
Abstract
BACKGROUND: Prediction of stroke and atrial fibrillation in healthy individuals is challenging. We examined whether excessive supraventricular ectopic activity (ESVEA) correlates with risk of stroke, death, and atrial fibrillation in subjects without previous stroke or heart disease. METHODS AND RESULTS: The population-based cohort of the Copenhagen Holter Study, consisting of 678 healthy men and women aged between 55 and 75 years with no history of cardiovascular disease, atrial fibrillation, or stroke, was evaluated. All had fasting laboratory tests and 48-hour ambulatory ECG monitoring. ESVEA was defined as >or=30 supraventricular ectopic complexes (SVEC) per hour or as any episodes with runs of >or=20 SVEC. The primary end point was stroke or death, and the secondary end points were total mortality, stroke, and admissions for atrial fibrillation. Median follow-up was 6.3 years. Seventy subjects had SVEC>or=30/h, and 42 had runs of SVEC with a length of >or=20 SVEC. Together, 99 subjects (14.6%) had ESVEA. The risk of primary end point (death or stroke) was significantly higher in subjects with ESVEA compared with those without ESVEA after adjustment for conventional risk factors (hazard ratio=1.64; 95% confidence interval, 1.03 to 2.60; P=0.036). ESVEA was also associated with admissions for atrial fibrillation (hazard ratio=2.78; 95% confidence interval, 1.08 to 6.99; P=0.033) and stroke (hazard ratio=2.79; 95% confidence interval, 1.23 to 6.30; P=0.014). SVEC, as a continuous variable, was also associated with both the primary end point of stroke or death and admissions for atrial fibrillation. CONCLUSIONS: ESVEA in apparently healthy subjects is associated with development of atrial fibrillation and is associated with a poor prognosis in term of death or stroke.
PubMed ID
20404258 View in PubMed
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Mild Hypokalemia and Supraventricular Ectopy Increases the Risk of Stroke in Community-Dwelling Subjects.

https://arctichealth.org/en/permalink/ahliterature283189
Source
Stroke. 2017 Mar;48(3):537-543
Publication Type
Article
Date
Mar-2017
Author
Nick Mattsson
Preman Kumarathurai
Bjørn Strøier Larsen
Olav Wendelboe Nielsen
Ahmad Sajadieh
Source
Stroke. 2017 Mar;48(3):537-543
Date
Mar-2017
Language
English
Publication Type
Article
Keywords
Aged
Atrial Premature Complexes - complications - epidemiology
Denmark - epidemiology
Electrocardiography, Ambulatory
Female
Humans
Hypokalemia - complications - epidemiology
Incidence
Independent living
Male
Middle Aged
Risk
Stroke - epidemiology - etiology
Abstract
Stroke is independently associated with the common conditions of hypokalemia and supraventricular ectopy, and we hypothesize that the combination of excessive supraventricular ectopic activity and hypokalemia has a synergistic impact on the prognosis in terms of stroke in the general population.
Subjects (55-75 years old) from the Copenhagen Holter Study cohort (N=671) with no history of atrial fibrillation or stroke were studied-including baseline values of potassium and ambulatory 48-hour Holter monitoring. Excessive supraventricular ectopic activity is defined as =30 premature atrial complexes per hour or any episodes of runs of =20. Hypokalemia was defined as plasma-potassium =3.6 mmol/L. The primary end point was ischemic stroke. Cox models were used.
Hypokalemia was mild (mean, 3.4 mmol/L; range, 2.7-3.6). Hypokalemic subjects were older (67.0±6.94 versus 64.0±6.66 years; P
PubMed ID
28174323 View in PubMed
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Patient satisfaction and suggestions for improvement of remote ICD monitoring.

