Cardiology 1

Vascular Biology and Intervention

Principal investigator

Prof.Dr E.E. van der Wall, Prof.Dr A. van der Laarse, Prof.Dr J.W. Jukema

Aim and focus

This programme encompasses basic, clinical (both diagnostic and therapeutic) and genetic research in the field of coronary atherosclerosis, in particular lipid metabolism, vascular biology, molecular plaque imaging, and novel therapeutic interventions. To this purpose, the collaboration in the working group Leiden Vascular Medicine (LVM) and Center for Medical Systems Biology (SMSB) aims to apply innovative multidisciplinary genomics and bioinformatics to improve diagnosis, therapy and prevention of common and rare diseases.

Content / highlights / achievements

In a recently launched programme, called DIACARM (DIAbetes CArdiovascular Risk Management), diabetic patients who are asymptomatic for cardiovascular disease are tested thoroughly for cardiovascular risk factors (in collaboration with the Department of Endocrinology and the Department of Nephrology).
Noninvasive imaging of coronary artery disease is an important focus in this programme, aiming at integration of intravascular echocardiography, nuclear cardiology, magnetic resonance imaging (MRI), and multislice computer tomography (CT) in cooperation with the Department of Radiology. Important in this programme is the future routing of patients with low, intermediate, high and very high risk of cardiovascular complications.
The first of the MISSION! programmes is devoted to patients admitted with acute myocardial infarction. This guideline implementation programme includes pre-hospital, in-hospital and post-clinical phases, involving all different health care providers in the Leiden area. Family physicians and ambulance personnel have been instructed to diagnose and transport the patient suffering from acute myocardial infarction according to guideline protocols, followed by primary percutaneous coronary intervention in the cathlab.
Patients with drug-refractory angina pectoris receive “stem cell” therapy to relieve angina and improve left ventricular function using autologous bone marrow-derived mononucleated cells, including mesenchymal stem cells (MSCs). These cells are injected into myocardial areas by transarterial catheter in cooperation with the Department of Hematology. These studies have shown that this cell therapy is safe, does not cause arrhythmias, contributes to relief of angina, reduces the number of segments with stress-induced ischemia, improves myocardial perfusion, and increases left ventricular diastolic and systolic function.

Future themes

• Genetic studies in large patient groups, such as collected in the GENDER/CONCOR study, will provide information about molecular processes that are implicated in restenosis after successful percutaneous coronary intervention.
• Stem cell research will lead to better selection of cell types, choice of pre-treatment of stem cells to guide differentiation, electrical properties and contractile capacities, and improve the number of stem cells that – after injection – remain present in the myocardium.Cohesion within the LUMC

Cohesion within the LUMC

Main goal of the research in the “Vascular Biology and Intervention” programme is to enhance the link between clinical and preclinical research in atherosclerosis and restenosis by means of an integrated approach of vascular cardiology/biology by collaborative clinical and preclinical research lines. To this purpose, the collaboration in the working group Leiden Vascular Medicine (LVM) and Center for Medical Systems Biology (SMSB) is very successful.

Key publications

Djaberi R, Schuijf JD, de Koning EJ, Pereira AM, Rabelink TJ, t Roodt JO, Smit JW, Spaans M, Jukema JW, Bax JJ. Potential of carotid intima media thickness to identify patients with diabetes mellitus at risk for coronary heart disease. J Am Coll Cardiol 2008; 51: 287-97.
IF 11.054

Grauss RW, van Tuyn J, Steendijk P, Winter EM, Pijnappels DA, Hogers B, Gittenberger-de Groot AC, van der Geest R, van der Laarse A, de Vries AAF, Schalij MJ, Atsma DE. Forced myocardin expression enhances the therapeutic effect of human mesenchymal stem cells after transplantation in ischemic mouse hearts. Stem Cells 2008; 26: 1083-93.
IF 7.531

Henneman MM, Schuijf JD, Pundziute G, van Werkhoven JM, van der Wall EE, Jukema JW, Bax JJ. Noninvasive evaluation with multislice computed tomography in suspected acute coronary syndrome. J Am Coll Cardiol 2008; 52: 216-22.
IF 11.054

Pons D, de Maat MPM, Zwinderman AH, de Winter RJ, Tio RA, Doevendans PAFM, Jukema JW. Epigenetic mechanisms may play a role in the susceptibility of diabetic patients to Restenosis after a percutaneous coronary intervention: A study in diabetic and nondiabetic patients. J Am Coll Cardiol 2008; 51: 284-94.
IF 11.054

Pons D, de Maat MPM, Zwinderman AH, de Winter RJ, Tio RA, Doevendans PAFM, Jukema JW. Genetic variation in the galectin 3 gene associates with angiographic restenosis after percutaneous coronary interventions. J Am Coll Cardiol 2008; 51: 287-97.
IF 11.054

Pundziute G, van Werkhoven JM, Schuijf JD, Jukema JW, Decramer I, Sarno G, Vanhoenacker PK, Reiber JHC, Wijns W, Bax JJ. Coronary plaque assessment with multi-slice computed tomography and virtual histology intravascular ultrasound in symptomatic patients with type 2 diabetes. J Am Coll Cardiol 2008; 51: 140-8.
IF 11.054

Scholte AJHA, Schuijf JD, Stokkel MP, de Roos A, Bax JJ. The difficulty of adequate risk stratification for patients with asymptomatic diabetes. Circulation 2008; 118: 65-8.
IF 12.755

van der Hoeven BL, Liem SS, Jukema JW, Suraphakdee N, Putter H, Dijkstra J, Atsma DE, Bootsma M, Zeppenfeld K, Oemrawsingh PV, van der Wall EE, Schalij MJ. Sirolimus-eluting stents versus bare-metal stents in patients with ST-segment elevation myocardial infarction: 9-month angiographic and intravascular ultrasound results and 12-month clinical outcome - Results from the MISSION! Intervention study. J Am Coll Cardiol 2008; 51: 618-26.
IF 11.054

van Werkhoven J, Schuijf J, Gaemperli O, Jukema JW, Boersma E, Wijns W, Pundziute G, Scholte A, van der Wall EE, Kaufmann P, Bax J. Enhanced risk stratification in patients with an intermediate pre-test likelihood using multi-slice computed tomography. J Am Coll Cardiol  2008; 51: 143-8.
IF 11.054

Beeres SLMA, Atsma DE, van Ramshorst J, Schalij MJ, Bax JJ. Cell therapy for ischaemic heart disease. Heart 2008; 94: 1214-26.
IF 4.141