CardiacCare@Home

2025

Heart failure poses a large burden on patients and healthcare, largely because heart failure patients have low fitness and require frequent hospitalisation for close monitoring. In CardiacCare@Home, researchers work together with patients, doctors, industry, and others to develop technology for home-based monitoring of cardiac function and rehabilitation. This approach facilitates early detection of worsening of cardiac function, which allows doctors to rapidly alter treatment and prevent hospitalisation. Moreover, home-based rehabilitation will improve patients’ fitness levels. Technological innovations will facilitate a new care path that improves patients’ quality of life and lower socio-economic costs, and lower burden for hospital staff.

The research
CardiacCare@Home has the following aims:

  1. To integrate a feasible, easy-to-use monitoring + biomarker system within the home environment of patients with HF, that is validated against gold standard measures, and to identify parameters suitable for integrated, frequent patient evaluation to improve and personalise treatment.
  2. To design an inclusive transmural home-based cardiac rehabilitation programme, personalised to patient (and caregivers) and disease characteristics, tailored to the needs and preferences and co-created with relevant end-users using a combination of user-friendly sensors and an eHealth platform.
  3. To develop a data analytics and decision support system to be incorporated in a novel eHealth platform to (i) enable effective monitoring of vital signs for the personalised, early detection of clinical deterioration, and (ii) facilitate personalised behaviour change to improve participation in rehabilitation.
  4. Co-develop an integrated, AI-driven, home-based monitoring and/or home-based rehabilitation program in patients with chronic HF after hospital admission due to decompensated HF, and assess its effects on quality of life, functional capacity and re-hospitalisation (WP3).
  5. To assess the impact, including cost-effectiveness and budget impact, of the home-based monitoring and/or rehabilitation CardiacCare@Home-intervention compared to current care from the perspective of patients with HF, healthcare providers, health insurance companies, and society.

The origin
Heart failure is linked to poor hospital recovery, low functional capacity, and high risk of hospital re-admission. CardiacCare@Home aims to develop and adopt innovative technology for home-based monitoring and cardiac telerehabilitation to improve quality of life, reduce admission and lower healthcare costs.

This project was funded by the NWO perspective TTW. This public-private program stimulates the development of innovative technologies that may impact economy and society.

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CUSTOM-AF

2020
Individuals with atrial fibrillation are at increased risk of an ischemic stroke. Active detection of atrial fibrillation (AF) and optimal referral and treatment of patients could prevent an estimated 1500 ischemic strokes annually. Effective collaboration between primary and secondary care professionals is essential for achieving this goal of stroke prevention attributed to AF. This is the primary objective of the implementation consortium known as CUSTOM-AF. The origin  The CUSTOM-AF was founded in June 2020 and restarted in 2022. CUSTOM-AF implementation consortium aims to share successful practice examples with regional networks and develop guidelines for organizing active detection and integrated care within a network. Additionally, consortium partners seek innovative methods for general practitioners to detect and manage AF without necessitating hospital referrals. With this consortium, the Dutch Heart Foundation, NVVC Connect, Harteraad, and the Dutch CardioVascular Alliance, all work together towards optimal care for patients with AF. The Dutch College of General Practitioners (NHG) serves as a key advisor to the consortium. Earlier detection and better treatment of atrial fibrillation, the most common cardiac arrhythmia in adults, is an important part of the cardiovascular disease research agenda that the Dutch Heart Foundatoin set in 2014, which funds the CUSTOM-AF consortium. The Research The scope of the consortium has been expanded to include two disorders: heart failure and AF. The consortium has undertaken significant initiatives over the past two years (2020-2022) to advance its objectives: Guideline Development: The consortium developed the "Screening and Treatment Optimization for AF" guideline, designed to facilitate early detection of AF within regional healthcare systems. Cost-Effectiveness Analysis: A comprehensive analysis conducted to assess various screening scenarios for AF, evaluating the economic feasibility of different approaches. Thematic Collaboration: In early 2022, a thematic collaboration titled "Juiste Hartzorg op de Juiste Plek" was established in partnership with the Heart Foundation and ZonMw. This collaboration secured funding for 22 regions to support transmural collaboration on AF and HF, with a focus on early detection and treatment optimization. Moving forward from September 2022, NVVC Connect will intensify support for the regions by emphasizing continuous improvement through the PDCA cycle, facilitating knowledge sharing, and implementing innovative approaches. These efforts are aimed at strengthening collaboration and improving outcomes in AF and HF care across the participating regions.
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IN CONTROL II

2019
The IN-CONTROL II consortium builds upon the success of IN-CONTROL I, which highlighted the pivotal role of the microbiome in low-grade inflammation associated with atherosclerotic cardiovascular diseases (CVD) and related risk factors such as lipid levels and microbiome-derived metabolites. These insights are crucial for addressing the rising rates of CVD-related mortality, particularly in aging and overweight populations. The Focus The objectives of IN-CONTROL II are to: Investigate the mechanisms underlying trained immunity in CVD patients, considering factors like senescence, age, sex, and obesity. Elucidate the interactions between microbiome-derived signals (aromatic amino acids, metabolites, bile acids) and immune senescence in obesity-related cardio-metabolic diseases. Identify novel therapeutic targets and develop pharmacological and microbiome-based therapies to counteract inappropriate induction of trained immunity and inflammation in cardiovascular disease. The Research The consortium aims to shift from association to causality, from population-based cohorts to patient groups with atherosclerotic cardiovascular disease (CVD) and from observation to intervention. In this transition, it will also take advantage of recent developments in the network of the consortium, delineating cellular senescence as a druggable target for the broad spectrum of age-related chronic diseases, including cardiovascular diseases, and identification of components of the bile acid-signaling system for this purpose. Another recent development of the recognition of innate immune memory (‘trained immunity’) as pathophysiological mechanism in atherosclerotic CVD. The consortium will conduct proof-of-principle trials in specific patient cohorts, employing advanced experimental techniques such as systems biology, single cell sequencing, innovative animal models, and metabolic flux quantification (fluxomics). A talent program will facilitate knowledge transfer and skill development for young researchers within the consortium, emphasizing rapid translation of research findings into clinical applications. Origin This consortium was funded through the Impulse Grant program by the Dutch Heart Foundation.
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