Center of Excellence: Pulmonary hypertension & Thrombosis
While pulmonary hypertension research almost exclusively takes place at the VUmc, thrombosis research is entirely located at the AMC. As such, research in both locations is highly complementary. Research in both themes is clinically focused and strongest in areas of diagnosis, patient monitoring (including imaging), specific women’s issues in thrombosis and hemostasis, clinical trials, and hemophilia. Basic research is still developing and strong collaborations already exist between clinical departments (internal medicine, pulmonology, cardiology, neurology, nuclear medicine, gynaecology and obstetrics, pediatrics, intensive care medicine) and research departments (experimental vascular medicine, physiology, reproductive medicine). Integrated within the themes of pulmonary hypertension (PH) and thrombosis are strong, well-funded groups working on cardiac function, respiratory muscle function, and on lung endothelial barrier function in ARDS.
Research in the field of thrombosis and haemostasis covers all aspects, including the etiology, diagnosis and treatment. The etiology research line aims to identify novel genetic risk factors, by means of classical linkage analysis and next generation whole exome sequencing in families that have been collected because of an unexplained tendency to familial venous thromboembolism. This research line has been extremely successful in the translation of findings to the clinical implications of thrombophilia. Large, multicentre clinical research into improving the diagnosis of both deep vein thrombosis as well as pulmonary embolism has been initiated by AMC researchers and remains a focus as many questions need to be solved. With respect to treatment, AMC researchers are internationally active and leading several international clinical studies with novel anticoagulant agents to optimize treatment of venous thrombosis. We focus on specific patient groups, such as women with thrombophilia, pregnant women with venous thrombosis, and patients with cancer-associated thrombosis.
Pulmonary circulation and right heart failure
Pulmonary hypertension research at the VUmc is focused on phenotyping of patient cohorts and careful monitoring of right heart function. In an extensive program for translational research, new therapeutic approaches are tested in vitro, in animal models and subsequently in relatively small but well-structured proof-of-concept investigator initiated clinical trials. Preclinical research of the pulmonary circulation and right heart failure is based on a strong collaboration between the departments of Physiology and Pulmonary Medicine. In addition, many patients are enrolled in large international randomized clinical trials of new PH medications.
Respiratory muscle stress in the critically ill
Patients with PH -and with other lung diseases- develop weakness of the (respiratory) muscles, a weakness which rapidly worsens during admission to the intensive care unit (ICU) and frequently leads to death. VUmc and AMC departments (Physiology and ICU VUmc and AMC) combine work on respiratory muscle biopsies with the monitoring of in vivo respiratory muscle function and patient-ventilator interaction to determine the pathophysiology of respiratory muscle weakness. In collaboration with pharmaceutical companies, the ability of novel compounds to restore respiratory muscle function is tested in vitro as well as in patients.