Publications by authors named "Bjarne L Norgaard"

The Western Denmark Heart Registry (WDHR) is a semi-national, multicenter-based clinical registry with unique potential for cardiovascular research. The registry has provided detailed prospectively registered information on patient and procedure characteristics since 1999. WDHR data can be linked to additional data in other healthcare registries in Denmark.

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Background: Patients with chronic kidney disease (CKD) are susceptible to vascular calcification and vitamin K deficiency. Matrix gla protein (MGP) is a potent inhibitor of calcification requiring vitamin K for activation. Inactive MGP, i.

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Aims: Concomitant coronary artery disease (CAD) is frequent in transcatheter aortic valve implantation (TAVI) candidates. Despite societal recommendations of performing invasive coronary angiography (ICA) for coronary assessment in the pre-TAVI diagnostic workup, the prognostic value of ICA and beneficial effect of revascularization in these patients remains unclear. We aimed to determine feasibility and outcomes following a strategy of cardiac CT + coronary CT angiography (cCTA) rather than cardiac CT + ICA before TAVI.

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Article Synopsis
  • Coronary computed tomography angiography (CCTA) is useful for analyzing coronary atherosclerotic plaques, but previous studies on the consistency of plaque volume measurements between scans are limited.
  • In a study involving 101 patients, CCTA scans were performed twice with a one-hour interval using identical protocols, and plaque volumes were assessed using semi-automated software.
  • Results showed high correlation for total, non-calcified, and calcified plaques, but lower for low-density non-calcified plaques, with reproducibility influenced by image quality, reconstruction settings, and lesion location, particularly in left anterior descending (LAD) arteries.
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Background: Transcatheter aortic valve replacement (TAVR) has become the standard-of-care treatment for a majority of patients with severe, symptomatic aortic stenosis. The postprocedural antithrombotic therapeutic management is still a topic of debate and could affect the incidence of HALT, a phenomenon which can be assessed by 4-dimensional computed tomography (4DCT).

Trial Design: The NOTION-4 trial is a randomized controlled trial comprising TAVR patients with no indication for oral anticoagulant (OAC) therapy, comparing lifelong single antiplatelet therapy (standard arm) versus early 3-month direct oral anticoagulant (DOAC) therapy followed by single antiplateletet therapy (experimental arm).

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Purpose To assess long-term geometric changes of the mitral valve apparatus using cardiac CT in individuals who underwent cardiac resynchronization therapy (CRT). Materials and Methods Participants from a randomized controlled trial with cardiac CT examinations before CRT implantation and at 6 months follow-up (Clinicaltrials.gov identifier NCT01323686) were invited to undergo an additional long-term follow-up cardiac CT examination.

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Background: Coronary computed tomography angiography (CCTA) is recommended as the first-line diagnostic imaging modality in low-to-intermediate-risk individuals suspected of stable coronary artery disease (CAD). However, CCTA exposes patients to ionizing radiation and potentially nephrotoxic contrast agents. Invasive coronary angiography is the gold-standard investigation to guide coronary revascularisation strategy; however, invasive procedures incur an inherent risk to the patient.

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  • The study investigates vulnerable plaque in significant coronary lesions, associating it with prognostic importance beyond just physical function.
  • Conducted across 5 countries, it involved 95 patients with specific pressure-related measurements, identifying features that predict vulnerable plaques.
  • Results showed a significant link between vulnerable plaque presence and pressure gradient (PPG) and fractional flow reserve (FFR), indicating these measures may help predict plaque vulnerability in low-FFR lesions.
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  • A study examined the relationship between how completely patients with stable angina were revascularized (opened blocked arteries) and their cardiovascular health outcomes, using a method called fractional flow reserve (FFR) to measure artery health.
  • In 900 patients, those who were incompletely revascularized had a significantly higher risk of cardiovascular events, like heart attacks, compared to those who were completely revascularized or had normal FFR readings.
  • The findings suggest that ensuring complete revascularization in patients with critical artery blockages (FFR ≤ 0.80) could lead to better heart health outcomes.
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Background: Some autoimmune diseases carry elevated risk for atherosclerotic cardiovascular disease (ASCVD), yet the underlying mechanism and the influence of traditional risk factors remain unclear.

Objectives: This study sought to determine whether autoimmune diseases independently correlate with coronary atherosclerosis and ASCVD risk and whether traditional cardiovascular risk factors modulate the risk.

Methods: The study included 85,512 patients from the Western Denmark Heart Registry undergoing coronary computed tomography angiography.