https://arctichealth.org/en/permalink/ahliterature126162
Source
J Interv Card Electrophysiol. 2012 Sep;34(3):317-24
Publication Type
Article
Date
Sep-2012
Author
Helen Høgh Petersen
Mie Christa Jensen Larsen
Olav Wendelboe Nielsen
Finn Kensing
Jesper Hastrup Svendsen
Author Affiliation
Department of Cardiology, The Heart Centre, Rigshospitalet, Blegdamsvej 9, 2100 Copenhagen OE, Denmark. hhp@dadlnet.dk
Source
J Interv Card Electrophysiol. 2012 Sep;34(3):317-24
Date
Sep-2012
Language
English
Publication Type
Article
Keywords
Cardiomyopathy, Dilated - physiopathology - therapy
Defibrillators, Implantable
Denmark
Female
Greenland
Humans
Linear Models
Male
Middle Aged
Myocardial Ischemia - physiopathology - therapy
Patient satisfaction
Questionnaires
Registries
Remote Consultation - methods
Abstract
The study aim was to evaluate patient acceptance and content with remote follow-up (FU) of their implantable cardioverter defibrillator (ICD) and to estimate patients' wish for changes in remote follow-up routines.
Four hundred seventy-four ICD patients at the device follow-up clinic at Rigshospitalet using CareLink® (Medtronic) remote follow-up, who had made =2 transmissions, received a questionnaire.
Three hundred eighty-five patients (81.2%) answered. Mean time with ICD was 56?±?45 months and mean age was 62?±?13 years; 80% was male. Diagnosis related to ICD implant was: ischemic heart disease in 56% and dilated cardiomyopathy in 21%. Twenty-six percent had primary prophylactic indication. Mean time on remote FU was 16.4?±?6.9 months. Mean time spent on in-clinic FU (two-way transport and FU) was 4 h and 36 min?±?7 h and 50 min, excluding 12 patients from Greenland and Faroe Islands. Ninety-five percent of the patients was very content or content with remote FU compared to in-clinic FU; 3% was less content and 2% was not content. For scheduled transmissions, 21% of the patients wished for a faster reply (sms or e-mail) compared to current practice with a letter. Eighty-four percent preferred more detailed information concerning ICD leads, battery status, and ICD therapies. A total of 96 patients (25%) had performed extra unscheduled remote transmissions: 20 due to shock, 20 due to alarm, 35 due to palpitations, and 18 for other or combined reasons.
Ninety-five percent of the patients were content with the remote FU. Only 25% had unscheduled transmissions and most unscheduled transmissions were for appropriate reasons. Eighty-four percent of the patients wished for a more detailed response and 21% wished for a faster reply after routine transmissions.
PubMed ID
22418649 View in PubMed
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Prevalence and prognosis of heart failure with preserved ejection fraction and elevated N-terminal pro brain natriuretic peptide: a 10-year analysis from the Copenhagen Hospital Heart Failure Study.

