High-intensity interval training in cardiac rehabilitation: a multi-centre randomized controlled trial

McGregor, Gordon; Powell, Richard; Begg, Brian; Birkett, Stefan T.; Nichols, Simon; Ennis, Stuart; McGuire, Scott; Prosser, Jonathon; Fiassam, Olivier; Hee, Siew Wan; Hamborg, Thomas; Banerjee, Prithwish; Hartfiel, Ned; Charles, Joanna M.; Edwards, Rhiannon T.; Drane, Aimee; Ali, Danish; Osman, Faizel; He, Hejie; Lachlan, Tom; Haykowsky, Mark J.; Ingle, Lee; Shave, Rob

Abstract

BACKGROUND: There is a lack of international consensus regarding the prescription of high-intensity interval training (HIIT) for people with coronary artery disease (CAD) attending cardiac rehabilitation (CR). AIMS: To assess the clinical effectiveness and safety of low-volume HIIT compared with moderate-intensity steady-state (MISS) exercise training for people with CAD. METHODS AND RESULTS: We conducted a multi-centre RCT, recruiting 382 patients from 6 outpatient CR centres. Participants were randomized to twice-weekly HIIT (n = 187) or MISS (n = 195) for 8 weeks. HIIT consisted of 10 × 1 min intervals of vigorous exercise (>85% maximum capacity) interspersed with 1 min periods of recovery. MISS was 20-40 min of moderate-intensity continuous exercise (60-80% maximum capacity). The primary outcome was the change in cardiorespiratory fitness [peak oxygen uptake (VO2 peak)] at 8 week follow-up. Secondary outcomes included cardiovascular disease risk markers, cardiac structure and function, adverse events, and health-related quality of life. At 8 weeks, VO2peak improved more with HIIT (2.37 mL.kg-1.min-1; SD, 3.11) compared with MISS (1.32 mL.kg-1.min-1; SD, 2.66). After adjusting for age, sex, and study site, the difference between arms was 1.04 mL.kg-1.min-1 (95% CI, 0.38 to 1.69; P = 0.002). Only one serious adverse event was possibly related to HIIT. CONCLUSIONS: In stable CAD, low-volume HIIT improved cardiorespiratory fitness more than MISS by a clinically meaningful margin. Low-volume HIIT is a safe, well-tolerated, and clinically effective intervention that produces short-term improvement in cardiorespiratory fitness. It should be considered by all CR programmes as an adjunct or alternative to MISS. TRIAL REGISTRATION: ClinicalTrials.gov: NCT02784873. https://clinicaltrials.gov/ct2/show/NCT02784873.

Citation

McGregor, G., Powell, R., Begg, B., Birkett, S. T., Nichols, S., Ennis, S., …Shave, R. (2023). High-intensity interval training in cardiac rehabilitation: a multi-centre randomized controlled trial. European Journal of Preventive Cardiology, 30(9), 745-755. https://doi.org/10.1093/eurjpc/zwad039

• Journal Article Type: Article
• Acceptance Date: Feb 3, 2023
• Online Publication Date: Feb 8, 2023
• Publication Date: Jul 12, 2023
• Deposit Date: Feb 13, 2023
• Publicly Available Date: Jul 14, 2023
• Journal: European journal of preventive cardiology
• Print ISSN: 2047-4873
• Electronic ISSN: 2047-4881
• Publisher: SAGE Publications
• Peer Reviewed: Peer Reviewed
• Volume: 30
• Issue: 9
• Pages: 745-755
• DOI: https://doi.org/10.1093/eurjpc/zwad039
• Keywords: Cardiac rehabilitation; Exercise training; High intensity interval training; Coronary artery disease; Cardiorespiratory fitness; National Health Service
• Public URL: https://hull-repository.worktribe.com/output/4200366