| 1. |
|
|
| 2. |
- Adamson, Carly, et al.
(författare)
-
Liver tests and outcomes in heart failure with reduced ejection fraction: findings from DAPA-HF.
- 2022
-
Ingår i: European journal of heart failure. - : Wiley. - 1879-0844 .- 1388-9842. ; 24:10, s. 1856-68
-
Tidskriftsartikel (refereegranskat)abstract
- Reflecting both increased venous pressure and reduced cardiac output, abnormal liver tests are common in patients with severe heart failure and are associated with adverse clinical outcomes. We aimed to investigate the prognostic significance of abnormal liver tests in ambulatory patients with heart failure with reduced ejection fraction (HFrEF), explore any treatment interaction between bilirubin and sodium-glucose cotransporter 2 (SGLT2) inhibitors and examine change in liver tests with SGLT2 inhibitor treatment.We explored these objectives in the Dapagliflozin And Prevention of Adverse outcomes in Heart Failure (DAPA-HF) trial, with focus on bilirubin. We calculated the incidence of cardiovascular death or worsening heart failure by bilirubin tertile. Secondary cardiovascular outcomes were examined, along with the change in liver tests at the end-of-study visit. Baseline bilirubin was available in 4720 patients (99.5%). Participants in the highest bilirubin tertile (T3) have more severe HFrEF (lower left ventricular ejection fraction, higher N-terminal pro-B-type natriuretic peptide [NT-proBNP] and worse New York Heart Association class), had a greater burden of atrial fibrillation but less diabetes. Higher bilirubin (T3 vs. T1) was associated with worse outcomes even after adjustment for other predictive variables, including NT-proBNP and troponin T (adjusted hazard ratio for the primary outcome 1.73 [95% confidence interval 1.37-2.17], p < 0.001; and 1.52 [1.12-2.07], p = 0.01 for cardiovascular death). Baseline bilirubin did not modify the benefits of dapagliflozin. During follow-up, dapagliflozin had no effect on liver tests.Bilirubin concentration was an independent predictor of worse outcomes but did not modify the benefits of dapagliflozin in HFrEF. Dapagliflozin was not associated with change in liver tests.ClinicalTrials.gov NCT03036124.
|
|
| 3. |
- Adamsson, Lisa, et al.
(författare)
-
Efficacy of dapagliflozin in heart failure with reduced ejection fraction according to body mass index.
- 2021
-
Ingår i: European journal of heart failure. - : Wiley. - 1879-0844 .- 1388-9842. ; 23:10, s. 1662-1672
-
Tidskriftsartikel (refereegranskat)abstract
- In heart failure with reduced ejection fraction (HFrEF), there is an 'obesity paradox', where survival is better in patients with a higher body mass index (BMI) and weight loss is associated with worse outcomes. We examined the effect of a sodium-glucose co-transporter 2 inhibitor according to baseline BMI in the Dapagliflozin And Prevention of Adverse-outcomes in Heart Failure trial (DAPA-HF).Body mass index was examined using standard categories, i.e. underweight (<18.5 kg/m2 ); normal weight (18.5-24.9 kg/m2 ); overweight (25.0-29.9 kg/m2 ); obesity class I (30.0-34.9 kg/m2 ); obesity class II (35.0-39.9 kg/m2 ); and obesity class III (≥40 kg/m2 ). The primary outcome in DAPA-HF was the composite of worsening heart failure or cardiovascular death. Overall, 1348 patients (28.4%) were under/normal-weight, 1722 (36.3%) overweight, 1013 (21.4%) obesity class I and 659 (13.9%) obesity class II/III. The unadjusted hazard ratio (95% confidence interval) for the primary outcome with obesity class 1, the lowest risk group, as reference was: under/normal-weight 1.41 (1.16-1.71), overweight 1.18 (0.97-1.42), obesity class II/III 1.37 (1.10-1.72). Patients with class I obesity were also at lowest risk of death. The effect of dapagliflozin on the primary outcome and other outcomes did not vary by baseline BMI, e.g. hazard ratio for primary outcome: under/normal-weight 0.74 (0.58-0.94), overweight 0.81 (0.65-1.02), obesity class I 0.68 (0.50-0.92), obesity class II/III 0.71 (0.51-1.00) (P-value for interaction = 0.79). The mean decrease in weight at 8 months with dapagliflozin was 0.9 (0.7-1.1) kg (P < 0.001).We confirmed an 'obesity survival paradox' in HFrEF. We showed that dapagliflozin was beneficial across the wide range of BMI studied.ClinicalTrials.gov NCT03036124.
|
|
| 4. |
- Bengtsson, Olof, et al.
