What does this research mean for the field?

High-intensity interval training (HIIT) is significantly more effective than moderate-intensity training (MIT) for improving peak VO2 and left-ventricular ejection fraction in heart failure patients, whereas combined aerobic and resistance training provides similar benefits to MIT alone. Novelty: ClaimNovelty.SYNTHESIS. Consensus alignment: ConsensusAlignment.NEUTRAL.

January 9, 2023Sports Medicine - OpenOpen Access

Exercise Mode in Heart Failure: A Systematic Review and Meta-Analysis

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Why the study?

Optimising exercise prescription in heart failure with preserved or reduced ejection fraction is clinically important.

Does high-intensity interval training or combined aerobic and resistance training improve peak VO2 and LVEF compared to moderate intensity training in adults with heart failure?

Comparison

MIT vs CT (4 studies) and MIT vs HIIT (13 studies)

Design

Systematic review and meta-analysis of randomized controlled trials

Authors

JEJamie EdwardsUniversity of East London NSNesan ShanmugamSt George’s University Hospitals NHS Foundation Trust RRRobin RaySt George's, University of London

Discussion

Member takes

Implication

Supports prioritizing HIIT over MIT in heart failure; extends prior trial evidence on intensity-dependent gains.

Structured PICO

Does high-intensity interval training or combined aerobic and resistance training improve peak VO2 and LVEF compared to moderate intensity training in adults with heart failure?

Population

715 adults (≥18 years) with heart failure (HFpEF or HFrEF) pooled from 17 randomized controlled trials.

Intervention

High-intensity interval training (HIIT) or combined aerobic and resistance training (CT) for 4 weeks to 6 months.

Comparator

Traditional moderate intensity training (MIT).

Outcome

Change in peak aerobic capacity (VO2) from baseline to follow-up.surrogate

High-intensity interval training is superior to moderate-intensity training for improving cardiorespiratory fitness and cardiac function in heart failure patients, while adding resistance training to moderate-intensity training does not blunt aerobic adaptations.

Limitations

Many HF patients struggle to reach prescribed HIIT intensities
Most included trials do not disclose if protocols are isocaloric
HFpEF remains comparatively under-researched with lower number of effect sizes
Evidence of publication bias (Egger's test significant for MIT vs HIIT)

Cite This Study

Edwards et al. (2023) studied this question.

synapsesocial.com/papers/6a19a82a196cd56b09ea869d https://doi.org/10.1186/s40798-022-00549-1

Topics

HFrEF treatment Heart failure HFpEF management

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Exercise Mode in Heart Failure: A Systematic Review and Meta-Analysis

Discussion

Member takes

Implication

Structured PICO

Limitations

Cite This Study

Topics

Exercise Mode in Heart Failure: A Systematic Review and Meta-Analysis

Discussion

Member takes

Implication

Structured PICO

Limitations

Cite This Study

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