Dataset Information

Aerobic high-intensity interval exercise training in patients with angina and no obstructive coronary artery disease: feasibility and physiological effects.

ABSTRACT:

Aims

Patients with chest pain and normal coronary angiogram [angina with normal coronary arteries (ANOCA)] constitute a therapeutic problem with considerable functional limitation and reduced quality of life. The aims of the current pilot study were to (i) explore if a structured aerobic high-intensity interval training (HIT) program for 12 weeks was feasible in patients with ANOCA, and (ii) to assess mechanisms related to symptoms in this population.

Methods and results

Sixteen patients with ANOCA underwent a 3-month aerobic HIT program with one-to-one monitored exercise sessions on treadmill in a 4 min × 4 manner, three times a week. Four patients served as controls. Coronary flow velocity reserve (CFVR) transthoracic Doppler, flow-mediated vasodilation (FMD) and VO_2max was measured at baseline and after 12 weeks. The average attendance to training sessions was 82.3% ± 10.1 (56-94). CFVR in the training group increased from 2.50 ± 0.48 to 3.04 ± 0.71 (P < 0.001) whereas FMD increased from 4.19 ± 2.42% to 8.28 ± 2.85% (P < 0.001). Improvement in CFVR correlated with the relative improvement in FMD (R = 0.45, P = 0.047). This was associated with an increase in VO_2max from 28.75 ± 6.51 mL/kg/min to 31.93 ± 6.46 mL/kg/min (P < 0.001).

Conclusion

A 3-month program of monitored HIT was feasible, with high adherence resulting in improved functional capacity in patients with ANOCA. CFVR improved and this improvement was associated with improved FMD.

Clinicaltrialsgov identifier

NCT02905630.

SUBMITTER: Larsen AI

PROVIDER: S-EPMC10127938 | biostudies-literature | 2023 Mar

REPOSITORIES: biostudies-literature

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Publications

Aerobic high-intensity interval exercise training in patients with angina and no obstructive coronary artery disease: feasibility and physiological effects.

Larsen Alf Inge AI Sæland Charlotte C Vegsundvåg Johnny J Skadberg Mette Storebø MS Nilsen Jorunn J Butt Noreen N Ushakova Anastasia A Valborgland Torstein T Munk Peter Scott PS Isaksen Kjetil K

European heart journal open 20230322 2

<h4>Aims</h4>Patients with chest pain and normal coronary angiogram [angina with normal coronary arteries (ANOCA)] constitute a therapeutic problem with considerable functional limitation and reduced quality of life. The aims of the current pilot study were to (i) explore if a structured aerobic high-intensity interval training (HIT) program for 12 weeks was feasible in patients with ANOCA, and (ii) to assess mechanisms related to symptoms in this population.<h4>Methods and results</h4>Sixteen p ...[more]

PMID: 37113515

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Project description:This study compared the acute physiological responses and performance changes during an integrated high-intensity interval aerobic and power protocol. Sixteen moderately trained athletes (age: 20.1 ± 2.2 years, body height: 180.0 ± 6.5 cm, body mass: 75.7 ± 6.4 kg, VO2max: 55.8 ± 4.3 mL/kg/min) performed a 2 × 6 min interval training protocol with 2 min passive recovery between sets on two different occasions in random and counterbalanced order. Each 6 min set included repeated periods of 15 s exercise interspersed with 15 s passive rest. On one occasion (RUN), all exercise periods included running at 100% of maximal aerobic speed, while on the other occasion an integrated protocol was used (INT) in which each of the two 6 min sets included 4 × 1.5 min periods of running exercise at 100% of maximal aerobic speed in combination with jumping (i.e., 2 × 15 running with 15 s rest and 1 × 15 s drop jumping with 15 s rest). Time spent above 85% HRmax was two-fold higher in INT compared to RUN (8.5 ± 3.6 vs. 4.3 ± 3.9 min, respectively, p = 0.0014). Interestingly, heart rate increased above 95% HRmax only in INT and almost no time was spent above 95% HRmax in RUN (1.4 ± 1.9 vs. 0.1 ± 0.2 min, respectively, p = 0.008). Blood lactate concentration at the end of the second set of INT was higher than RUN (7.3 ± 3.2 vs. 4.6 ± 2.7 mmol/L, p = 0.002). Countermovement jump was higher in INT after the end of second set by 6.4% (p = 0.04), 6.7% (p = 0.04), 7.8% (p < 0.01) and 7.3% (p < 0.001), at 2, 6 and 8 min after set 2. In conclusion, the comparison between INT and RUN shows that INT not only elicits higher physiological and metabolic responses, but also acutely enhances neuromuscular performance for at least 8 min after the end of exercise. The integrated running/jumping high-intensity interval exercise approach could be a very useful and time efficient method for strength and conditioning coaches, especially in team sports, in which the time available for the improvement of physical parameters is limited.

