The Effects of High-Intensity Interval Training on Exercise Capacity and Prognosis in Heart Failure and Coronary Artery Disease: A Systematic Review and Meta-Analysis

Abstract

Objective. The purpose of this study is to compare the effects of high-intensity interval training (HIIT) versus moderate-intensity continuous training (MICT) on exercise capacity and several prognostic markers in patients with coronary artery disease (CAD) and heart failure (HF). Methods. This systematic review is registered on the INPLASY website (number: INPLASY202080112). We conducted a comprehensive search in eight databases of literature before September 13, 2019. Trials comparing HIIT and MICT in participants with CAD or HF aged 52–78 years were included. Exercise capacity (peak oxygen consumption (peak VO2)) and prognostic markers, such as the anaerobic threshold (AT), minute ventilation/carbon dioxide production (VE/VCO2) slope, left ventricular ejection fraction (LVEF), and prognostic value of the predicted VO2 max per cent (the predicted VO2 peak (%)) were examined. Results. A total of 15 studies were included comprising 664 patients, 50% of which were male, with an average age of 60.3 ± 13.2 years. For patients with CAD, HIIT significantly improved peak VO2 values (95% CI 0.7 to 2.11) compared with MICT, but peak VO2 values in patients with HF did not seem to change. For training lasting less than eight weeks, HIIT significantly improved peak VO2 values (95% CI 0.70 to 2.10), while HIIT lasting 12 weeks or longer resulted in a modestly increased peak VO2 value (95% CI 0.31 to 5.31). High-intensity interval training significantly increased the AT when compared with MICT (95% CI 0.50 to 1.48). High-intensity interval training also caused a moderate increase in LVEF (95% CI 0.55 to 5.71) but did not have a significant effect on the VE/VCO2 slope (95% CI −2.32 to 0.98) or the predicted VO2 peak (95% CI −2.54 to 9.59) compared with MICT. Conclusions. High-intensity interval training is an effective therapy for improving peak VO2 values in patients with CAD. High-intensity interval training in the early stage (eight weeks or fewer) is superior to MICT. Finally, HIIT significantly improved prognostic markers, including the AT and LVEF in patients with CAD and HF.

Global trends and frontiers in research on exercise training for heart failure: a bibliometric analysis from 2002 to 2022

“…This type of exercise training is often used to compare with traditional moderate intensity training. Recent meta-analyses proposed that HIIT is significantly more effective than moderate intensity training for improving peak VO 2 value and left-ventricular ejection fraction among patients with HF, which are independent predictor of cardiovascular mortality in patients with cardiovascular diseases ( 41 , 42 ). Furthermore, a previous meta-analysis recommended that patients with HF conduct HIIT at least three days a week, while the active recovery intervals should be between 40% and 60% of the peak VO 2 ( 43 ).…”

Research trends and hotspots in exercise rehabilitation for coronary heart disease: A bibliometric analysis

“…In terms of improving exercise performance, high-intensity interval training (HIIT) is more effective than medium-intensity continuous training (MICT) and can effectively improve the peak oxygen consumption and functional capacity of patients. Long-term and stronger HIIT significantly improves exercise endurance [ 61 ] and has been shown to have fewer adverse effects in studies of heart failure. [ 62 ] Performing HIIT requires a personalized exercise program according to the patient functional status and exercise preferences to ensure safe rehabilitation while reducing physical discomfort.…”

Exercise in primary and secondary prevention of CVDs

“…Besides, other studies have found that Moderate-to-vigorous physical activities can lower the hazard of CAD more than low-intensity exercise and has a better protective effect on CAD [6,7]. In the research made by some Chinese scientists, the researchers randomly enrolled 664 CAD or heart failure (HF) patients aged between 52-78 years old (50% male) and conducted a comparison experiment between HIIT and MICT on the participants.…”

“…While anaerobic threshold (AT), RER, or RHR were found to be less statistically significant. Therefore, to increase cardiopulmonary performance and exercise endurance in CAD patients, HIIT is preferable to MICT [7].…”