title: Effects of high-intensity interval training on central haemodynamics and skeletal muscle oxygenation during exercise in patients with chronic heart failure.
abstract: Background High-intensity interval training (HIT) improves exercise capacity in patients with chronic heart failure (CHF). Moreover, HIT was associated with improved resting cardiac function. However, the extent to which these improvements actually contribute to training-induced changes in exercise capacity remains to be elucidated. Therefore, we evaluated the effects of HIT on exercising central haemodynamics and skeletal muscle oxygenation. Methods Twenty-six CHF patients were randomised to a 12-week 4 × 4 minute HIT program at 85-95% of peak VO2or usual care. Patients performed maximal and submaximal cardiopulmonary exercise testing with simultaneous assessment of cardiac output and skeletal muscle oxygenation by near infrared spectroscopy, using the amplitude of the tissue saturation index (TSIamp). Results Peak workload increased by 11% after HIT ( p between group = 0.01) with a non-significant increase in peak VO2(+7%, p between group = 0.19). Cardiac reserve increased by 37% after HIT ( p within group = 0.03, p between group = 0.08); this increase was not related to improvements in peak workload. Oxygen uptake recovery kinetics after submaximal exercise were accelerated by 20% ( p between group = 0.02); this improvement was related to a decrease in TSIamp ( r = 0.71, p = 0.03), but not to changes in cardiac output kinetics. Conclusion HIT induced improvements in maximal exercise capacity and exercising haemodynamics at peak exercise. Improvements in recovery after submaximal exercise were associated with attenuated skeletal muscle deoxygenation during submaximal exercise, but not with changes in cardiac output kinetics, suggesting that the effect of HIT on submaximal exercise capacity is mediated by improved microvascular oxygen delivery-to-utilisation matching.
authors.affiliation: 1 Department of Cardiology, Máxima Medical Center, Veldhoven, The Netherlands.|2 ICIN, Netherlands Heart Institute, Utrecht, The Netherlands.
authors.forename: Ruud F
authors.initials: RF
authors.lastname: Spee
authors.affiliation: 1 Department of Cardiology, Máxima Medical Center, Veldhoven, The Netherlands.
authors.forename: Victor M
authors.initials: VM
authors.lastname: Niemeijer
authors.affiliation: 3 Department of Clinical Physics and Clinical Informatics, Máxima Medical Center, Veldhoven, The Netherlands.|4 Department of Applied Physics, Eindhoven University of Technology, Eindhoven, The Netherlands.
authors.forename: Pieter F
authors.initials: PF
authors.lastname: Wijn
authors.affiliation: 2 ICIN, Netherlands Heart Institute, Utrecht, The Netherlands.|5 Department of Cardiology, University Medical Center, Utrecht, The Netherlands.
authors.forename: Pieter A
authors.initials: PA
authors.lastname: Doevendans
authors.affiliation: 1 Department of Cardiology, Máxima Medical Center, Veldhoven, The Netherlands.
authors.forename: Hareld M
authors.initials: HM
authors.lastname: Kemps
mesh_terms: D000368:Aged; D005080:Exercise Test; D005081:Exercise Therapy / Q000379:methods*; D017079:Exercise Tolerance / Q000502:physiology; D005260:Female; D005500:Follow-Up Studies; D006333:Heart Failure / Q000175:diagnosis / Q000503:physiopathology / Q000534:rehabilitation*; D006352:Heart Ventricles / Q000000981:diagnostic imaging / Q000503:physiopathology; D006439:Hemodynamics / Q000502:physiology*; D000072696:High-Intensity Interval Training / Q000379:methods*; D006801:Humans; D019028:Magnetic Resonance Imaging, Cine; D008297:Male; D008875:Middle Aged; D018482:Muscle, Skeletal / Q000378:metabolism*; D010101:Oxygen Consumption / Q000502:physiology*; D011446:Prospective Studies; D012146:Rest / Q000502:physiology; D013997:Time Factors
keywords: High-intensity interval training; cardiac output; chronic heart failure; oxygen uptake kinetics; skeletal muscle oxygenation