Martin Halle

• MD
• Professor (Full) at Technical University of Munich

Diabetes, obesity, and cardiovascular disease (CVD) represent an escalating global health challenge, contributing significantly to morbidity, mortality, and healthcare costs. Evidence from large cohort studies and clinical trials underscores the impact of diabetes and obesity as major risk factors for CVD, causing systemic inflammation, insulin res...

Objectives Physical activity is associated with positive health effects and improved cognitive function in children. However, these data are primarily based on cross-sectional studies. We investigated changes in cognitive function, physical fitness and physical activity in children following a school-based intervention. Methods The ‘fit4future’ st...

Aims Exercise training improves aerobic capacity (V̇O2peak) in patients with heart failure and preserved ejection fraction (HFpEF), but underlying mechanisms remain unclear. We aimed to evaluate whether exercise training could improve systolic and diastolic function during exercise. Methods This was a substudy of the multicentre Optimizing Exercis...

Patients with coronary heart disease (CHD) and type 2 diabetes mellitus (T2DM) have a substantially increased risk for major cardiovascular events and mortality. Increasing physical activity and improving a healthy diet may effectively reduce cardiovascular risk factors; however, the effects are often transient. In a multicenter, 1:1 randomized con...

Background Cardiac myosin binding protein C (cMyC) is an emerging new biomarker of myocardial injury rising earlier and cleared faster than cardiac troponins. It has discriminatory power similar to high‐sensitive troponins in diagnosing myocardial infarction in patients presenting with chest pain. It is also associated with outcome in patients with...

Endurance exercise training (ET) is an effective treatment in heart failure with preserved ejection fraction (HFpEF), but the efficacy of resistance training in this patient population has been only scarcely evaluated. In this multicenter, randomized trial, we evaluated the effects of combined endurance and resistance training over 12 months in pat...

Aims Exercise training (ET) is an effective therapy in heart failure with preserved ejection fraction (HFpEF), but the influence of different ET characteristics is unclear. We aimed to evaluate the associations between ET frequency, duration, intensity [% heart rate reserve (%HRR)] and estimated energy expenditure (EEE) with the change in peak oxyg...

Aims Heart failure (HF) has a major impact on exercise tolerance that may (in part) be due to abnormalities in body and skeletal muscle composition. This systematic review and meta-analysis aims to assess how differences in whole-body and skeletal muscle composition between patients with HF and non-HF controls (CON) contribute to reduced peak oxyge...

Objective Concerns exist about the possible detrimental effects of exercise training on aortic size and valve function in individuals with bicuspid aortic valve (BAV). This multicentre international study aimed to determine the characteristics of aortic size and valve function in athletes versus non-athletes with BAV and athletes with tricuspid aor...

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...

The bicuspid aortic valve (BAV) is the most common congenital heart defect among adults, often leading to severe valve dysfunction and aortic complications. Despite its clinical significance, uncertainties persist regarding the impact of sports participation on the natural course of BAV disease. The SPREAD (Sport PRactice and its Effects on Bicuspi...

Background In patients with heart failure with preserved ejection fraction (HFpEF), ventilatory inefficiency is associated with worse prognosis, and may indicate co-existing pulmonary hypertension (PH) or a higher risk of developing PH. While different exercise training modes [e.g., moderate continuous training (MCT), high-intensity interval traini...

Background Exercise training (ET) is an effective therapy to improve peak oxygen consumption (V̇O2) in patients with heart failure with preserved ejection fraction (HFpEF). However, it remains unknown if such an intervention has a sustainable effect beyond the active study period. Purpose To investigate peakV̇O2 in the long-term period after compl...

Aims Supervised exercise training improves aerobic capacity (V̇O2peak) in patients with heart failure and preserved ejection fraction (HFpEF), but underlying mechanisms remain unclear. We aimed to evaluate whether exercise training could improve parameters of systolic and diastolic function assessed during exercise echocardiography. Methods This w...

Background Lifelong endurance exercise is associated with increased arteriosclerosis and, in particular, an accelerated rate of coronary artery calcification (CAC) and higher plaque burden. The mechanisms underlying the progression of CAC remain incompletely understood. Purpose We aimed to determine the potential pathomechanism for carotid artery...

Introduction Previous studies described various adaptive neuroplastic brain changes associated with physical activity (PA). EEG studies focused mostly on effects during or shortly after short bouts of exercise. This is the first study to investigate the capability of EEG to display PA‐induced long‐lasting plasticity in runners compared to a sedenta...

