title: Effect of moderate- versus high-intensity exercise on vascular function, biomarkers and quality of life in heart transplant recipients: A randomized, crossover trial.
abstract: BACKGROUND
  Growing evidence in long-term treatment of heart transplant (HTx) recipients indicates effects of high-intensity interval training (HIIT) on several parameters, including oxygen uptake, vascular function and psychological distress. In this study we compare the effect of HIIT vs continued moderate training (CON) on vascular function, biomarkers and health-related quality of life (HRQoL) in HTx recipients.
  
  
  METHODS
  A randomized, controlled crossover trial of stable HTx recipients >12 months after transplantation was done on patients with 12 weeks of HIIT or 12 weeks of CON, followed by a 5-month washout and crossover. Outcomes included endothelial function, arterial stiffness, biomarkers, HRQoL and markers of anxiety and depression.
  
  
  RESULTS
  Sixteen HTx recipients (mean age 52 years, 75% male) completed the study. HIIT increased VO(2peak) more than CON (between-group difference, p < 0.001). The physical component score of the 36-item Short Form (SF-36) was increased significantly in HIIT patients (p = 0.02) and borderline increased in CON patients (p = 0.07), whereas there was no significant effect of exercise on the mental component. Depression score decreased significantly in HIIT patients (p = 0.04) with no change in CON patients (p = 0.75), whereas anxiety score decreased significantly in both HIIT (p < 0.01) and CON (p < 0.05) patients. There were no between-group differences in any of the measures (all p > 0.05). Arterial stiffness and biomarkers were not changed, nor did endothelial function change after HIIT (p = 0.08) or CON (p = 0.68).
  
  
  CONCLUSIONS
  HIIT and CON are both well tolerated and induce similar improvements in physical components of HRQoL and in markers of anxiety. Effects of either training modality on vascular function and biomarkers could not be confirmed.
authors.affiliation: Department of Cardiology, Bispebjerg Hospital, University of Copenhagen; Institute of Sports Medicine Copenhagen (ISMC/MRRU). Electronic address: christian.have.dall@regionh.dk.
authors.forename: Christian H
authors.initials: CH
authors.lastname: Dall
authors.affiliation: Department of Cardiology, Heart Centre, Rigshospitalet, University of Copenhagen.
authors.forename: Finn
authors.initials: F
authors.lastname: Gustafsson
authors.affiliation: Department of Cardiology, Gentofte Hospital, University of Copenhagen.
authors.forename: Stefan B
authors.initials: SB
authors.lastname: Christensen
authors.affiliation: Xlab, Center for Healthy Aging, University of Copenhagen.
authors.forename: Flemming
authors.initials: F
authors.lastname: Dela
authors.affiliation: CopenRehab, Department of Public Health, University of Copenhagen, Copenhagen, Denmark.
authors.forename: Henning
authors.initials: H
authors.lastname: Langberg
authors.affiliation: Department of Cardiology, Bispebjerg Hospital, University of Copenhagen.
authors.forename: Eva
authors.initials: E
authors.lastname: Prescott
mesh_terms: D000328:Adult; D000368:Aged; D001007:Anxiety / Q000209:etiology / Q000517:prevention & control; D015415:Biomarkers / Q000378:metabolism; D018592:Cross-Over Studies; D005081:Exercise Therapy; D005260:Female; D006333:Heart Failure / Q000503:physiopathology* / Q000523:psychology / Q000628:therapy*; D016027:Heart Transplantation; D006801:Humans; D008297:Male; D008875:Middle Aged; D011788:Quality of Life; D013315:Stress, Psychological / Q000209:etiology / Q000517:prevention & control*; D059289:Vascular Stiffness / Q000502:physiology*
chemical_list: D015415:Biomarkers
keywords: anxiety and depression; biomarkers; endothelial function; exercise; heart transplantation; quality of life