Description

Diagnosis and treatment of coronary syndromes (PI: Prof. Dr. J.J. Piek)

Diagnosis and treatment of coronary syndromes. This part of the research field on diagnosis and treatment of coronary syndromes involves a close collaboration between preclinical and clinical disciplines with emphasis on a translational program on the topics coronary and left ventricular hemodynamics, therapeutic arteriogenesis and cell therapy. The clinical studies on the aforementioned topics are evaluated using non-invasive (perfusion scintigraphy, magnetic resonance imaging) and invasive diagnostic techniques.

Coronary and left ventricular hemodynamics. This program is performed in close collaboration with the department of medical physics at the Academic Medical Center, University of Amsterdam (Prof. Spaan, Dr. Siebes), the department of cardiology at the Hospital Clinico San Carlos, Madrid, Spain (Prof. J. Escaned) and the department of cardiology at the Imperial College, London, UK (prof. J. Davies), regarding the translation of basic physiological concepts to clinical decision making in the cardiac catheterization laboratory. It involves an integrative analysis of epicardial, microvascular and left ventricular hemodynamics in patient with coronary artery disease using ultrathin sensor-equipped intracoronary guide wires and left ventricular pressure volume-loop catheters. Prof Spaan, Dr. Siebes, Prof. Escaned and Prof. Davies are internationally recognized leaders in this field of interest and members of the writing committee on ESC/ACC/AHA guidelines for coronary hemodynamics.

Therapeutic arteriogenesis. This program is performed in an international oriented working group and in close collaboration with the department of Experimental Cardiology at the University Medical Center Utrecht (Prof. Pasterkamp, Dr. Hoefer) and the department of Cardiology and the department of Biochemistry and Molecular Cell Biology at the Free University Medical Center Amsterdam (Prof. van Royen, Prof. Horrevoets). The main focus of the program is related to therapeutic arteriogenesis, i.e. the stimulation of collateral vascular growth to compensate the negative effects of arterial obstruction, using a bench to bedside approach. We recently performed a large whole-genome array study in patients with coronary artery disease, defining the transcriptome of monocytes (key players in arteriogenesis), showing striking differences in signaling pathways between good and bad collateral responders. Future studies will focus on the validation of these new targets in animal models. Using this reversed bedside to bench approach, we aim to identify new pro-arteriogenic targets available for testing in clinical studies.
Cell therapy. This program is part of the research projects on adjuvant therapy in acute myocardial infarction (AMI). A Dutch multicenter study on cell therapy in the treatment of AMI (the HEBE trial) was coordinated at the AMC as part of the clinical platform of a national cell therapy program supported by the Interuniversity Cardiology Institute of the Netherlands (ICIN) and the Dutch Heart Foundation (NHS). This national program aims to facilitate our insight into fundamental knowledge on this new mode of therapy towards clinical application. The results of the HEBE trial show that the natural humoral and cellular response in AMI is more relevant for left ventricular recovery than the intracoronary administration of stem cells. This novel insight into the key role of monocytes led to a close collaboration with the department of pathology at the Free University Medical Center, Amsterdam (Prof. Niessen) and Harvard Medical School Boston, USA (Prof. Nahrendorf) on this topic of interest to modify these natural responses in AMI.
StatusActive
Effective start/end date1/01/06 → …

ID: 180732