Format

Send to

Choose Destination
Circulation. 2017 Feb 28;135(9):839-849. doi: 10.1161/CIRCULATIONAHA.116.022924. Epub 2017 Jan 12.

High-Intensity Interval Training in Patients With Heart Failure With Reduced Ejection Fraction.

Author information

1
From St. Olavs Hospital, Trondheim University Hospital, Norway (Ø.E., A.S., H.D., V.V., T.K.); K.G. Jebsen Center for Exercise in Medicine, Department of Circulation and Medical Imaging, Norwegian University of Science and Technology, Trondheim, Norway (Ø.E., H.D., T.K.); Department of Prevention, Rehabilitation and Sports Medicine, Technische Universität München, Klinikum rechts der Isar, Germany (M.H., J.W.C., A.P.); DZHK (German Center for Cardiovascular Research), Partner Site Munich Heart Alliance, Munich, Germany (M.H.); Else-Kröner-Fresenius Prevention Center, Klinikum rechts der Isar, Munich, Germany (M.H.); Antwerp University Hospital, Edegem, Belgium (V.C., E.M.V.C., P.B.); University of Antwerp, Belgium (V.C., E.M.V.C., P.B.); Department of Circulation and Medical Imaging (A.S., T.H.) and Department of Laboratory Medicine, Children's and Women's Health (V.V.), NTNU-Norwegian University of Science and Technology, Trondheim, Norway; Department of Medicine, Levanger Hospital, Nord-Trøndelag Hospital Trust, Norway (H.D.); Centre Hospitalier de Luxembourg, Luxembourg (C.D., P.F.); Department of Cardiology, Stavanger University Hospital, Norway (A.- I.L., T.V.); Department of Clinical Science, University of Bergen, Norway (A.-I.L., T.V.); Ålesund Hospital, Møre og Romsdal Health Trust, Norway (T.H.); Cardiac Rehabilitation Division, Salvatore Maugeri Foundation IRCCS, Scientific Institute of Veruno, Italy (A.M.); Division of Cardiovascular Medicine, Stanford Center for Inherited Cardiovascular Disease, CA (J.W.C.); Department of Cardiology, Herzzentrum, Universität Leipzig, Germany (E.W., N.M., F.W., R. Höllriegel, A.L.); Department of Cardiology, Bispebjerg Hospital, University of Copenhagen, Denmark (T.M.-H., M.S., E.P.); University of Oslo, Rikshospitalet University Hospital, Norway (J.K.); Department of Cardiology and Angiology, Klinikum Links der Weser, Bremen, Germany (R. Hambrecht); and Department of Cardiology, Angiology and Intensive Care, Klinikum Lippe, Detmold, Germany (S.G.). oyvind.ellingsen@ntnu.no.
2
From St. Olavs Hospital, Trondheim University Hospital, Norway (Ø.E., A.S., H.D., V.V., T.K.); K.G. Jebsen Center for Exercise in Medicine, Department of Circulation and Medical Imaging, Norwegian University of Science and Technology, Trondheim, Norway (Ø.E., H.D., T.K.); Department of Prevention, Rehabilitation and Sports Medicine, Technische Universität München, Klinikum rechts der Isar, Germany (M.H., J.W.C., A.P.); DZHK (German Center for Cardiovascular Research), Partner Site Munich Heart Alliance, Munich, Germany (M.H.); Else-Kröner-Fresenius Prevention Center, Klinikum rechts der Isar, Munich, Germany (M.H.); Antwerp University Hospital, Edegem, Belgium (V.C., E.M.V.C., P.B.); University of Antwerp, Belgium (V.C., E.M.V.C., P.B.); Department of Circulation and Medical Imaging (A.S., T.H.) and Department of Laboratory Medicine, Children's and Women's Health (V.V.), NTNU-Norwegian University of Science and Technology, Trondheim, Norway; Department of Medicine, Levanger Hospital, Nord-Trøndelag Hospital Trust, Norway (H.D.); Centre Hospitalier de Luxembourg, Luxembourg (C.D., P.F.); Department of Cardiology, Stavanger University Hospital, Norway (A.- I.L., T.V.); Department of Clinical Science, University of Bergen, Norway (A.-I.L., T.V.); Ålesund Hospital, Møre og Romsdal Health Trust, Norway (T.H.); Cardiac Rehabilitation Division, Salvatore Maugeri Foundation IRCCS, Scientific Institute of Veruno, Italy (A.M.); Division of Cardiovascular Medicine, Stanford Center for Inherited Cardiovascular Disease, CA (J.W.C.); Department of Cardiology, Herzzentrum, Universität Leipzig, Germany (E.W., N.M., F.W., R. Höllriegel, A.L.); Department of Cardiology, Bispebjerg Hospital, University of Copenhagen, Denmark (T.M.-H., M.S., E.P.); University of Oslo, Rikshospitalet University Hospital, Norway (J.K.); Department of Cardiology and Angiology, Klinikum Links der Weser, Bremen, Germany (R. Hambrecht); and Department of Cardiology, Angiology and Intensive Care, Klinikum Lippe, Detmold, Germany (S.G.).

Abstract

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.

KEYWORDS:

exercise; heart failure

PMID:
28082387
PMCID:
PMC5325251
DOI:
10.1161/CIRCULATIONAHA.116.022924
[Indexed for MEDLINE]
Free PMC Article

Supplemental Content

Full text links

Icon for Atypon Icon for PubMed Central
Loading ...
Support Center