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Updated: Oct 14, 2025
Retinal Vascular Reactivity as Assessed by Optical Coherence Tomography Angiography
Published on: March 26, 2020
A randomized clinical study using optical coherence tomography to evaluate the short-term effects of high-intensity
Muzammil Rafique1,2, Ole Geir Solberg1, Lars Gullestad1,2,3
1Department of Cardiology, Oslo University Hospital, Rikshospitalet, Oslo, Norway.
Insights
High-intensity interval training (HIT) did not significantly slow cardiac allograft vasculopathy (CAV) progression in new heart transplant recipients compared to moderate-intensity training over nine months. Early intervention with HIT did not attenuate CAV development in this patient group.
Area of Science:
- Cardiology
- Transplantation Medicine
- Exercise Physiology
Background:
- Cardiac allograft vasculopathy (CAV) is a primary cause of death in long-term heart transplant survivors.
- Current preventive and treatment strategies for CAV are limited.
- Understanding exercise interventions' effects on CAV is crucial for improving patient outcomes.
Purpose of the Study:
- To assess the short-term impact of high-intensity interval training (HIT) on CAV progression in de novo heart transplant (HTx) recipients.
- To compare the effects of HIT versus moderate-intensity continuous training (MICT) on intima area changes in HTx recipients.
- To evaluate CAV development using optical coherence tomography (OCT) over a nine-month period.
Main Methods:
- A subgroup of 81 patients from the HITTS study were randomized to HIT or MICT for nine months.
- Optical coherence tomography (OCT) was used to compare baseline and 12-month images for CAV assessment.
- The primary endpoint was the change in mean intima area, analyzed in 56 patients with paired OCT data.
Main Results:
- The mean intima area increased by 25% across the entire study population.
- Intima area progression was twofold higher in the MICT group compared to the HIT group.
- The difference in CAV progression between HIT and MICT was not statistically significant (P = 0.29).
Conclusions:
- Early initiation of HIT does not appear to attenuate CAV progression compared to MICT in de novo HTx recipients.
- Further research is needed to explore optimal exercise strategies for managing CAV.
- HIT may not be a superior intervention for preventing early CAV development post-heart transplantation.
Abstract:
Cardiac allograft vasculopathy (CAV) remains a leading cause of long-term mortality after heart transplantation. Both preventive measures and treatment options are limited. This study aimed to evaluate the short-term effects of high-intensity interval training (HIT) on CAV in de novo heart transplant (HTx) recipients as assessed by optical coherence tomography (OCT). The study population was a subgroup of the 81-patient HITTS study in which HTx recipients were randomized to HIT or moderate intensity continuous training (MICT) for nine consecutive months. OCT images from baseline and 12 months were compared to assess CAV progression. The primary endpoint was defined as the change in the mean intima area. Paired OCT data were available for 56 patients (n = 23 in the HIT group and n = 33 in the MICT group). The intima area in the entire study population increased by 25% [from 1.8±1.4 mm2 to 2.3±2.0 mm2 , P < .05]. The change was twofold higher in the MICT group (.6±1.2 mm2 ) than in the HIT group (.3±.6 mm2 ). However, the treatment effect of HIT was not significant (treatment effect = -.3 mm2 , 95% CI [-.825 to .2 mm2 ] P = .29). These results suggest that early initiation of HIT compared with MICT does not attenuate CAV progression in de novo HTx recipients.
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