Comparison of cardiovascular structure and function in physical active subjects with or without myocardial infarction

The World Health Organization has reported that that since 1990, more people
have died worldwide from cardiovascular disease (CVD) than any other cause.
Previous studies support a strong inverse relationship between the amount of
physical activity CVD morbidity and mortality.
While physical inactivity is considered an important independent risk factor
for the development of CVD and atherosclerosis and increased physical activity
(i.e. exercise) is beneficial in the prevention and treatment of CVD, the
mechanisms that underlie the beneficial effects of physical activity are still
largely unknown. It appears that only ~60% of the beneficial effects of
exercise could be attributed to favourable changes in traditional risk factors
such as lipids, cholesterol, high blood pressure, etc. Plausible proposed
mechanisms for exercise-induced coronary heart disease protection include
improved endothelial function, attenuated plaque progression, stabilization of
vulnerable plaques, infarct sparing due to myocardial preconditioning,
correction of autonomic imbalance, reduction in myocardial oxygen demand,
decreased thrombosis, enhanced collateralization, and decreased inflammatory
mediator release. Although physical exercise seems to be a powerful preventive
tool for CVD, it is known that CVD and myocardial infarction (MI) occur in
physically active populations. Interestingly, post-mortem studies from the
1960s do not reveal any association between coronary atherosclerosis and
different levels of physical activity.
To further enhance the knowledge on potential underlying mechanism of CVD and
the role of physical activity level, the main objective of this proposal is to
compare cardiovascular structure and function in habitual physical active
subjects with or without MI.

To assess cardiovascular structure and function, physical capacity and
traditional CVD risk factors in i) physical active subject with MI and ii)
physical active subjects without MI.

Exploratory Observational study

Noninvasive vascular and cardiac testing procedures in this study are not
related to any potential risk for the participant. Headache and dizziness of
short duration may occur following nitroglycerin spray. Although inflation of
the blood pressure cuff during the vascular measurements may induce a slight
uncomfortable sensation, this is brief (5 minutes) and stops when the cuff is
deflated. A possible complication of venipuncture is a hematoma, which is
induced in ~5% of all cases. To prevent complications, the blood withdrawal
will be performed by an experienced professional and sufficient pressure will
be provided after withdrawal of the needle.
At the department of Physiology, we have a long-standing tradition in
performing the non-invasive testing as used in this present study, i.e.
exercise test, cardiac and vascular function and structure measurements. All
procedures are performed routinely at the Department of Physiology and have
been accepted by the ethics committee in numerous previous applications in
healthy as well as various patients groups. Maximal cycling tests will be
performed at the hospital under supervision of highly qualified personnel.
Participants may experience benefits upon participation, as they will obtain
extensive information on their cardiovascular health and physical fitness
status.
Findings of this study will contribute to further enhance our understanding on
potential underlying mechanism of CVD and the role of physical activity.