Kort præsentation

My research is essentially translational. In my early research, I have studied aspects of the role of sub-inflammation in vascular and metabolic insulin resistance based on experimental human studies. I subsequently established a new model in vitro in the department of Biomedicine, in Copenhagen (UCPH), to study mechanisms that may explain the effect of a high-glucose environment for a defective vascular function.
Since sub-inflammation is a risk for increased formation of blood clots, vascular and heart muscle stiffness on patients with insulin resistance, I initiated mechanistic studies associated to a randomized clinical trial, LAACS (Left Atrial Appendage Closure by Surgery). In LAACS patients were randomized to closure of the left atrial appendage or it remained open, in addition to planned heart surgery, aiming to elucidate whether this can protect these patients from future brain damage. After encouraging results with a modest number of patients (N 205) a subsequent multicenter international study (LAACS-2) is dimensioned (N 1500 patients) elucidates whether such procedure protects the patients from stroke.
The REAFEL (Reaching the Frail Elderly) project arouse inspired on the LAACS patients who found cumbersome to attend the hospital ambulatory repeatedly for follow-up on to assess atrial fibrillation occurrence. In REAFEL, patients can be evaluated at home through a novel collaborative model, “cardio-relay”, where the hospital-based cardiologist supports the Family doctor using telemedicine to engage the patient and car-givers for evaluation and treatment of heart disease. The focus condition in REAFEL is atrial fibrillation, supported by a Grand Solutions grant from Innovation Foundations.
When I presented the cardio-relay model in an international seminar, doctors from Brazil found it particularly suitable for patients in the slum areas in Rio de Janeiro. Danida supports BRAHIT, Brazilian Heart Insufficiency with Telemedicine, developed as a Danish-Brazilian collaboration.

Primære forskningsområder

Aktuel forskning

LAACS-2. Left atrial appendage closure by surgery-2. A multicenter international study where patients undergoing heart surgery are randomized to closure of the left atrial appendage, or leaving it open in the control group. Currently active sites are Rigshospitalet (Copenhagen, Denmark), Århus University Hospital (Skejby, Denmark), Sahlgrenska University Hospital (Gothemburg, Sweden) and Vall d’Hebron University Hospital (Barcelona, Spain). The study was initiated in March 2019 and is scheduled until end of 2023. 
SECAFIB. Secondary Atrial Fibrillation to temporary conditions. To identify atriopathy, 300  consecutive patients have undergone continuous heart rhythm monitoring and electrocardiogram (AI algorithms based on conventional ECG and wavECG, Myovista). The upcoming cohorts include frail elderly patients admitted with bone fractures.
Mechanistic studies are based on data and material collected in the LAACS-2 and the SECAFIB studies. Algorithms to predict patients at risk for atrial fibrillation are based on selected patients from these cohorts and re-tested prospectively in REAFEL. 
REAFEL. Reaching the Frail Elderly. Mixed methods are used to evaluate the impact of the cardio-relay model to reach frail populations. These include initial ethnographic observations, followed by a feasibility study where the cardio-relay model is tested in selected Primary Care Clinic. Patients provide their perspective through questionnaires and semi-structured interviews. Experiences from the pilot study are evaluated by the participant clinics in workshops and focus-group interviews. Equivalent methods are applied to a cluster-randomization study where Primary Clinics using the cardio-relay model are compared with Primary Clinics who refer patients to the cardiologists conventionally.
BRAHIT. Mixed methods as described in REAFEL are used in Primary care clinics. Further information on the study is described in www.bmi.ku.dk/english/brahit
REACHFIT. Reaching Frail Patients to stay Fit with Telemedicine. Is a study equivalent to BRAHIT in Danish settings.

CV

Born 1963, Barcelona, Spain.
MD, UAB, Spain, 1988.
PhD, UCPH, Denmark, 2005
Specialist in Internal Medicine and Cardiology, Denmark, 2007.

POSITIONS

• 2014-  Research Consultant, Cardiology Dept. Y, Bispebjerg-Frederiksberg Hospital
• 2017-  Assoc.Prof., Biomedicine dept., Univ. Copenhagen (Ext. Assoc. Prof 2013-17)
• 2013-2014  Post-doc at Hypertension Clinic, Endocrinology dept., Odense Univ. Hosp., Denmark
• 2009-2013  Head of Research and Cardiology Ambulatory, Herlev Univ. Hosp., Denmark
• 2007-2009 Consultant, Research fellow, Cardiology dept., Gentofte Univ. Hosp., Denmark.
• 2005-2007  Cardiology training, Bispebjerg and Gentofte Hospital, Copenhagen Univ. Hosp., Denmark
• 2001-2004  Research Fellow, Cardiology dept., Gentofte Hospital, University of Copenhagen.
• 1990-2000  Resident, cardiology, int. med. and oncology, Herlev and Gentofte Hospital, Denmark. Int. med. Esbjerg, Hillerød and Glostrup, Denmark
• 1989-1990  Guest Researcher, Pathology dept. Linköping University Hospital, Sweden
• 1984-1988 Research stud., Physiology, UAB, Spain.

