High-intensity interval training was not superior to moderate continuous training at improving left atrial reservoir strain (MD 2.31%; 95% CI -4.18 to 8.81; p=0.474) in patients with HFpEF.
RCT (n=46)
Does high-intensity interval training improve left atrial strain parameters more than moderate continuous training in patients with heart failure with preserved ejection fraction?
In patients with HFpEF, both high-intensity interval training and moderate continuous training partially improve left atrial function, with neither regimen demonstrating superiority over 12 weeks.
Mean Difference: 2.31 (95% CI -4.18–8.81)
p-value: p=0.474
Abstract Background/Introduction Left atrial (LA) strain parameters are increasingly recognized as diagnostic and prognostic markers in heart failure with preserved ejection fraction (HFpEF). They are associated with V̇O2peak and both LA strain parameters and V̇O2peak can be improved by exercise training. The optimal training regime to improve LA strain parameters in HFpEF patients has yet to be determined. Purpose In this sub-study of the HIT-HF project we investigated whether moderate continuous training (MCT) or high-intensity interval training (HIIT) is superior in improving LA strain parameters. Methods 46 HFpEF patients participated in either guided MCT (n=22) or HIIT (n=24) for 12 weeks. V̇O2peak was assessed by cardiopulmonary exercise testing prior to and after the training intervention. Resting echocardiography was obtained prior to each exercise testing. LA strain parameters and LA stiffness were measured post-acquisition. For each LA parameter, an ANCOVA was fitted with the respective post-training value as the outcome variable and the respective pre-training value as well as the training group as independent variables. Results V̇O2peak improved from 21.57 (5.49)ml/kg/min to 23.45 (6.45)ml/kg/min in the MCT and 22.29 (4.94)ml/kg/min to 25.39 (5.34)ml/kg/min in the HIIT group. There was also improvement in LA reservoir (0.97 (6.23)% vs. 0.05 (11.60)%) and LA stiffness (-0.03 (0.18) vs. -0.13 (0.24)). LA conduit strain did not change (-0.95 (7.78)% vs. 0.50 (7.27)%). LA contraction strain decreased slightly (-0.22 (5.17)% vs. -0.47 (8.59)%). No evidence was found for a significant superior effect of either training regime on LA reservoir (2.31% (95%-CI: -4.18, 8.81), p=0.474), conduit (2.35% (95%-CI: -7.33, 2.63), p=0.344), or contraction strain (0.13% (95%-CI: -4.82, 4.55), p=0.954) and LA stiffness (-0.08 (95%-CI: -0.23, 0.06), p=0.244). Conclusion While LA function partially improved in both training regimens, neither HIIT nor MCT was more effective at improving LA mechanics.
Prechtl et al. (Mon,) conducted a rct in Heart failure with preserved ejection fraction (HFpEF) (n=46). High-intensity interval training (HIIT) vs. Moderate continuous training (MCT) was evaluated on Left atrial reservoir strain (MD 2.31%, 95% CI -4.18, 8.81, p=0.474). High-intensity interval training was not superior to moderate continuous training at improving left atrial reservoir strain (MD 2.31%; 95% CI -4.18 to 8.81; p=0.474) in patients with HFpEF.
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