Publications by authors named "D H J Thijssen"

279 Publications

Acute Exercise-Induced Changes in Cardiac Function Relates to Right Ventricular Remodeling Following 12-weeks Hypoxic Exercise Training.

J Appl Physiol (1985) 2021 Jun 10. Epub 2021 Jun 10.

Research Institute for Sport and Exercise Sciences, grid.4425.7Liverpool John Moores University, United Kingdom.

Repeated ventricular exposure to alterations in workload may relate to subsequent cardiac remodeling. We examined whether baseline acute changes in right (RV) and left ventricular (LV) function relate to chronic cardiac adaptation to 12-week exercise training. Twenty-one healthy individuals performed 12-week high-intensity endurance running training under hypoxia (fraction of inspired oxygen: 14.5%). Resting transthoracic echocardiography was performed before and after the training programme to assess ventricular structure, function and mechanics (including strain-area/volume loops). In addition, we examined systolic cardiac function during recumbent exercise under hypoxia at baseline (heart rate of 110-120 bpm, 'stress echocardiography'). Fifteen individuals completed training (22.0±2.4y, 10 male). Hypoxic exercise training increased RV size, including diameter and area (all p<0.05). With exception of an increase in RV fractional area change (p=0.03), RV function did not change post-training (all p>0.05). Regarding the RV strain-area loop, lower systolic and diastolic slopes were found post-training (p<0.05). No adaptation in LV structure, function or mechanics were observed (all p>0.05). To answer our primary aim, we found that a greater increase in RV fractional area change during baseline stress echocardiography (r=-0.67, P=0.01) inversely correlated with adaptation in RV basal diameter following 12-week training. In conclusion, 12-week high-intensity running hypoxic exercise training induced right-sided structural remodeling, which was, in part, related to baseline increase in RV fractional area change to acute exercise. These data suggest that acute cardiac responses to exercise may relate to subsequent RV remodeling after exercise training in healthy individuals.
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http://dx.doi.org/10.1152/japplphysiol.01075.2020DOI Listing
June 2021

Exercise-Based Cardiac Rehabilitation and All-Cause Mortality Among Patients With Atrial Fibrillation.

J Am Heart Assoc 2021 Jun 5;10(12):e020804. Epub 2021 Jun 5.

Liverpool Centre for Cardiovascular Science University of Liverpool and Liverpool Heart & Chest Hospital Liverpool United Kingdom.

Background There is limited evidence of long-term impact of exercise-based cardiac rehabilitation (CR) on clinical end points for patients with atrial fibrillation (AF). We therefore compared 18-month all-cause mortality, hospitalization, stroke, and heart failure in patients with AF and an electronic medical record of exercise-based CR to matched controls. Methods and Results This retrospective cohort study included patient data obtained on February 3, 2021 from a global federated health research network. Patients with AF undergoing exercise-based CR were propensity-score matched to patients with AF without exercise-based CR by age, sex, race, comorbidities, cardiovascular procedures, and cardiovascular medication. We ascertained 18-month incidence of all-cause mortality, hospitalization, stroke, and heart failure. Of 1 366 422 patients with AF, 11 947 patients had an electronic medical record of exercise-based CR within 6-months of incident AF who were propensity-score matched with 11 947 patients with AF without CR. Exercise-based CR was associated with 68% lower odds of all-cause mortality (odds ratio, 0.32; 95% CI, 0.29-0.35), 44% lower odds of rehospitalization (0.56; 95% CI, 0.53-0.59), and 16% lower odds of incident stroke (0.84; 95% CI, 0.72-0.99) compared with propensity-score matched controls. No significant associations were shown for incident heart failure (0.93; 95% CI, 0.84-1.04). The beneficial association of exercise-based CR on all-cause mortality was independent of sex, older age, comorbidities, and AF subtype. Conclusions Exercise-based CR among patients with incident AF was associated with lower odds of all-cause mortality, rehospitalization, and incident stroke at 18-month follow-up, supporting the provision of exercise-based CR for patients with AF.
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http://dx.doi.org/10.1161/JAHA.121.020804DOI Listing
June 2021

Cocoa-flavanols enhance moderate-intensity pulmonary [Formula: see text] kinetics but not exercise tolerance in sedentary middle-aged adults.

Eur J Appl Physiol 2021 May 10. Epub 2021 May 10.

School of Sport and Exercise Science, Liverpool John Moores University, Byrom Street, Liverpool, L3 3AF, UK.

Introduction: Cocoa flavanols (CF) may exert health benefits through their potent vasodilatory effects, which are perpetuated by elevations in nitric oxide (NO) bioavailability. These vasodilatory effects may contribute to improved delivery of blood and oxygen (O) to exercising muscle.

Purpose: Therefore, the objective of this study was to examine how CF supplementation impacts pulmonary O uptake ([Formula: see text]) kinetics and exercise tolerance in sedentary middle-aged adults.

