High-intensity Interval Training Dosage for Heart Failure and Coronary Artery Disease Cardiac Rehabilitation. A Systematic Review and Meta-analysis

Abstract

Introduction and objectives: High-interval intensity training (HIT) has been suggested to improve peak VO₂ in cardiac rehabilitation programs. However, the optimal HIT protocol is unknown. The objective of this study was to identify the most effective doses of HIT to optimize peak VO₂ in coronary artery disease (CAD) and heart failure (HF) patients.

Methods: A search was conducted in 6 databases (MEDLINE, Web of Science, LILACS, CINAHL, Academic Search Complete, and SportDiscus). Studies using a HIT protocol in CAD or HF patients and measuring peak VO₂ were included. The PEDro Scale and Cochrane Collaboration tools were used.

Results: Analyses reported significant improvements in peak VO₂ after HIT in both diseases (P = .000001), with a higher increase in HF patients (P = .03). Nevertheless, in HF patients, there were no improvements when the intensity recovery was ≤ 40% of peak VO₂ (P = .19) and the frequency of training was ≤ 2 d/wk (P = .07). There were significant differences regarding duration in CAD patients, with greater improvements in peak VO₂ when the duration was < 12 weeks (P = .05). In HF, programs lasting < 12 weeks did not significantly improve peak VO₂ (P = .1).

Conclusions: The HIT is an effective method for improving peak VO₂ in HF and CAD, with a significantly greater increase in HF patients. The recovery intervals should be active and be between 40% and 60% of peak VO₂ in HF patients. Training frequency should be ≥ 2 d/wk for CAD patients and ≥ 3 d/wk for HF patients.

Keywords: Coronary artery disease; Ejercicio interválico; Ejercicio interválico de alta intensidad; Enfermedad arterial coronaria; Heart failure; High-interval intensity training; Insuficiencia cardiaca; Interval training; Peak VO(2); VO(2máx).