Title Promoter Affiliations Abstract "Automatic detection of exercise oscillatory ventilation (EOV) in cardiopulmonary exercise testing (CPET): developing an accurate, practical and clinical applicable graphical user interface (GUI)." "Dirk Vissers" "Movement Antwerp (MOVANT)" "Exercise oscillatory ventilation (EOV) is a strong prognostic parameter indicating early mortality. Before, this abnormal breathing pattern is often unrecognized because it is assessed subjectively by visual inspection or manually computed. The goal of this proof-of-concept, is to obtain automated detection of EOV and to create a clinical applicable interface. This interface could be integrated in existing cardiopulmonary exercise test software worldwide." "The automated interpretation of cardiopulmonary exercise testing." "Wim Janssens" "Laboratory of Respiratory Diseases and Thoracic Surgery (BREATHE), Dynamical Systems, Signal Processing and Data Analytics (STADIUS), Research Group for Rehabilitation in Internal Disorders" "The digital era, where medical information of the patients’ history can be electronically organised, offers a unique opportunity for revolutionizing the impact of personalised medicine. Medical decisions, from initial diagnosis up to predicting optimal treatment approaches and prognostic outcomes, should be tuned based on all available data from this patient. In order to make this vision a reality, analytic approaches that turn datasets into actionable information are needed. Artificial intelligence (AI) is a broad class of methods that learns from large datasets and subsequently uses novel insights to make prospective predictions for unseen examples. However, the application and integration of AI models in clinical practice is still at its infancy. The goal of this project is to develop AI algorithms by learning from heterogeneous datasets, which address the clinical questions coming with the assessment and diagnosis of complex respiratory diseases. These AI algorithms should enable or support (respiratory) physicians to tailor diagnostic and therapeutic choices to the individual patient. We will focus on two carefully selected challenges in the field of respiratory medicine for which we have large data available as well as clinical expertise, being complex medical diagnosis of multidisciplinary boards regarding interstitial lung diseases and protocolling of cardiopulmonary exercise testing." "Cardiopulmonary exercise testing with echocardiography in diagnosis, phenotyping and treatment of heart failure with preserved ejection fraction." "Andreas Gevaert" "Cardiovascular diseases (CARDIOVASC)" "Heart failure with preserved ejection fraction (HFpEF) is the most common form of heart failure, with limited therapeutic options and a poor prognosis. Challenges in HFpEF diagnosis, undifferentiated treatment of HFpEF patients despite phenotypical differences, and underutilization of exercise as part of therapy contribute to the unfavorable prognosis. Although exercise intolerance is a general symptom among HFpEF patients, and current guidelines recommend exercise training, the underlying pathophysiological mechanisms remain unclear. Recent research shows that combined echocardiography and cardiopulmonary exercise testing (CPETecho) is a non-invasive method that can characterize physiological limits to exercise, including in HFpEF patients. In this study, we aim to (1) evaluate whether routine use of CPETecho can improve the accuracy of HFpEF diagnosis, (2) identify subgroups of HFpEF patients with different exercise limitations (exercise phenotypes), and (3) assess the impact of exercise training on these HFpEF exercise phenotypes. We will recruit HFpEF patients from 3 third-line hospitals and perform CPETecho. We will also analyze multicentre exercise training trials to assess the influence of exercise training on HFpEF exercise phenotypes. Our study will address the clinical need for better efficiency in HFpEF diagnosis. By defining HFpEF exercise phenotypes and evaluating the benefits of exercise training, we aim to improve the precision of HFpEF treatment." "Defining the role of exercise testing and cardiac rehabilitation in the detection and prevention of early-stage heart failure: a roadmap to personalised profiling" "Tatiana Kouznetsova" "Hypertension and Cardiovascular Epidemiology, Cardiology, Research Group for Rehabilitation in Internal Disorders" "The postdoc will help in a planned clinical study that aims to define the role of exercise testing and cardiac rehabilitation in the detection and prevention of early-stage heart failure. The postdoc will be the key person for the study preparation, patient recruitment, the data acquisition and post-processing, the biobanking and the data management related to the study. He will also continue analysing data from the Flemish Study on Environment, Genes and Health Outcomes, a large-scale population study directed by the Research Unit of Hypertension and Cardiovascular Epidemiology. He will also participate in ongoing and planned projects