Dominique Hansen

Hasselt University · Department Rehabilitation Sciences

A proper determination of the exercise intensity is important for the rehabilitation of patients with cardiovascular disease (CVD) since it affects the effectiveness and medical safety of exercise training. In 2013, the European Association of Preventive Cardiology (EAPC), together with the American Association of Cardiovascular and Pulmonary Rehab...

Exercise training is highly recommended in current guidelines on primary and secondary prevention of cardiovascular disease (CVD). This is based on the cardiovascular benefits of physical activity and structured exercise, ranging from improving the quality of life to reducing CVD and overall mortality. Therefore, exercise should be treated as a pow...

A key factor to successful secondary prevention of cardiovascular disease (CVD) is optimal patient adherence to treatment. However, unsatisfactory rates of adherence to treatment for CVD risk factors and CVD have been observed consistently over the last few decades. Hence, achieving optimal adherence to lifestyle measures and guideline-directed med...

Whereas exercise training, as part of multidisciplinary rehabilitation, is a key component in the management of patients with chronic coronary syndrome (CCS) and/or congestive heart failure (CHF), physicians and exercise professionals disagree among themselves on the type and characteristics of the exercise to be prescribed to these patients, and t...

Background Physical activity plays a crucial role in cardiac rehabilitation for secondary prevention. Despite its importance, participation rates in cardiac rehabilitation programs remain low. Telemedicine, particularly telerehabilitation, presents a viable solution by offering remote access to cardiac rehabilitation services. This innovative appro...

Background Peak oxygen uptake (VO2peak), measured by cardiopulmonary exercise test (CPET), is an established variable for prognostic assessment. Other VO2peak-derived variables, such as the peak oxygen pulse (peakO2pulse), also provide valuable information for risk stratification in patients with cardiac diseases. For individualized assessment, the...

This study aims to (1) compare the kinetics of pulmonary oxygen uptake (VO2p), skeletal muscle deoxygenation ([HHb]), and microvascular O2 delivery (QO2mv) between heart failure (HF) patients with reduced ejection fraction (HFrEF) and those with preserved ejection fraction (HFpEF), and (2) explore the correlation between body composition, kinetic p...

Background Advancements in smartphone technology have paved the way for innovative interventions aimed at promoting physical activity (PA) and have led to the development of an mHealth app called MIA. The primary objective of this feasibility study is to comprehensively investigate the potential of the MIA app in effectively promoting PA and foster...

Background: Type 2 diabetes (T2DM) affects brain structure and function, and is associated with an increased risk of dementia and mild cognitive impairment. It is known that exercise training has a beneficial effect on cognition and the brain, at least in healthy people, but the impact of exercise training on cognition and the brain remains to be f...

Optimizing endurance exercise intensity prescription is crucial to maximize the clinical benefits and minimize complications for individuals at risk for or with cardiovascular disease (CVD). However, standardization remains incomplete due to variations in clinical guidelines. This review provides a practical and updated guide for health professiona...

In recent years, major advances in our understanding of risk factors implicated in the development of cardiovascular disease (CVD), in available tools for early detection of CVD, and in effective interventions to prevent subclinical or clinically manifest disease, have led to an increasing appreciation of prevention as a major pillar of cardiovascu...

Individuals with type 2 diabetes mellitus (T2DM) are at an increased risk for heart failure, yet preventive cardiac care is suboptimal in this population. Pyridoxamine (PM), a vitamin B6 analog, has been shown to exert protective effects in metabolic and cardiovascular diseases. In this study, we aimed to investigate whether PM limits adverse cardi...

Background Half of patients with heart failure with preserved ejection fraction (HFpEF) remain undiagnosed by resting evaluation alone. Therefore, exercise testing is proposed. The diastolic stress test (DST), however, has limited sensitivity. We aimed to determine the clinical significance of adding the mean pulmonary artery pressure over cardiac...

Background/Objectives: Gestational hypertensive disorders (GHD) pose significant maternal and fetal health risks during pregnancy. Preconception physical exercise has been associated with a lower incidence of GHD, but insights into the cardiovascular mechanisms remain limited. This study aimed to evaluate the effect of preconception physical exerci...

