High-intensity interval training is effective and superior to moderate continuous training in patients with heart failure with preserved ejection fraction: A randomized clinical trial. (November 2020)

• Record Type: Journal Article
• Authors: Donelli da Silveira, Anderson; Beust de Lima, Juliana; da Silva Piardi, Diogo; dos Santos Macedo, Débora; Zanini, Maurice; Nery, Rosane; Laukkanen, Jari A; Stein, Ricardo
• Is Part Of: European journal of preventive cardiology. Volume 27:Number 16(2020)
• Page Start: 1733
• Page End: 1743
• Publication Date: 2020-11
• Subjects: Exercise training -- heart failure -- peak oxygen uptake; Cardiovascular system -- Diseases -- Prevention -- Periodicals; Cardiac patients -- Rehabilitation -- Periodicals; 616.12
• DOI: 10.1177/2047487319901206
• Languages: English
• ISSNs: 2047-4873

Abstract

Background: Heart failure with preserved ejection fraction (HFpEF) is a prevalent syndrome, with exercise intolerance being one of its hallmarks, contributing to worse quality of life and mortality. High-intensity interval training is an emerging training option, but its efficacy in HFpEF patients is still unknown. Design: Single-blinded randomized clinical trial. Methods: Single-blinded randomized clinical trial with exercise training 3 days per week for 12 weeks. HFpEF patients were randomly assigned to high-intensity interval training or moderate continuous training. At baseline and after 12 week follow-up, patients underwent clinical assessment, echocardiography and cardiopulmonary exercise testing (CPET). Results: Mean age was 60 ± 9 years and 63% were women. Both groups ( N = 19) showed improved peak oxygen consumption (VO2 ), but high-intensity interval training patients ( n = 10) had a significantly higher increase, of 22%, compared with 11% in the moderate continuous training ( n = 9) individuals (3.5 (3.1 to 4.0) vs . 1.9 (1.2 to 2.5) mL·kg −1 ·min −1, p < 0.001). Ventilatory efficiency and other CPET measures, as well as quality of life score, increased equally in the two groups. Left ventricular diastolic function also improved with training, reflected by a significant reduction in E/e′ ratio by echocardiography (−2.6 (−4.3 to −1.0) vs . −2.2 (−3.6 to −0.9) for high-intensity interval training and moderate continuous training, respectively; p < 0.01). There were no exercise-related adverse events. Conclusions: This randomized clinical trial provided evidence that high-intensity interval training is a potential exercise modality for HFpEF patients, being more effective than moderate continuous training in improving peak VO2 . However, the two strategies were equally effective in improving ventilatory efficiency and other CPET parameters, quality of life score and diastolic function after 3 months of training.