PhD defence L.W. (Laurie) Geenen

The contribution of improved medical therapies and care to pediatric congenital cardiology and surgery, has resulted in an improved life expectancy of children with congenital heart
disease (CHD). Survival of patients with CHD into adulthood has introduced a new field within cardiology that is characterized by an unique population of relatively young adults with a
high incidence of heart failure, arrhythmia, re-operations and premature death. Many of the medical issues in adult patients with CHD are rare, or do not occur in acquired heart disease, the reason why these patients require specialized care. Therefore, this particular field of adult congenital heart disease (ACHD) has received increasing attention and expertise over the last years. Despite the fact that ACHD patients will be confronted with their disease throughout their entire life, and may have concerns about their uncertain longevity, ACHD patients have desires equal to their peers; they want to become pregnant, go on extreme vacations, and participate in sports games. Gaining insight in their disease progression and management in terms of risk stratification and easy monitoring is therefore of great significance, and can contribute to better coping strategies for patients and management of their expectations. Adults with pulmonary hypertension (PH) are characterized by a rapid disease progression resulting in a very poor prognosis. The etiology of PH is highly heterogeneous and symptoms caused by the disease are nonspecific; therefore, PH is a challenging disease for doctors to recognize resulting in a substantial delay between the first onset of symptoms and the diagnosis. PH is also a complex and rare disease that requires care in tertiary centers specialized in PH. Other than ACHD, PH is an acquired disease that can develop at any age, and ultimately leads to early demise. Therapeutic options have evolved over the last years, improving the life expectancy of patients with PH. As the etiology of the disease is diverse, so is the course of the disease, which makes it difficult to adequately estimate prognosis in these patients. Blood biomarkers have potential to help to monitor disease progression and optimization of followup strategies. This thesis investigated the potential value of blood biomarkers in the risk stratification of adults with CHD and adults with PH.

Due to corona, the PhD defences do not take place publicly in the usual way in the Senate Hall or in the Professor Andries Querido Room. The candidates will defend their dissertation either in a small group or online.