High-Intensity Interval Training in Patients with Pulmonary Embolism: A Randomized Controlled Trial

Med Sci Sports Exerc. 2021 Oct 1;53(10):2037-2044. doi: 10.1249/MSS.0000000000002680.


Purpose: High-intensity interval training (HIIT) appears to be safe and effective in cardiovascular diseases. However, there is a paucity of data on the effect of HIIT for patients with acute pulmonary embolism (PE). The present randomized controlled trial (RCT) therefore examined the efficiency and safety of HIIT in patients with acute PE.

Methods: In single-center parallel open-label RCT, 24 patients (5 women) discharged recently with a diagnosis of intermediate-high-risk acute PE were randomized (1:1) to supervised HIIT (n = 12) or control (n = 12) group. The primary outcomes were exercise capacity evaluated in terms of the estimated maximal oxygen uptake (eV˙O2max), lung function (forced expiratory volume in 1 s [FEV1]), right ventricular (RV) function (RV/left ventricular diameter [LV] ratio), and health-related quality of life (HRQoL). Safety was the secondary outcome.

Results: Eight weeks of HIIT improved eV˙O2max (+65%, P < 0.001), FEV1 (%) (+17%, P = 0.031), and RV/LV ratio diameter (-27%, P = 0.005), as well as HRQoL. All patients in the HIIT group tolerated exercise training without serious adverse events. The control group did not improve (P > 0.05) eV˙O2max, RV/LV ratio diameter, or HRQoL; however, FEV1 (%) was slightly reduced (-6%, P = 0.030).

Conclusions: The present RCT of a tailored center-based HIIT intervention provides preliminary evidence that this intervention could improve exercise capacity, lung function, RV function, and HRQoL without serious adverse events, which could provide marked clinical benefits after PE. Further larger multicenter randomized controlled studies are needed to confirm these promising findings.

Publication types

  • Randomized Controlled Trial

MeSH terms

  • Aged
  • Echocardiography
  • Exercise Therapy / methods*
  • Exercise Tolerance
  • Female
  • Forced Expiratory Volume
  • High-Intensity Interval Training*
  • Humans
  • Middle Aged
  • Oxygen Consumption
  • Prospective Studies
  • Pulmonary Embolism / physiopathology
  • Pulmonary Embolism / therapy*
  • Quality of Life
  • Ventricular Function, Left
  • Ventricular Function, Right

Associated data

  • ISRCTN/IRCT20170111031884N2