Impact of 2 different aerobic periodization training protocols on left ventricular function in patients with stable
Maxime Boidin1,2, Louis-Philippe David3, Lukas D Trachsel2,4
1School of Kinesiology and Exercise Science, Faculty of Medicine, University of Montreal, Montreal, QC H3T 1J4, Canada.
Insights
Both linear and nonlinear aerobic training improved cardiac function in coronary artery disease patients, enhancing ejection fraction and radial strain without adverse effects. Further research is needed for patients with severe cardiac dysfunction.
Area of Science:
- Cardiology
- Exercise Physiology
- Cardiac Rehabilitation
Background:
- Coronary artery disease (CAD) impacts cardiac function, necessitating effective rehabilitation strategies.
- Aerobic training is crucial for cardiovascular health, but optimal periodization remains under investigation.
- Understanding the effects of different training periodizations on cardiac remodeling is vital for patient outcomes.
Purpose of the Study:
- To compare the effects of linear periodization (LP) and nonlinear periodization (NLP) aerobic training on left ventricular (LV) function and geometry in CAD patients.
- To assess changes in 3D LV ejection fraction (LVEF), diastolic function, and myocardial strain parameters.
- To determine if different aerobic training periodizations yield distinct cardiac adaptations in CAD patients.
Main Methods:
- Thirty-nine CAD patients were randomized into 3-month supervised LP or NLP aerobic training programs.
- Training involved high-intensity interval and moderate-intensity continuous sessions, 3 times/week.
- Echocardiography assessed 3D LVEF, diastolic function, strain, and strain rate at baseline and study end.
Main Results:
- Both LP and NLP significantly improved 3D LVEF and radial strain in CAD patients.
- Improvements in radial strain rate were observed, particularly with LP.
- No significant differences were found between LP and NLP for most cardiac function parameters, indicating similar efficacy.
Conclusions:
- Linear and nonlinear aerobic periodization strategies induce comparable improvements in LVEF and radial strain in CAD patients.
- These adaptations suggest favorable cardiac remodeling and myofiber reorganization.
- Further investigation is warranted in CAD patients with more severe cardiac dysfunction.
Abstract:
We compared the impacts of linear (LP) and nonlinear (NLP) aerobic training periodizations on left ventricular (LV) function and geometry in coronary artery disease (CAD) patients. Thirty-nine CAD patients were randomized to either a 3-month isoenergetic supervised LP or NLP. All underwent standard echocardiography with assessment of 3D LV ejection fraction (LVEF), diastolic function, strain (global longitudinal, radial, and circumferential), and strain rate at baseline and study end. Training was performed 3 times/week and included high-intensity interval and moderate-intensity continuous training sessions. Training load was progressively increased in the LP group, while it was deeply increased and intercepted with a recovery week each fourth week in the NLP group. For the 34 analyzed patients, we found similar improvements for 3D LVEF (effect size (ES): LP, 0.29; NLP, 0.77), radial strain (ES: LP, 0.58; NLP, 0.48), and radial strain rate (ES: LP, 0.87; NLP, 0.17) in both groups (time for all: p ≤ 0.01). All other parameters of cardiac function remained similar. In conclusion, NLP and LP led to similar improvements in 3D LVEF and radial strain, suggesting a favourable positive cardiac remodelling through myofibers reorganization. These findings must be investigated in patients with more severe cardiac dysfunction. The study was registered on ClinicalTrials.gov (NCT03443193). Novelty: Linear and nonlinear periodization programs improved radial strain, accompanied by improvement of ejection fraction. Both aerobic periodization programs did not negatively impact cardiac function in coronary artery disease patients.
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