July 1, 2020Vascular Health and Risk ManagementOpen Access

Cardiovascular Protection Variables Based on Exercise Intensity in Stable Coronary Heart Disease Patients After Coronary Stenting: A Comparative Study

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Why the study?

The study aimed to determine and compare the mechanisms of cardiovascular protection variables between moderate-intensity continuous training and high-intensity interval training in patients with stable coronary heart disease after coronary stenting.

Does high-intensity interval training improve surrogate markers of cardiovascular protection compared to moderate-intensity continuous training in stable coronary heart disease patients after coronary stenting?

Structured PICO

Population

11 stable coronary heart disease (CHD) patients after coronary stenting

Intervention

High-intensity interval training (HIIT) with 4x4 minute intervals at 60-80% heart rate reserve, each followed by three minutes of active recovery at 40-50% heart rate reserve, conducted three times a week for two weeks

Comparator

Moderate-intensity continuous training (MICT) for 29 minutes at 50-60% heart rate reserve, conducted three times a week for two weeks

Outcome

Levels of adrenaline, noradrenaline, endothelial nitric oxide synthase (eNOS), extracellular superoxide dismutase (EC-SOD) activity, and flow-mediated dilatation (FMD) before and after treatmentssurrogate

In stable coronary heart disease patients post-stenting, a two-week high-intensity interval training program was superior to moderate-intensity continuous training in improving surrogate markers of endothelial function and cardiovascular protection.

Implication

HIIT may enhance endothelial markers over MICT in small stented CHD cohorts; leaves open need for outcome trials before practice change.

Abstract

PURPOSE: Our study aimed at determining and comparing the mechanism of cardiovascular protection variables in moderate-intensity continuous training (MICT) and high-intensity interval training (HIIT) in patients with stable coronary heart disease (CHD) after coronary stenting. PARTICIPANTS AND METHODS: This experimental study used the same subject and cross-over design, involving eleven stable CHD patients after coronary stenting. These were randomly divided into two groups; MICT for 29 minutes at 50-60% heart rate reserve and HIIT with 4x4 minute intervals at 60-80% heart rate reserve, each followed by three minutes of active recovery at 40-50% heart rate reserve. These were conducted three times a week for two weeks. The participants' levels of adrenaline, noradrenaline, endothelial nitric oxide synthase (eNOS), extracellular superoxide dismutase (EC-SOD) activity assayed, and flow-mediated dilatation (FMD) were examined before and after treatments were completed. RESULTS: The HIIT significantly increased the levels of noradrenaline and eNOS compared with MICT (p<0.05). Also, HIIT was better in maintaining EC-SOD activity and FMD compared with MICT (p<0.05). Through the noradrenalin pathway, HIIT had a direct and significant effect on eNOS and FMD (p<0.05) but MICT, through the noradrenaline pathways, had a direct and significant effect on eNOS (p<0.05), and through the EC-SOD activity pathways had a direct and significant effect on FMD (p<0.05). MICT reduced EC-SOD activity and also decreased the FMD value. CONCLUSION: HIIT is superior to MICT in increasing cardiovascular protection by increasing the concentrations of noradrenalin and eNOS, maintaining EC-SOD activity, and FMD in stable CHD patients after coronary stenting.