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High-Intensity Interval Training Improves Peak Oxygen Uptake and Muscular Exercise Capacity in Heart Transplant Recipients

https://doi.org/10.1111/j.1600-6143.2012.04221.xGet rights and content
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Heart transplant (HTx) recipients usually have reduced exercise capacity with reported VO2peak levels of 50–70% predicted value. Our hypothesis was that high-intensity interval training (HIIT) is an applicable and safe form of exercise in HTx recipients and that it would markedly improve VO2peak.

Secondarily, we wanted to evaluate central and peripheral mechanisms behind a potential VO2peak increase. Forty-eight clinically stable HTx recipients >18 years old and 1–8 years after HTx underwent maximal exercise testing on a treadmill and were randomized to either exercise group (a 1-year HIIT-program) or control group (usual care). The mean ± SD age was 51 ± 16 years, 71% were male and time from HTx was 4.1 ± 2.2 years. The mean VO2peak difference between groups at follow-up was 3.6 [2.0, 5.2] mL/kg/min (p < 0.001). The exercise group had 89.0 ± 17.5% of predicted VO2peak versus 82.5 ± 20.0 in the control group (p < 0.001). There were no changes in cardiac function measured by echocardiography. We have demonstrated that a long-term, partly supervised and community-based HIIT-program is an applicable, effective and safe way to improve VO2peak, muscular exercise capacity and general health in HTx recipients. The results indicate that HIIT should be more frequently used among stable HTx recipients in the future.

Key words:

Aerobic exercise
chronotropic response
heart transplantation
maximum oxygen uptake
muscle strength
VO2peak

Abbreviations:

% HRmax
percent of age-predicted maximum heart rate
AT
anaerobic threshold (ventilatory threshold)
BIA
bioelectrical impedance analysis
CG
control group
CO
cardiac output
CRI
chronotropic response index
CRP
C-reactive protein
DXA
dual-emission X-ray absorptiometry
EG
exercise group
eGFR
estimated glomerular filtration rate
Hb
hemoglobin
HF
heart failure
HIIT
high-intensity interval training
HR
heart rate
HRmax
maximum heart rate
HRQoL
health-related quality of life
HTx
heart transplant
J
Joule
LV
left ventricle
LVe’
left ventricle early diastolic mitral annular velocity
LVEF
left ventricle ejection fraction
Nm
Newtonmeter
NT-proBNP
N-terminal prohormone of brain natriuretic peptide
RER
respiratory exchange ratio
RPE
rated perceived exertion
VAS scale
visual analog scale
VEmax
maximum ventilation
VO2peak
peak oxygen uptake

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