New methods to assess aortic valve and coronary health
On July 3rd, Rob Eerdekens successfully defended his dissertation at the Department of Biomedical Engineering, in which he investigated new measurement methods to better understand how aortic valve stenosis affects the heart, with the aim of improving the timing and effectiveness of treatments.
Aortic valve stenosis is a common heart valve disease that obstructs blood flow from the heart. Current assessments usually take place at rest, while symptoms often arise during physical activity. By researching better methods to measure the severity of the condition during exercise, patients can receive earlier and more targeted treatment.
In his dissertation, investigates the physiology of aortic valve stenosis (AS), with particular focus on the limitations of traditional evaluation methods and the added value of dynamic approaches. This helps doctors better identify which patients with a narrowed heart valve may benefit from early intervention, reducing the risk of complications and improving heart function. Through new indices and evaluations, the goal is to improve the diagnosis and treatment of AS and related coronary artery disease.
Traditional AS assessments are often static and based on measurements at rest, which do not fully capture the valve鈥檚 dynamics during exercise. In his research, Eerdekens introduces a new index, the Stress Aortic Valve Index (SAVI), which provides better insight into the valve鈥檚 behavior under stress. Various studies demonstrate that SAVI is more effective in identifying patients who may benefit from early intervention compared to traditional methods. SAVI also offers improved hemodynamic understanding and supports clinical decision-making.
Coronary impact
Besides focusing on the aortic valve itself, the research also examines the interaction between AS and coronary artery disease. Eerdekens discusses the changes occurring after interventions such as transcatheter aortic valve implantation (TAVI) and surgical valve replacement. These procedures can affect coronary blood flow and the physiology of the heart鈥檚 small vessels (microvasculature). Coronary flow reserve (CFR) measurements improved after these interventions, indicating improved heart function and perfusion of the heart muscle tissue.
In the context of acute heart and coronary conditions such as ST-elevation myocardial infarction (STEMI), microvascular resistance is introduced as an important predictor of long-term outcomes. Parameters like the index of microvascular resistance (IMR) and the microvascular resistance ratio (MRR) prove valuable for assessing prognosis and guiding treatment.
Finally, external factors such as hydrostatic pressure, which can influence coronary measurements and the assessment of stenosis, are also investigated.
With his research, Eerdekens provides valuable new insights into the function of the aortic valve and the complex interactions between aortic stenosis, coronary heart disease, and microvascular changes. It emphasizes the importance of a dynamic and precise approach to AS evaluation, aiming to improve the treatment of patients with aortic valve and coronary conditions.
Title of PhD thesis: 鈥�鈥�
Supervisors: (Catharina Hospital), (McGovern Medical School Houston) and (Catharina Hospital)
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