• Christoffer Waldorff Madsen, Prevention of stroke in secondary atrial fibrillation in surgery (ongoing since JAN 2019)
• Sadaf Kamil, Risks in atrial fibrillation related to aterosclerosis based on Danish registries (ongoing since SEP 2018)
• Jesper Park-Hansen, 2017, LAACS (Left Atrial Appendage Closure at Surgery). A randomized study to prevent cerebral damage assessed by brain MRI and clinical outcomes.
• Thomas Guterbaum 2016, Signalling mechanisms of endothelial nitric oxide activation in human endothelial cells. The role of high glucose on endothelial damage in a model for reperfusion injury.

PhD co-supervisor:

• May Poulsen, Recovery and risk reduction after stroke, 2016.
• Pernille Holmager, Effect of GLP-1 on body composition, inflammatory biomarkers and adipokines in type 2 diabetes mellitus and heart failure, 2015.
• Britt Falskov, Effect of beta blockers on endothelial function in patients with type 2 diabetes and heart failure, 2013. 
• Jakob Raunsø, Atrial fibrillation – Prognosis in heart failure and risk during interruption of anticoagulant treatment, 2012.

Main project supervisor over 20 master and bachelor projects at Faculty of Health Sciences, Copenhagen University 2007-
Jury PhD, Universidad Autónoma de Madrid, Spain: Laura Villalobos 2013 and Tania Romacho, 2011.
Clinical research supervisor, Pharmacy master: Troy Hammer, “Warfarin treatment in anticoagulation clinic” Bergen Universitet, Norway, 2009. Co-advisor bachelor for Bioanalysts B. Nielsen and C. Jølving,”Use of CoaguChek XS Plus for monitoring INR during initiation and stable peroral anticoagulation”, 2008.
Participation in sponsored CRT since 1995 as PI on current and previous studies (VERDICT, HOKUSAI, EPHESUS, SCOUT, etc) and as sub-investigator (IDEAL, CHARM, VALLIANT, etc). Latest GCP Nov 2017.

TEACHING
“Heart and Lung Physiology” since 2013.
“Basal Metabolism and Molecular Mechanisms in the Metabolic Syndrome”, PhD School of Molecular Metabolism, Odense Univ., Denmark, 2009-2015.
“Diabetes and heart disease”, Nurse Cardiology Module-II, 2006-2008.

AWARDS

• 2011 “Excellent quality reviewer” for Annals of Internal Medicine
• 2005 Nordic Congress of Cardiology (Malmö, Sweden)
• 2004 and 2002 Danish Society of Cardiology, Denmark
• 2002 “Diabetes and Heart Disease”, Frederiksberg, Denmark
• 2002 Bispebjerg Hospital Research Day, Denmark.

• REAFEL - InnovationsFond Grand Solutions, 2017. REAFEL - Reaching the Frail Elderly for the management of Atrial Fibrillation (2017-2020). DKK 13,147,508
• NovoNordisk Fonden, 2018. LAACS2 - Left Atrial Appendage Closure with Surgery-2 (Jan 2019 -Dec 2021). DKK 2,999,420   
• Ib Mogens Kristiansen, 2018. LAACS2 - (Jan 2019 - Dec 2021). Dkk 584,689
• Bispebjerg-Frederiksberg Hospital, 2018. LAACS2 - (Jan 2019 - Dec 2021). DKK 120,000
• DANIDA, 2018. BRAHIT - Brazilian Heart Insufficiency with Telemedicine (Mar 2019 - Feb 2022). DKK 5,000,000
• Kaj Hansens Fond (DanaLim), 2019. LAACS2 - (Oct 2019 - Dec 2022). DKK 450,000
• Toyota Fonden, 2020. LAACS2 - (Apr 2020 - Dec 2022). DKK 200,000
• Alfred-Benzon worshkops , 2020. REAFEL. DKK 19,695.
• Skibsredder P. Henriksen og hustru Legat, 2020. LAACS2. DKK 250,000

Undervisnings- og vejledningsområder

Lung and Heart Physiology for 4th. Semester Medicine Students. I undertake group- teaching (SAU24) and I am the responsible and coordinator of exercises on electrocardiography and echocardiography (SAU12).