Little is known either about either physical activity patterns, or other lifestyle-related prevention measures in heart transplantation (HTx) recipients. The history of HTx started more than 50 years ago but there are still no guidelines or position papers highlighting the features of prevention and rehabilitation after HTx. The aims of this scient...

Little is known either about either physical activity patterns, or other lifestyle-related prevention measures in heart transplantation (HTx) recipients. The history of HTx started more than 50 years ago but there are still no guidelines or position papers highlighting the features of prevention and rehabilitation after HTx. The aims of this scient...

Little is known either about either physical activity patterns, or other lifestyle-related prevention measures in heart transplantation (HTx) recipients. The history of HTx started more than 50 years ago but there are still no guidelines or position papers highlighting the features of prevention and rehabilitation after HTx. The aims of this scient...

BACKGROUND Advancements in smartphone technology have paved the way for innovative interventions aimed at promoting physical activity (PA). OBJECTIVE The main objective of this feasibility study is to thoroughly assess the feasibility, usability, and acceptability of the MIA, a specifically developed app, in promoting PA among healthy older adults...

Background Cardiopulmonary exercise testing (CPET) is the gold-standard for determining ventilatory thresholds (VTs) and prescribing exercise intensity for patients with cardiometabolic diseases (CMD). Multivariable equations to predict heart rate (HR) at the first and second VTs (VT1, VT2) offer a new alternative for indirect prescription when CPE...

Background/Introduction Physical activity in daily life (PADL) is a crucial factor influencing mortality and quality of life in individuals with cardiovascular diseases (CVDs). While previous research demonstrates notable differences in exercise habits and PADL levels between men and women in the general population, little is known about the patter...

Introduction Adults with type 2 diabetes mellitus (T2DM) commonly present with a worse exercise capacity compared to their healthy peers. The underlying mechanisms of this exercise intolerance, such as impaired microcirculation and altered tissue oxygenation, remain to be elucidated. Purpose To evaluate the role of muscle oxygenation during exerci...

Background An impressive amount of evidence exists on the effectiveness of guideline-based exercise for cardiac rehabilitation and secondary prevention. Also, studies show that exercise prescriptions are sub-optimal and not compliant with ESC/EAPC exercise guidelines. Decision support systems (DSS) for guideline-based exercise prescription, such as...

Background The respiratory system is not the limiting step to humans’ tolerance to dynamic exercise in most physiological circumstances. For instance, minute ventilation at peak exercise (VEpeak) is appreciably lower than the maximal sustained ventilatory capacity (MSVC). Using the estimated (from forced expiratory volume in one second (FEV1)) maxi...

Introduction Possible differences in the oxygen supply and the dynamics may impact the exercise's response between heart failure (HF) with reduced ejection fraction (HFrEF) and preserved (HFpEF), mainly due to body composition differences. Thus, our study was designed to determine whether pulmonary and muscle oxygen kinetics responses may be presen...

Background Non-invasive methods that assess endothelial function may improve the evaluation of cardiovascular risk in primary care. Previous research showed that flow-mediated slowing (FMS) of the brachial-radial pulse wave velocity reflects cardiovascular risk, but larger studies on the FMS response in at-risk populations are required to further u...

Published in The New England Journal of Medicine (no official ISSN in Researchgate).

Objective Non-invasive methods assessing endothelial function may enhance cardiovascular risk evaluation in primary care. Previous research showed that flow-mediated slowing (FMS) of the brachial-radial pulse wave velocity (PWV) reflects cardiovascular risk, but larger studies on the FMS response in at-risk populations are required to further unrav...

Aims To develop and validate equations predicting heart rate (HR) at the first and second ventilatory thresholds (VTs) and an optimized range-adjusted prescription for patients with cardiometabolic disease (CMD). To compare their performance against guideline-based exercise intensity domains. Methods Cross-sectional study involving 2,868 CMD patie...

