Effect of High-Intensity Interval Training on Aerobic Capacity and Heart Rate Control of Heart Transplant Recipients: a Systematic Review with Meta-Analysis

Abstract

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.

A randomized clinical study using optical coherence tomography to evaluate the short‐term effects of high‐intensity interval training on cardiac allograft vasculopathy: a HITTS substudy

“…12 The significant change in VO 2 peak was similarly evident in the subpopulation of the current study, indicating that there was no selection bias. The magnitude of VO 2 peak change in the treatment groups of the HITTS study was higher than in other studies conducted in maintenance HTx recipients, and the differences could not account for the diminished observed effects 28 . However, the current substudy did not find significant benefits of HIT over MICT for any of the measured OCT outcomes, including the mean intima area.…”

The impact Of high-intensity interval training On functioning And health-related quality Of life In post-stroke patients: A systematic review With meta-analysis

“…Balance was assessed using the Berg Balance Scale (0-56 points). The total number of patients in the high-intensity interval training group was 33, while 31 Four studies 25,26,28,29 assessed gait speed as an outcome. Gait speed was assessed by the Three studies 21,24,27 assessed cardiorespiratory fitness as an outcome.…”

“…The results of this review are in accordance with the findings of previous systematic reviews on poststroke patients 10,11 High-intensity interval training has also been shown to have positive effects on functioning in the context of other cardiovascular diseases. 30,31 Nevertheless, it is important to note that the superiority of high-intensity training for VO2peak is still controversial in different populations. 3,7,[30][31][32] In patients with cardiovascular disease, for example, the superiority of high-intensity interval training over continuous aerobic training may disappear when comparative analysis of isocaloric protocols is performed.…”

High-Intensity Interval Training Among Heart Failure Patients and Heart Transplant Recipients: A Systematic Review

“…Thus, combined training may have a greater effect on cardiac remodeling than surmised. However, more extensive studies on this outcome are needed [31]. Nevertheless, this result shows that HIIT may be more effective when combined with MDP than alone as exercise training in cardiac rehabilitation.…”

“…This outcome could be due to patients exercising HIIT below the prescribed target [14]. This result is why a more adaptable HIIT protocol is recommended to ensure that the patients continue with the program, such as the gradual increase in speed or progression from short HIIT interval to medium, and then long [12,33,31]. In addition, the stability of the patient's disease should also be considered [34].…”