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High intensity interval training versus moderate intensity continuous training on exercise capacity and quality of life in patients with heart failure with reduced ejection fraction: A systematic review and meta-analysis.
Int J Cardiol. 2018 06 15; 261:134-141.IJ

Abstract

OBJECTIVE

The aim of this study was to investigate the effects of high intensity interval training (HIIT) versus moderate intensity continuous training (MICT) in heart failure patients with reduced ejection fraction (HFrEF).

BACKGROUND

Despite the well-known positive effects of exercise in heart failure patients, the best mode of exercise is still under discussion.

METHODS

We searched Pubmed/MEDLINE, Cochrane Central Register of Controlled Trials, PEDro data base, and SciELO (from the earliest date available to October 2017) for randomized controlled trials that evaluated the effects of HIIT versus MICT in HFrEF patients. Weighted mean differences (WMD) with 95% confidence interval (CI) were calculated, and heterogeneity was assessed using the I2 test.

RESULTS

13 studies met the study criteria, including 411 patients. Compared to MICT, HIIT resulted in improvement in Peak VO2 WMD (1.35 mL·kg-1·min-1 95% CI: 0.03 to 2.64 N = 411). HIIT resulted in no difference in VE/VCO2 slope WMD (-1.21 95% CI: -3.0 to 0.58 N = 135), and quality of life measured by Minnesota Living with Heart Failure questionnaire WMD (1.19 95% CI: -5.81 to 8.19 N = 79). Sub-group analyses comparing studies with and without isocaloric exercise training protocol also showed a nonsignificant difference in peak VO2 for participants in the HIIT group compared with MICT group.

CONCLUSIONS

HIIT improves peak VO2 and should be considered as a component of care of HFrEF patients. However, its superiority versus MICT disappears when isocaloric protocols are compared. An important caveat is uncertainty and variation of actual training intensities compared to program targets.

Authors+Show Affiliations

Physical Therapy Department, Federal University of Bahia - UFBA, Salvador, Bahia, Brazil; Programa de Pós-Graduação em Medicina e Saúde - UFBA, Salvador, BA, Brazil; Physiotherapy Research Group, UFBA, Brazil; The GREAT Group (GRupo de Estudos em ATividade física), Brazil. Electronic address: mansueto.neto@ufba.br.Programa de Pós-Graduação em Medicina e Saúde - UFBA, Salvador, BA, Brazil.The GREAT Group (GRupo de Estudos em ATividade física), Brazil; Physical Therapy Department, Federal University of Sergipe - UFS, Aracaju, SE, Brazil.Physical Therapy Department, Federal University of Bahia - UFBA, Salvador, Bahia, Brazil; Programa de Pós-Graduação em Medicina e Saúde - UFBA, Salvador, BA, Brazil; Physiotherapy Research Group, UFBA, Brazil.K.G. Jebsen Center for Exercise in Medicine, Department of Circulation and Medical Imaging, Faculty of Medicine and Health Sciences, Norwegian University of Science and Technology, Trondheim, Norway; Department of Cardiology, St. Olavs Hospital, Trondheim University Hospital, Trondheim, Norway.Physiotherapy Research Group, UFBA, Brazil; The GREAT Group (GRupo de Estudos em ATividade física), Brazil; Physical Therapy Department, Federal University of Sergipe - UFS, Aracaju, SE, Brazil.