led by this research unit as well as in projects resulting from our interuniversity partnership with the Stanford Cardiovascular Institute (Stanford University, California, USA). From next academy year on, he will also supervise Master students in Medicine and co-supervise a PhD student. Furthermore, he will help writing grant applications." "A Hybrid exercise program for claudication : ACTION. wAlking therapy Combined wiTh cardIO-pulmoNary exercise" "Inge Fourneau" "Vascular Surgery, Research Group for Rehabilitation in Internal Disorders" "Our primary objective is to provide the clinical evidence base for the use of a hybrid* exercise program to improve functional outcomes and cardiovascular health of patients with lower extremity artery disease (LEAD). Outcome will be determined with an exercise tests before and after completion of the program with additional follow-up after 1 year. Patients will be randomized between the exercise program and the actual standard of care (walking advise). Our secondary objective is to get a better understanding on the determinants of motivation and barriers to participate in an exercise program and take up a physically active lifestyle. * = Hybrid exercise program (=Action program) combines supervised and non-supervised exercise therapy. The supervised sessions will include more cardio-oriented exercises to maximally affect cardiorespiratory fitness while the non-supervised sessions will be more focused on walking exercise." "VAD-patient interaction: from rest to exercise." "Bart Meyns" "Cardiac Surgery" "Heart failure is the first cause of death in industrialized countries. Despite the use of medical therapy a certain percentage of patients (PTs) will progress to end stage heart failure. In this case the ventricular assist device (VAD) is a viable therapy that nowadays is used increasingly not only as a bridge to transplantation, but also as destination therapy and as a bridge to recovery. Therefore, there is a clinical need to understand how to estimate and modulate the optimal level of support (VAD rotational speed) to be provided according to PTs’ activity (resting, standing up, bicycle riding etc).This project is aimed at studying the effects of VAD speed modulation on PTs’ hemodynamics during physical activity (PA) and to compare them with a fixed VAD speed. To this aim clinical data will be acquired before and during VAD implantation surgery. Then two follow-ups will be organized to acquire data on VAD PTs performing different levels of PA at constant vs. manually increased VAD speed. Besides, due to the complexity of the issue involving both cardiovascular and respiratory variables, a computational cardio–respiratory simulator will be developed. It will be able to reproduce beat-to-beat PTs’ specific hemodynamic and respiratory condition (in terms of heart rate, flows, pressures, O2 and CO2 saturations, vascular resistances etc), at rest and during PA including the effects of VAD support.The present clinical study may contribute to improve VAD therapy with benefits on both PTs’ quality of life and on possible PTs’ improvements/recovery. Besides, the simulator will be a user friendly tool exploitable as a clinical support for VAD therapy optimization and PTs clinical management improvement. Moreover the simulator will be exploitable as a training tool for clinicians, VAD technicians, nurses etc. It will be also a computational test bench where different VAD speed modulation strategies (also from VAD manufacturers) can be simulated and tested." "MicroRNA in heart failure: Exercise as a tool to discover candidate microRNA for therapy and personalized medicine." "Hein Heidbuchel" "Cardiovascular diseases (CARDIOVASC)" "The burden of heart failure is substantial and likely to grow, urging for development of new therapies. Exercise training is one of the most successful therapies for heart failure but unfortunately, 20% of patients show no response and thus fail to improve prognosis. MicroRNA were recently put forward as key players in the response to exercise training. Identification of exercise-related microRNA could lead towards novel microRNA-based therapies that mimic exercise effects and could lead to a microRNA biomarker panel that can assist in tailoring of training programmes. Preliminary data from our group support this hypothesis: by performing a large unbiased screening, we designed a microRNA fingerprint that discriminates responders from non-responders to exercise training. We anticipate that the microRNA fingerprint may guide us towards microRNA that are crucial in a favorable adaptation to exercise. This translational project proposal involves both fundamental research (an animal study on microRNA-based therapy, including in vitro studies to gain mechanistic insight in microRNA-mRNA targets) and clinical translation (a prospective clinical trial to assess the predictive capacity of circulating microRNA for tailoring exercise therapy). This bedside-to-bench-and-back approach will maximize the potential for translation in relevant