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Short-term effects of a 3-week interval training program on heart rate variability in chronic heart failure. A randomised controlled trial - 20/09/19

Doi : 10.1016/j.rehab.2019.06.013 
Florent Besnier a, b, Marc Labrunée a, c, Lisa Richard b, Florence Faggianelli c, Hélène Kerros b, Laurent Soukarié b, Marc Bousquet b, Jean-Louis Garcia b, Atul Pathak a, d, Céline Gales a, Thibaut Guiraud a, , Jean Michel Sénard a, e
a Institute of Cardiovascular and Metabolic Diseases, National Institute of Health and Medical Research (Inserm), UMR-1048, 1, avenue Professeur Jean-Poulhès, BP 84225, 31432, Toulouse, France 
b ELSAN, Clinic of Saint-Orens, Cardiovascular and Pulmonary Rehabilitation Center, 12 avenue de Revel, 31650, Saint-Orens-de-Gameville, France 
c Department of Cardiovascular Rehabilitation, Toulouse University Hospital, 1 avenue du Professeur Jean Poulhès, 31400, Toulouse, France 
d Department of Cardiovascular Medicine, Hypertension and Heart Failure Unit, Clinique Pasteur, 45 avenue de Lombez - BP 27617, 31076, Toulouse, France 
e Department of Clinical Pharmacology, Toulouse University Hospital, 1 avenue du Professeur Jean Poulhès, 31400, Toulouse, France 

Corresponding author at: Institute of Cardiovascular and Metabolic Diseases, team 8, Inserm-UMR-1048, 1, avenue Professeur Jean-Poulhès, BP 84225, 31432 Toulouse cedex 4, France.Institute of Cardiovascular and Metabolic Diseases, team 8, Inserm-UMR-10481, avenue Professeur Jean-Poulhès, BP 84225Toulouse cedex 431432France

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Highlights

Our optimized high intensity interval training (HIIT) protocol (short and intense with passive recovery) was significantly superior to the classical moderate intensity continuous training (MICT) program for individuals with chronic heart failure.
HIIT was well tolerated, with no adverse events.
It significantly improved parasympathetic tone (high-frequency power increased by 25% and low-frequency/high-frequency ratio reduced by 35%).
It significantly improved peak oxygen uptake (+20%) and left ventricular ejection fraction (+9%).

El texto completo de este artículo está disponible en PDF.

Abstract

Background

Exaggerated sympathetic nervous system activity associated with low heart rate variability (HRV) is considered to trigger cardiac arrhythmias and sudden death. Regular exercise training is efficient to improve autonomic balance.

Objective

We aimed to verify the superiority of high-intensity interval training (HIIT) to enhance HRV, cardiorespiratory fitness and cardiac function as compared with moderate intensity continuous training (MICT) in a short, intense cardiac rehabilitation program.

Methods

This was a prospective, monocentric, evaluator-blinded, randomised (1:1) study with a parallel two-group design. Overall, 31 individuals with voluntary chronic heart failure (CHF) (left ventricular ejection fraction [LVEF]<45%) were allocated to MICT (n=15) or HIIT (n=16) for a short rehabilitation program (mean [SD] 27 [4] days). Participants underwent 24-hr electrocardiography, echocardiography and a cardiopulmonary exercise test at entry and at the end of the study.

Results

High-frequency power in normalized units (HFnu%) measured as HRV increased with HIIT (from 21.2% to 26.4%, P<0.001) but remained unchanged with MICT (from 23.1% to 21.9%, P=0.444, with a significant intergroup difference, P=0.003). Resting heart rate (24-hr Holter electrocardiography) decreased significantly for both groups (from 68.2 to 64.6 bpm and 66.0 to 63.5 bpm for MICT and HIIT, respectively, with no intergroup difference, P=0.578). The 2 groups did not differ in premature ventricular contractions. Improvement in peak oxygen uptake was greater with HIIT than MICT (+21% vs. +5%, P=0.009). LVEF improved with only HIIT (from 36.2% to 39.5%, P=0.034).

Conclusions

In this short rehabilitation program, HIIT was significantly superior to the classical MICT program for enhancing parasympathetic tone and peak oxygen uptake.

ClinicalTrials.gov identifier

NCT03603743

El texto completo de este artículo está disponible en PDF.

Keywords : Exercise training, Cardiovascular, Rehabilitation, Chronic heart failure, Parasympathetic, Cardiorespiratory fitness


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Vol 62 - N° 5

P. 321-328 - septembre 2019 Regresar al número
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