To investigate the impact of different doses of handgrip exercises (moderate vs high intensity) and stimuli (exercise vs ischemia) on the ability to protect endothelial damage from ischemia-reperfusion injury in healthy humans. A secondary goal is…
ID
Source
Brief title
Condition
- Vascular injuries
Synonym
Research involving
Sponsors and support
Intervention
Outcome measures
Primary outcome
Change in endothelial function (measured with flow-mediated dilation) before
and after IR injury (induced by 15-minute ischemia to the forearm, followed by
20 minutes of reperfusion)
Secondary outcome
The reduction of cardiac injury via the transfer of humoral cardioprotective
agents in ex vivo models of ischemia-reperfusion.
Background summary
Exercise training has strong cardioprotective effects in asymptomatic subjects
as well as those with established cardiovascular risk and/or disease.
Ischaemia-reperfusion (IR) represents a significant and harmful stimulus for
tissues, including the myocardium and the vascular endothelium. Studies have
found evidence that exercise training is associated with reduced endothelial
and cardiac IR injury, which may partly contribute to the protective effects of
exercise training. Possibly, acute bouts of exercise possess the ability to
prevent endothelial IR injury in humans and potentially myocardial rescue.
Recent studies have demonstrated that also handgrip exercise has a distinct
impact on the ability to prevent endothelial and potentially cardiac IR injury.
Such protection through exercise would be similar as observed with ischaemic
preconditioning (IPC), i.e. a validated and successful method to prevent
endothelial IR injury and is typically applied with short episodes of local arm
ischaemia. This raises the question of whether local (forearm) exercise may be
sufficient to induce systemic protective effects. This is highly relevant since
whole-body training is a demanding type of exercise, which might be difficult
to implement in the clinical setting. Local, handgrip exercise, however, would
be more feasible to implement in clinical settings to reduce IR injury.
Previous studies using handgrip exercise have presented conflicting results
which may relate to the intensity of exercise, highlighting that also the dose
of handgrip exercise is crucial for establishing protection.
Study objective
To investigate the impact of different doses of handgrip exercises (moderate vs
high intensity) and stimuli (exercise vs ischemia) on the ability to protect
endothelial damage from ischemia-reperfusion injury in healthy humans. A
secondary goal is to investigate the possible mechanisms by which
preconditioning mediates its beneficial effects on IR damage.
Study design
An explorative randomized cross-over trial.
Intervention
Two sessions of local handgrip exercise (i.e., low and moderate intensities),
one session of ischaemic conditioning, and a control session.
Study burden and risks
Non-invasive cuff occlusion is used to examine endothelial function (5-minute
ischemia) and produce the stimulus that induces IR injury (15-minute ischemia).
Cuff inflation is non-invasive and not associated with a health risk for the
subject. Also, handgrip exercise is not associated with a significant health
risk in our participants. Blood will be drawn three times per session for the
analysis of cardioprotective factors using ex vivo models of IR. The volunteers
will not benefit directly from participating in this study. Participants will
not benefit from participating in this study.
Reinier Postlaan 4
Nijmegen 6525GC
NL
Reinier Postlaan 4
Nijmegen 6525GC
NL
Listed location countries
Age
Inclusion criteria
- Adults >18 years, <64 years.
- BMI < 30kg/m2
- Recreational athlete (i.e. minimal 1h/week exercise, maximal 5 days/week of
exercise)
- Mentally able/allowed to give informed consent.
Exclusion criteria
A potential subject who meets any of the following criteria will be excluded
from participation in this study:
- Presence of an absolute contra-indication for the performance of exercise
(see also SOP Inspanningstest Department of Physiology):
- Acute myocardial infarction (3-5 days)
- Unstable angina
- Uncontrolled arrhythmias causing symptoms or hemodynamic compromise
- Active endocarditis
- Acute myocarditis or pericarditis
- Symptomatic severe aortic stenosis
- Uncontrolled heart failure
- Acute pulmonary embolus or pulmonary infarction
- Thrombosis of lower extremities
- Suspected dissecting aneurysm
- Uncontrolled asthma
- Pulmonary oedema
- Respiratory failure
- Acute noncardiopulmonary disorder that may affect exercise performance or be
aggravated by exercise (i.e. infection, renal failure, thyrotoxicosis)
- Mental impairment leading to inability to cooperate
- Use of medication that alters the effect of cardioprotection:
• β-blockers
• Calcium Channel blockers
• Nitrates
• Opioids
• Anti-platelet agents (e.g. paracetamol)
• Statins and anti-hyperlipidaemic drugs
• Anti-diabetic treatment
Design
Recruitment
Followed up by the following (possibly more current) registration
No registrations found.
Other (possibly less up-to-date) registrations in this register
No registrations found.
In other registers
| Register | ID |
|---|---|
| CCMO | NL86485.091.24 |