Best poster to Jose Bianco Moreira

Jose Bianco Moreira won best poster in his session during 14th Annual CHFR SymposiumCongratulations to our researcher Jose Bianco Moreira!

Dr. Moreira was awarded the best poster prize for his poster Exercise reveals potential therapeutic targets in heart failure in the section entitled Cardiac function during heart failure and exercise training of the 14th Annual CHFR Symposium on Heart Failure in Oslo last week. The conference is organized by the Center for Heart Failure Research.

PhD candidate, Silvana Bucher Sandbakk, also presented at the same session as Moreira, and also delivered a good presentation. Her poster was named High age-specific cardiorespiratory fitness attenuates the adverse effect of sedentary time on cardiovascular risk factor clustering in older adults: the generation 100 study.

Andrea Hegdahl Tiltnes, Communication Adviser at CERG

Summary – day 2 of the seminar

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Erich Gnaiger visiting the mitochondrial lab

Thursday evening involved a refreshing expedition in extreme weather followed by a delicious dinner in traditional surroundings. Luckily, everybody survived the storm and were ready for a new day full of scientific input. Day 2 started with a session focusing on mitochondrial function. First speaker was professor Erich Gnaiger from Medical University of Innsbruck, Austria – with the most suitable tie of the day:) His scientific contribution to the field of mitochondrial physiology and pathology is quite impressive, including significant contribution to more than 200 publications. Gnaiger is also the initiator and chairman of the International Mitochondrial Physiology Society. His lesson gave insight into mitochondrial respiratory control and early defects of oxidative phosphorylation in hearts affected by heart failure. Several studies have also shown the negative effects of an inactive lifestyle on the mitochondrial function in the heart. We even learned that human beings have very much in common with pigs – although there are some differences.

Dr. Boyett and CERG's Morten A. Høydal

Dr. Boyett and CERG’s Morten A. Høydal

The next session addressed basic mechanisms of cardiac function. Professor of Cardiac Electrophysiology Mark Boyett from the University of Manchester has been investigating the “ion channels” of the heart for several years, and held the presentation “Exercise training reduces the resting heart rate via downregulation of the funny channel, HCN4, and the funny current, If”. Further, Dr. Daniele Catalucci from Humanitas Clinical and Research Center and National Research Counsil (CNR) in Italy presented “Novel insights and new corrective strategies for the recovery of cardiac perfomance”.The calcium handling in the myocytes represents a very central part of the research activity in CERG, for instance as shown in this blog post. Several of our researchers therefore listened extra carefully when dr. Luigi Venetucci from the University of Manchester spoke about inherited calcium channelopathies in the pathophysiology of arrhytmias. This research plays an important role in the development of new drugs. However, as shown in our group, exercise training also affects the calcium handling in the myocytes, for instance with reduced phosphorylation of cytosolic CaMKII, which again is associated with improved contractile function.

IMGP4791Almost 40 % of heart failure patients have atrial fibrillation. Dr. Anthony J. Workman, University of Glasgow, gave us a very useful introduction to basic mechanisms of this disease, with insights from human atrial cells and cells from rabbits with heart failure. Workman and his colleagues have demonstrated that electric currents and voltage signals generated by single heart cells obtained from patients with AF are disturbed in a way that may exacerbate the disease, by so-called “electrical remodelling”. For example, the atrial cell’s refractory period is reduced, which may promote a rapid and chaotic rhythm. He also investigates the effects of beta-blockers, as well as the effect of heart failure, on electric currents, calcium movements and the proteins which regulate these, in human atrial cells and tissues.

IMGP4796Is cardiopulmonary exercise testing (CPET) more than VO2max? Definitely yes, according to dr. Sandy Jack, from the University of Southampton. She is a routined teacher of several CPET courses, with many of the CERG researchers as satisfied students. Her lesson highlighted the use of exercise testing in preoperative assessment and perioperative management, including prehabilitation in cancer patients undergoing major surgery. Further, research suggests that exercise enhances the effect of chemotherapy in cancer patients.

The scientific program was followed by the arrangement “Man in Extreme Environments” at Samfundet. More about that in the next blog post!

Maria Henningsen, CERG

The 5th seminar on Exercise in medicine – summary day 1

For a long time we have been busy planning the 5th seminar in Exercise in Medicine here in Trondheim. The former seminars have given many good experinces, especially since this is a small-scale arrangement with a limited number of participants, providing great opportunities to socialize with possible research partners, exchanging ideas and getting to know each other better. Although the weather is rather dissapointing nowadays for those who wanted to see Norway from the best side, we believe that this year’s seminar is going to be just as interesting as the previous ones.

