High-intensity interval training versus progressive high-intensity circuit resistance training on endothelial function and cardiorespiratory fitness in heart failure: A preliminary randomized controlled trial

Abstract

Introduction: Exercise training is strongly recommended as a therapeutic approach to treat individuals with heart failure. High-intensity exercise training modalities still controversial in this population. The study aims to preliminary assess the consequences of high-intensity exercise training modalities, aerobic interval training (HIIT) and progressive high circuit-resistance training (CRT), on primarily endothelial function and cardiorespiratory fitness, and secondly on muscle strength and physical performance in heart failure patients.

Methods: This preliminary multicentric randomized controlled trial comprised 23 heart failure patients, aged 56 ± 10 years old, mainly New York Heart Association classification I and II (%), hemodynamically stable, who compromise at least 36 exercise sessions of a randomly assigned intervention (HIIT, CRT or control group). Endothelial function, cardiopulmonary exercise testing, muscle strength and physical performance were completed at baseline and post-intervention.

Results: Although no effects on endothelial function; both HIIT and CRT modalities were able to produce a positive effect on [Formula: see text] peak (HIIT = +2.1±6.5, CRT = +3.0±4.2 and control group = -0.1± 5.3 mL/kg/min, time*group p-value<0,05) and METs (HIIT = +0.6±1.8, CRT = +0.9±1.2 and control group = 0±1.6, time*group p-value<0,05). Only HIIT increased isokinetic torque peak (HIIT = +8.8±55.8, CRT = 0.0±60.7 and control group = 1.6±57.6 Nm) matched p-value<0,05. Regarding the physical performance, the CRT modality reduced chair stand test completion time (HIIT = -0.7±3.1, CRT = -3.3±3.2 and control group = -0.3±2.5 s, matched p-value<0,05 and HIIT improved global physical performance(time*group p<0,05).

Conclusion: This preliminary study trends to indicate for the first time that high-intensity interval training promotes a jointly superior effect compared to progressive high intensity circuit-resistance training by improving cardiorespiratory fitness, muscular strength, and physical performance. Further research with larger cohort is necessary.

Clinical trial registration number: ReBEC RBR-668c8v.

Fig 1. Study flowchart.

HIIT, high-intensity interval training; CRT, circuit-resistance training; CPET, cardiopulmonary exercise testing; FMD, flow-mediated dilatation.

Fig 2. Study design.

Study overview flowchart. HIIT, high-intensity interval training; CRT, circuit-resistance training; CG, control group; NT-pro BNP, N‐terminal pro‐brain natriuretic peptide; FMD, flow-mediated dilatation; CPET, cardiopulmonary exercise test; SPPB, Short Physical Performance Battery.

Fig 3. Training protocol.

Design of the training protocol. HIIT, high-intensity interval training; CRT, circuit-resistance training; 1RM, one-repetition maximum; W, weeks; rep, repetitions; min, minute.

Fig 4. Clinical measurements at training sessions.

HIIT, high-intensity interval training; CRT, circuit-resistance training; CG, control group; SBP, systolic blood pressure; mmHg, milimeters of mercury; DBP, diastolic blood pressure; HR, heart rate; bpm, beats per minute; Borg (6–20), perceived of exertion.

Fig 5. Individuals dynamics per groups.

HIIT, high-intensity interval training; CRT, circuit-resistance training; CG, control group; $\dot{\mathrm{V}}\mathrm{O}2$, oxygen uptake; mL/kg/min, millimeter per kilogram per minute; SPPB, short physic performance battery; PT, peak torque; Nm, newton-meter; p, statistical significance.

Fig 6. Delta change variation.

Responder threshold for $\dot{\mathrm{V}}\mathrm{O}2$ (minimum 6% increase mL/kg/min). HIIT, high-intensity interval training; CRT, circuit-resistance training; CG, control group; $\dot{\mathrm{V}}\mathrm{O}2$, oxygen uptake; mL/kg/min, millimeter per kilogram per minute; W, watt; SPPB, short physic performance battery.