Background Long COVID syndrome has had a major impact on million patients’ lives worldwide. The cardiovascular system is an important aspect of this multifaceted disease that may manifest in many ways. We have hereby performed a narrative review in order to identify the extent of the cardiovascular manifestations of the Long COVID syndrome. Method...

Endurance exercise training is a promising cardioprotective strategy in type 2 diabetes mellitus (T2DM), but the impact of its intensity is not clear. We aimed to investigate whether and how isocaloric moderate-intensity exercise training (MIT) and high-intensity interval exercise training (HIIT) could prevent the adverse cardiac remodeling and dys...

Background Physical activity (PA) is a recognized boon for older adults, enhancing their overall well-being and mitigating health risks. Nevertheless, to encourage active lifestyles in this demographic, it is vital to understand the factors influencing PA. Conventional approaches predominantly rely on supervised cross-sectional evaluations, presumi...

BACKGROUND The effectiveness of cardiac rehabilitation (CR) programs following either percutaneous coronary intervention (PCI) or coronary artery bypass grafting (CABG) has been separately studied. Few studies have compared the effects of similar CR programs between PCI and CABG. This study aimed to compare the effects of CR in patients recruited f...

Background: Physical activity is a key component of cardiac rehabilitation. However, EUROASPIRE V concluded that intending 48% of coronary artery disease (CAD) patients do not intend to do physical activity in the next six months. Patient involvement improves patient satisfaction, adherence, and health outcomes and is a prerequisite for good clinic...

Background Physical activity (PA) has wide-ranging, and well documented benefits for older adults, encompassing physical, cognitive, and mental well-being. The World Health Organization advocates for a minimum of 150–300 min of moderate intensity PA per week, supplemented by muscle-strengthening exercises. However, the rates of PA among older adult...

Background and objective: Physiotherapy is highly recommended for early recovery from stroke. This study aimed to document physiotherapy practices for people with acute and early sub-acute stroke in Benin. Methods: In this prospective observational study, physiotherapists working with acute stroke people documented the content of their treatment fr...

Exercise training is an encouraging approach to treat cardiac dysfunction in type 2 diabetes (T2DM), but the impact of its intensity is not understood. We aim to investigate whether and, if so, how moderate-intensity training (MIT) and high-intensity interval training (HIIT) alleviate adverse cardiac remodeling and dysfunction in rats with T2DM. Ma...

Exercise-based cardiac rehabilitation (CR) reduces the risk of hospital admissions and improves the quality of life (QoL), aerobic and walking capacity, and muscle strength in patients with congestive heart failure (CHF).¹ According to EAPC/ESC recommendations, low intense (LI) to moderate intense (MI) endurance exercises should be supplemented by...

Objectives To compare the elicited exercise responses at ventilatory thresholds (VTs: VT1 and VT2) identified by cardiopulmonary exercise testing (CPET) in patients with cardiovascular disease (CVD) with the guideline-directed exercise intensity domains; to propose equations to predict heart rate (HR) at VTs; and to compare the accuracy of prescrip...

There is an immediate need to optimize cardiovascular (CV) risk management and primary prevention of childhood obesity to timely and more effectively combat the health hazard and socioeconomic burden of CV disease from childhood development to adulthood manifestation. Optimizing screening programs and risk management strategies for obesity-related...

Aim: Histidine-containing dipeptides (HCDs) are pleiotropic homeostatic molecules with potent antioxidative and carbonyl quenching properties linked to various inflammatory, metabolic, and neurological diseases, as well as exercise performance. However, the distribution and metabolism of HCDs across tissues and species are still unclear. Methods:...

In Europe alone, on a yearly basis millions of people need an appropriate exercise prescription to prevent the occurrence or progression of cardiovascular disease (CVD). A general exercise recommendation can be provided to these individuals (at least 150 min of moderate-intensity endurance exercise, spread over 3-5 days/week, complemented by dynami...

Secondary prevention is recommended after a cardiac event to stimulate recovery and reduce the risk of recurrent events. To optimize the results and support the patients to actively play a part in the prevention programme, the European guidelines and EAPC position statements on prevention of cardiovascular diseases suggest a holistic approach and s...

