Cardiovascular Moonshot (RegMed XB)

2018

Heart failure is a global public health issue with a largely equal distribution between men and women. For patients with end-stage heart failure limited treatment options are available. The Cardiovascular Moonshot of RegMed-XB (CMRM-XB) is a comprehensive program based on the concept of developing personalized cardiac regenerative therapies tailored to individual patients. The researchers aim to enhance the body's inherent regenerative capacity, such as improving contractility and perfusion of the heart muscle, repairing or replacing coronary arteries and heart valves. Importantly, researchers will gain insights into optimizing heart treatment and potentially preventing certain cardiovascular diseases in patients.

The Research
The research is focused on the creation of  a(n) (additional) solution(s) for patients by regenerating the human heart inside (in-situ) or outside of the body (ex-situ). Repair of the heart in a cardiac perfusion bioreactor (ex-situ) offers unique opportunities, including the possibility to  apply treatments without off-target effects to distant organs or wash-out of therapeutics. Initially, this could be an option to restore donor hearts for transplant recipients. After restoring the heart, it will be re-implanted. This strategy also facilitates exploration of gene therapy for hereditary diseases. Along this process, the researchers learn how to treat the heart better and eventually also aim to deduce how to treat the heart inside a patient.

The Cardiovascular Moonshot of RegMed XB is the most recent addition to the Moonshot initiatives. To date, it has completed a hypothermic pilot study that has enhanced researchers' expertise in perfusion models. Currently, this model is undergoing further refinement for optimal heart preservation. Additionally, ongoing histopathological analysis of heart valves aims to elucidate how these valves remodel in response to altered fluid dynamics within the ex vivo heart platform.

The cardiovascular Moonshot consists of a multidisciplinary team of transplant surgeons (Utrecht), cardiologists (Utrecht, Maastricht), engineers (Eindhoven) and biologists (Leiden) with the support and input of key stakeholders including patients and companies.

The origin

RegMed XB is a virtual institute that currently comprises Dutch and Belgian public (universities and governments) and private (health foundations and companies) partners that work together to develop regenerative medicine solutions. Regenerative medicine aims to restore degenerated, diseased, or damaged tissues and organs, thereby increasing vital functioning and reducing the cost of healthcare. RegMed XB collaborates on ambitious projects in the field of regenerative medicine. Initially, five health foundations have joined the TKI-program by Health~Holland to define the research objectives and co-govern the projects. Numerous companies have joined and the regional governments support both the research and its valorisation.

The cardiovascular Moonshot recently received follow-up funding from the Dutch Heart Foundation through the Open PSS program, which the Dutch Heart Foundation receives from Health~Holland. In addition, companies involved are also making a financial contribution; these are Coagulation Profile and Axion Biosystems.

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Contact person:

Prof. Dr. P. Doevendans (Pieter)

Principal investigators

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Delta Plan Heart Failure

2023
Heart failure is a severe and chronic condition were the heart is unable to pump blood around the body properly, due to a structural and/or functional abnormality of the heart. It has many different causes, with the most common being hypertension and coronary artery disease. Heart failure is an unpredictable condition with sudden exacerbations of the disease, hospitalization, and will ultimately lead to death. Proper (and early) treatment may improve the symptoms of health failure and may lead to a relatively longer and better quality of life. The origin 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 DCVA also announced the Delta Plan Heart Failure in the 2022 annual plan. 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. The research We expect that burden of disease can largely be reduced by addressing the following key-points: Increasing public awareness of heart failure Early detection of heart failure Stimulating the collaboration among all (different) disciplines within the field of health failure Initiation of research consortia for innovative treatment and management of heart failure patients Furthermore, this project will not only focus on positively influencing survival but also on optimizing the patient’s quality of life and will pursue a strategic and operational approach.
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Right Heart Care In the Right Place

2023
Atrial fibrillation and heart failure are two of the major cardiovascular challenges of our time. It is important that these conditions are detected in time and treated according to guidelines. This is far from always the case. It is sometimes not clear that certain symptoms are caused by atrial fibrillation or heart failure, neither to the patient himself nor to health care providers. As a result, it sometimes takes a long time before someone receives the right treatment. The chronic nature of heart diseases such as atrial fibrillation and heart failure also means that patients with these conditions are seen by many healthcare providers. To achieve this in a high-quality and transparent manner, optimal cooperation between the various care domains is necessary. It is important that the principle of right care in the right place (JZOJP) is applied. However, network care is complex and the effective organization of JZOJP by the right healthcare professional is still far from commonplace despite the many initiatives. The origin Better treatment of these conditions was a priority on the cardiovascular disease research agenda. This is why the Dutch Heart Foundation and ZonMw have started the thematic collaboration “Right Heart Care In the Right Place". By combining expertise, we want to detect as many people as possible with atrial fibrillation and heart failure early and treat them optimally. We are doing this in various ways: jointly setting up subsidy rounds to support regional collaborations, supporting a national support structure for the regions and overarching activities that contribute to knowledge development. As part of Right Heart Care In the Right Place, the network program of the Dutch Society of Cardiology, NVVC Connect, together with involved network partners, facilitates an adequate national support structure for affiliated regional collaborations, or Connect regions. The Connect regions are supported and guided in, for example, preparing the subsidy application and they receive support during the implementation of the regional transmural agreements. The research The Right Heart Care In the Right Place consists of two forms of support: the National Impulse: the aim is to set up a sustainable national support structure that stimulates and guides regions in the regional design and implementation of network care in the field of atrial fibrillation and heart failure the Regional Impulse: the aim of the Regio-Impulse Cardiac Care is to support regional alliances, the Connect regions, in implementing regional transmural agreements. By bringing together the various care providers from the 3rd, 2nd and 1st line, these collaborative ventures jointly offer cardiological care for atrial fibrillation or heart failure more integrally and transmurally. In this way, the patient comes into contact with the healthcare provider who can best contribute to the care need at that moment. A maximum of 22 Connect regions can receive funding to implement the transmural agreements or to optimize the implementation in their region.
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