title: Aerobic interval training and continuous training equally improve aerobic exercise capacity in patients with coronary artery disease: the SAINTEX-CAD study.
abstract: BACKGROUND
  Exercise-based cardiac rehabilitation increases peak oxygen uptake (peak VO₂), which is an important predictor of mortality in cardiac patients. However, it remains unclear which exercise characteristics are most effective for improving peak VO₂ in coronary artery disease (CAD) patients. Proof of concept papers comparing Aerobic Interval Training (AIT) and Moderate Continuous Training (MCT) were conducted in small sample sizes and findings were inconsistent and heterogeneous. Therefore, we aimed to compare the effects of AIT and Aerobic Continuous Training (ACT) on peak VO₂, peripheral endothelial function, cardiovascular risk factors, quality of life and safety, in a large multicentre study.
  
  
  METHODS
  Two-hundred CAD patients (LVEF >40%, 90% men, mean age 58.4 ± 9.1 years) were randomized to a supervised 12-week cardiac rehabilitation programme of three weekly sessions of either AIT (90-95% of peak heart rate (HR)) or ACT (70-75% of peak HR) on a bicycle. Primary outcome was peak VO₂; secondary outcomes were peripheral endothelial function, cardiovascular risk factors, quality of life and safety.
  
  
  RESULTS
  Peak VO₂ (ml/kg/min) increased significantly in both groups (AIT 22.7 ± 17.6% versus ACT 20.3 ± 15.3%; p-time<0.001). In addition, flow-mediated dilation (AIT+34.1% (range -69.8 to 646%) versus ACT+7.14% (range -66.7 to 503%); p-time<0.001) quality of life and some other cardiovascular risk factors including resting diastolic blood pressure and HDL-C improved significantly after training. Improvements were equal for both training interventions.
  
  
  CONCLUSIONS
  Contrary to earlier smaller trials, we observed similar improvements in exercise capacity and peripheral endothelial function following AIT and ACT in a large population of CAD patients.
authors.affiliation: Department of Cardiology, Antwerp University Hospital, Edegem, Belgium; University of Antwerp, Antwerp, Belgium.
authors.forename: Viviane M
authors.initials: VM
authors.lastname: Conraads
authors.affiliation: Department of Rehabilitation Sciences, KU Leuven, Leuven, Belgium. Electronic address: nele.pattyn@faber.kuleuven.be.
authors.forename: Nele
authors.initials: N
authors.lastname: Pattyn
authors.affiliation: Department of Cardiology, Antwerp University Hospital, Edegem, Belgium; University of Antwerp, Antwerp, Belgium. Electronic address: catherine.demaeyer@uza.be.
authors.forename: Catherine
authors.initials: C
authors.lastname: De Maeyer
authors.affiliation: Department of Cardiology, Antwerp University Hospital, Edegem, Belgium; University of Antwerp, Antwerp, Belgium. Electronic address: paul.beckers@uza.be.
authors.forename: Paul J
authors.initials: PJ
authors.lastname: Beckers
authors.affiliation: Department of Rehabilitation Sciences, KU Leuven, Leuven, Belgium. Electronic address: ellen.coeckelberghs@faber.kuleuven.be.
authors.forename: Ellen
authors.initials: E
authors.lastname: Coeckelberghs
authors.affiliation: Department of Rehabilitation Sciences, KU Leuven, Leuven, Belgium. Electronic address: veronique.cornelissen@faber.kuleuven.be.
authors.forename: Véronique A
authors.initials: VA
authors.lastname: Cornelissen
authors.affiliation: Department of Cardiology, Antwerp University Hospital, Edegem, Belgium; CoRPS-Centre of Research on Psychology in Somatic diseases, Tilburg University, Tilburg, The Netherlands. Electronic address: j.denollet@uvt.nl.
authors.forename: Johan
authors.initials: J
authors.lastname: Denollet
authors.affiliation: Department of Cardiology, Antwerp University Hospital, Edegem, Belgium; Laboratory of Cellular and Molecular Cardiology, Antwerp University Hospital, Edegem, Belgium. Electronic address: geert.frederix@uza.be.
authors.forename: Geert
authors.initials: G
authors.lastname: Frederix
authors.affiliation: Department of Rehabilitation Sciences, KU Leuven, Leuven, Belgium; Department of Cardiovascular Diseases, University Hospitals of Leuven, Leuven, Belgium. Electronic address: kaatje.goetschalckx@uzleuven.be.
authors.forename: Kaatje
authors.initials: K
authors.lastname: Goetschalckx
authors.affiliation: Department of Cardiology, Antwerp University Hospital, Edegem, Belgium; University of Antwerp, Antwerp, Belgium; Laboratory of Cellular and Molecular Cardiology, Antwerp University Hospital, Edegem, Belgium. Electronic address: vicky.hoymans@uza.be.
authors.forename: Vicky Y
authors.initials: VY
authors.lastname: Hoymans
authors.affiliation: Department of Cardiology, Antwerp University Hospital, Edegem, Belgium. Electronic address: nadine.possemiers@uza.be.
authors.forename: Nadine
authors.initials: N
authors.lastname: Possemiers
authors.affiliation: Department of Rehabilitation Sciences, KU Leuven, Leuven, Belgium. Electronic address: dirk.schepers@uzleuven.be.
authors.forename: Dirk
authors.initials: D
authors.lastname: Schepers
authors.affiliation: Department of Cardiology, Antwerp University Hospital, Edegem, Belgium; University of Antwerp, Antwerp, Belgium. Electronic address: bharati.shivalkar@uza.be.
authors.forename: Bharati
authors.initials: B
authors.lastname: Shivalkar
authors.affiliation: Department of Cardiovascular Diseases, University Hospitals of Leuven, Leuven, Belgium. Electronic address: jens.uwe.voigt@gmx.net.
authors.forename: Jens-Uwe
authors.initials: JU
authors.lastname: Voigt
authors.affiliation: Department of Cardiology, Antwerp University Hospital, Edegem, Belgium; University of Antwerp, Antwerp, Belgium; Laboratory of Cellular and Molecular Cardiology, Antwerp University Hospital, Edegem, Belgium. Electronic address: emeline.vancraenenbroeck@uantwerpen.be.
authors.forename: Emeline M
authors.initials: EM
authors.lastname: Van Craenenbroeck
authors.affiliation: Department of Rehabilitation Sciences, KU Leuven, Leuven, Belgium; Department of Cardiovascular Diseases, University Hospitals of Leuven, Leuven, Belgium. Electronic address: luc.vanhees@faber.kuleuven.be.
authors.forename: Luc
authors.initials: L
authors.lastname: Vanhees
mesh_terms: D000368:Aged; D003324:Coronary Artery Disease / Q000175:diagnosis / Q000503:physiopathology* / Q000628:therapy*; D015444:Exercise / Q000502:physiology*; D005080:Exercise Test / Q000379:methods* / Q000639:trends; D005081:Exercise Therapy / Q000379:methods* / Q000639:trends; D017079:Exercise Tolerance / Q000502:physiology; D005260:Female; D006801:Humans; D008137:Longitudinal Studies; D008297:Male; D008875:Middle Aged; D010101:Oxygen Consumption / Q000502:physiology*; D011446:Prospective Studies
keywords: Cardiac rehabilitation; Coronary artery disease; Endothelial function; Exercise intensity; Secondary prevention; Training modality