Aim: Physiotherapists often treat patients with (elevated risk for) cardiovascular disease (CVD), and should thus be able to provide evidence-based exercise advice to these patients.This study therefore aims to examine whether exercise prescriptions by physiotherapists to patients with CVD are in accordance with European recommendations. Methods...

Patients with cardiovascular disease benefit from cardiac rehabilitation, which includes structured exercise and physical activity as core components. This position statement provides pragmatic, evidence-based guidance for the assessment and prescription of exercise and physical activity for cardiac rehabilitation clinicians, recognising the latest...

Aims A key treatment for patients with varying stages of heart failure with preserved ejection fraction (HFpEF) is exercise. Yet, despite a Class 1A recommendation, only one-third of patients exercise sufficiently. A huge treatment gap exists between guidelines and clinical practice. PRIORITY aims to establish the feasibility, clinical effectivenes...

Funding Acknowledgements Type of funding sources: Public grant(s) – National budget only. Main funding source(s): This work was supported by the Flemish Research Fund (FWO, FWO-ICA: G0F4220N). Background Exercise prescriptions by clinicians to patients with cardiovascular disease (CVD) often disagree with recommendations, thus requiring improvemen...

Funding Acknowledgements Type of funding sources: Public grant(s) – National budget only. Main funding source(s): FWO - Research Foundation – Flanders. Background Exercise is a key therapy for patients across all the stages of heart failure with preserved ejection fraction (HFpEF). Despite being a class I recommendation, the EUROASPIRE registry sh...

Aims: After heart transplantation (HTx), increments in physical activity are strongly recommended. However, participation rates in exercise-based cardiac rehabilitation and engagement in physical activity (PA) are insufficient in many patients. Hence, this study aimed to explore the central factors and the interconnections among distinct types of...

The American College of Sports Medicine determined the energy consumption of daily activities and sports. Cardiac telerehabilitation (CTR) requires knowing how much energy people consume in daily life outside of cardiac rehabilitation activities. Therefore, we have investigated if the estimated values are valid in CTR. Data from two studies were in...

Purpose: The purpose of this study is to provide comprehensive reference values for oxygen uptake efficiency slope (OUES) in healthy adults. International heterogeneity was also explored through published databases. Methods: A cross-sectional study was conducted with treadmill cardiopulmonary exercise testing (CPX) from a Brazilian healthy adult...

Background Exercise prescriptions by clinicians to patients with cardiovascular disease (CVD) often disagree with recommendations, thus requiring improvement. Aim To assess whether exercise prescriptions by physiotherapists to patients with CVD are better in agreement with European (ESC/EAPC) recommendations when the EXPERT (EXercise Prescription...

Resumo Fundamento A pandemia da COVID-19 teve um impacto sobre os programas de reabilitação cardiovasculares (RC) no Brasil. Objetivos Descrever características dos programas de RC no Brasil, os impactos da primeira onda epidemiológica da COVID-19 (primeiros 60 dias) sobre os programas, e apresentar as iniciativas usadas para superar esses impactos...

Histidine-containing dipeptides (HCDs) are pleiotropic homeostatic molecules linked to inflammatory, metabolic and neurological diseases, as well as exercise performance. Using a sensitive UHPLC-MS/MS approach and an optimized quantification method, we performed a systematic and extensive profiling of HCDs in the mouse, rat, and human body (in n=26...

Background Exercise oscillatory ventilation (EOV) is characterized by periodic oscillations of minute ventilation during cardiopulmonary exercise testing (CPET). Despite its prognostic value in chronic heart failure (HF), its diagnosis is complex due to technical limitations. An easier and more accurate way of EOV identification can contribute to a...

Background: Although aerobic training (AT) and resistance training (RT) are recommended after stroke, the optimal dosage of these interventions and their effectiveness on balance, walking capacity, and quality of life (QoL) remain conflicting. Objective: Our study aimed to quantify the effects of different modes, dosages and settings of exercise t...

