An important way to achieve our shared ambition is by promoting cooperation in the cardiovascular field and joining forces. One way to do this is by identifying opportunities in research and funding and jointly exploiting them and resolving any bottlenecks. To establish this kind of cooperation, the DCVA has experimented with various ways to stimulate research collaboration, including by guiding so-called "Explorations".
From various perspectives, the process of conducting an exploration emerges as a valuable approach to start and establish a national collaboration. We have described the whole process of conducting an exploration, clarifying the roles and responsibilities of the DCVA Office and the Research Policy Working Group. By being clear and transparant in this process, we aim to facilitate future collaborations.
At the request of several DCVA partners, including the Dutch Heart Foundation, which has earlier recognition of cardiovascular disease highly prioritized on its national research agenda, which was drawn up at the initiative of the Dutch Heart Foundation in 2014 and revised in 2020, the DCVA explored the potential for a national initiative to develop the first population screening for cardiovascular disease in 2020.
The Check@Home study builds on previous studies, including the KidneyCheck study. To achieve a national approach to the early detection of diabetes, cardiovascular disease and chronic kidney damage, the DCVA, Dutch Heart Foundation, Dutch Kidney Foundation and Dutch Diabetes Fund established the Check@Home consortium. This is a collaboration of multiple research groups, private parties, and research funders: NWO, the Dutch Heart Foundation, the Dutch Kidney Foundation and the Dutch Diabetes Fund.
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On the cardiovascular disease research agenda, as drawn up at the initiative of the Dutch Heart Foundation in 2014 and revised in 2020, the themes "Earlier recognition of cardiovascular disease" and "Heart failure" have been placed on the agenda. The Dutch CardioVascular Alliance (DCVA) also announced the Heart Failure Delta Plan in the 2022 Annual Plan. Based on this, an exploration was carried out at the initiative of the Dutch Heart Foundation.
This resulted in the Delta Plan Heart Failure, which is initiated and financed by the Hartstichting, the Netherlands Heart Institute, and the Dutch Cardiovascular Alliance. In this national project, healthcare professionals, researchers, and patients have joined forces and will focus on the entire continuum of the disease from prevention to palliative care.
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Several partners of the DCVA, including the Heart Foundation, NVIVG, NVvV, NVVC, NHG, Harteraad, VKGN, but also beyond (Erfocentrum) wondered if and how more people at hereditary risk could be detected earlier. Therefore, after consulting the Research Policy Working Group in 2021, they took the initiative for this exploration to identify what is needed to make a difference for people with (the risk of) hereditary cardiovascular diseases. The Dutch Heart Foundation provided a project leader (Ineke Nederend). The Research Policy pillar set up a supervisory committee, which consisted of several partners. This exploration resulted in the report ‘Verbetering vroege opsporing van erfelijke hart- en vaatziekten in Nederland’.
Afterwards, an inventory of ongoing research in the Netherlands in the field of hereditary heart disease as well as opportunities to improve the treatment of hereditary heart disease was performed by Imke Christiaans (clinical geneticist, UMC Groningen) and Leon de Windt (professor of molecular cardiovascular biology, Maastricht University).
Based on the exploration, and in synergy, several researchers took the initiative to apply for various (major) funding opportunities in 2023.
Based on this exploration, the Dutch Heart Foundation took the initiative to develop a call together with NWO, named ‘KIC Samen voor een beter leven met erfelijke hartziekten - Innovaties voor vroegdetectie, risicopredictie en therapie’.
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The Dutch Heart Foundation has asked DCVA to set up and supervise an exploration to make an inventory of which topics within arterial calcification, and through which collaborations, a new future-proof consortium could be set up. Using existing networks, but also with plenty of room for 'new' talent. The exploration was conducted in end of 2022/start of 2023 by Gerard Pasterkamp (experimental cardiology, UMC Utrecht), Menno de Winther (medical biochemist, Amsterdam UMC) and Jeanine Roeters van Lennep (vascular internist, Erasmus MC). The 3 explorers visited all academic hospitals. This led to a 3-pager report, which was shared with all partners, where it was recommended to set up a new national consortium, ATHERO-NL. Based on this, further content broadening was sought with an input session.