Background Metabolic syndrome (MetS) is defined by the presence of central obesity plus ≥two metabolic/cardiovascular risk factors (RF), with inflammation being a major disease-driving mechanism. Structured endurance exercise training (ET) may positively affect these traits, as well as cardiorespiratory fitness (V̇O2peak). Aims We explore individu...

Intense physical exercise is known to increase cardiac biomarkers; however, it is unclear, whether this phenomenon is physiological, or if it indicates myocardial tissue injury. The aim of our study was to investigate the effects of seven consecutive days of excessive endurance exercise on continuous assessment of cardiac biomarkers, function, and...

Introduction High exercise adherence is a key factor for effective exercise programmes. However, little is known about predictors of exercise adherence to a multimodal machine‐based training in older retirement home residents. Aims To assess exercise adherence and potential predictors of adherence. Furthermore, to evaluate user acceptance of the m...

Aims The aims of this sub‐study of the SMARTEX trial were (1) to evaluate the effects of a 12‐week exercise training programme on serum levels of high sensitivity cardiac troponin I (hs‐cTnI) in patients with moderate chronic heart failure (CHF), in New York Heart Association class II‐III with reduced ejection fraction (HFrEF) and (2) to explore th...

ZUSAMMENFASSUNG Bewegung ist für alle Formen des Diabetes mellitus eine der wichtigsten Maßnahmen, die Gesundheit zu erhalten. Regelmäßige körperliche Aktivität, möglichst uniform und täglich, kann vergleichbare Stoffwechseleffekte induzieren und somit die Glukoseregulation langfristig optimieren. Dabei ist die konkrete Blutzuckerantwort jedes Einz...

Physical activity (PA) has positive effects on various health aspects and neuronal functions, including neuronal plasticity. Exceeding a certain exercise frequency and duration has been associated with negative effects. Our study investigated the effects of excessive PA with a marathon run (MA) and regular PA (training and recovery phases) on elect...

Background Skeletal muscle dysfunction contributes to exercise intolerance in chronic heart failure. The randomized multicenter Study of Myocardial Recovery After Exercise Training in Heart Failure (SMART-EX) has shown that high-intensity exercise training (HIIT) but not moderate continuous training (MCT) reduced the left ventricular end diastolic...

Aims Small studies and observations suggested that exercise training may improve peak oxygen consumption (peakVO 2 ) in patients with advanced heart failure and left ventricular assist device (LVAD). We investigated whether in this patient group a supervised exercise training can improve exercise capacity. Methods and results In this multicenter,...

Background Physical functioning is a crucial factor for independence and quality of life in old age. The aim of the "bestform—Best function of range of motion" trial is to investigate the effects of a 6 months multimodal machine-based strength, coordination and endurance training on physical function, risk of falls and health parameters in older ad...

Non-communicable diseases (NCDs), including coronary heart disease, stroke, hypertension, type 2 diabetes, dementia, depression and cancers, are on the rise worldwide and are often associated with a lack of physical activity (PA). Globally, the levels of PA among individuals are below WHO recommendations. A lack of PA can increase morbidity and mor...

Aims: The benefit of non-invasive remote patient management (RPM) for patients with heart failure (HF) has been demonstrated. We evaluated the effect of left ventricular ejection fraction (EF) on treatment outcomes in the TIM-HF2 (Telemedical Interventional Management in Heart Failure II; NCT01878630) randomized trial. Methods and results: TIM-H...

Background: Kidney failure patients on hemodialysis experience physical deconditioning and multi-morbidity. Exercise interventions may counteract this cycle of high health economic burden, but the clinical role is unclear. Methods: This multi-center, cluster-randomized, controlled trial evaluated combined endurance and resistance exercise training...

Background: Previous studies have described various neuroplasticity effects of physical activity (PA). EEG studies have described effects mostly during or shortly after short bouts of PA. This is the first study to investigate the capability of EEG to display PA-induced long-lasting plasticity in runners compared to a sedentary control group. Metho...

Funding Acknowledgements Type of funding sources: Foundation. Main funding source(s): German Centre for Cardiovascular Research (DZHK). Background Alterations of endothelial function and nitric oxide (NO) release are involved in pathophysiology and clinical symptoms of heart failure (HF). Regular exercise training improves vascular and endothelial...

Funding Acknowledgements Type of funding sources: Public grant(s) – National budget only. Main funding source(s): Innovationsfonds des Gemeinsamen Bundesausschusses. Introduction Exercise interventions are well established in the treatment of chronic ischaemic heart disease (CIHD) and type 2 diabetes mellitus (T2DM). Yet, there remains a significa...

