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June 12, 2026Journal of Clinical MedicineOpen Access

Time-Course of Physiological Adaptations to High-Intensity Interval Training-Based Cardiac Rehabilitation After Myocardial Infarction

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Why the study?

The temporal sequence of physiological, cardiac, biochemical, and functional adaptations to HIIT in exercise-based cardiac rehabilitation after myocardial infarction remains incompletely characterized.

Does 12-week supervised outpatient high-intensity interval training (HIIT) improve physiological, cardiac, biochemical, and functional adaptations in stable post-STEMI patients?

Population

Stable post-STEMI patients and previously inactive participants without known cardiovascular, metabolic, or systemic disease

Comparison

12-week supervised outpatient HIIT in stable post-STEMI patients vs inactive controls

Design

Observational study

Follow-up

12 weeks

Key result

Supervised high-intensity interval training significantly increased VO2peak in post-STEMI patients (median 20.1 to 24.5 mL/kg/min; p<0.001) and healthy controls, with early improvements in LVEF.

Authors

KSKristina SkročeDSDijana Travica SamsaMNMarina Njegovan

Discussion

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Overview

Supports cardiac rehab to enhance fitness post-MI; confirms VO2peak gains in this RCT.

Key Points

  • This study aims to characterize the time-course of physiological adaptations to high-intensity interval training in patients after myocardial infarction.
  • Participants post-STEMI and a control group completed 12-week HIIT (4 × 4 min intervals at 85–90% HRpeak).
  • Assessments at 0, 4, 8, and 12 weeks included various tests like CPET and echocardiography.
  • Longitudinal changes analyzed using Friedman tests and Mann–Whitney U tests for between-group comparisons.
  • VO2peak increased significantly by ~22% in MI and ~23% in CTRL from baseline to 12 weeks (both p < 0.001).
  • LVEF improved from 52.5% at baseline to 60% at 12 weeks in MI (p < 0.001).
  • CRP decreased in MI from 2.1 to 0.7 mg·L−1 (p = 0.008), while NT-proBNP showed no significant change (p = 0.510).

Study Design

Type

Observational

Structured PICO

Does 12-week supervised outpatient high-intensity interval training (HIIT) improve physiological, cardiac, biochemical, and functional adaptations in stable post-STEMI patients?

P
Population
Stable post-STEMI patients and previously inactive healthy controls undergoing a 12-week supervised outpatient high-intensity interval training program.
E
Exposure
12-week supervised outpatient high-intensity interval training (HIIT) consisting of 4 × 4 min intervals at 85–90% HRpeak (~80–90% of VO2peak), 3 sessions/week.
C
Comparator
No clinical comparator group (observational design); healthy inactive participants (CTRL group) received the same HIIT intervention.
O
Outcome
Longitudinal changes in cardiopulmonary exercise testing (VO2peak), echocardiography (LVEF, LV dimensions), blood biomarkers (NT-proBNP, CRP), body composition (body fat %), six-minute walk test (6MWT), and RAND-36 at 4, 8, and 12 weeks.surrogate

Main Result

Absolute Event Rate: 24.5% vs 27.6%

p-value: p=<0.001

A 12-week supervised HIIT program in stable post-STEMI patients is associated with significant improvements in exercise capacity and left ventricular ejection fraction without increasing cardiac stress biomarkers.

Limitations

  • Observational design
  • Absence of clinical comparator groups
  • observational design
  • absence of clinical comparator groups

Cite This Study

Skroče et al. (2026) conducted an observational in ST-segment elevation myocardial infarction (STEMI). High-intensity interval training (HIIT) vs. Previously inactive participants without known cardiovascular, metabolic or systemic disease (CTRL group) was evaluated on VO2peak (p=<0.001). Supervised high-intensity interval training significantly increased VO2peak in post-STEMI patients (median 20.1 to 24.5 mL/kg/min; p<0.001) and healthy controls, with early improvements in LVEF.

synapsesocial.com/papers/6a2bd1386550ea4541ffe92ahttps://doi.org/10.3390/jcm15124545
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