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Background: Left atrial appendage occlusion (LAAO) is performed increasingly, but long-term follow-up imaging data are lacking.

Aims: The aim of this study was to evaluate the safety and durability of the Amplatzer Amulet device >4 years after LAAO.

Methods: This was a prospective observational cohort study including 52 patients implanted with the Amplatzer Amulet device at Aarhus University Hospital, Denmark.

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  • Coronary CT angiography (CCTA) is a reliable method for diagnosing coronary artery disease and may also help in planning percutaneous coronary interventions (PCI) and stent sizing, though its effectiveness was previously unclear.! -
  • In a study analyzing 65 blood vessels, researchers compared stent sizes determined by CCTA and optical coherence tomography (OCT), finding that CCTA measurements were very close to those of OCT, with a substantial agreement in stent sizing.! -
  • The results indicated that while CCTA generally provides accurate assessments for stent diameter, it overestimated the size in 20% of cases and underestimated it in 27.7%, suggesting it can be a useful tool in PCI planning but not
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  • A study was conducted to improve the prediction of which coronary artery lesions could lead to acute coronary syndrome (ACS) by integrating artificial intelligence (AI) with traditional methods.
  • The research focused on patients who had undergone coronary CT angiography (CTA) before experiencing an ACS event, analyzing both culprit (problematic) and nonculprit lesions.
  • The new model incorporating AI features showed significantly better predictability for identifying high-risk lesions compared to standard methods, suggesting that AI can enhance cardiac risk assessment.
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Introduction: Based on technical advancements and clinical evidence, transcatheter aortic valve implantation (TAVI) has been widely adopted. New generation TAVI valve platforms are continually being developed. Ideally, new valves should be superior or at least non-inferior regarding efficacy and safety, when compared to best-in-practice contemporary TAVI valves.

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  • The study investigated how smoking status affects the coronary volume-to-myocardial mass ratio (V/M) in individuals with coronary artery disease (CAD) who underwent CT analysis.
  • It included a sample of 2,874 participants, revealing that former smokers had higher coronary volume than never-smokers, while current smokers had greater myocardial mass but both groups exhibited lower V/M ratios compared to never-smokers.
  • The findings suggest that both current and former smoking status are significant predictors of lower V/M, alongside other factors like diabetes and severity of coronary stenosis.
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Background: Chronic kidney disease (CKD) is associated with accelerated vascular calcification and increased central systolic blood pressure when measured invasively (invCSBP) relative to cuff-based brachial systolic blood pressure (cuffSBP). The contribution of aortic wall calcification to this phenomenon has not been clarified. We, therefore, examined the effects of aortic calcification on cuffSBP and invCSBP in a cohort of patients representing all stages of CKD.

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  • - The study examines the relationship between luminal stenosis, computed tomography-derived fractional-flow reserve (FFR), and high-risk plaque features on coronary CT angiography, focusing on their impact on patient outcomes and plaque volume measurements.
  • - Data from 4,430 patients were analyzed using artificial intelligence to assess coronary plaque and determine optimal plaque volume cutoffs, considering factors like age, sex, hypertension, and diabetes.
  • - Results showed that patients with total plaque volume and percent atheroma volume above specific cutoffs faced higher risks of major adverse cardiac events and late revascularization within one year.
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  • This study investigates the connection between coronary artery disease patterns, assessed using optical coherence tomography (OCT), and outcomes after stent implantation in patients undergoing percutaneous coronary intervention (PCI).
  • 102 patients were analyzed, revealing that those with focal coronary artery disease had larger minimum stent areas and lower rates of stent malapposition compared to those with diffuse disease.
  • Findings indicate that the type of coronary disease impacts post-PCI imaging outcomes, suggesting that OCT can be a valuable tool for understanding these relationships.
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Background: Coronary artery fistulas (CAFs) are abnormal communications between the coronary arteries and the heart chambers, arteries, or veins, potentially leading to significant shunting, myocardial ischaemia and heart failure. Computed tomographic (CT) angiography or conventional invasive angiography is the reference standard for the diagnosis of coronary fistulas. The fistula anatomy can become very complex, which makes surgical or interventional planning challenging.

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Background: The association between coronary computed tomography angiography (CTA) derived fractional flow reserve (FFR) and risk of recurrent angina in patients with new onset stable angina pectoris (SAP) and stenosis by CTA is uncertain.

Methods: Multicenter 3-year follow-up study of patients presenting with symptoms suggestive of new onset SAP who underwent first-line CTA evaluation and subsequent standard-of-care treatment. All patients had at least one ≥30 ​% coronary stenosis.

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