Arterial hypertension is the most important modifiable cardiovascular risk factor for all-cause morbidity and mortality worldwide. It is associated with an increased risk of cardiovascular diseases (CVD) and cognitive impairment. In this regard, accumulating evidence points to beneficial effects of intensified blood pressure lowering by implementat...

Purpose Occupational health programmes have been successfully implemented to improve body composition, physical fitness and cardiovascular risk. However, most programmes have been small and have not included long-term evaluation. Therefore, we evaluated a twelve-month life-style change programme in a German refinery. Methods We offered a supervise...

Background Exercise training improves peak oxygen uptake (V̇O2peak) in heart failure with preserved ejection fraction (HFpEF). Multiple adaptations have been addressed, but the role of circulating endothelium-repairing cells and vascular function have not been well defined. Objectives The authors investigated effects of moderate-intensity continuou...

Background: Prolonged and strenuous exercise has been linked to potential exercise-induced myocardial damages. One potential key to unmask the discussed underlying mechanisms of this subclinical cardiac damage could be markers of immunogenic cell damage (ICD). We investigated the kinetics of high-mobility group box 1 protein (HMGB1), soluble recept...

Background. Extensive physical activity (PA; ≥18 MET∗h/week, MET metabolic equivalent of tasks hours) postcancer diagnosis has shown favorable effects on colorectal cancer disease-free survival. However, the feasibility of introducing this high volume of PA in this patient group is unclear. Therefore, the aim of the F-PROTECT study was to evaluate...

Background Industrially processed trans-fatty acids (IP-TFA) have been linked to altered lipoprotein metabolism, inflammation and increased NT-proBNP. In patients with heart failure with preserved ejection fraction (HFpEF), associations of TFA blood levels with patient characteristics are unknown. Methods This is a secondary analysis of the Aldo-D...

Physical activity (PA) has positive effects on various health aspects and neuronal functions, including neuronal plasticity. Exceeding a certain exercise frequency and duration has been associated with negative effects. Our study investigated the effects of excessive PA with a marathon run (MA) and regular PA (training and recovery phases) on elect...

Background: Industrially processed trans-fatty acids (IP-TFA) have been linked to altered lipoprotein metabolism, inflammation and increased NTproBNP. In patients with heart failure with preserved ejection fraction (HFpEF), associations of TFA blood levels with patient characteristics are unknown. Methods: This is a secondary analysis of the Aldo-D...

Background: Exercise intolerance is a cardinal feature of heart failure with preserved ejection fraction and so far exercise training (ET) is the most effective treatment. Since the improvement in exercise capacity is only weakly associated with changes in diastolic function other mechanisms, like changes in the skeletal muscle, contribute to impr...

Introduction In heart failure with preserved ejection fraction (HFpEF), moderate continuous training (MCT) and high-intensity interval training (HIIT) are both effective in increasing peak oxygen uptake (peak V̇O2). Purpose The aim of this study was to investigate the association of training characteristics (i.e. average sessions/week, average dur...

Background Prognosis in HFpEF is determined by risk factor control and treatment of comorbidities. Industrially processed TFA (IP-TFA) from partially hydrogenated oils have been linked to altered lipoprotein metabolism, endothelial dysfunction, increased biomarkers of inflammation and increased NTproBNP. In patients with heart failure with preserve...

Within cardiology the field of sports cardiology has gradually increased in importance over the past 10 years. This is mainly due to the fact that the spectrum of issues relating to physical training in prevention and secondary prevention has expanded beyond classical cardiovascular rehabilitation. This spectrum affects above all adolescents and yo...

Background: Circulating long-chain (LCSFAs) and very long-chain saturated fatty acids (VLSFAs) have been differentially linked to risk of incident heart failure (HF). In patients with heart failure with preserved ejection fraction (HFpEF), associations of blood SFA levels with patient characteristics are unknown. Methods: From the Aldo-DHF-RCT,...

Cardiac sequelae after COVID-19 have been described in athletes, prompting the need to establish a return-to-play (RTP) protocol to guarantee a safe return to sports practice. Sports participation is strongly associated with multiple short- and long-term health benefits in children and adolescents and plays a crucial role in counteracting the psych...

Regular exercise that meets or exceeds the current physical activity guidelines is associated with a reduced risk of cardiovascular disease (CVD) and mortality. Therefore, exercise training plays an important role in primary and secondary prevention of CVD. In this part 1 of a 4-part focus seminar series, we highlight the mechanisms and physiologic...