Project description:BackgroundPoststroke guidelines recommend moderate-intensity, continuous aerobic training (MCT) to improve aerobic capacity and mobility after stroke. High-intensity interval training (HIT) has been shown to be more effective than MCT among healthy adults and people with heart disease. However, HIT and MCT have not been compared previously among people with stroke.ObjectiveThe purpose of this study was to assess the feasibility and justification for a definitive randomized controlled trial (RCT) comparing HIT and MCT in people with chronic stroke.DesignA preliminary RCT was conducted.SettingThe study was conducted in a cardiovascular stress laboratory and a rehabilitation research laboratory.PatientsAmbulatory people at least 6 months poststroke participated.InterventionBoth groups trained 25 minutes, 3 times per week, for 4 weeks. The HIT strategy involved 30-second bursts at maximum-tolerated treadmill speed alternated with 30- to 60-second rest periods. The MCT strategy involved continuous treadmill walking at 45% to 50% of heart rate reserve.MeasurementsMeasurements included recruitment and attendance statistics, qualitative HIT acceptability, adverse events, and the following blinded outcome variables: peak oxygen uptake, ventilatory threshold, metabolic cost of gait, fractional utilization, fastest treadmill speed, 10-Meter Walk Test, and Six-Minute Walk Test.ResultsDuring the 8-month recruitment period, 26 participants consented to participate. Eighteen participants were enrolled and randomly assigned to either the HIT group (n=13) or the MCT group (n=5). Eleven out of the 13 HIT group participants attended all sessions. Participants reported that HIT was acceptable and no serious adverse events occurred. Standardized effect size estimates between groups were moderate to very large for most outcome measures. Only 30% of treadmill speed gains in the HIT group translated into overground gait speed improvement.LimitationsThe study was not designed to definitively test safety or efficacy.ConclusionsAlthough further protocol optimization is needed to improve overground translation of treadmill gains, a definitive RCT comparing HIT and MCT appears to be feasible and warranted.

Project description:This study analyzed whether 100- and 200-m interval training (IT) in swimming differed regarding temporal, perceptual, and physiological responses. The IT was performed at maximal aerobic velocity (MAV) until exhaustion and time spent near to maximalVO2 peak oxygen uptake (⩒O2peak), total time limit (tLim), peak blood lactate [La-] peak, ⩒O2 kinetics (⩒O2K), and rate of perceived exertion (RPE) were compared between protocols. Twelve swimmers (seven males 16.1 ± 1.1 and five females 14.2 ± 1 years) completed a discontinuous incremental step test for the second ventilatory threshold (VT2), ⩒O2peak, and MAV assessment. The swimmers subsequently completed two IT protocols at MAV with 100- and 200-m bouts to determine the maximal ⩒O2 (peak-⩒O2) and time spent ≥VT2, 90, and 95% of ⩒O2peak for the entire protocols (IT100 and IT200) and during the first 800-m of each protocol (IT8x100 and IT4x200). A portable apparatus (K4b2) sampled gas exchange through a snorkel and an underwater led signal controlled the velocity. RPE was also recorded. The Peak-⩒O2 attained during IT8x100 and IT4x200 (57.3 ± 4.9 vs. 57.2 ± 4.6 ml·kg-1·min-1) were not different between protocols (p = 0.98) nor to ⩒O2peak (59.2 ± 4.2 ml·kg-1·min-1, p = 0.37). The time constant of ⩒O2K (24.9 ± 8.4 vs. 25.1 ± 6.3-s, p = 0.67) and [La-] peak (7.9 ± 3.4 and 8.7 ± 1.5 mmol·L-1, p = 0.15) also did not differ between IT100 and IT200. The time spent ≥VT2, 90, and 95%⩒O2peak were also not different between IT8x100 and IT4x200 (p = 0.93, 0.63, and 1.00, respectively). The RPE for IT8x100 was lower than that for IT4x200 (7.62 ± 2 vs. 9.5 ± 0.7, p = 0.01). Both protocols are considered suitable for aerobic power enhancement, since ⩒O2peak was attained with similar ⩒O2K and sustained with no differences in tLim. However, the fact that only the RPE differed between the IT protocols suggested that coaches should consider that nx100-m/15-s is perceived as less difficult to perform compared with nx200-m/30-s for the first 800-m when managing the best strategy to be implemented for aerobic power training.

Project description:IntroductionIn patients with large abdominal aortic aneurysm (AAA), open surgical or endovascular aneurysm repair procedures are often used to minimise the risk of aneurysm-related rupture and death; however, aneurysm repair itself carries a high risk. Low cardiopulmonary fitness is associated with an increased risk of early post-operative complications and death following elective AAA repair. Therefore, fitness should be enhanced before aneurysm repair. High-intensity interval exercise training (HIT) is a potent, time-efficient strategy for enhancing cardiopulmonary fitness. Here, we describe a feasibility study for a definitive trial of a pre-operative HIT intervention to improve post-operative outcomes in patients undergoing elective AAA repair.Methods and analysisA minimum of 50 patients awaiting elective repair of a 5.5-7.0 cm infrarenal AAA will be allocated by minimisation to HIT or usual care control in a 1:1 ratio. The patients allocated to HIT will complete three hospital-based exercise sessions per week, for 4 weeks. Each session will include 2 or 4 min of high-intensity stationary cycling followed by the same duration of easy cycling or passive recovery, repeated until a total of 16 min of high-intensity exercise is accumulated. Outcomes to be assessed before randomisation and 24-48 h before aneurysm repair include cardiopulmonary fitness, maximum AAA diameter and health-related quality of life. In the post-operative period, we will record destination (ward or critical care unit), organ-specific morbidity, mortality and the durations of critical care and hospital stay. Twelve weeks after the discharge, participants will be interviewed to reassess quality of life and determine post-discharge healthcare utilisation. The costs associated with the exercise intervention and healthcare utilisation will be calculated.Ethics and disseminationEthics approval was secured through Sunderland Research Ethics Committee. The findings of the trial will be disseminated through peer-reviewed journals, and national and international presentations.Trial registrationCurrent Controlled Trials ISRCTN09433624.

Dataset Information

Aerobic high-intensity interval exercise training in patients with angina and no obstructive coronary artery disease: feasibility and physiological effects.

Aims

Methods and results

Conclusion

Clinicaltrialsgov identifier

Publications

Aerobic high-intensity interval exercise training in patients with angina and no obstructive coronary artery disease: feasibility and physiological effects.

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