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Clin Cardiol. 2017 Jun;40(6):370-376. doi: 10.1002/clc.22670. Epub 2017 Mar 21.

Adaptations following an intermittent hypoxia-hyperoxia training in coronary artery disease patients: a controlled study.

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I. M. Sechenov First Moscow State Medical University, Moscow, Russia.
School of Health and Human Performance, Dublin City University, Dublin, Ireland.



Repeated exposure to intermittent normobaric hypoxia improves exercise tolerance in cardiac patients. Little is known on the effects of intermittent normobaric hypoxia-hyperoxia exposure in coronary artery disease (CAD) patients (New York Heart Association II-III).


IHHT improves exercise tolerance, cardiometabolic profile, and quality of life in CAD patients.


The study design was a nonrandomized, controlled, before-and-after trial. Forty-six CAD patients volunteered to take part in the study: a group of 27 patients undertook the intermittent hypoxia (O2 at 10%)-hyperoxia (O2 at 30%) training (IHHT), whereas a control group (CTRL) of 19 patients, who already completed an 8-week standard cardiac rehabilitation program, was allocated to sham-IHHT treatment (breathing room air, O2 at 21%). Exercise performance, blood and metabolic profiles, and quality of life (Seattle Angina Questionnaire [SAQ]) were measured before and after in the IHHT group (IHHG) and sham-IHHT in the CTRL group.


The IHHG showed improved exercise capacity, reduced systolic and diastolic blood pressures, enhanced left ventricle ejection fraction, and reduced glycemia, but only at 1-month follow-up. Angina as a reason to stop exercising was significantly reduced after treatment and at 1-month follow-up. The IHHT SAQ profile was improved in the IHHG and not significantly different to the CTRL group after standard rehabilitation. The IHHG was also compared to the CTRL group at 1-month follow-up, and no differences were found.


In CAD patients, an IHHT program is associated with improved exercise tolerance, healthier risks factors profile, and a better quality of life. Our study also suggests that IHHT is as effective as an 8-week standard rehabilitation program.


Intermittent hypoxia-hyperoxia training, exercise tolerance, cardiometabolic profile, coronary artery disease, cardiac rehab

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