Background Exercise for heart failure (HF) with reduced ejection fraction (HFrEF) is recommended by guidelines, but exercise mode and intensities are not differentiated between HF etiologies. We, therefore, investigated the effect of moderate or high intensity exercise on left ventricular end-diastolic diameter (LVEDD), left ventricular ejection fr...

Common knowledge implies that individuals engaging in outdoor sports and especially in regular and extreme mountaineering are exceptionally healthy and hardened. Physical activity in outdoor environments has a positive effect on physical and mental health. However, regular and/or extreme mountaineering might share similarities with behavioural addi...

Background Lifestyle interventions are a cornerstone in the treatment of chronic ischaemic heart disease (CIHD) and type 2 diabetes mellitus (T2DM). This study aimed at identifying differences in clinical characteristics between categories of the common lifestyle intervention targets BMI, exercise capacity (peak V̇O 2 ) and health literacy (HL). M...

Introduction Telemedicine is being used in an increasing number of healthy lifestyle intervention studies in preventive cardiology. However, the optimal telemedicine-based approach for patients with cardiovascular disease remains unclear. Therefore, the aim of this systematic review is to identify which design features are associated with the accep...

Purpose Mobility is a crucial factor for independence and quality of life in old age. Nevertheless, many old people in retirement homes do not meet the physical activity recommendations. The aim of the Bestform-F – Best Function of Range of Motion feasibility study (bestform-F) was to evaluate the feasibility of implementing a machine-based multimo...

Endurance sports carry a high risk of exercise addiction (EA) compared to other physical activities. Previous research has established a link between EA and depressive symptoms. The aim of this study was to evaluate a sample of amateur marathoners concerning risk of EA and investigate the relationship to fitness measures, affect and the general lev...

Patients with heart failure with preserved ejection fraction (HFpEF) universally complain of exercise intolerance and dyspnoea as key clinical correlates. Cardiac as well as extracardiac components play a role for the limited exercise capacity, including an impaired cardiac and peripheral vascular reserve, a limitation in mechanical ventilation and...

Aims: In heart failure with preserved ejection fraction (HFpEF), the reduction of nitric oxide (NO)-bioavailability and consequently endothelial dysfunction leads to LV stiffness and diastolic dysfunction of the heart. Besides shear stress, high-density lipoprotein (HDL) stimulates endothelial cells to increased production of NO via phosphorylatio...

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...

Major depression, bipolar disorder, and schizophrenia are severe mental illnesses. Despite receiving psychopharmacological and psychosocial treatments, about half of patients develop a chronic course with residual cognitive and negative symptoms and have a high risk for cardiovascular disease and reduced life expectancy. Therefore, add-on innovativ...

Funding Acknowledgements Type of funding sources: Public grant(s) – National budget only. Main funding source(s): Federal Joint Committee Germany Background Ischaemic heart disease is the leading cause of global mortality and when accompanied by type 2 diabetes mellitus (T2DM), prognosis is even worse. Lifestyle (LS) interventions are recommended,...

Abstract available @ DOI https://doi.org/10.1007/s00392-022-02002-5

Mit zunehmender Urbanisierung steigt auch das Risiko für kardiovas- kuläre Erkrankungen. Neben mit dem Stadtleben assoziierten negativen Verhaltensänderungen sind die Menschen in den Städten diversen Umweltrisiken ausgesetzt. Für die Prävention kardiovaskulärer Erkrankungen ist es somit ein entscheidendes Ziel, gesunde urbane Lebensräume zu schaffe...

Objectives To evaluate associations of omega-3 fatty acid (O3-FA) blood levels with cardiometabolic risk markers, functional capacity and cardiac function/morphology in patients with heart failure with preserved ejection fraction (HFpEF). Background O3-FA have been linked to reduced risk for HF and associated phenotypic traits in experimental/clin...

The muscle disease sarcopenia, which is characterised by a loss of muscle strength, muscle quantity, and physical performance, restricts mobility and independence in an ageing society. The aim of this systematic review and meta-analysis is to analyse the effects that long-term progressive resistance training interventions performed on weight machin...

Aims Iron deficiency (ID) is linked to reduced aerobic exercise capacity and poor prognosis in patients with heart failure (HF) with reduced ejection fraction (HFrEF); however, data for HF with preserved ejection fraction (HFpEF) is scarce. We assessed the relationship between iron status and diastolic dysfunction as well as aerobic exercise capaci...

