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Modified high-intensity interval training increases peak cardiac power output in patients with heart failure

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European Journal of Applied Physiology Aims and scope Submit manuscript

Abstract

Purpose

Although high-intensity interval aerobic training (HIT) effectively improves aerobic fitness, the risk of cardiac arrest transiently increases during strenuous physical exertion in patients with cardiovascular disease. For safety and efficacy concerns, this investigation explored the effect of a modified HIT (mHIT) on exertional ventilatory-hemodynamic efficiency in heart failure patients with reduced ejection fraction (HFREF).

Methods

HFREF patients were prospectively assigned to two groups: mHIT and usual healthcare (UC). The former comprised supervised continuous aerobic training at ventilatory anaerobic threshold for 50 min/day, 3 days/week for 4 weeks, and then 3-min intervals at 40 and 80 % VO2 reserve for 50 min/day, 3 days/week for 8 weeks. The latter received optimal medical treatment only. Ventilatory and hemodynamic responses during exercise were measured before and after the intervention. Paired-t and repeated measures ANOVA with post hoc tests were adopted.

Results

Each group had an N of 33. The mHIT and UC group had matched baseline characteristics including health-promotion concept and behavior score. The mHIT for 12 weeks (1) increased VO2, cardiac output, and notably, cardiac power output at peak workload (1,151 ± 573 vs. 1,306 ± 596 L/min/mmHg); (2) reduced V E/VO2 (32.4 ± 4.6 vs. 30.0 ± 4.0), breathing frequency, ventilation, and enhanced stroke volume compliance at identical submaximal intensity (50 % peak workload at pre-intervention evaluation). No significant changes in ventilatory and hemodynamic responses to exercise were observed following the UC.

Conclusions

The mHIT regimen improves peak cardiac pumping capacity with reducing cardiac after-load and simultaneously increases ventilation efficiency during exercise in patients with HFREF. Thereby, aerobic fitness is ameliorated.

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Abbreviations

50 %pre W peak :

Workload at the 50 % of the peak during the pre-training evaluation

BF:

Breathing frequency

CO:

Cardiac output

CPET:

Cardiopulmonary exercise test

CPO:

Cardiac power output

DavO2 :

Arterio-venous O2 difference

HIT:

High-intensity aerobic interval training

HR:

Heart rate

HRQOL:

Health-related quality of life

mHIT:

Modified high-intensity aerobic interval training

MAP:

Mean arterial pressure

MCT:

Moderate continuous training

OUES:

Oxygen uptake efficiency slope

PVC:

Peripheral vascular conductance

RPP:

Rate-pressure product

HFREF:

Heart failure with reduced ejection fracture

SV:

Stroke volume

SVC:

Stroke volume compliance

UC:

Usual care

VAT:

Ventilatory anaerobic threshold

V E :

Minute ventilation

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Acknowledgments

The authors would like to thank the Chang Gung Medical Research Program (Grant number CMRPG 391201-3) for the financial support. Support from the staff of the Cardiac Rehabilitation Center in Chang Gung Memorial Hospital during the assessment and exercise training sessions is acknowledged and appreciated.

Conflict of interest

There are no potential conflict of interest regarding this study, including relationships with medical device companies or other corporations whose products or services are related to the subject matter of the article.

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Authors and Affiliations

  1. Department of Physical Medicine and Rehabilitation, Chang Gung Memorial Hospital, Linkuo, Taiwan

    Shu-Chun Huang & Mei-Kuen Wong

  2. Division of Thoracic and Cardiovascular Surgery, Chang Gung Memorial Hospital, Linkuo, Taiwan

    Pyng-Jing Lin & Feng-Chun Tsai

  3. Department of Physical Medicine and Rehabilitation, Chang Gung Memorial Hospital, Keelung, Taiwan

    Tieh-cheng Fu

  4. Second Section of Cardiology, Department of Medicine, Chang Gung Memorial Hospital, Linkuo, Taiwan

    Ming-Shien Wen

  5. First Cardiovascular Division, Department of Cardiology, Chang Gung Memorial Hospital, Linkuo, Taiwan

    Chi-Tai Kuo

  6. Healthy Aging Research Center, Graduate Institute of Rehabilitation Science, Medical College, Chang Gung University, 259 Wen-Hwa 1st Road, Kwei-Shan, Tao-Yuan, 333, Taiwan

    Shu-Chun Huang & Jong-Shyan Wang

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  1. Shu-Chun Huang
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  2. Mei-Kuen Wong
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Correspondence to Jong-Shyan Wang.

Additional information

Communicated by Keith Phillip George.

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Huang, SC., Wong, MK., Lin, PJ. et al. Modified high-intensity interval training increases peak cardiac power output in patients with heart failure. Eur J Appl Physiol 114, 1853–1862 (2014). https://doi.org/10.1007/s00421-014-2913-y

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  • DOI: https://doi.org/10.1007/s00421-014-2913-y

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