Methods: We employed a double-blind cross-over, placebo-controlled design whereby 17 participants (11 male, 6 female; mean ± SD, 45 ± 6 years) randomly received either 7 days of daily CF (400 mg) or placebo (PL) supplementation. On day 7, participants completed a series of 'step' moderate- and severe-intensity exercise tests for the determination of [Formula: see text] kinetics.

Results: During moderate-intensity exercise, the time constant of the phase II [Formula: see text] kinetics ([Formula: see text]) was decreased by 15% in CF as compared to PL (mean ± SD; PL 40 ± 12 s vs. CF 34 ± 9 s, P = 0.019), with no differences in the amplitude of [Formula: see text] (A[Formula: see text]; PL 0.77 ± 0.32 l min vs. CF 0.79 ± 0.34 l min, P = 0.263). However, during severe-intensity exercise, [Formula: see text], the amplitude of the slow component ([Formula: see text]) and exercise tolerance (PL 435 ± 58 s vs. CF 424 ± 47 s, P = 0.480) were unchanged between conditions.

Conclusion: Our data show that acute CF supplementation enhanced [Formula: see text] kinetics during moderate-, but not severe-intensity exercise in middle-aged participants. These novel effects of CFs, in this demographic, may contribute to improved tolerance of moderate-activity physical activities, which appear commonly present in daily life.

Trial Registration: Registered under ClinicalTrials.gov Identifier no. NCT04370353, 30/04/20 retrospectively registered.
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http://dx.doi.org/10.1007/s00421-021-04682-9DOI Listing
May 2021

The association between treatment and systemic inflammation in acromegaly.

Growth Horm IGF Res 2021 Apr-Jun;57-58:101391. Epub 2021 Apr 30.

Department of Internal Medicine, Radboud University Medical Center, Nijmegen, the Netherlands.

Objective: Acromegaly is characterized by an excess of growth hormone (GH) and insulin like growth-factor 1 (IGF1), and it is strongly associated with cardiovascular diseases (CVD). Both acute and long-lasting pro-inflammatory effects have been attributed to IGF1. Previous results suggest the presence of systemic inflammation in treated patients. Here we assessed the association between treatment of acromegaly, systemic inflammation and vascular function.

Design: Ex vivo cytokine production and circulating inflammatory markers were assessed in peripheral blood from treated and untreated acromegaly patients (N = 120), and compared them with healthy controls. A more comprehensive prospective inflammatory and vascular assessment was conducted in a subgroup of six treatment-naive patients with follow-up during treatment.

Results: Circulating concentrations of VCAM1, E-selectin and MMP2 were higher in patients with uncontrolled disease, whereas the concentrations of IL18 were lower. In stimulated whole blood, cytokine production was skewed towards a more pro-inflammatory profile in patients, especially those with untreated disease. Prospective vascular measurements in untreated patients showed improvement of endothelial function during treatment.

Conclusions: Acromegaly patients are characterized by a pro-inflammatory phenotype, most pronounced in those with uncontrolled disease. Treatment only partially reverses this pro-inflammatory bias. These findings suggest that systemic inflammation could contribute to the increased risk of CVD in acromegaly patients.
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http://dx.doi.org/10.1016/j.ghir.2021.101391DOI Listing
April 2021

EXERCISE MODALITY, BUT NOT EXERCISE TRAINING, ALTERS THE ACUTE EFFECT OF EXERCISE ON ENDOTHELIAL FUNCTION.

J Appl Physiol (1985) 2021 May 6. Epub 2021 May 6.

Research Institute for Sport and Exercise Sciences, grid.4425.7Liverpool John Moores University, United Kingdom.

Purpose: We used a within-subject cross-over design to examine the impact of exercise modality, i.e. resistance (RT) and endurance (END), on the acute impact of exercise on endothelial function. Secondly, we examined whether 4-week exercise training altered the exercise-induced change in endothelial function in healthy individuals.

Methods: Forty young healthy men (21±2 years) reported to our laboratory to complete assessment of endothelial function (using the brachial artery flow-mediated dilation test [FMD]) before and immediately after a single bout of RT (leg-extension) or END (cycling). Subsequently, participants completed a 4-week period of training (12 sessions), followed by evaluation of the FMD before and after a single bout of exercise. Following a 3-week washout, participants repeated these experiments with the different exercise modality (in a balanced cross-over design).

Results: An Exercise*Modality-interaction effect was found (P=0.003), with post-hoc analysis revealing a decrease in FMD after END (P=0.03 and P<0.001, pre and post training respectively), but no change in FMD after RT (P=0.06 and P=0.39, before and after the training intervention respectively). Four weeks of exercise training did not alter the acute effect of exercise on FMD (Acute*Training*Modality effect: P=0.63), an effect independent of the modality of exercise (Acute*Training interaction: P=0.46 and P=0.11 in RT and END respectively).

Conclusion: We found that exercise modality, but not exercise training, alters the effect of acute exercise on endothelial function in healthy subjects. Specifically, endurance exercise, but not resistance exercise, causes a decrease in brachial artery endothelial function, which was unaffected by 4 weeks of training.
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http://dx.doi.org/10.1152/japplphysiol.00004.2021DOI Listing
May 2021