(författare)
-
A Computational Load-Pull Investigation of Harmonic Loading effects on AM-PM conversion
- 2008
-
Ingår i: GigaHertz Symposium 2008. ; , s. 83-83
-
Konferensbidrag (övrigt vetenskapligt/konstnärligt)abstract
- In this work computational harmonic load-pull have been used to study the effect of harmonic loading on AM-PM conversion for an RF-Power LDMOS transistor. It is found that especially the load impedance seen at the 2nd harmonic has a large impact (up to 2° or 15% difference) on the phase distortion at P1dB in this investigation conducted at chip level.
|
|
| 5. |
|
|
| 6. |
- Bengtsson, Olof, et al.
(författare)
-
A Computational Load-Pull Method for TCAD Optimization of RF-Power Transistors in Bias-Modulation Applications
- 2008
-
Ingår i: Proceedings of the 3rd European Microwave Integrated Circuits Conference. - 9782874870071
-
Konferensbidrag (refereegranskat)abstract
- In this paper a method for TCAD evaluation of RF-Power transistors for high-efficiency operation using drain bias-modulation is presented. The method is based on large signal time-domain transient computational load-pull. With the method, intrinsic device parasitics and mechanisms affecting device efficiency under drain bias modulation can be investigated and optimized for the application making it very useful for RFIC design. A case study has been done on a CMOS compatible LDMOS. For verification under dynamic operation two-tone signals with varying envelope has been simulated. The results show a possible 15% increase in the efficiency of a modulated signal for the studied device at the expense of increased phase distortion observable also in the time-domain waveforms generated. Since the method is based on TCAD it is also useful in the investigation of e.g. dynamic breakdown during high envelope under bias-modulation operation.
|
|
| 7. |
- Bengtsson, Olof, et al.
(författare)
-
A Computational Load-Pull Method with Harmonic Loading for High-Efficiency Investigations
- 2009
-
Ingår i: Solid-State Electronics. - : Elsevier BV. - 0038-1101 .- 1879-2405. ; 53:1, s. 86-94
-
Tidskriftsartikel (refereegranskat)abstract
- In this paper a method for TCAD evaluation of RF-power transistors in high-efficiency operation using harmonic loading is presented. The method is based on large signal time-domain computational load-pull. Active loads are used in the harmonic load-pull for simulation time reduction. With the method device performance under different harmonic load impedance can be investigated at an early stage in the design process. Alternative designs can be compared and the mechanisms affecting device efficiency in class-F can be studied at chip-level. For method validation, a case study is made on an LDMOS transistor. The transistor is load-pulled in class-AB and then optimized for efficiency at 2f0 and 3f0 using a novel approach with passive fundamental load and active harmonic loads. A swept simulation is conducted using passive fundamental and harmonic loads. Waveforms in compression are analyzed and the mechanisms creating the increased efficiency in class-F are identified by a comparative study to class-AB. Class-F harmonic termination is shown to give a 17% overall reduction of dissipated power and a 9% increase in output power. The expected efficiency increase is about 3–10% in the compression region depending on level of compression.
|
|
| 8. |
|
|
| 9. |
- Bengtsson, Olof, et al.
(författare)
-
A Method for Device Intermodulation Analysis from 2D, TCAD Simulations using a Time-domain Waveform Approach
- 2006
-
Ingår i: Proceedings of the 36th European Microwave Conference. ; , s. 169-171
-
Konferensbidrag (refereegranskat)abstract
- This paper describes a fast method useful for IMD analysis at TCAD design level. The method is based on the static load-line transfer function extracted from 2D device simulations. The transfer function is exposed to a time domain signal through a look-up table and the output response is analyzed using the Fast Fourier Transform. The response is compared to measurements of a fabricated device. The method is shown to accurately predict the IMD behavior of a two-tone signal for the 3’rd, 5’th and 7’th order IMD products with regards to sweet spot tracking and relative IMD magnitude. We present a fast and simple way to predict IMD performance from TCAD simulations at an early stage in the design process. The method enables prediction of output response from any signal due to the time domain approach.
|
|
| 10. |
|
|
