OUTREACH

2021

The successful treatment of congenital heart disease (ConHD) has greatly increased the survival of children with this condition. Many of these defects require surgical or catheter interventions immediately after birth. However, complete restoration of the defect is often unachievable, a high risk of developing heart failure, arrhythmias, sudden cardiac death or blood vessel dilatation or stenosis relatively early in life.

Currently, there is a lack of personalized risk predictors and optimal clinical decision tools, highlighting an unmet need to develop new effective strategies for treating and preventing ventricular failure, arrhythmias, and large vessel diseases.

The Focus
The OUTREACH consortium focuses on specific types of congenital heart diseases (ConHD) related to outflow tract defects, such as transposition of the great arteries, congenital aortic stenosis, and tetralogy of Fallot, which collectively account for over half of all ConHD cases. The goal of OUTREACH is to reduce the risk of mortality and morbidity and improve the quality of life for these patients (both children and adults) by improving follow-up practices based on outcomes, implementing personalized risk assessment tools, and advancing therapeutic strategies.

The Research
The OUTREACH consortium integrates expertise in preclinical research, developmental biology, disease modeling, and clinical research from academic centers specializing in pediatric and adult congenital cardiology and surgery. Its objectives are:

  1. identifying better parameters for risk assessment and early detection of heart failure or ventricular arrhythmias in ConHD patients with outflow tract defects.
  2. Exploring efficient treatments to enhance adaptation and prevent heart failure and vascular damage in at-risk ConHD patients.

This consortium conducts extensive research involving a large cohort of ConHD patients to unravel the underlying causes and mechanisms of cardiac adaptations following surgical interventions. It investigates the molecular mechanisms responsible for outflow tract defects and evaluates whether stimulating heart regeneration in ConHD models can mitigate adverse remodeling and heart failure. Additionally, the consortium explores new non-invasive imaging techniques and blood-derived biomarkers to develop innovative risk analysis tools for clinical decision-making. In OUTREACH a nationwide registry is created for all patients (children and adults) with ConHD in the Netherlands by harmonizing existing registries KinCor and ConCor. This is an important step towards optimizing the quality of care for the ConHD population and fostering scientific research on ConHD.

Origin
The Dutch Heart Foundation and Stichting Hartekind, who collaborate within the Dutch CardioVascular Alliance, initiated an invitational grant to start and fund large-scale research aimed at earlier detection and better treatment of the consequences of congenital heart defects.

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Funded

Contact person:

Prof. W.A. Helbing (Wim)

Principal investigators

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COVID@Heart

2020
About 10% of the COVID-19 affected patients develop critical illness with a high mortality rate. This critical illness appears to be strongly linked with cardiovascular disease, as the prevalence of cardiovascular comorbidities and risk factors (such as diabetes and obesity) are often found among hospitalized COVID-19 patients. The consortium COVID@Heart believes that mitigating this cardiovascular burden of Covid-19 should start early, while patients are (still) outside the hospital. The Research COVID@Heart has three core activities: Develop a tool to identify high-risk cardiovascular patients with COVID-19 in a home environment, before the critical illness emerges. This tool will allow general practitioners to better notify high-risk patients, monitor them more closely (e.g. by using home saturation measurements), prescribe preventive cardiovascular medication earlier ('moon shot') and refer them to a hospital promptly when needed. Create a diagnostic tool to improve early differentiation between COVID-19 and a myocardial infarction, addressing the challenge of overlapping symptoms faced by general practitioners. Design a questionnaire supplemented by select biomarkers and blood tests to enhance the detection of cardiovascular disease in COVID-19 survivors experiencing prolonged symptoms of fatigue and shortness of breath, as these symptoms are potentially linked to accelerated subclinical cardiovascular disease. Origin Accurate information on how cardiovascular patients fared while still at home is lacking. This information is crucial to prevent hospital admissions. Therefore, COVID@HEART focuses on people who are not hospitalized but are at home and treated by their general practitioners. The Dutch Heart Foundation supports and funds this research into the best treatment for cardiovascular patients with a coronavirus infection.  
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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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