PhD defence R.W.B. (Richard) van Duin

Pulmonary hypertension is a pathophysiological disorder that is defined as a mean pulmonary arterial pressure of >25 mmHg at rest. Symptoms include shortness of breath, fatigue, swelling of the legs and exercise intolerance. There are many forms of pulmonary hypertension and each form has its own aetiology and pathophysiology. Some forms originate from the lungs itself, for instance when the pulmonary vasculature is constricted and stiffened. Other forms originate from the legs, where thrombi are formed that follow the blood stream to the lungs and ultimately cause multiple emboli. By far the most prevalent form of pulmonary hypertension originates from dysfunction of the heart. Treatment of this form of pulmonary hypertension is challenging and mostly consists of symptomatic treatment as well as treatment of the underlying heart disease. However, therapies specifically targeting the pulmonary vasculature in this form of pulmonary hypertension are lacking. The research described in this thesis has identified mechanisms that play a role in the pathophysiology of pulmonary hypertension due to left heart failure. The testing of different ways to pharmacologically interfere with these mechanisms has led to a recommendation for the optimal medication to dilate the pulmonary vessels. In addition, the research has shown that the deterioration of right ventricular function in this disease is associated with reduced blood flow to the heart muscle. This finding can lead to improved diagnostics and therapy. In conclusion, the knowledge gathered in this thesis brings us closer to a curative therapy for pulmonary hypertension due to left heart failure.

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.