title: High-intensity interval training vs. moderate-intensity continuous exercise training in heart failure with preserved ejection fraction: a pilot study.
abstract: Heart failure with preserved ejection fraction (HFpEF) is a major cause of morbidity and mortality. Exercise training is an established adjuvant therapy in heart failure; however, the effects of high-intensity interval training (HIIT) in HFpEF are unknown. We compared the effects of HIIT vs. moderate-intensity aerobic continuous training (MI-ACT) on peak oxygen uptake (V̇o₂peak), left ventricular diastolic dysfunction, and endothelial function in patients with HFpEF. Nineteen patients with HFpEF (age 70 ± 8.3 yr) were randomized to either HIIT (4 × 4 min at 85-90% peak heart rate, with 3 min active recovery) or MI-ACT (30 min at 70% peak heart rate). Fifteen patients completed exercise training (HIIT: n = 9; MI-ACT: n = 6). Patients trained 3 days/wk for 4 wk. Before and after training patients underwent a treadmill test for V̇o₂peak determination, 2D-echocardiography for assessment of left ventricular diastolic dysfunction, and brachial artery flow-mediated dilation (FMD) for assessment of endothelial function. HIIT improved V̇o₂peak (pre = 19.2 ± 5.2 ml·kg(-1)·min(-1); post = 21.0 ± 5.2 ml·kg(-1)·min(-1); P = 0.04) and left ventricular diastolic dysfunction grade (pre = 2.1 ± 0.3; post = 1.3 ± 0.7; P = 0.02), but FMD was unchanged (pre = 6.9 ± 3.7%; post = 7.0 ± 4.2%). No changes were observed following MI-ACT. A trend for reduced left atrial volume index was observed following HIIT compared with MI-ACT (-3.3 ± 6.6 vs. +5.8 ± 10.7 ml/m(2); P = 0.06). In HFpEF patients 4 wk of HIIT significantly improved V̇o₂peak and left ventricular diastolic dysfunction. HIIT may provide a more robust stimulus than MI-ACT for early exercise training adaptations in HFpEF.
authors.affiliation: School of Nutrition and Health Promotion, Arizona State University, Phoenix, Arizona; Department of Cardiovascular Diseases, Mayo Clinic Arizona, Scottsdale, Arizona; and sangadi@asu.edu.
authors.forename: Siddhartha S
authors.initials: SS
authors.lastname: Angadi
authors.affiliation: Department of Cardiovascular Diseases, Mayo Clinic Arizona, Scottsdale, Arizona; and.
authors.forename: Farouk
authors.initials: F
authors.lastname: Mookadam
authors.affiliation: School of Nutrition and Health Promotion, Arizona State University, Phoenix, Arizona;
authors.forename: Chong D
authors.initials: CD
authors.lastname: Lee
authors.affiliation: School of Nutrition and Health Promotion, Arizona State University, Phoenix, Arizona;
authors.forename: Wesley J
authors.initials: WJ
authors.lastname: Tucker
authors.affiliation: Faculty of Rehabilitation Medicine, University of Alberta, Edmonton, Alberta, Canada.
authors.forename: Mark J
authors.initials: MJ
authors.lastname: Haykowsky
authors.affiliation: School of Nutrition and Health Promotion, Arizona State University, Phoenix, Arizona;
authors.forename: Glenn A
authors.initials: GA
authors.lastname: Gaesser
mesh_terms: D000368:Aged; D001916:Brachial Artery / Q000503:physiopathology; D003971:Diastole / Q000502:physiology; D004452:Echocardiography / Q000379:methods; D015444:Exercise / Q000502:physiology*; D005080:Exercise Test / Q000379:methods; D005081:Exercise Therapy / Q000379:methods; D017079:Exercise Tolerance / Q000502:physiology*; D005260:Female; D006333:Heart Failure / Q000503:physiopathology*; D006339:Heart Rate / Q000502:physiology; D006801:Humans; D008297:Male; D010101:Oxygen Consumption / Q000502:physiology; D010865:Pilot Projects; D016277:Ventricular Function, Left / Q000502:physiology
keywords: diastolic dysfunction; exercise training; heart failure with preserved ejection fraction; high-intensity interval exercise; peak oxygen uptake