TY - JOUR
T1 - High-Intensity Interval Training in Patients With Heart Failure With Reduced Ejection Fraction
AU - Ellingsen, Øyvind
AU - Halle, Martin
AU - Conraads, Viviane
AU - Støylen, Asbjørn
AU - Dalen, Håvard
AU - Delagardelle, Charles
AU - Larsen, Alf-Inge
AU - Hole, Torstein
AU - Mezzani, Alessandro
AU - Van Craenenbroeck, Emeline M
AU - Videm, Vibeke
AU - Beckers, Paul
AU - Christle, Jeffrey W
AU - Winzer, Ephraim
AU - Mangner, Norman
AU - Woitek, Felix
AU - Höllriegel, Robert
AU - Pressler, Axel
AU - Monk-Hansen, Tea
AU - Snoer, Martin
AU - Feiereisen, Patrick
AU - Valborgland, Torstein
AU - Kjekshus, John
AU - Hambrecht, Rainer
AU - Gielen, Stephan
AU - Karlsen, Trine
AU - Prescott, Eva
AU - Linke, Axel
AU - SMARTEX Heart Failure Study (Study of Myocardial Recovery After Exercise Training in Heart Failure) Group
N1 - © 2017 The Authors.
PY - 2017/2/28
Y1 - 2017/2/28
N2 - BACKGROUND: Small studies have suggested that high-intensity interval training (HIIT) is superior to moderate continuous training (MCT) in reversing cardiac remodeling and increasing aerobic capacity in patients with heart failure with reduced ejection fraction. The present multicenter trial compared 12 weeks of supervised interventions of HIIT, MCT, or a recommendation of regular exercise (RRE).METHODS: Two hundred sixty-one patients with left ventricular ejection fraction ≤35% and New York Heart Association class II to III were randomly assigned to HIIT at 90% to 95% of maximal heart rate, MCT at 60% to 70% of maximal heart rate, or RRE. Thereafter, patients were encouraged to continue exercising on their own. Clinical assessments were performed at baseline, after the intervention, and at follow-up after 52 weeks. Primary end point was a between-group comparison of change in left ventricular end-diastolic diameter from baseline to 12 weeks.RESULTS: Groups did not differ in age (median, 60 years), sex (19% women), ischemic pathogenesis (59%), or medication. Change in left ventricular end-diastolic diameter from baseline to 12 weeks was not different between HIIT and MCT (P=0.45); left ventricular end-diastolic diameter changes compared with RRE were -2.8 mm (-5.2 to -0.4 mm; P=0.02) in HIIT and -1.2 mm (-3.6 to 1.2 mm; P=0.34) in MCT. There was also no difference between HIIT and MCT in peak oxygen uptake (P=0.70), but both were superior to RRE. However, none of these changes was maintained at follow-up after 52 weeks. Serious adverse events were not statistically different during supervised intervention or at follow-up at 52 weeks (HIIT, 39%; MCT, 25%; RRE, 34%; P=0.16). Training records showed that 51% of patients exercised below prescribed target during supervised HIIT and 80% above target in MCT.CONCLUSIONS: HIIT was not superior to MCT in changing left ventricular remodeling or aerobic capacity, and its feasibility remains unresolved in patients with heart failure.CLINICAL TRIAL REGISTRATION: URL: http://www.clinicaltrials.gov. Unique identifier: NCT00917046.
AB - BACKGROUND: Small studies have suggested that high-intensity interval training (HIIT) is superior to moderate continuous training (MCT) in reversing cardiac remodeling and increasing aerobic capacity in patients with heart failure with reduced ejection fraction. The present multicenter trial compared 12 weeks of supervised interventions of HIIT, MCT, or a recommendation of regular exercise (RRE).METHODS: Two hundred sixty-one patients with left ventricular ejection fraction ≤35% and New York Heart Association class II to III were randomly assigned to HIIT at 90% to 95% of maximal heart rate, MCT at 60% to 70% of maximal heart rate, or RRE. Thereafter, patients were encouraged to continue exercising on their own. Clinical assessments were performed at baseline, after the intervention, and at follow-up after 52 weeks. Primary end point was a between-group comparison of change in left ventricular end-diastolic diameter from baseline to 12 weeks.RESULTS: Groups did not differ in age (median, 60 years), sex (19% women), ischemic pathogenesis (59%), or medication. Change in left ventricular end-diastolic diameter from baseline to 12 weeks was not different between HIIT and MCT (P=0.45); left ventricular end-diastolic diameter changes compared with RRE were -2.8 mm (-5.2 to -0.4 mm; P=0.02) in HIIT and -1.2 mm (-3.6 to 1.2 mm; P=0.34) in MCT. There was also no difference between HIIT and MCT in peak oxygen uptake (P=0.70), but both were superior to RRE. However, none of these changes was maintained at follow-up after 52 weeks. Serious adverse events were not statistically different during supervised intervention or at follow-up at 52 weeks (HIIT, 39%; MCT, 25%; RRE, 34%; P=0.16). Training records showed that 51% of patients exercised below prescribed target during supervised HIIT and 80% above target in MCT.CONCLUSIONS: HIIT was not superior to MCT in changing left ventricular remodeling or aerobic capacity, and its feasibility remains unresolved in patients with heart failure.CLINICAL TRIAL REGISTRATION: URL: http://www.clinicaltrials.gov. Unique identifier: NCT00917046.
KW - Aged
KW - Echocardiography
KW - Exercise Test
KW - Exercise Tolerance
KW - Female
KW - Follow-Up Studies
KW - Heart Failure
KW - Heart Rate
KW - Heart Ventricles
KW - High-Intensity Interval Training
KW - Humans
KW - Male
KW - Middle Aged
KW - Quality of Life
KW - Stroke Volume
KW - Ventricular Remodeling
KW - Journal Article
KW - Multicenter Study
KW - Randomized Controlled Trial
U2 - 10.1161/CIRCULATIONAHA.116.022924
DO - 10.1161/CIRCULATIONAHA.116.022924
M3 - Journal article
C2 - 28082387
VL - 135
SP - 839
EP - 849
JO - Circulation (Baltimore)
JF - Circulation (Baltimore)
SN - 0009-7322
IS - 9
ER -