https://arctichealth.org/en/permalink/ahliterature127206
Source
Eur J Heart Fail. 2012 Mar;14(3):240-7
Publication Type
Article
Date
Mar-2012
Author
Christian Malchau Carlsen
Morten Bay
Vibeke Kirk
Jens Peter Gøtze
Lars Køber
Olav Wendelboe Nielsen
Author Affiliation
Department of Cardiology, Bispebjerg Hospital, Copenhagen University Hospital, Copenhagen, Denmark. cmc@dadlnet.dk
Source
Eur J Heart Fail. 2012 Mar;14(3):240-7
Date
Mar-2012
Language
English
Publication Type
Article
Keywords
Adult
Aged
Aged, 80 and over
Confidence Intervals
Denmark - epidemiology
Enzyme-Linked Immunosorbent Assay
Female
Heart Failure - epidemiology - mortality - ultrasonography
Humans
Kaplan-Meier Estimate
Male
Middle Aged
Natriuretic Peptide, Brain - blood
Peptide Fragments - blood
Prevalence
Prognosis
Stroke Volume
Time Factors
Ventricular Function, Left
Young Adult
Abstract
The aim of this study was to assess the epidemiological features and prognosis of heart failure with preserved ejection fraction (HFPEF) and to compare these findings with those from patients with reduced ejection fraction. Furthermore the effects of N-terminal pro brain natriuretic peptide (NT-proBNP) requirement in the heart failure diagnosis were assessed by repeating the analyses in the subgroup of patients with elevated NT-proBNP.
In 1844 patients admitted, a clinical diagnosis of heart failure was made in 433; amongst these 61% had HFPEF. An elevated NT-proBNP applied to the heart failure diagnosis reduced the number of heart failure patients to 191, and amongst these 29% had preserved ejection fraction. Use of NT-proBNP reduced clinical differences between heart failure patients with preserved and reduced ejection fraction. When not using NT-proBNP, patients with reduced ejection fraction had higher mortality [hazard ratio (HR) 1.24, 95% confidence interval (CI) 1.01-1.52; P = 0.04], even after adjustment for other significant predictors of mortality, except NT-proBNP (HR 1.29, 95% CI 1.04-1.59; P = 0.02). However, no difference in mortality was observed when NT-proBNP was adjusted for (HR 0.90, 95% CI 0.71-1.15; P = 0.4), or used for the heart failure diagnosis (HR 0.96; 95% CI 0.71-1.29; P = 0.8).
Using a heart failure diagnosis requiring elevated NT-proBNP reduces the prevalence of HFPEF and results in a survival similar to that of heart failure with reduced ejection fraction. In contrast, when NT-proBNP is not used for the heart failure diagnosis or adjusted for, HFPEF is associated with a lower mortality in both univariate and multivariate analysis.
PubMed ID
22315457 View in PubMed
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Prevalence and prognostic significance of daily-life silent myocardial ischaemia in middle-aged and elderly subjects with no apparent heart disease.

https://arctichealth.org/en/permalink/ahliterature45714
Source
Eur Heart J. 2005 Jul;26(14):1402-9
Publication Type
Article
Date
Jul-2005
Author
Ahmad Sajadieh
Olav Wendelboe Nielsen
Verner Rasmussen
Hans Ole Hein
Jørgen Fischer Hansen
Author Affiliation
Department of Cardiology, Copenhagen University Hospital of Bispebjerg, Bispebjerg Bakke 23, DK-2400 Copenhagen NV, Denmark. ahs@dadlnet.dk
Source
Eur Heart J. 2005 Jul;26(14):1402-9
Date
Jul-2005
Language
English
Publication Type
Article
Keywords
Aged
Circadian Rhythm
Denmark - epidemiology
Electrocardiography, Ambulatory
Epidemiologic Methods
Female
Humans
Male
Middle Aged
Myocardial Infarction - mortality
Myocardial Ischemia - mortality
Prognosis
Research Support, Non-U.S. Gov't
Survival Analysis
Abstract
AIMS: We aimed to determine the prevalence and prognostic significance of daily-life silent myocardial ischaemia (SMI) in healthy middle-aged and elderly subjects with no previous heart disease. METHODS AND RESULTS: Six hundred and seventy-eight healthy men and women between 55 and 75 years of age and with no history of cardiovascular disease or stroke were included. Baseline examinations included physical examination, fasting laboratory testing, and 48 h ambulatory electrocardiogram monitoring. An episode of ischaemia was defined by a down-sloped or horizontal ST depression of at least 1 mm at a duration of at least 1 min. Seventy-seven subjects (11.4%) had SMI. All participants were followed for up to 5 years. In 77 subjects with SMI, 16 (20.7%) had an event (death or myocardial infarction). In 601 subjects without SMI, 50 (8.3%) had an event. The hazard ratios for SMI in relation to cardiac and combined events after correction for conventional risk factors were 3.1 [(1.24-7.97), P=0.016] and 1.97 [(1.06-3.69), P=0.033], respectively. CONCLUSION: SMI as detected by Holter monitoring was detected in 11.4% of these subjects and was associated with more than three-fold increase in the cardiac event rate after correction for risk factors, implying that this test could be used to identify high-risk individuals among these subjects.
PubMed ID
15774494 View in PubMed
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Prognostic value of high sensitive C-reactive protein in subjects with silent myocardial ischemia.

