Impact of high-intensity interval training on cardiac structure and function after COVID-19: an investigator-blinded
Iben Elmerdahl Rasmussen1, Mathilde Løk2, Cody Garett Durrer1
1Centre for Physical Activity Research, University Hospital Copenhagen, Rigshospitalet, Copenhagen, Denmark.
Insights
High-intensity interval training (HIIT) effectively increased left ventricular mass in patients recovering from COVID-19. This exercise intervention shows promise for improving cardiac health after hospitalization for the virus.
Area of Science:
- Cardiology
- Exercise Physiology
- Infectious Disease Research
Background:
- Persistent cardiorespiratory fitness reduction is common post-COVID-19 hospitalization.
- Cardiac effects of COVID-19 may be reversible with targeted exercise interventions like HIIT.
Purpose of the Study:
- To investigate if high-intensity interval training (HIIT) increases left ventricular mass (LVM) in COVID-19 survivors.
- To assess HIIT's impact on functional status and health-related quality of life (HRQoL) post-COVID-19.
Main Methods:
- Investigator-blinded, randomized controlled trial comparing 12 weeks of supervised HIIT with standard care.
- Primary outcome: LVM assessed by cardiac MRI. Secondary outcomes: pulmonary diffusing capacity (DLCO), functional status (PCFS), and HRQoL (KBILD).
Main Results:
- HIIT significantly increased LVM compared to standard care (mean difference 6.8g, P=0.029).
- No significant between-group differences were observed in DLCO or other lung function metrics.
- Functional status showed descriptive improvement in the HIIT group; HRQoL improved similarly in both groups.
Conclusions:
- Supervised high-intensity interval training (HIIT) is an effective intervention for increasing left ventricular mass in individuals hospitalized for COVID-19.
- HIIT specifically targets cardiac improvements, while pulmonary function gradually recovered in both intervention and control groups.
Abstract:
A large proportion of patients suffer from a persistent reduction in cardiorespiratory fitness after recovery from COVID-19, of which the effects on the heart may potentially be reversed through the effect of high-intensity interval training (HIIT). In the present study, we hypothesized that HIIT would increase left ventricular mass (LVM) and improve functional status and health-related quality of life (HRQoL) in individuals previously hospitalized for COVID-19. In this investigator-blinded, randomized controlled trial, 12 wk of supervised HIIT (4 × 4 min, three times a week) was compared with standard care (control) in individuals recently discharged from hospital due to COVID-19. LVM was assessed by cardiac magnetic resonance imaging (cMRI, primary outcome), whereas the pulmonary diffusing capacity (DLCOc, secondary outcome) was examined by the single-breath method. Functional status and HRQoL were assessed by Post-COVID-19 functional scale (PCFS) and King's brief interstitial lung disease (KBILD) questionnaire, respectively. A total of 28 participants were included (age 57 ± 10, 9 females; HIIT: 58 ± 11, 4 females; standard care: 57 ± 9, 5 females), LVM increased in the HIIT vs. standard care group with a between-group difference of 6.8 [mean, 95%CI: 0.8; 12.8] g; P = 0.029. There were no between-group differences in DLCOc or any other lung function metric, which gradually resolved in both groups. Descriptively, PCFS suggested fewer functional limitations in the HIIT group. KBILD improved similarly in the two groups. HIIT is an efficacious exercise intervention for increasing LVM in individuals previously hospitalized for COVID-19.NEW & NOTEWORTHY In this randomized clinical trial on individuals previously hospitalized for COVID-19, a 12 wk supervised high-intensity interval training (HIIT) scheme was found to increase left ventricular mass, whereas pulmonary diffusing capacity was unaffected. The findings indicate that HIIT is an efficacious exercise intervention for targeting the heart after COVID-19.
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