Thomas Ehlig Hjermind Justesen - PhD Scholarship 2024

Project summary:
Small vessel disease of the hearts and brain. A perfusion PET study of training effects

The current development in diagnostics and treatments of ischemic heart disease does not address the most common subtype of ischemic disease seen in elderly patients i.e., small vessel disease. However, small vessel disease also affects the brain where it might lead to dementia. Hence, we wish increase of understanding of the pathophysiology behind small vessel disease as well as examine if HIIT-training can combat its effects.

Project Title

Small vessel disease of the hearts and brain. A perfusion PET study of training effects

Background

Management of cardiovascular large vessel disease (coronary plaques) has improved significantly. Yet, most elderly patients with ischemic heart disease do not have large vessel heart disease and it seems that small vessel disease of the heart may explain a large fraction of these cases as well as the cardiovascular morbidity in elderly. Additionally, we suspect that mall vessel disease of the brain can lead to dementia.

Aim

The main objectives are:

1. Evaluate if small vessel disease is a systemic disease that affects both the heart and brain function in the same individuals

2. Improve our understanding of how small vessel disease of not only the brain but also the heart may lead to cognitive dysfunction

3. To examine whether improve-ments in cardiorespiratory fitness through supervised training can reverse or limit cognitive dysfunction.

Methods/design

48 patients with diabetes and signs of small vessel disease will be included from Herlev Hospital. 24 healthy controls will also be included. Initially, differences in blood supply to the heart and brain, cognitive capacity and fitness level between these two groups will be assessed. Then, patients with diabetes undergo either five months of supervised HIIT-training or passive stretching followed by repeated baseline measurements.