High-Intensity Aerobic Interval Exercise in Chronic Heart Failure
- PDF / 253,744 Bytes
- 9 Pages / 595.276 x 790.866 pts Page_size
- 90 Downloads / 200 Views
PATHOPHYSIOLOGY: NEUROENDOCRINE, VASCULAR, AND METABOLIC FACTORS (S.D. KATZ, SECTION EDITOR)
High-Intensity Aerobic Interval Exercise in Chronic Heart Failure Philippe Meyer & Mathieu Gayda & Martin Juneau & Anil Nigam
Published online: 10 February 2013 # Springer Science+Business Media New York 2013
Abstract Aerobic exercise training is strongly recommended in patients with heart failure (HF) and reduced left ventricular ejection fraction (LVEF) to improve symptoms and quality of life. Moderate-intensity aerobic continuous exercise (MICE) is the best established training modality in HF patients. For about a decade, however, another training modality, high-intensity aerobic interval exercise (HIIE), has aroused considerable interest in cardiac rehabilitation. Originally used by athletes, HIIE consists of repeated bouts of high-intensity exercise interspersed with recovery periods. The rationale for its use is to increase exercise time spent in high-intensity zones, thereby increasing the training stimulus. Several studies have demonstrated that HIIE is more effective than MICE, notably for improving exercise capacity in patients with HF. The aim of the present review is to describe the general principles of HIIE prescription, the acute physiological effects, the longer-term training effects, and finally the future perspectives of HIIE in patients with HF. Keywords Intermittent exercise . Interval training . Cardiac rehabilitation . Heart failure
P. Meyer University Hospital of Geneva, Geneva, Switzerland e-mail: [email protected] M. Gayda : M. Juneau : A. Nigam (*) Cardiovascular Prevention and Rehabilitation Centre (Centre ÉPIC), Montreal Heart Institute, Université de Montréal, 5000 Belanger Street, Montreal H1T 1C8, Canada e-mail: [email protected] M. Gayda : M. Juneau : A. Nigam Department of Medicine, Montreal Heart Institute, Université de Montréal, Montréal, Canada
Introduction and Historical Perspective Until the late 1980s, heart failure (HF) was widely regarded as a classical contraindication to exercise training in the belief that patients with a severely reduced left ventricular ejection fraction (LVEF) had an excessive risk for exercise-related morbidity and mortality. In the 3rd edition of Braunwald’s heart disease textbook published in 1988, one could read: “Reduced physical activity is critical in the care of patients with HF throughout their entire course” [1]. This fear was supported by a nonrandomized study performed in the pre-angiotensin converting enzyme inhibitor and beta-blocker eras, which suggested adverse cardiac remodeling in patients with recent anterior myocardial infarction after a 12-week low-level exercise training program [2]. Since the initial landmark trial conducted by Sullivan et al. [3], many randomized trials demonstrated that regular exercise is safe and provides many benefits in the care of patients with chronic HF and reduced LVEF. Meta-analyses of these studies reported an average increase of peak oxygen uptake (VO2peak) of 15 to 20 % following exercise trai
Data Loading...
