DEFENCE

In the past decade, there has been significant progress in understanding sex- and gender-based differences in cardiovascular diseases (CVD). However, this knowledge remains scattered across medical literature, highlighting the need for a centralized platform accessible to healthcare professionals, scientists, policymakers, and patients. The IMPRESS consortium aims to establish a knowledge platform focused on gathering, summarizing, and prioritizing existing knowledge related to sex- and gender-specific aspects of CVD. This initiative seeks to promote the implementation of existing knowledge into clinical practice, identify knowledge gaps, and inform policymakers about areas requiring additional attention. In substantial portions of women with symptoms of myocardial ischemia, obstructive disease in the epicardial coronary arteries is absent. Currently, such women undergo multiple diagnostic tests, which do not always result in a conclusive diagnosis. IMPRESS seeks to reduce missed and delayed diagnoses of heart diseases in women, improving cardiovascular care outcomes nationwide. The knowledge platform will serve as a national resource, fostering collaboration and supporting the adoption of sex- and gender-sensitive practices in cardiovascular medicine. The Research IMPRESS consolidates existing knowledge, fosters research, and implements findings into practice wherever possible (for example by creating a Decision Support Tool for primary care and for cardiologists). Within the IMPRESS consortium, the following studies are being conducted: Delphi study: delayed or missed diagnosis of heart disease Silent heart attacks: causes, symptoms, and risk factors of silent myocardial infarctions UMCU-IMPRESS pilot study: undetected coronary microvascular disease (CMD) Peripheral-Flow: LASCA technique in CMD Dutch registry of coronary function tests   The origin In the past decade, the understanding of sex- and gender differences in CVD has considerably improved. However, relevant evidence is scattered throughout the medical literature. There is a need to make this information easily accessible to health care professionals, scientists, policy makers and patients. Implementation of existing knowledge in clinical practice will then be promoted, knowledge gaps identified, and policy makers informed on the areas that need additional attention. This is also of high importance to the Dutch Heart Foundation, which therefore funded the IMPRESS consortium; a collaboration between several DCVA partners; the Nederlandse Vereniging voor Cardiologie (NVVC), WCN, Netherlands Heart Institute (NLHI), ZonMw and the Dutch Heart Foundation, supported by the DCVA.  

The focus of this project is to develop a novel home-based exergaming system aimed at enhancing resistance to falls among individuals post-stroke. Preventing falls and fall-related injuries, minimizes healthcare utilization and societal costs and supports stroke survivors in maintaining independence in daily life. The Research The HEROES system is designed to target balance perturbations and improve stepping responses. It utilizes action observation and motor imagery techniques to personalize training for individuals with stroke. Stroke survivors will undergo a single training session in a rehabilitation center to practice recovering from real balance perturbations before using HEROES at home. The effectiveness of the HEROES-system will be assessed through a proof-of-principle randomized controlled trial (RCT) involving 60 stroke survivors, evaluating its impact on fall resistance and balance enhancement post-stroke. The approach of involving stroke survivors sets HEROES clearly apart from the currently available home-based exergames, which uses ‘healthy’ people and lack the required personalization of different post-stroke individuals. Origin This project is funded within the Innovative Medical Devices Initiative (IMDI) program 'Heart for Sustainable Care'. The focus of this program is the development of medical technology for the earlier detection, monitoring, and better treatment of cardiovascular diseases to ensure accessible healthcare and sufficient staffing. The program has been developed en funded by the Dutch Heart Foundation, ZonMw and NWO, who collaborate within the Dutch CardioVascular Alliance.