High-intensity interval training was associated with better 10-year survival compared to guideline-directed medical therapy alone (80.3% vs 68.6%, P=0.015) in patients with heart failure.
Cohort (n=214)
Does high-intensity interval training improve 10-year survival in patients with heart failure?
High-intensity interval training is associated with improved 10-year survival in patients with HFrEF and HFmrEF, an effect significantly mediated by the reversal of left ventricular remodeling.
Absolute Event Rate: 80.3% vs 68.6%
p-value: p=0.015
Background This study aimed to assess the left ventricular (LV) remodeling response and long‐term survival after high‐intensity interval training (HIIT) in patients with various heart failure (HF) phenotypes during a 10‐year longitudinal follow‐up. Methods and Results Among 214 patients with HF receiving guideline‐directed medical therapy, those who underwent an additional 36 sessions of aerobic exercise at alternating intensities of 80% and 40% peak oxygen consumption (V ̇ V̇ O 2peak) were considered HIIT participants (n=96). Patients who did not undergo HIIT were considered participants receiving guideline‐directed medical therapy (n=118). Participants with LV ejection fraction (EF) V ̇ V̇ O 2peak, serial LV geometry, and time to death were recorded. In all included participants, 10‐year survival was better (P =0. 015) for participants who underwent HIIT (80. 3%) than for participants receiving guideline‐directed medical therapy (68. 6%). An increased V ̇ V̇ O 2peak, decreased minute ventilation carbon dioxide production slope, and reduced LV end‐diastolic diameter were protective factors against all‐cause mortality. Regarding 138 patients with HF with reduced EF (P =0. 044) and 36 patients with HF with mid‐range EF (P =0. 036), 10‐year survival was better for participants who underwent HIIT than for participants on guideline‐directed medical therapy. Causal mediation analysis showed a significant mediation path for LV end‐diastolic diameter on the association between HIIT and 10‐year mortality in all included patients with HF (P <0. 001) and those with LV ejection fraction <50% (P =0. 006). HIIT also had a significant direct association with 10‐year mortality in patients with HF with LV ejection fraction <50% (P =0. 027) but not in those with LV ejection fraction ≥50% (n=40). Conclusions Reversal of LV remodeling after HIIT could be a significant mediating factor for 10‐year survival in patients with HF with reduced EF and those with HF with mid‐range EF.
Hsu et al. (Fri,) conducted a cohort in Heart failure (n=214). High-intensity interval training (HIIT) vs. Guideline-directed medical therapy alone was evaluated on 10-year survival (p=0.015). High-intensity interval training was associated with better 10-year survival compared to guideline-directed medical therapy alone (80.3% vs 68.6%, P=0.015) in patients with heart failure.