The Addition of Strength Training to Aerobic Interval Training

Bouchla, Anthi; Karatzanos, Eleftherios; Dimopoulos, Stavros; Tasoulis, Athanasios; Agapitou, Varvara; Διάκος, Νικόλαος; Tseliou, Eleni; Terrovitis, John; Nanas, Serafim

doi:10.1097/hcr.0b013e3181e174d7

Cited by 49 publications

(24 citation statements)

References 15 publications

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“…These findings indicate the activation of intramuscular angiogenic program following exercise training, and those transcriptional changes were partially correlated to changes in post-training muscle capillarization in these patients. Given that there is a growing body of evidence documenting the safety and importance of utilizing HIIT or combined HIIT with strength training in HF patients [6,[22][23][24][25], our findings regarding the improved skeletal muscle angiogenesis post-training in this population are clinically important. Specifically, we observed the upregulation of major pro-angiogenic factors, i.e., VEGF, VEGFR-2, Ang-2, and HIF-1α [11,26] in skeletal muscles of HF patients post-training, as well as several correlations between the post-exercise training changes in skeletal muscle expression of the angiogenic factors examined in these patients.…”

Section: Discussionmentioning

confidence: 94%

Exercise Training Enhances Angiogenesis-Related Gene Responses in Skeletal Muscle of Patients with Chronic Heart Failure

Tryfonos

Tzanis

Pitsolis

et al. 2021

Cells

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Peripheral myopathy consists of a hallmark of heart failure (HF). Exercise enhanced skeletal muscle angiogenesis, and thus, it can be further beneficial towards the HF-induced myopathy. However, there is limited evidence regarding the exercise type that elicits optimum angiogenic responses of skeletal muscle in HF patients. This study aimed to (a) compare the effects of a high-intensity-interval-training (HIIT) or combined HIIT with strength training (COM) exercise protocol on the expression of angiogenesis-related factors in skeletal muscle of HF patients, and (b) examine the potential associations between the expression of those genes and capillarization in the trained muscles. Thirteen male patients with chronic HF (age: 51 ± 13 y; BMI: 27 ± 4 kg/m2) were randomly assigned to a 3-month exercise program that consisted of either HIIT (N = 6) or COM training (N = 7). Vastus lateralis muscle biopsies were performed pre- and post-training. RT-PCR was used to quantify the fold changes in mRNA expression of vascular endothelial growth factor (VEGF), vascular endothelial growth factor receptor 2 (VEGFR-2), hypoxia-inducible factor 1 alpha (HIF-1α), angiopoietin 1 (Ang-1), angiopoietin 2 (Ang-2), angiopoietin receptor (Tie2), and matrix metallopeptidase 9 (MMP-9), and immunohistochemistry to assess capillarization in skeletal muscle post-training. There was an overall increase in the expression levels of VEGF, VEGFR-2, HIF-1α, Ang2, and MMP9 post-training, while these changes were not different among groups. Changes in capillary-to-fibre ratio were found to be strongly associated with Tie2 and HIF-1α expression. This was the first study demonstrating that both HIIT and combined HIIT with strength training enhanced similarly the expression profile of angiogenic factors in skeletal muscle of HF patients, possibly driving the angiogenic program in the trained muscles, although those gene expression increases were found to be only partially related with muscle capillarization.

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Section: Discussionmentioning

confidence: 94%

Exercise Training Enhances Angiogenesis-Related Gene Responses in Skeletal Muscle of Patients with Chronic Heart Failure

Tryfonos

Tzanis

Pitsolis

et al. 2021

Cells

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“…The work rates were calculated individually using the Hansen et al equation [24]. VO 2peak was calculated as the highest 20 s average of the data [25]. Anaerobic threshold (AT) was determined using the V slope method [26] and graphs were created of ventilatory equivalent for oxygen (VE/VO 2 ), carbon dioxide (VE/VCO 2 ), end tidal O 2 (PetO 2 ) and CO 2 tension (PetCO 2 ) against workload.…”

Section: Cardiopulmonary Exercise Testmentioning

confidence: 99%

Acute Cardiorespiratory Responses to Different Exercise Modalities in Chronic Heart Failure Patients—A Pilot Study