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Wednesday evening there were two evening sessions, followed by delicious tapas for everyone. The first lesson was held by professor Jerome A Dempsey from the University of Wisconsin, USA. Dempsey is the director of the John Rankin Laboratory of Pulmonary Medicine and has for decades been investigating the aspects related to the regulation of breathing in various physiologic states in humans and animals. He is also former editor of the Journal of Applied Physiology. We got to hear a very interesting speech about the Volkerhistory of exercise physiology and future challenges.

Further, we had a lesson from professor Volker Adams from Heart Centre Leipzig, a well-known research partner through many years, among others from the SMARTEX-HF study. The lesson had the title “Impact of exercise training on striated muscle and endothelium in patients with cardiovascular disease”.

The varied and interesting program continued on Thursday. Professor Steven Keyetian from the University of Michigan, Detroit, has for several years been working with the ACTION-HF trial, and gave an overview of important clinical messages and lessons learned from the trial. 2331 heart failure patients from all over the US, Canada and France were randomized to usual care plus aerobic exercise training, consisting of 36 supervised sessions followed by home-based training, or usual care alone. Median follow-up time was Keyetian30 months. The main results were that exercise training resulted in nonsignificant reductions in the primary end point of all-cause mortality or hospitalization and in key secondary clinical end points. However, after adjustment for highly prognostic predictors of the primary end point, exercise training was associated with modest significant reductions for both all-cause mortality or hospitalization and cardiovascular mortality or heart failure hospitalization. According to prof. Keyetian, interval training would probably have been included as an intervention if the study was designed today. Further, the challenge of long-term adherence to exercise was addressed, and different measures to improve adherence were discussed in public.

Cardiopulmonary exercise testing  (CPET) is a well-known test method, often used here in our group to measure different physiological parameters during exercise. Dr. and associate professor Marco Guazzi from the University of Milan and Sao Paolo told us how CPET variables reflect the degree of diastolic dysfunction in patients with heart failure with normal ejection fraction. This kind of heart failure is called Heart Failure with Preserved Ejection Fraction (HFPEF) and will be the main charasteric of the humans and animals included in the OptimEx study.

EvaDuring the last decades, the fact that there are gender differences in mechanisms involved in cardiovascular disease has been highlighted. Professor and cardiologist Eva Gerdts presented results from different studies focusing on diastolic heart failure (HFPEF) in females. The main conclusion is that we don’t know enough about this topic, and this field needs further investiogation in the future. 

The recent improvements in cardiac revascularization therapy have reduced death rates of myocardial infarction, but steadily increased the number of individuals developing cardiac remodeling and heart failure in the future. In this setting, approaches using microRNAs as novel diagnostic and therapeutic strategies for cardiac remodeling and heart failure are highlighted. Dr. Regella Kumarswamy from Hannover Medical School presented some of the results from his research in this field.

HoustisThe last speaker of the day was dr. Nick Houstis from Harvard Medical School, Boston. His research focuses on transcriptional mechanisms regulating the response to cardiac exercise, and he presented some of the results from his studies, among others on hyperthrofic swimming mice.

At the end of the day the guests were brought on a tour on the CERG facilities: the microscope and mitochondrial labs, the training facilities of Generation 100 and a quick update on the SMARTEX-HF trial. More exciting experiences to come – this evening the seminar guests will get to know the storm “Ivar” better, as they will be taken by bus to dinner in an old barn on the countryside.

 

Maria Henningsen, CERG 

Can aerobic interval training reverse heart dysfunctions?

At our center there is a wide focus on increasing the knowledge of the mechanisms involved in heart disease, and developing methods aimed to prevent or treat disease. A recently published study by PhD student Anne Berit Johnsen and CERG colleagues provides a significant contribution to the field.

What we know from before, is that impaired cardiomyocyte contractility and Ca2+ handling is typically observed in patients with left ventricular contractile dysfunction. Further, previous studies have shown that exercise may improve the left ventricular function in patients suffering from heart failure after heart infarction. Exercise is also found to improve cardiomyocyte function and Ca2+ handling in rats with the same disease. But is there even beneficial effects of exercise on atrial myocyte function and Ca2+ handling?

heartTo explore this, contractile function and Ca2+ handling in atrial myocytes of sham-operated rats and rats with post-infarction heart failure was compared. The effects of aerobic interval training was also investigated. The results were in line with what previous research: high intensity aerobic interval training restored atrial myocyte contractile function and reversed changes in atrial Ca2+ handling in heart failure rats.

This study increases our understanding of how atrial myocyte contractile dysfunction in post-infarction heart failure is associated with major impairment in Ca2+ handling, whereas aerobic interval training can restore the dysfunction via improved Ca2+ handling. As mentioned in a previous blog post, animal studies are important steps on the way to understanding the human heart. In future studies this model can help to highlight important mechanisms behind heart failure as a substrate that promotes atrial fibrillation, and also the effect of training as a treatment.

Maria Henningsen, CERG.