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Heart failure is an escalating global health challenge, affecting over 64 million people worldwide. Despite advancements in guideline-directed medical therapy (GDMT) that significantly reduce mortality and hospitalizations, many patients still do not receive optimal medication regimens or dosages. This gap in care highlights the need for innovative, collaborative approaches to improve treatment delivery and outcomes. The research The ADMINISTER I study demonstrated the potential of digital care solutions to enhance medication prescription accuracy and accelerate the time required to achieve GDMT. In real-world clinical practice, optimizing medications to meet GDMT standards is a complex and time-intensive process. It requires frequent monitoring, adjustments, and multiple visits to healthcare providers, posing a significant burden on both patients and clinicians. Building on this foundation, the ADMINISTER II consortium is a collaborative effort uniting multiple stakeholders, including healthcare providers, researchers, and (biomedical) engineers. This consortium aims to evaluate the impact of a cutting-edge digital care intervention designed to streamline medication optimization. By leveraging a robust remote monitoring infrastructure, this approach seeks to make the process more efficient, scalable, and accessible, while focusing on improving critical clinical outcomes. This collaborative digital intervention represents a transformative step toward patient care and offers hope for better heart failure management. Insights from ADMINISTER II could pave the way for the widespread adoption of innovative, integrated solutions, benefiting patients, caregivers, and healthcare systems worldwide. The ADMINISTER II consortium brings together the expertise of a leading Technical University, major referral hospitals, and a renowned academic center to deliver state-of-the-art digital care across a large nationwide hospital network. This unique synergy is pivotal to achieving the ambitious goals set by the Dutch Cardiovascular Alliance (DCVA): a 25% reduction in the cardiovascular burden by 2030. By integrating cutting-edge digital infrastructure with clinical excellence, the consortium aims to significantly lower hospitalizations and mortality rates. This partnership not only accelerates the adoption of innovative digital solutions but also ensures their effective implementation in diverse healthcare settings, marking a critical step toward transforming cardiovascular care on a national scale. The origin The ADMINISTER II is created after successful completion of the ADMINISTER I trial. The ADMINISTER I was fully funded by Amsterdam UMC and was a collaboration with Netherlands heart institute, UMC Utrecht, Rode Kruis hospital and CCN. The ADMINISTER II consortium will be on a larger scale; with a larger network and multiple funders.

Currently, it is largely unknown to what extent the heart is involved in COVID-19. The aim of this project is to assess the incidence and consequences of cardiac damage in patients who have experienced COVID-19. How often does COVID-19 lead to myocardial damage? What are the short- and long-term consequences of this damage and what can we do to prevent it from occurring? These are the central questions that will be answered within the DEFENCE consortium. The Research The DEFENCE consortium integrates several national studies initiated at the onset of the COVID-19 pandemic, encompassing diverse patient groups as part of the COPP study, ranging from elite athletes (COMMIT study) and individuals recovering at home (COVID@Heart study) to hospitalized patients (CAPACITY-COVID registry and CAPACITY 2 study) and children with post-infection inflammatory syndromes affecting the heart (MIS-C). By harmonizing these initiatives, a unique cohort spanning the entire spectrum of COVID-19 severity has been established. The ongoing studies are extended at multiple levels within the DEFENCE project. This includes: Standardized Healthcare Pathway Implementation: Implementing and evaluating a standardized healthcare pathway to assess cardiac damage occurrence within 6 months post-hospitalization for COVID-19. Serial Cardiac Magnetic Resonance (CMR) Imaging: Performing serial CMR imaging to determine the prevalence and reversibility of myocardial damage, with all scans assessed in a core lab. Evaluation of Cardiovascular Symptoms: Assessing the incidence of cardiovascular symptoms such as chest pain and palpitations in the post-acute phase through patient questionnaires. Linking Data to National Datasets: Linking study data to national datasets at Statistics Netherlands to analyze long-term cardiovascular morbidity and mortality. To evaluate whether cardiovascular disease is a characteristic feature of COVID-19, a comparison with other respiratory tract infections, including seasonal influenza will be made. Origin This research has is funded by ZonMw, but has been set up through the efforts of WCN, NLHI, NHR, the Dutch Heart Foundation, NVVC, NVIC, Harteraad, and the EuroQol Research Foundation, who collaborate within the Dutch CardioVascular Alliance.