Ever since the Medical Faculty of the Maastricht University was founded, research on cardiovascular diseases has had a prominent place in this faculty. In 1988 the Maastricht research efforts on cardiovascular diseases were concentrated in the Cardiovascular Research Institute Maastricht (CARIM), an institute under the Dutch University Education Act (WWO). In 1992 CARIM together with the Institute for Cardiovascular Research (ICaR) of the Free University in Amsterdam was recognized as a Research School on Cardiovascular Diseases by the Royal Netherlands Academy of Arts and Sciences, a recognition which was extended for another 5 years in 1997 and 2002. In various reviews performed by the Academy CARIM received the highest grading possible for its research and training program. In 1993 CARIM received the recognition as training centre for postdoctoral fellows from the European Union in the framework of the Human Capital and Mobility Program. In 2000 this support was renewed when CARIM received support as a EU-Marie Curie training site.

The importance of the subject for public health is obvious. Cardiovascular disorders, often caused by atherosclerosis, are at the root of a large number of serious diseases, and cause about half of all mortalities. Since it would be impossible to study all aspects of cardiovascular diseases, CARIM has set priorities for the main lines of research, based on the available expertise and the relevance for health care. Three main areas of research can be distinguished within the institute:

1. research focusing on thrombosis and hemostasis. These research activities are largely concentrated in 4 programs;
2. research on the functioning of the normal and failing heart, and on the possibilities for detecting and treating high risk cardiac patients. These research activities are concentrated in 5 programs.
3. research focusing on vascular biology of both large and small vessels.

These research activities are also concentrated in 5 programs. Each program is led by one to three principal investigators (PI's). The PI's are responsible for the scientific progress of their program, the mentoring of their PhD-students and post-docs and the financial basis of their program.

All three themes of research involve fundamental as well as clinical studies. The institute has expertise in a wide range of areas, ranging from molecular biology to population-based studies. Its goal is to focus on clinically important questions, integrating knowledge from molecule to patient. Activities within the three main areas of research are not isolated entities, since close cooperation exists both between and within the main research areas. The research areas within CARIM are depicted schematically in the figure below. top

MAIN THEME 1: THROMBOSIS AND HAEMOSTASIS

sub themes

programmes

A

Humoral aspects

Structure and function of coagulation factors

Pathophysiology of thrombin formation

Regulation of thrombin formation by antithrombotic drugs

FXa and thrombin formation at macroscopic surfaces

B

Cellular aspects

Signal transduction in platelets and endothelial cells

Mechanism and regulation of procoagulant cell surfaces

Lupus anticoagulants and "antiphospholipid syndrome"

C

Vascular aspects

Vit K-dependent carboxylase enzyme-substrate interactions

Uptake and biological availability of K-vitamins

Role of Vit K-dependent proteins in atherosclerosis

Annexin V: apoptosis, thrombosis and athero­sclerosis

D

Clinical aspects

Pathophysiology of arterial thrombosis

Blood coagulation and organ failure

MAIN THEME 2: CARDIAC FUNCTION AND FAILURE

sub themes

programmes

A

Ischemic damage and adaptation

Acute ischemic cardiac injury

Prevention and treatment of post-operative myocardial ischemia

Programmed cell survival and cell death

Functional adaptation and wound healing and tissue adaptation after myocardial infarction

B

Cardiac metabolic disorders

Disturbances in the regulation of cardiac substrate uptake and utilization

Genetic control of cardiac metabolism

Disturbed myocardial energy metabolism and calcium homeostasis

C

Cardiac mechanical dysfunction

Mechanical heterogeneties and dysfunction in the intact heart

Mechanical dysfunction in cardiac cells

Non-pharmacological interventions and devices in heart failure

Clinical approach to cardiac failure

D

Cardiac arrhythmias

Pathophysiological mechanisms of atrial fibrillation

Ventricular arrhythmias

Clinical aspects of cardiac arrhythmias

E

Cardiac genomics

Cardiovascular genetics and genomics

MAIN THEME 3: VASCULAR BIOLOGY

sub themes

programmes

A

Vascular development

Angiogenesis

B

Vascular model and remodelling

Non invasive assessment of human vascular function

Experimental vascular remodelling

C

Predisposition to vascular disease

Predisposition to disturbances in the circulation and therapeutic interventions

Predisposition to insulin resistance/familial combined hyperlipidemia/diabetes mellitus

D

Mechanism of vascular occlusion

Microvascular aspects of vascular occlusion

Atherogenesis and inflammation

The instabile atherosclerotic plaque

E

Vascular medicine

Clinical vascular medicine

Occlusive vascular disease

Imaging of vascular disease

Vascular growth

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