Karatzanos

Ferentinos²,

Mitsiou

et al. 2021

JCDD

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The purpose of this study was to compare the acute cardiorespiratory responses and time spent above different %VO2peak intensities between three “iso-work” protocols: (a) a high intensity interval training protocol (HIIT), (b) a higher intensity continuous protocol (CON70) and (c) a lower intensity continuous protocol (CON50) in patients with chronic heart failure (CHF). Ten male CHF patients (aged 55.1 ± 16.2 years) performed in separate days a single session of a HIIT protocol consisted of 4 sets × 4 min cycling at 80% VO2peak with 3 min of recovery at 50% VO2peak, a CON70 protocol corresponding to 70% VO2peak and a CON50 protocol corresponding to 50% VO2peak. Cardiopulmonary data were collected by an online gas analysis system. The HIIT and CON70 elicited higher cardiorespiratory responses compared to CON50 with no differences between them (p > 0.05). In HIIT and CON70, patients exercised longer at >80% and >90% VO2peak. The completion rate was 100% for the three protocols. Not any adverse events were observed in either protocol. Both HIIT and CON70 elicited a stronger physiological stimulus and required shorter time than CON50. Both HIIT and CON70 also induced comparable hemodynamic responses and ventilatory demand.

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“…The effect and symptoms of CHF on individuals' everyday routines are reflected in their health-related quality of life (QoL), which is usually decreased in these patients [17,18]. During the last decades, studies investigating aerobic exercise are shown to improve microcirculation [19,20] and vascular endothelial function [21][22][23], exercise capacity [21][22][23][24][25][26], skeletal myopathy [19,27,28], and QoL [25,29,30] in CHF patients. The most recent 2021 European guidelines for managing and treating chronic heart failure, include a class IA recommendation for patients with CHF to engage in regular aerobic exercise protocols which are the most studied aspects of cardiac rehabilitation (CR) pro- grams [31].…”

Section: Introductionmentioning

confidence: 99%

Does the Addition of Strength Training to a High-Intensity Interval Training Program Benefit More the Patients with Chronic Heart Failure?

Alshamari¹,

Kourek²,

Sanoudou³

et al. 2023

Rev. Cardiovasc. Med.

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Background: Aerobic exercise, either continuous or high intensity interval training (HIIT), induces important benefits in chronic heart failure (CHF) patients. Resistance training has been also shown to be beneficial in CHF. However, data regarding combined aerobic exercise and muscle strength training is still limited. The aim of this study was to investigate whether adding strength training to a HIIT protocol within a cardiac rehabilitation (CR) program has a cumulative beneficial effect on the functional capacity (FC) and quality of life (QoL) in patients with CHF. Methods: Forty-four consecutive patients [35 males, ejection fraction (EF) <50%] with CHF under medication enrolled in a 36-session CR program and were randomized in two exercise groups; HIIT (HIIT group) or HIIT combined with strength training (high intensity interval training combined with strength training (COM) group). All patients underwent baseline and endpoint outcome measures of a symptom-limited maximal cardiopulmonary exercise testing (CPET), 1 repetition maximum (1RM) test, muscular endurance test, echocardiography, and Minnesota Living with Heart Failure Questionnaire (MLWHFQ). Results: Most of the CPET indices, EF, 1RM test, muscular endurance and QoL were improved after the CR program in each exercise training group (p < 0.05). However, COM group demonstrated a further improvement in chest muscle testing and workload at anaerobic threshold (AT) compared to HIIT group. Conclusions: An exercise-based CR program, consisted of either HIIT or HIIT combined with strength training, improves FC and QoL of patients with CHF. However, the addition of strength training to HIIT seems to have further beneficial effects on chest muscle strength and endurance, as well as workload at AT. Clinical Trial Registration: The study was registered in ClinicalTrials.gov with number NCT02387411.

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The Addition of Strength Training to Aerobic Interval Training

Abstract: Combined aerobic interval and strength training induces a greater benefit than interval training alone on muscle strength in CHF patients. Adaptations other than hypertrophy, such as muscle fiber type alterations and/or neuromuscular adjustments, may account for these results.

Cited by 49 publications

References 15 publications

Exercise Training Enhances Angiogenesis-Related Gene Responses in Skeletal Muscle of Patients with Chronic Heart Failure

Exercise Training Enhances Angiogenesis-Related Gene Responses in Skeletal Muscle of Patients with Chronic Heart Failure

Acute Cardiorespiratory Responses to Different Exercise Modalities in Chronic Heart Failure Patients—A Pilot Study

Does the Addition of Strength Training to a High-Intensity Interval Training Program Benefit More the Patients with Chronic Heart Failure?

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