HBCx

Cardiovascular disease (CVD) and dementia are closely intertwined, often resulting in cognitive impairment among individuals with cardiovascular or cerebrovascular conditions. Approximately one-third of dementia cases are linked to vascular injury, emphasizing that vascular cognitive impairment (VCI) is a preventable aspect of cognitive decline.

The Focus
The Heart-Brain Connection Crossroads (HBCx) consortium investigates hemodynamic alterations as reversible contributors to VCI, seeking to enhance our understanding of the connection between cardiovascular health and cognitive function.

The Research
HBCx builds upon the foundation laid by HBC1 (CVON 2012-06), which established a national network dedicated to studying, diagnosing, and treating VCI. Clinical investigations within HBC1, focusing on patients with chronic heart failure (CHF), carotid occlusive disease (COD), and clinically evident VCI, emphasized the role of hemodynamics along the heart-brain axis in VCI. These findings underscored significant associations between heart-brain connections and VCI.

The HBCx program, launched in 2019, takes a comprehensive approach by investigating hemodynamics in key cardiac conditions such as atrial fibrillation and heart failure, while also exploring vascular factors and their interplay with amyloid pathology. Moreover, HBCx considers modulating factors like age and sex. The program aims to improve early detection, identify treatable targets, and integrate the Heart-Brain Connection approach into routine care. Ultimately, the long-term vision of HBCx is to reduce VCI prevalence among CVD patients through enhanced understanding and innovative treatment strategies.

Grants, awards and Dissertations

  • Alzheimer Nederland (2020) - L. Exalto: Does sexe modulate the phenotype and prognosis of vascular cognitive impairment.
  • Cross Cohort Collaboration, NIH project from Unit Texas - Arfan Ikram.
  • PPS project ÏmProVas" Hartstichting met Quantib and HBC partners (EMC, AUMC, UMCU) - Esther Bron
  • Doeschka Ferro (27-10-2020) Dissertation: Causes and consequences of cerebral microinfarcts Characterizing the “(in)visible”lesion
  • Eline Oudeman (4-7-2019) Dissertation: Transient Neurological Attacks
  • Annebet Leeuwis (2-7-2019): Dissertation: Connecting heart and brain: vascular determinants of cognitive impairment and depressive symptoms
  • Frank Wolters (5-9-2018) Dissertation: On the Origin of Dementia. A Population Perspective on Risk and Aetiology

Publications
A selection:

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Funded

Contact person:

Dr. A. Scholman (Annemarie)

Principal investigators

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PERFECT-FIT

Smoking tobacco and physical inactivity are key preventable risk factors of cardiovascular disease (CVD). Perfect Fit aims to prevent CVD, promote well-being, and reduce healthcare costs, particularly targeting disadvantaged populations where smoking and physical inactivity are prevalent. The Research The project develops tailored, evidence-based, near real-time computer coaching for quitting smoking and enhancing PA. For every individual, a personal model is designed which generates personalized recommendations based on high-quality existing and newly collected data, and adapts to changing circumstances/progress (similar to a TomTom navigation system), using machine learning techniques and incorporating domain-specific expert knowledge (e.g. health behaviour change strategies). Virtual coaches (VCs) communicate advice in a motivating way that fits individuals’ persuasive communication styles. Perfect Fit integrates big-data science, sensor technology, and personalized real-time feedback to support smoking cessation and promote adequate physical activity (in both gym settings and daily life). The key questions of this study are: Which adaptivity is needed to create a robust, safe, and effective interaction between individuals and machines? How can we develop advanced data science methods and embed this in current smoking cessation and PA coaching practice? How do measurement modalities, feedback and communication affect individuals’ smoking status and PA?  
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DEFENCE

2021
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.
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