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Thesis Defence

PhD degree for Martijn Maessen

MartijnMaessen promotie 16 Jun 2017

Martijn Maessen obtained his Ph.D. degree in the Medical Sciences of the Radboud University Nijmegen after the successful defense of his thesis entitled "Cardiovascular Benefits of Lifelong Exercise".

The outline of his thesis: 

Despite the well-established benefits of exercise training, some studies raise concerns that extreme volumes of exercise training have detrimental effects on cardiovascular health. In the first part of this thesis, the dose-response relation between the volume of exercise training and cardiovascular health is examined. First, Chapter 2 discusses the relation between exercise training and longevity. Secondly, Chapter 3 explores the relation between lifetime exercise dose and the prevalence of cardiovascular risk factors and cardiovascular events in a large cohort of Dutch amateur athletes.

Early detection of people at risk for CVD is of paramount importance to prevent life treating events, such as stroke or myocardial infarction. Several guidelines recommend the body mass index (BMI) to evaluate the cardiovascular risk pro le in the general population. Exercise training, however, does not necessarily lower body weight and using the BMI among physically active individuals might overestimate their cardiovascular risk. Chapter 4 describes whether novel body indices ('a body shape index' and 'body roundness index') may improve disease risk evaluation among physically active individuals. High-resolution ultrasound imaging techniques are other popular methods to assess cardiovascular risk by evaluating the properties of the arteries. Compound strain imaging is a promising novel ultrasound method for the noninvasive assessment of vascular properties. The technique has the potential to contribute in an early risk strati cation of the individual patient without apparent vascular abnormalities (e.g. stenotic arteries). Chapter 5 describes the association between compound strain imaging and cardiovascular diseases. 
Exercise training exerts many favourable cardiovascular health benefits, which are often described as improvements in 'traditional' cardiovascular risk factors. The second part of this thesis focuses on the benefits of exercise training from a physiological perspective.
Advanced glycation endproducts (AGEs) are a complex group of modified proteins or lipids that are formed by a process of non-enzymatically glycation and oxidation. Highly reactive dicarbonyls are involved in the fast formation of AGEs and accumulation of dicarbonyls is known as dicarbonyl stress. High dicarbonyl stress and concentration of AGEs are linked to the development of diabetes and cardiovascular diseases. Chapter 6 describes the effects of exercise on highly reactive dicarbonyl stress and the formation of advanced glycation endproducts.
Ischemic events are the most common cardiovascular events and reperfusion is essential for the survival of ischemic tissue, but causes additional damage to the endothelium (i.e. ischemia-reperfusion injury). Ischemic preconditioning refers to short repetitive episodes of ischemia, which can protect against ischemic-reperfusion injury, but the efficacy of ischemic preconditioning is lost at older age. Chapter 7 explores whether lifelong exercise training is associated with attenuated endothelial ischemia reperfusion, and relates to preservation of the efficacy of Ischemic preconditioning in veteran athletes.
Despite the fact that exercise training lowers the risk for future events, athletes are not exempted from a myocardial infarction. Chapter 8 discusses whether veteran post myocardial athletes have an improved vascular function (endothelial function) and reduced vascular wall thickness compared to sedentary post-myocardial infarction individuals. Directly after a myocardial infarction the pathological left ventricular remodelling begins. Chapter 9 assesses the hypothesis that lifelong exercise training is associated with an
attenuated and/or maintained left ventricular function after myocardial infarction.


Click here to access Martijn' thesis digitally.




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