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Published on: February 22, 2022
High-Intensity Interval Training in Patients With Heart Failure With Reduced Ejection Fraction
Øyvind Ellingsen1, Martin Halle2, Viviane Conraads2
1From St. Olavs Hospital, Trondheim University Hospital, Norway (Ø.E., A.S., H.D., V.V., T.K.); K.G. Jebsen Center for Exercise in Medicine, Department of Circulation and Medical Imaging, Norwegian University of Science and Technology, Trondheim, Norway (Ø.E., H.D., T.K.); Department of Prevention, Rehabilitation and Sports Medicine, Technische Universität München, Klinikum rechts der Isar, Germany (M.H., J.W.C., A.P.); DZHK (German Center for Cardiovascular Research), Partner Site Munich Heart Alliance, Munich, Germany (M.H.); Else-Kröner-Fresenius Prevention Center, Klinikum rechts der Isar, Munich, Germany (M.H.); Antwerp University Hospital, Edegem, Belgium (V.C., E.M.V.C., P.B.); University of Antwerp, Belgium (V.C., E.M.V.C., P.B.); Department of Circulation and Medical Imaging (A.S., T.H.) and Department of Laboratory Medicine, Children's and Women's Health (V.V.), NTNU-Norwegian University of Science and Technology, Trondheim, Norway; Department of Medicine, Levanger Hospital, Nord-Trøndelag Hospital Trust, Norway (H.D.); Centre Hospitalier de Luxembourg, Luxembourg (C.D., P.F.); Department of Cardiology, Stavanger University Hospital, Norway (A.- I.L., T.V.); Department of Clinical Science, University of Bergen, Norway (A.-I.L., T.V.); Ålesund Hospital, Møre og Romsdal Health Trust, Norway (T.H.); Cardiac Rehabilitation Division, Salvatore Maugeri Foundation IRCCS, Scientific Institute of Veruno, Italy (A.M.); Division of Cardiovascular Medicine, Stanford Center for Inherited Cardiovascular Disease, CA (J.W.C.); Department of Cardiology, Herzzentrum, Universität Leipzig, Germany (E.W., N.M., F.W., R. Höllriegel, A.L.); Department of Cardiology, Bispebjerg Hospital, University of Copenhagen, Denmark (T.M.-H., M.S., E.P.); University of Oslo, Rikshospitalet University Hospital, Norway (J.K.); Department of Cardiology and Angiology, Klinikum Links der Weser, Bremen, Germany (R. Hambrecht); and Department of Cardiology, Angiology and Intensive Care, Klinikum Lippe, Detmold, Germany (S.G.). oyvind.ellingsen@ntnu.no.
High-intensity interval training (HIIT) and moderate continuous training (MCT) did not differ in improving heart failure with reduced ejection fraction. Neither exercise improved cardiac remodeling or aerobic capacity long-term.
Area of Science:
- Cardiology
- Exercise Physiology
- Heart Failure Management
Background:
- Previous small studies suggested high-intensity interval training (HIIT) surpasses moderate continuous training (MCT) for heart failure with reduced ejection fraction (HFrEF).
- This multicenter trial aimed to compare HIIT, MCT, and regular exercise recommendations in HFrEF patients.
Purpose of the Study:
- To compare the efficacy of 12-week supervised HIIT versus MCT in patients with HFrEF.
- To assess the impact on left ventricular remodeling and aerobic capacity.
Main Methods:
- 261 HFrEF patients (LVEF ≤35%, NYHA class II-III) were randomized to HIIT, MCT, or regular exercise recommendation (RRE).
- Interventions lasted 12 weeks, with follow-up at 52 weeks. Primary endpoint was change in left ventricular end-diastolic diameter.
Main Results:
- No significant difference in left ventricular end-diastolic diameter change between HIIT and MCT.
- Both HIIT and MCT improved peak oxygen uptake compared to RRE, but not significantly different between HIIT and MCT.
- Observed benefits were not sustained at 52-week follow-up. Adherence varied, with many patients not meeting prescribed intensity targets.
Conclusions:
- HIIT is not superior to MCT for improving cardiac remodeling or aerobic capacity in HFrEF patients.
- The feasibility and long-term effectiveness of HIIT in this population require further investigation.
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