title: Cardiovascular effects of high-intensity interval aerobic training combined with strength exercise in patients with chronic heart failure. A randomized phase III clinical trial.
abstract: BACKGROUND
  The aim of this work was to evaluate the effect of high-intensity interval exercise (i.e., 30s at 100% of max workload, followed by 30s at rest, 45 min 3 days/week working-out schedule for 12 weeks) on left ventricular function and aortic elastic properties among chronic heart failure (CHF) patients.
  
  
  METHODS
  This study is a phase III clinical trial. Of the 100 consecutive CHF patients (NYHA classes II-IV, ejection fraction<50%) that were randomly allocated, 72 completed the study (exercise training group, n=33, 63 ± 9 years, 88% men, and control group, n=39, 56 ± 11 years, 82% men). All patients underwent cardiopulmonary stress test, non-invasive high-fidelity tonometry of the radial artery, pulse wave velocity measurement using a SphygmoCor device and echocardiography before and after the completion of the training program.
  
  
  RESULTS
  Both groups reported similar medical characteristics and physical activity status. General mixed effects models revealed that the intervention group reduced pulse wave velocity by 9% (p=0.05); Emv/Vp by 14% (p=0.06); E to A ratio by 24% (p=0.004), E to Emv ratio by 8% (p=0.05), MLHFQ score by 66% (p=0.003) and the depression score by 19% (p=0.5); increased augmentation index by 29%; VTI by 4% (p=0.05), 6-minute-walk distance up to 13% (p=0.05), peak oxygen uptake by 28% (p=0.001) and peak power by 25% (p=0.005). There were no significant changes in the control group.
  
  
  CONCLUSIONS
  Interval high-intensity aerobic training, combined with strength exercise, seems to benefit aortic dilatation capacity and augmented systolic pressure in parallel with improvement in left ventricular diastolic function and quality of life.
authors.affiliation: First Cardiology Clinic, Hippokration Hospital, School of Medicine, National and Kapodistrian University of Athens, Athens, Greece. Electronic address: chrysohoou@usa.net.
authors.forename: Christina
authors.initials: C
authors.lastname: Chrysohoou
authors.affiliation: First Cardiology Clinic, Hippokration Hospital, School of Medicine, National and Kapodistrian University of Athens, Athens, Greece.
authors.forename: Athanasios
authors.initials: A
authors.lastname: Angelis
authors.affiliation: First Cardiology Clinic, Hippokration Hospital, School of Medicine, National and Kapodistrian University of Athens, Athens, Greece.
authors.forename: George
authors.initials: G
authors.lastname: Tsitsinakis
authors.affiliation: Physical Education and Sports Science, National and Kapodistrian University of Athens, Athens, Greece.
authors.forename: Stavroula
authors.initials: S
authors.lastname: Spetsioti
authors.affiliation: Physical Education and Sports Science, National and Kapodistrian University of Athens, Athens, Greece.
authors.forename: Ioannis
authors.initials: I
authors.lastname: Nasis
authors.affiliation: First Cardiology Clinic, Hippokration Hospital, School of Medicine, National and Kapodistrian University of Athens, Athens, Greece.
authors.forename: Dimitris
authors.initials: D
authors.lastname: Tsiachris
authors.affiliation: First Department of Respiratory Medicine, Pulmonary Rehabilitation Unit, Sotiria Hospital, National and Kapodistrian University of Athens, Greece.
authors.forename: Panagiotis
authors.initials: P
authors.lastname: Rapakoulias
authors.affiliation: First Cardiology Clinic, Hippokration Hospital, School of Medicine, National and Kapodistrian University of Athens, Athens, Greece.
authors.forename: Christos
authors.initials: C
authors.lastname: Pitsavos
authors.affiliation: First Department of Respiratory Medicine, Pulmonary Rehabilitation Unit, Sotiria Hospital, National and Kapodistrian University of Athens, Greece.
authors.forename: Nikolaos G
authors.initials: NG
authors.lastname: Koulouris
authors.affiliation: Physical Education and Sports Science, National and Kapodistrian University of Athens, Athens, Greece; First Department of Respiratory Medicine, Pulmonary Rehabilitation Unit, Sotiria Hospital, National and Kapodistrian University of Athens, Greece.
authors.forename: Ioannis
authors.initials: I
authors.lastname: Vogiatzis
authors.affiliation: First Cardiology Clinic, Hippokration Hospital, School of Medicine, National and Kapodistrian University of Athens, Athens, Greece.
authors.forename: Tousoulis
authors.initials: T
authors.lastname: Dimitris
mesh_terms: D000368:Aged; D002908:Chronic Disease; D004452:Echocardiography; D005080:Exercise Test; D005081:Exercise Therapy / Q000379:methods*; D005260:Female; D006333:Heart Failure / Q000503:physiopathology* / Q000628:therapy*; D006801:Humans; D008297:Male; D008875:Middle Aged; D063177:Pulse Wave Analysis; D016896:Treatment Outcome; D018487:Ventricular Dysfunction, Left / Q000503:physiopathology / Q000628:therapy
keywords: Aortic elastic properties; Heart failure; Quality of life; Rehabilitation