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Introduction Heart transplantation (HTx) is the gold standard procedure for selected individuals with refractory heart failure. High-intensity interval training (HIIT) is safe and allows patients to exercise in high intensity for longer time when compared to moderate-intensity continuous training (MICT). The primary aim of this study was to perform a systematic review and meta-analysis about the effect of HIIT compared to MICT on exercise capacity, peak heart rate, and heart rate reserve in HTx recipients. Secondarily, we pooled data comparing MICT and no exercise training in these patients. Methods This systematic review followed the standardization of the Preferred Reporting Items for Systematic Reviews and Meta-analyses statement and the Cochrane Collaboration Handbook. We presented the treatment effects of HIIT on the outcomes of interest as mean difference (MD) and 95% confidence interval (CI). Meta-analysis was performed using the random-effects, generic inverse variance method. Results HIIT improved peak oxygen consumption (peakVO2) (MD = 2.1; 95% CI 1.1, 3.1; P <0.0001), peak heart rate (MD = 3.4; 95% CI 0.8, 5.9; P =0.009), and heart rate reserve (MD = 4.8; 95% CI -0.05, 9.6; P =0.05) compared to MICT. Improvements on peakVO 2 (MD = 3.5; 95% CI 2.3, 4.7; P <0.00001) and peak heart rate (MD = 5.6; 95% CI 1.6, 9.6; P =0.006) were found comparing HIIT and no exercise training. Conclusion Current available evidence suggests that HIIT leads to improvements on peakVO 2 , peak heart rate, and heart rate reserve compared to MICT in HTx recipients. However, the superiority of HIIT should be tested in isocaloric protocols.

Background. There is a growing use of water-based exercises in cardiac rehabilitation programs. However, there is little data concerning the effects of water-based exercise on the exercise capacity of coronary artery disease (CAD) patients. Objective. To perform a systematic review to investigate the effects of water-based exercise on peak oxygen consumption, exercise time, and muscle strength in patients with CAD. Methods. Five databases were searched to find randomized controlled trials that evaluated the effects of water-based exercise for coronary artery disease patients. Mean differences (MD) and 95% confidence intervals (CIs) were calculated, and heterogeneity was assessed using the I 2 test. Results. Eight studies were included. Water-based exercise resulted in an improvement in peak VO2 of 3.4 mL/kg/min (95% CI, 2.3 to 4.5; I 2 = 0 %; 5 studies, N = 167 ), exercise time of 0.6 (95% CI, 0.1 to 1.1; I 2 = 0 %; 3 studies, N = 69 ), and total body strength of 32.2 kg (95% CI, 23.9 to 40.7; I 2 = 3 %; 3 studies, N = 69 ) when compared to no exercising controls. Water-based exercise resulted in an improvement in peak VO2 of 3.1 mL/kg/min (95% CI, 1.4 to 4.7; I 2 = 13 %; 2 studies, N = 74 ), when compared to the plus land exercise group. No significant difference in peak VO2 was found for participants in the water-based exercise plus land exercise group compared with the land exercise group. Conclusions. Water-based exercise may improve exercise capacity and should be considered as an alternative method in the rehabilitation of patients with CAD.

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Background Low cardiorespiratory fitness is associated with poor prognosis in individuals with coronary artery disease and after coronary artery bypass grafting surgery. Thus, we comment about a meta-analysis that adds important information about the effect of exercise training on cardiac autonomic function in individuals following coronary artery bypass grafting surgery. Main body The study by Kushwaha et al. showed positive effects for heart rate variability and heart rate recovery in subjects after coronary artery bypass grafting surgery in response to acute physical training. These data are relevant, since heart rate variability is an independent predictor of for all-cause and cardiovascular mortality for individuals with cardiovascular disorders. Additionally, attenuated heart rate recovery is associated with increased risk for the same outcomes. Moreover, we summarize the quantitative data from studies that compared the effect of physical training in comparison with control group in cardiorespiratory fitness in adults following coronary artery bypass grafting. Conclusions Our findings suggest that improvements in peak oxygen consumption result in an additional benefit in adults following coronary artery bypass grafting. Considered that, the increased cardiorespiratory fitness is an independent predictor of longer survival in coronary artery disease.