PhD Conferral Mrs. Judith H.G. van Haare, MSc.

Keywords: endothelial dysfunction, microvascular angina, glycocalyx, imaging, perfusion, obesity

"Microvascular dysfunction as an early hallmark of cardiac disease”

In the Netherlands, more than 400,00 patients are diagnosed with angina pectoris, i.e. chest pain, each year. These symptoms result from a lack of oxygen experienced by the cardiac muscle. For a long time, abnormalities of the coronary arteries were considered responsible for this process. However, in more than 40% of patients with angina pectoris, the symptoms do not result from coronary occlusions. In these cases, the symptoms may be caused by coronary microvascular dysfunction. This is called microvascular angina (MVA). We also studied the role of glycocalyx, a protective gel layer lining the inside of all blood vessels. Glycocalyx is involved in various functions of blood vessel walls. In a preclinical obesity animal model and a clinical setting, research has been conducted using two techniques to image the small vessels, namely sublingual or muscular camera measurements and cardiac MRI measurements. Glycocalyx is shown to be one of the modulators of cardiac muscle perfusion. Therapeutic interventions aimed at glycocalyx may repair microvascular dysfunction. Sublingual camera measurements seem to be a promising diagnostic method to detect microvascular dysfunction in clinical practice.