Physical fitness is of indisputable importance for both health, and sports. Currently, the brain is being increasingly recognized as a contributor to physical fitness. Hereby, transcranial direct current stimulation (tDCS), as an ergogenic aid, has gained scientific interest. The current PRISMA-adherent review aimed to examine the effect of tDCS on...

Background Appropriate exercise prescription for cardiovascular diseases patients is a keystone for efficient and safe cardiovascular rehabilitation (CR). Exercise intensity prescribed according to the first and second ventilatory threshold (VT1 and VT2), identified by cardiopulmonary exercise testing (CPET), is considered the gold-standard method....

Background In current ESC/EAPC guidelines, adding resistance training to endurance training is advised for patients with heart failure (HF), but the optimal intensity of the resistance training is unknown (40–80% of 1RM is advised). Purpose To investigate the effects of high- vs low-intensity resistance training as an adjunct to endurance training...

Three-dimensional echocardiography (3DE) is the most accurate cardiac ultrasound technique to assess cardiac structure. 3DE has shown close correlation with cardiac magnetic resonance imaging (CMR) in various populations. There is limited data on the accuracy of 3DE in athletes and its value in detecting alterations during follow-up. Indexed left a...

Increasing evidence links changes in epigenetic systems, such as DNA methylation, histone modification and non-coding RNA expression, to the occurrence of cardiovascular disease (CVD). These epigenetic modifications can change genetic function under influence of exogenous stimuli, and can be transferred to next generations, providing a potential me...

In recent years, patient care has partially shifted from the hospital to the patients’ homes.¹ This evolution is also seen in cardiac rehabilitation, in which a growing number of patients is participating in cardiac telerehabilitation programmes. At present, a limiting factor in offering fully remote care is the need for assessing and reassessing t...

Aim To compare the cardiac function and pulmonary vascular function during exercise between dyspneic and non-dyspneic patients with type 2 diabetes mellitus (T2DM). Methods 47 T2DM patients with unexplained dyspnea and 50 asymptomatic T2DM patients underwent exercise echocardiography combined with ergospirometry. Left ventricular (LV) function (st...

Background Overweight/obesity in children and adolescents, largely arising due to increased food intake and reduced physical activity, is a major health concern. Physical activity (PA) integrated into learning has been shown to not only lead to improved health outcomes and wellbeing but also positively affect academic performance. The Health and Ac...

The six-minute walk test (6MWT) provides an objective measurement of a person's functional exercise capacity. In this study, we developed a smartphone application that allows cardiac patients to do a self-administered 6MWT at home on a random trajectory. In a prospective study with 102 cardiovascular disease patients, we aimed to identify the optim...

Funding Acknowledgements Type of funding sources: Public grant(s) – National budget only. Main funding source(s): Research Foundation – Flanders (FWO) Introduction Approximately half of the heart failure population has heart failure with preserved ejection fraction (HFpEF), a chronic disease starting with cardiovascular risk factors such as hypert...

Funding Acknowledgements Type of funding sources: Public grant(s) – National budget only. Main funding source(s): CAPES e FAPERGS. Background The brain natriuretic peptide (BNP) is a marker of ventricular dysfunction related to severity and prognosis in heart failure patients. Exercise oscillatory ventilation (EOV) is a phenomenon in the ventilato...

Funding Acknowledgements Type of funding sources: Public grant(s) – National budget only. Main funding source(s): research Foundation - Flanders (FWO) Introduction Cardiac dysfunction is highly prevalent in patients with type 2 diabetes mellitus (T2DM), leading to increased risk of cardiac morbidity and premature death. Previous research underscor...

Funding Acknowledgements Type of funding sources: Public Institution(s). Main funding source(s): Hasselt University Background Adding resistance training on top of endurance training is recommended in the rehabilitation of patients with heart failure. However, it is unknown which intensity of resistance training should be preferred. Purpose To co...

Funding Acknowledgements Type of funding sources: Public grant(s) – National budget only. Main funding source(s): CAPES and FAPERGS. Background Exercise oscillatory ventilation (EOV) is an abnormal ventilatory phenomenon observed in chronic heart failure (HF) patients usually defined as EOV-positive or EOV-negative based on a dichotomous diagnosis...