High-intensity interval training combined with moderate-intensity continuous training in post-PCI acute myocardial
Weilin Wang1, Yingchun Gu2, Dongwei Wang2
1Medical Science and Technology Innovation Center, Shandong First Medical University and Shandong Academy of Medical Sciences, Jinan, China.
Background:
Conventional moderate-intensity continuous training (MICT) has certain shortcomings in enhancing peak oxygen consumption (VO2peak) and recovery of left ventricular function in post-percutaneous coronary intervention (PCI) acute myocardial infarction (AMI) patients, while high-intensity interval training (HIIT) raises safety concerns despite evidence of its effectiveness.
Objective:
To assess the efficacy and safety of combined HIIT and MICT training compared to single training modalities in post-PCI AMI patients.
Methods:
This single-center, three-arm parallel, assessor-blinded randomized controlled trial enrolled 204 clinically stable post-PCI AMI patients, who were randomized 1:1:1 to combined training (HIIT+MICT, n = 68), MICT alone (n = 68), or HIIT alone (n = 68) groups for 12-week supervised cardiac rehabilitation. The primary outcome was the change in VO2peak; secondary outcomes included left ventricular ejection fraction (LVEF), N-terminal pro-B-type natriuretic peptide (NT-proBNP), exercise capacity, and major adverse cardiovascular events (MACE).
Results:
Combined training showed superior improvement in VO2peak (5.6 ± 2.3 mL/kg/min) compared with MICT alone (2.7 ± 1.9 mL/kg/min, P < .001) and HIIT alone (4.2 ± 1.8 mL/kg/min, P = .003), with 76.7% reaching clinically meaningful improvement (≥3 mL/kg/min). In the combined training group, LVEF increased 8.6 ± 3.2% and NT-proBNP decreased -706 pg/mL. Incidence of MACE remained low at 2.9%, without significant inter-group differences, P = .85.
Conclusions:
Combined HIIT and MICT training produces synergistic effects, superior to single modalities, in improving cardiopulmonary function and cardiac remodeling in post-PCI AMI patients, with comparable safety profile, providing evidence-based optimization strategy for cardiac rehabilitation.
Trial Registration:
Chinese Clinical Trial Registry (ChiCTR); Registration No. ChiCTR2000031251; https://www.chictr.org.cn/showproj.html?proj=31251.
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