Objective: It is unclear whether and to what extent COVID-19 infection poses health risks and a chronic impairment of performance in athletes. Identification of individual health risk is an important decision-making basis for managing the pandemic risk of infection with SARS-CoV-2 in sports and return to play (RTP). Methods: This study aims 1) to a...

Funding Acknowledgements Type of funding sources: Public Institution(s). Main funding source(s): Norwegian University of Science and Technology Danish Research Council Background Exercise training (ET) exerts many beneficial effects on the cardiovascular system, and longitudinal observational data from epidemiological studies suggest that higher p...

Anti-viral immunity continuously declines over time after SARS-CoV-2 infection. Here, we characterize the dynamics of anti-viral immunity during long-term follow-up and after BNT162b2 mRNA-vaccination in convalescents after asymptomatic or mild SARS-CoV-2 infection. Virus-specific and virus-neutralizing antibody titers rapidly declined in convalesc...

Background Cardiac myosin-binding protein C (cMyC), a cardiac contractile protein, is a novel biomarker of myocardial injury, rising earlier and disappearing faster than cardiac troponins. It is a promising biomarker for use in triage of patients with chest pain presenting in the emergency department. It also has prognostic significance in patients...

Background Exercise training improves peak oxygen uptake (VO2) in heart failure with preserved ejection fraction (HFpEF), but the underlying mechanisms are unknown. In other cardiovascular diseases, exercise training improves vascular function and increases levels of circulating endothelium-repairing cells. We aimed to investigate the effects of mo...

Aims Data about the influence of short-term lifestyle intervention in children with obesity on long-term follow-up body weight, adipokines and cardiometabolic risk parameters is scarce. Methods In a subgroup of the LOGIC-trial (Long-term Effects of Lifestyle Intervention in Obesity and Genetic Influence in Children), we assessed anthropometry (BMI...

Aims: In patients with heart failure with preserved ejection fraction (HFpEF), exercise training improves the quality of life and aerobic capacity (peakV·O2). Up to 55% of HF patients, however, show no increase in peakV·O2 despite adequate training. We hypothesized that circulating microRNAs (miRNAs) can distinguish exercise low responders (LR) fr...

Aims ACTIVITY-HF was a randomized, double-blind, active-controlled study, which assessed the short-term effect of sacubitril/valsartan compared with the active-comparator enalapril on improving maximal exercise capacity in patients with heart failure with reduced ejection fraction (HFrEF). Methods and results A total of 201 ambulatory patients wit...

Patients with chronic kidney disease (CKD) on hemodialysis (HD) experience treatment-related immobility and physical deconditioning, which is responsible for an increased risk of frailty and a high burden of multi-morbidity. Exercise has been shown to counteract this vicious cycle; however, its effectiveness has only been investigated in small coho...

In Reply Dr Brubaker and colleagues and Dr Buckley and colleagues question the interpretation of the clinically meaningful change in peak V̇o2 in our study of the effects of different exercise modes on peak V̇o2 in HFpEF.¹ We agree that based on expert opinion and some observational trials,²,3 changes in peak V̇o2 less than our a priori definition...

Background: Physical exercise has been linked to beneficial effects on brain plasticity. One potential key mechanism for this relationship is an exercise-induced increase of brain-derived neurotrophic factor (BDNF). However, the kinetics of BDNF in athletes during training phase, extreme exercise competition, and recovery period have not been inves...

Background Falls and fall-related injuries are common in community-dwelling older persons. Longitudinal data on effective fall prevention programs are rare. Objective Therefore, we evaluated a 4-months multi-component exercise fall prevention program in a primary care setting on long-term effects over 24 months on falls and concomitant injuries in...

Background Although structured exercise training is strongly recommended in cardiac patients, uncertainties exist about the methods for determining exercise intensity (EI) and their correspondence with effective EI obtained by ventilatory thresholds. We aimed to determine the first (VT1) and second ventilatory threshold (VT2) in cardiac patients, s...

Infection with the Severe Acute Respiratory Syndrome Coronavirus 2 (SARS-CoV-2) is controlled by the host´s immune response1-4, but longitudinal follow-up studies of virus-specific immunity to evaluate protection from re-infection are lacking. Here, we report the results from a prospective study that started during the first wave of the COVID-19 pa...

Human metabolism is highly variable. At one end of the spectrum, defects of enzymes, transporters, and metabolic regulation result in metabolic diseases such as diabetes mellitus or inborn errors of metabolism. At the other end of the spectrum, favorable genetics and years of training combine to result in physiologically extreme forms of metabolism...

The Task Force on sports cardiology and exercise in patients with cardiovascular disease of the European Society of Cardiology (ESC)