The impact
The impact of CRUCIAL’s work is to assess microvascular rarefaction in people with comorbidities such that they can be identified as having early symptoms of HFpEF and/or VCI. Our second impact is to study mechanisms of rarefaction, to investigate how it will be possible to stop rarefaction from occurring.
Management and treatment of disorders that arise from highly prevalent comorbidities in Europe (hypertension, aging, diabetes, obesity, etc.) is one of the biggest challenges facing medicine today:
- In Europe, approximately 10.5 million people are suffering from dementia. The associated overall health care costs for dementia are about €790 billion of which 40% is at the cost of VCI.
- Every year in Europe, 3.6 million people are newly diagnosed with HF. It is the most prominent cause of hospitalizations, with an economic cost of billions of euros per year (ESC).
- Up to 70% of all patients with HFpEF are female 98. VCI is more common in men, but given the same comorbidities, the relative risk of developing cognitive impairment is higher for women 99.
- With increasing rates of obesity and Type 2 diabetes and with an increasingly older population, the prevalence of these diseases can only increase.
The impact of CRUCIAL’s work is to assess microvascular rarefaction in people with comorbidities such that they can be identified as having early symptoms of HFpEF and/or VCI. Our second impact is to study mechanisms of rarefaction, to investigate how it will be possible to stop rarefaction from occurring.
Development of biomarkers for more accurate diagnosis/prognosis
Every organ needs blood flow to deliver oxygen and nutrients. Our larger vessels are our delivery “highways” to the tissues and the microvasculature is where the exchange of oxygen and nutrients actually occurs. Because microvessels are so small, their health and functioning have never been evaluated as a diagnostic tool. CRUCIAL aims, in one part, at addressing this diagnostic gap by developing both imaging biomarkers (MRI measurements, OCT angiograph, Glycocheck) and non-imaging biomarkers (microvesicles) of microvascular rarefaction.
Improved prognosis and management of co- and multimorbidities
Being able to measure microvascular rarefaction means that we can assess the role of microvascular rarefaction in these diseases and identify which at risk patients will precede to develop HFpEF and/or VCI. CRUCIAL will investigate whether rarefaction correlates with disease severity and can be used as an early diagnosis tool. Together, these findings will allow us to identify the underlying pathophysiological processes in VCI and HFpEF at an earlier stage, thereby will allow us to reduce cost of treatment and improve the quality of life.
Improved therapeutic options to manage co- and multi-morbidities
There is little research into therapies targeting microvascular health specifically and even less aimed at altering the vascular regression process. Therefore, CRUCIAL also aims to specifically study how to prevent or reverse microvascular rarefaction by identifying the molecular pathways involved. If we can identify at risk patients early and prevent rarefaction, then we would prevent disease onset. Our proposal includes aspects of basic investigation of the molecular cause of vessel regression in these disorders. The current option of treating only the underlying comorbidities and symptoms (e.g. diet changes, anti-hypertensive drugs, etc.) is ineffective and only delays rather than prevents development of VCI and HFpEF 109, 110.
This project has received funding from the SESAR Joint Undertaking under the European Union’s Horizon 2020 research and innovation programme under grant agreement No 848109.