clinical results. In conclusion, we will use exercise as a model to discover candidate microRNA for therapy and to guide patient-tailored therapy." "Tackling FRAILTY: ACTIVE-AGE@home: a home-based functional exercise program for community dwelling frail older adults." "David Beckwée" "Arteveldehogeschool, Odisee, Ghent University, Vrije Universiteit Brussel, Movement Antwerp (MOVANT)" "The growing number of frail older people is exposed to high risks of adverse health outcomes e.g. falls, hospitalization, diminished mobility, increased disability in activities of daily living and ultimately premature death. Frailty affects also health-care expenditure. Physical activity (PA) interventions are the first-choice treatment to tackle frailty, but this is mostly not the first choice of the frail themselves. PA programs should be culturally appropriate, population-based taking into account barriers and facilitators reported by the frail themselves. In order to overcome the barriers and optimally benefit from the facilitators, we developed and piloted a functional training program based on the British Medical Research Council guidance, ACTIVE-AGE@home. In this program each person's goals will be identified and achieved for. The Proof of Concept studies were promising and so, we set out to conduct a pragmatic RCT to test the effectiveness and costeffectiveness. Participants are frail community dwelling older adults, the intervention is a PA program administered by professionals and the same program delivered by volunteers under supervision of professionals which we will compare with a control group receiving care as usual. The primary outcome of the study is the timed chair rise since this is one of the most important functional evaluation clinical tests because it measures lower body strength and relates it to the most demanding activities of daily living. The test is also proven valid, reliable, responsive to change. The TCR is considered a 'stress test', i.e. a test that aims to challenge the maximal physiological and/or physical capacity of the participant. Positive results will help to reduce health and social expenditures and allow to collaboration in prevention and health promotion. Therefore, during the project, a synergistic relation between all relevant stakeholders is forseen." "Exercise physiology with a Ventricular Assist Device" "Bart Meyns" "Cardiac Surgery" "Ventricular assist devices (VADs) are a valuable option for the treatment of end stage heart failure patients. VAD patients show a stable hemodynamic at rest but their exercise capacity is strongly limited. Aim of this project is to develop an 'in vivo' ovine model to study the hemodynamic interaction between the VAD and the native ventricle during exercise. In addition an 'in vitro' cardiorespiratory simulator will be implemented to reproduce the pathophysiology of exercise observed on the animals. The two models will provide a basic understanding of the complex VAD-heart interaction at rest and at exercise. They will be used to test and develop VAD speed controllers aimed at modulating VAD flow according to body needs. We expect this project to improve VAD in the direction of a “smart” device physiologically responding to daily hemodynamic changes, and to improve patients’ exercise capacity in the nearly future." "Understanding mitochondrial function and the role of exogenous ketone supplementation in combating exercise intolerance and chronic fatigue in long COVID." "Elisabeth De Waele" "Physiotherapy, Human Physiology and Anatomy, Clinical sciences" "Around 10-20% of people with a COVID-19 history suffer from long term effects (long COVID). The symptoms (mostly fatigue and postexertional symptom exacerbation (PESE)) influence the life of these patients. The current guidelines for rehabilitation are insufficient and the pathogenesis is not fully understood. The first aim is to understand the role of mitochondrial function (MF) in long COVID, using a cross-sectional study to test if there is a difference in MF between long COVID patients and healthy individuals. The second aim is to validate the COMET measurement system, which measures mitochondrial oxygen consumption on the skin, as a proxy for MF, compared to a Seahorse assay in blood cells. The third aim is to investigate the role of ketone supplementation to mitigate long COVID symptoms. We hypothesize that beta-hydroxybutyrate (BHB) supplementation can reduce PESE after physical activity in long COVID patients, which will be studied in a cross-over study with 2 interventions: BHB supplementation, BHB combined with quality and quantity adapted nutrition (QuaQua), and the control. Another hypothesis is that BHB supplementation combined with physical rehabilitation reduces long-term fatigue in long COVID patients, which will be studied in a pilot randomized controlled trial. During this trial, the intervention group will receive a physical exercise program, combined with QuaQua and BHB supplementation, while the control group will only receive the exercise program"