Pub Type(s)

Comparative Study
Journal Article
Meta-Analysis
Review
Systematic Review

Language

eng

PubMed ID

29572084

Citation

Gomes Neto, Mansueto, et al. "High Intensity Interval Training Versus Moderate Intensity Continuous Training On Exercise Capacity and Quality of Life in Patients With Heart Failure With Reduced Ejection Fraction: a Systematic Review and Meta-analysis." International Journal of Cardiology, vol. 261, 2018, pp. 134-141.
Gomes Neto M, Durães AR, Conceição LSR, et al. High intensity interval training versus moderate intensity continuous training on exercise capacity and quality of life in patients with heart failure with reduced ejection fraction: A systematic review and meta-analysis. Int J Cardiol. 2018;261:134-141.
Gomes Neto, M., Durães, A. R., Conceição, L. S. R., Saquetto, M. B., Ellingsen, Ø., & Carvalho, V. O. (2018). High intensity interval training versus moderate intensity continuous training on exercise capacity and quality of life in patients with heart failure with reduced ejection fraction: A systematic review and meta-analysis. International Journal of Cardiology, 261, 134-141. https://doi.org/10.1016/j.ijcard.2018.02.076
Gomes Neto M, et al. High Intensity Interval Training Versus Moderate Intensity Continuous Training On Exercise Capacity and Quality of Life in Patients With Heart Failure With Reduced Ejection Fraction: a Systematic Review and Meta-analysis. Int J Cardiol. 2018 06 15;261:134-141. PubMed PMID: 29572084.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - High intensity interval training versus moderate intensity continuous training on exercise capacity and quality of life in patients with heart failure with reduced ejection fraction: A systematic review and meta-analysis. AU - Gomes Neto,Mansueto, AU - Durães,André Rodrigues, AU - Conceição,Lino Sergio Rocha, AU - Saquetto,Micheli Bernardone, AU - Ellingsen,Øyvind, AU - Carvalho,Vitor Oliveira, Y1 - 2018/03/05/ PY - 2017/12/20/received PY - 2018/02/02/revised PY - 2018/02/20/accepted PY - 2018/3/25/pubmed PY - 2018/11/9/medline PY - 2018/3/25/entrez SP - 134 EP - 141 JF - International journal of cardiology JO - Int. J. Cardiol. VL - 261 N2 - OBJECTIVE: The aim of this study was to investigate the effects of high intensity interval training (HIIT) versus moderate intensity continuous training (MICT) in heart failure patients with reduced ejection fraction (HFrEF). BACKGROUND: Despite the well-known positive effects of exercise in heart failure patients, the best mode of exercise is still under discussion. METHODS: We searched Pubmed/MEDLINE, Cochrane Central Register of Controlled Trials, PEDro data base, and SciELO (from the earliest date available to October 2017) for randomized controlled trials that evaluated the effects of HIIT versus MICT in HFrEF patients. Weighted mean differences (WMD) with 95% confidence interval (CI) were calculated, and heterogeneity was assessed using the I2 test. RESULTS: 13 studies met the study criteria, including 411 patients. Compared to MICT, HIIT resulted in improvement in Peak VO2 WMD (1.35 mL·kg-1·min-1 95% CI: 0.03 to 2.64 N = 411). HIIT resulted in no difference in VE/VCO2 slope WMD (-1.21 95% CI: -3.0 to 0.58 N = 135), and quality of life measured by Minnesota Living with Heart Failure questionnaire WMD (1.19 95% CI: -5.81 to 8.19 N = 79). Sub-group analyses comparing studies with and without isocaloric exercise training protocol also showed a nonsignificant difference in peak VO2 for participants in the HIIT group compared with MICT group. CONCLUSIONS: HIIT improves peak VO2 and should be considered as a component of care of HFrEF patients. However, its superiority versus MICT disappears when isocaloric protocols are compared. An important caveat is uncertainty and variation of actual training intensities compared to program targets. SN - 1874-1754 UR - https://www.unboundmedicine.com/medline/citation/29572084/High_intensity_interval_training_versus_moderate_intensity_continuous_training_on_exercise_capacity_and_quality_of_life_in_patients_with_heart_failure_with_reduced_ejection_fraction:_A_systematic_review_and_meta_analysis_ L2 - https://linkinghub.elsevier.com/retrieve/pii/S0167-5273(17)37879-8 DB - PRIME DP - Unbound Medicine ER -