Research into a stiff heart

“Diastolic heart failure has a major impact on people’s lives. Due to the stiff heart muscle, the heart pumps less blood into the body with each beat. As a result, people are extremely tired and very short of breath. Climbing stairs and cycling are often hardly or no longer possible. Some can no longer even manage independently at home,” says Van Empel. The symptoms can sometimes be reduced with medication, but a cure is not possible. “That is why we are looking for new ways to detect and inhibit the disease.”

Cardiologist Vanessa van Empel

In order to be able to treat diastolic heart failure, it must first be clear why certain people develop this form of heart failure. It is clear that it affects more women than men. Furthermore, people with diabetes, high blood pressure and overweight appear to be at greater risk. However, the cause of the disease is not yet clear. However, there are strong indications that the smallest blood vessels have something to do with it. The research by Van Empel and her team therefore focuses specifically on these smallest branches of the blood vessels, the microcirculation in our body.

Initially, the researchers imaged the vessels with MRI scans to gain insight into the blood flow, capacity and fuel production of the heart. But that turned out to be too stressful for the patient. Therefore, a search was made for how microcirculation could be measured in a different way. “We performed measurements in the skin using a camera and laser light,” says Van Empel.

That sounds strange, information about your heart by not looking at your heart, but it is not. One of the ideas behind ‘stiff heart’ is that it arises because people have something else going on, which causes a mild inflammation in the small blood vessels. This happens in the heart, but also elsewhere in the body. If this hypothesis is correct, people with diastolic heart failure should also have abnormalities in other blood vessels. “A test of the blood vessels in a different location could therefore also say something about the blood vessels in your heart.” All measurements have now been carried out, which has yielded an enormous amount of data. This data will be analyzed and presented at an international conference.

Man Woman
Van Empel’s team is also looking at biomarkers. Signaling substances in the blood that say something about the condition of the small blood vessels. All kinds of data and signal substances from hundreds of people have been measured and stored. This information is also still being analysed. Data that are important not only for predicting a ‘stiff heart’, but also for examining whether there are relevant differences between men and women. If that is the case, it could lead to a more gender-specific approach to the disease: women will be tested and treated differently than men.

The ultimate goal is that people with diastolic heart failure no longer develop serious complaints and can live longer and more vitally. “That would really make a world of difference for patients. It is possible if we succeed in detecting, inhibiting and treating the disease earlier. Of course, our ultimate goal is to find a way to prevent a heart muscle from becoming stiff and thick, so that people don’t get this disease at all. But we are certainly not there yet,” concludes Van Empel.


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