https://arctichealth.org/en/permalink/ahliterature128226
Source
J Electrocardiol. 2012 May-Jun;45(3):260-4
Publication Type
Article
Author
Mette Rauhe Mouridsen
Theodoros Intzilakis
Zeynep Binici
Olav Wendelboe Nielsen
Ahmad Sajadieh
Author Affiliation
Department of Cardiology, Copenhagen University Hospital of Bispebjerg, Bispebjerg Bakke 23, Copenhagen NV, Denmark. mettemouridsen@hotmail.com
Source
J Electrocardiol. 2012 May-Jun;45(3):260-4
Language
English
Publication Type
Article
Keywords
Aged
Biological Markers - blood
C-Reactive Protein - analysis
Denmark - epidemiology
Female
Humans
Incidence
Male
Middle Aged
Myocardial Ischemia - blood - diagnosis - mortality
Prognosis
Reproducibility of Results
Risk assessment
Risk factors
Sensitivity and specificity
Survival Analysis
Survival Rate
Abstract
The aim of this study was to evaluate the prognostic value of high sensitive C-reactive protein (CRP) in subjects with silent myocardial ischemia (SMI).
In total, 678 healthy men and women aged 55 to 75 years with no history of cardiovascular disease or stroke were included. High-sensitive CRP and 48-hour ambulatory ECG monitoring were performed. The primary endpoint was the combined endpoint of death and myocardial infarction.
The median follow-up time was 76 months. Seventy-seven subjects (11.4%) had SMI. The combined endpoint occurred in 26% of the subjects with SMI and 14% of the subjects without SMI (P = .005). SMI had a poor prognosis in the group with an elevated CRP = 3.0 µg/mL (hazard ratio, 3.46; 95% confidence interval, 1.67-7.16; P = .001) compared with the group of subjects with SMI and a low CRP
PubMed ID
22217366 View in PubMed
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Resting heart rate is a predictor of mortality in COPD.

https://arctichealth.org/en/permalink/ahliterature119068
Source
Eur Respir J. 2013 Aug;42(2):341-9
Publication Type
Article
Date
Aug-2013
Author
Magnus Thorsten Jensen
Jacob L Marott
Peter Lange
Jørgen Vestbo
Peter Schnohr
Olav Wendelboe Nielsen
Jan Skov Jensen
Gorm B Jensen
Author Affiliation
Copenhagen University Hospital Gentofte, Hellerup, Denmark. magnustjensen@gmail.com
Source
Eur Respir J. 2013 Aug;42(2):341-9
Date
Aug-2013
Language
English
Publication Type
Article
Keywords
Adult
Aged
Denmark
Female
Forced expiratory volume
Heart rate
Humans
Life expectancy
Male
Middle Aged
Multivariate Analysis
Proportional Hazards Models
Prospective Studies
Pulmonary Disease, Chronic Obstructive - diagnosis - mortality - physiopathology
Respiratory Function Tests
Abstract
The clinical significance of high heart rate in chronic obstructive pulmonary disease (COPD) is unexplored. We investigated the association between resting heart rate, pulmonary function, and prognosis in subjects with COPD. 16 696 subjects aged =40 years from the Copenhagen City Heart Study, a prospective study of the general population, were followed for 35.3 years, 10 986 deaths occurred. Analyses were performed using time-dependent Cox-models and net reclassification index (NRI). Resting heart rate increased with severity of COPD (p85 bpm was 5.5 years without COPD, 9.8 years in mild (Global Initiative for Chronic Obstructive Lung Disease (GOLD) stage I), 6.7 years in moderate (GOLD stage II) and 5.9 years in severe/very severe COPD (GOLD stage III/IV), (p
PubMed ID
23143550 View in PubMed
Less detail
Source
Ugeskr Laeger. 2012 Oct 15;174(42):2555
Publication Type
Article
Date
Oct-15-2012

[The epidemiology of heart failure from a Danish perspective]

https://arctichealth.org/en/permalink/ahliterature53404
Source
Ugeskr Laeger. 2004 Jan 19;166(4):243-7
Publication Type
Article
Date
Jan-19-2004

11 records – page 1 of 2.