Thereafter, a first consortium application was submitted via the Knowledge and Innovation Convenant (KIC) of NWO – a so-called Demand-driven Partnership for Consortia. The DHF committed co-funding for this application. Despite excellent reviews, this application was not successful – the biomedical signature of the proposed consortium was not a perfect fit with the criteria of the call.
As atherosclerosis is the key disease mechanism underlying a large part of the cardiovascular disease burden and therefore a highly important topic for the Dutch Heart Foundation, they sharpened the scope and objectives for a new atherosclerosis consortium in a new invitational call. To guide the formation of this new atherosclerosis consortium and develop a full consortium proposal, they have invited: Jeanine Roeters van Lennep (Erasmus MC), Niels Riksen (Radboud UMC), Menno de Winther (Amsterdam UMC), and Gerard Pasterkamp (UMC Utrecht).
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Conversations with several DCVA partners in recent years revealed that applications in the field of aneurysms were regularly submitted. These applications did not lead to a successful grant award because the projects were often too small and unicentered. It was therefore agreed to conduct an exploration, with the goal of increasing the chances of receiving funding through more national cooperation between the various centers. This exploration aimed to identify opportunities for a national initiative on this relevant topic. Important in this exploration was that aneurysms in the head as well as in the aorta would be included.
This exploration was done in 2022 and 2023 by Hanneke Takkenberg (epidemiologist thoracic surgery, Erasmus MC), Mervyn Vergouwen (vascular neurologist, UMC Utrecht) and Barend Mees (vascular surgeon, Maastricht UMC). DCVA partners and a number of scientific and patient associations were asked to delegate individuals for a number of input sessions in 2022 and 2023. This led to the report "DCVA inventarisatie landelijk aneurysma-onderzoek" which was shared with all partners.
The Dutch Heart Foundation endorses the findings of the exploration and the importance of national cooperation on this important topic. Much high quality research and good knowledge exchange is needed to make this serious disease more treatable. The Dutch Heart Foundation has therefore decided to make funding available for a national consortium on aneurysms.
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There is a common challenge to protect and improve the health of everyone through a healthy lifestyle and environment (prevention), continuously and at specific moments (major life events). In doing so, we save healthcare costs and contribute to accessibility to (necessary) care in the short and long term. Prehabilitation is a multimodal preventive lifestyle intervention prior to an elective medical intervention, such as major surgery, and focuses primarily on patients with suboptimal health and/or lifestyle and environment. Prehabilitation consists of short-term intensive lifestyle interventions, for example physical therapy, diet, smoking and mental health, during the waiting period before surgery. The “passive” waiting period thus becomes an active “preparation phase". Prehabilitation, if applied properly, can result in reduced operative risks, postoperative complications, care burden and costs, and improved postoperative recovery.
Therefore, it seems opportune to implement prehabilitation as part of the perioperative course of cardiosurgical patients on a national scale in a controlled manner and to evaluate it both practically and scientifically, including for cost-effectiveness. Collaboration to this end is crucial. In fall 2023, multiple institutes and partners organisations approached the DCVA as there were several initiatives in the field of prehabilitation. Because this subject involves several disciplines, and it can make an important contribution to the ambition of the Dutch CardioVascular Alliance, bringing the project under the banner of the DCVA fits well. The goal is to bring these initiatives together (where possible) to accelerate on a national scale. A working group with interested individuals was formed.
To do so, a brainstorm meeting was held in March 2024. There was a diverse group of people, with different insights and expertise, who spoke about the possibility of setting up a national study on prehabilitation for patients undergoing cardiac surgery and the considerations to be taken. Following this meeting, the working group worked to further shape a research proposal, carefully incorporating all considerations discussed. The outlines of the research proposal will be discussed in September 2024. If you are interested, please reach out to us!
