TY - JOUR
T1 - High-intensity interval training in patients with left ventricular assist devices
T2 - A pilot randomized controlled trial
AU - Moreno-Suarez, Ignacio
AU - Scheer, Anna
AU - Lam, Kaitlyn
AU - Dembo, Lawrence
AU - Spence, Angela L.
AU - Hayward, Christopher
AU - Kaye, David M.
AU - Leet, Angela
AU - Fuller, Louise M.
AU - Jacques, Angela
AU - Naylor, Louise H.
AU - Green, Daniel J.
AU - Maiorana, Andrew
PY - 2020/12
Y1 - 2020/12
N2 - BACKGROUND: Left ventricular assist device (LVAD) implantation is an established treatment for patients with advanced heart failure. To date, studies evaluating the impact of aerobic training in patients with LVADs have focused on moderate-intensity exercise.METHODS: This pilot randomized controlled trial compared the effects of high-intensity interval training (HIIT) with those of moderate-intensity continuous training (MICT) on peak oxygen consumption ((V)over dotO(2) peak) in patients with LVADs. Secondary outcomes included 6-minute walk test distance, flow-mediated dilation, and anthropometry. Assessments were conducted at baseline and after 12 weeks of supervised training performed 3 times weekly. Participants were randomized to HIIT (4 sets of 4 minutes at 80%-90% (V)over dotO(2) reserve, alternating with 3 minutes at 50%-60% V.O2 reserve) or MICT groups (28 minutes continuously at 50%-60% (V)over dotO(2) reserve). Within and between-group differences were analyzed using linear mixed models. Data are expressed as marginal means with 95% confidence intervals or as mean +/- SD.RESULTS: A total of 21 participants were randomized (HIIT: age 57.7 +/- 13.1 years; n = 11 and MICT: age 55.6 +/- 14.2 years; n = 10) (mean +/- SD). No major adverse events occurred in response to training in either group. HIIT significantly improved (V)over dotO(2) peak (15.6 [13.2-17.8] to 18.4 [16.0-20.8] ml/kg/ min) (marginal mean [95% CI]) compared with MICT (16.2 [13.8-18.7] to 17.2 [14.6-19.7] ml/kg/ min; p CONCLUSION: In patients with LVADs, HIIT was well tolerated and increased aerobic capacity more than MICT. These preliminary findings support the prescription of high-intensity exercise in clinically stable patients with LVADs but warrant validation in a larger sample and across a broader range of physiologic and clinical outcomes. CLINICAL TRIAL REGISTRATION: URL: https://www.anzctr.org.au, unique identifier: ACTRN12616001596493. (C) 2020 International Society for Heart and Lung Transplantation. All rights reserved.
AB - BACKGROUND: Left ventricular assist device (LVAD) implantation is an established treatment for patients with advanced heart failure. To date, studies evaluating the impact of aerobic training in patients with LVADs have focused on moderate-intensity exercise.METHODS: This pilot randomized controlled trial compared the effects of high-intensity interval training (HIIT) with those of moderate-intensity continuous training (MICT) on peak oxygen consumption ((V)over dotO(2) peak) in patients with LVADs. Secondary outcomes included 6-minute walk test distance, flow-mediated dilation, and anthropometry. Assessments were conducted at baseline and after 12 weeks of supervised training performed 3 times weekly. Participants were randomized to HIIT (4 sets of 4 minutes at 80%-90% (V)over dotO(2) reserve, alternating with 3 minutes at 50%-60% V.O2 reserve) or MICT groups (28 minutes continuously at 50%-60% (V)over dotO(2) reserve). Within and between-group differences were analyzed using linear mixed models. Data are expressed as marginal means with 95% confidence intervals or as mean +/- SD.RESULTS: A total of 21 participants were randomized (HIIT: age 57.7 +/- 13.1 years; n = 11 and MICT: age 55.6 +/- 14.2 years; n = 10) (mean +/- SD). No major adverse events occurred in response to training in either group. HIIT significantly improved (V)over dotO(2) peak (15.6 [13.2-17.8] to 18.4 [16.0-20.8] ml/kg/ min) (marginal mean [95% CI]) compared with MICT (16.2 [13.8-18.7] to 17.2 [14.6-19.7] ml/kg/ min; p CONCLUSION: In patients with LVADs, HIIT was well tolerated and increased aerobic capacity more than MICT. These preliminary findings support the prescription of high-intensity exercise in clinically stable patients with LVADs but warrant validation in a larger sample and across a broader range of physiologic and clinical outcomes. CLINICAL TRIAL REGISTRATION: URL: https://www.anzctr.org.au, unique identifier: ACTRN12616001596493. (C) 2020 International Society for Heart and Lung Transplantation. All rights reserved.
KW - left ventricular assist device
KW - high intensity
KW - exercise training
KW - aerobic capacity
KW - endothelial function
KW - six minute walk test
KW - anthropometry
KW - HEART-FAILURE PATIENTS
KW - MECHANICAL CIRCULATORY SUPPORT
KW - CARDIAC REHABILITATION
KW - VASCULAR FUNCTION
KW - EXERCISE CAPACITY
KW - BRACHIAL-ARTERY
KW - VASODILATION
KW - METAANALYSIS
KW - DYSFUNCTION
KW - GUIDELINES
UR - http://www.scopus.com/inward/record.url?scp=85091203839&partnerID=8YFLogxK
U2 - 10.1016/j.healun.2020.08.005
DO - 10.1016/j.healun.2020.08.005
M3 - Article
C2 - 32958408
SN - 1053-2498
VL - 39
SP - 1380
EP - 1388
JO - Journal of Heart and Lung Transplantation
JF - Journal of Heart and Lung Transplantation
IS - 12
ER -