Research progress of high intensity interval training on chronic heart failure

doi:10.3760/cma.j.issn.1007-1245.2023.21.001

Abstract

Abstract:

The study on the safety and efficacy of high intensity interval training (HIIT) in chronic heart failure (CHF) has been the hot spot of clinical research. Low and moderate intensity aerobic exercise is chosen for clinical intervention in CHF. It is concerned that more and more sports rehabilitation programs choose HIIT as a means of cardiac rehabilitation. This review summarizes the clinical effect of HIIT intervention on CHF in terms of maximum oxygen consumption (VO₂ max), vascular endothelial function, and cardiac function, and compares HIIT with other exercise training such as moderate intensity continuous training, moderate intensity interval training, and resistance training, in order to provide a reference for the safe and effective treatment of CHF patients with HIIT.

Key words:

High intensity interval training, Chronic heart failure, Cardiac rehabilitation, Sports rehabilitation, Cardiopulmonary function, Progress

摘要：

高强度间歇性训练（high intensity interval training，HIIT）干预慢性心力衰竭（chronic heart failure，CHF）的安全性和有效性研究一直是临床研究热点。CHF临床通常选择中低强度有氧运动进行干预，越来越多的运动康复方案选择HIIT，使其作为一种心脏康复手段备受关注。本文从最大摄氧量（maximal oxygen consumption，VO₂ max）、血管内皮功能及心脏射血功能等方面总结HIIT干预CHF的临床疗效，并将HIIT和中等强度持续运动、中等强度间歇运动、抗阻运动等运动训练形式进行比较，旨在为HIIT能够安全有效地辅助治疗CHF患者提供参考依据。

关键词:

高强度间歇性训练, 慢性心力衰竭, 心脏康复, 运动康复, 心肺功能, 进展

Wang Wen, Zhao Xianli, Wu Xubo.

Research progress of high intensity interval training on chronic heart failure [J]. International Medicine and Health Guidance News, 2023, 29(21): 2985-2989.

汪文赵仙丽吴绪波.

高强度间歇性训练干预慢性心力衰竭的研究进展 [J]. 国际医药卫生导报, 2023, 29(21): 2985-2989.

References

[1] 中华医学会心血管病学分会心力衰竭学组,中国医师协会心力衰竭专业委员会,中华心血管病杂志编辑委员会.中国心力衰竭诊断和治疗指南2018[J].中华心血管病杂志,2018,46(10):760-789. DOI:10.3760/cma.j.issn.0253-3758.2018.10.004.
[2] 中国心血管健康与疾病报告编写组.中国心血管健康与疾病报告2020概要[J].中国循环杂志,2021,36(6):521-545. DOI:10.3969/j.issn.1000-3614.2021.06.001.
[3] Groehs RV, Toschi-Dias E, Antunes-Correa LM, et al. Exercise training prevents the deterioration in the arterial baroreflex control of sympathetic nerve activity in chronic heart failure patients[J]. Am J Physiol Heart Circ Physiol, 2015, 308(9):H1096-H1102. DOI: 10.1152/ajpheart.00723.2014.
[4] 黄艳,滕林,席祖洋,等.慢性心衰患者对不同运动类型的耐受性[J].昆明医科大学学报,2019,40(5):96-102. DOI:10.3969/j.issn.1003-4706.2019.05.018.
[5] Franklin BA, Eijsvogels TMH, Pandey A, et al. Physical activity, cardiorespiratory fitness, and cardiovascular health: a clinical practice statement of the American Society for Preventive Cardiology Part II: physical activity, cardiorespiratory fitness, minimum and goal intensities for exercise training, prescriptive methods, and special patient populations[J]. Am J Prev Cardiol, 2022, 12:100425. DOI: 10.1016/j.ajpc.2022.100425.
[6] 黎涌明.高强度间歇训练对不同训练人群的应用效果[J].体育科学,2015,35(8):59-75,96. DOI:10.16469/j.css.201508009.
[7] Bloomfield P. Captain Barclay[J]. Eugen Rev, 1962, 54(1):25-28.
[8] Wisløff U, Støylen A, Loennechen JP, et al. Superior cardiovascular effect of aerobic interval training versus moderate continuous training in heart failure patients: a randomized study[J]. Circulation, 2007, 115(24):3086-3094. DOI: 10.1161/CIRCULATIONAHA.106. 675041.
[9] Meyer K, Lehmann M, Sünder G, et al. Interval versus continuous exercise training after coronary bypass surgery: a comparison of training-induced acute reactions with respect to the effectiveness of the exercise methods[J]. Clin Cardiol, 1990, 13(12):851-861. DOI: 10.1002/clc.4960131208.
[10] Meyer K, Schwaibold M, Westbrook S, et al. Effects of short-term exercise training and activity restriction on functional capacity in patients with severe chronic congestive heart failure[J]. Am J Cardiol, 1996, 78(9):1017-1022. DOI: 10.1016/s0002-9149(96)00527-9.
[11] Roditis P, Dimopoulos S, Sakellariou D, et al. The effects of exercise training on the kinetics of oxygen uptake in patients with chronic heart failure[J]. Eur J Cardiovasc Prev Rehabil, 2007, 14(2):304-311. DOI: 10.1097/hjr.0b013e32808621a3.
[12] Smart NA, Steele M. A comparison of 16 weeks of continuous vs intermittent exercise training in chronic heart failure patients[J]. Congest Heart Fail, 2012, 18(4):205-211. DOI: 10.1111/j.1751-7133.2011.00274.x.
[13] Rognmo Ø, Moholdt T, Bakken H, et al. Cardiovascular risk of high- versus moderate-intensity aerobic exercise in coronary heart disease patients[J]. Circulation, 2012, 126(12):1436-1440. DOI: 10.1161/CIRCULATIONAHA. 112.123117.
[14] Wang JS, Fu TC, Lien HY, et al. Effect of aerobic interval training on erythrocyte rheological and hemodynamic functions in heart failure patients with anemia[J]. Int J Cardiol, 2013, 168(2):1243-1250. DOI: 10.1016/j.ijcard.2012.11.053.
[15] Shoemaker MJ, Dias KJ, Lefebvre KM, et al. Physical therapist clinical practice guideline for the management of individuals with heart failure[J]. Phys Ther, 2020, 100(1):14-43. DOI: 10.1093/ptj/pzz127.
[16] Meyer P, Normandin E, Gayda M, et al. High-intensity interval exercise in chronic heart failure: protocol optimization[J]. J Card Fail, 2012, 18(2):126-133. DOI: 10.1016/j.cardfail.2011.10.010.
[17] 丁岚,徐懿,洪慧,等.高强度间歇性训练对慢性心力衰竭患者心脏康复的效果观察[J].护理实践与研究,2022,19(2):228-232. DOI:10.3969/j.issn.1672-9676.2022.02.014.
[18] Guiraud T, Nigam A, Juneau M, et al. Acute responses to high-intensity intermittent exercise in CHD patients[J]. Med Sci Sports Exerc, 2011, 43(2):211-217. DOI: 10.1249/MSS.0b013e3181ebc5de.
[19] Koufaki P, Mercer TH, George KP, et al. Low-volume high-intensity interval training vs continuous aerobic cycling in patients with chronic heart failure: a pragmatic randomised clinical trial of feasibility and effectiveness[J]. J Rehabil Med, 2014, 46(4):348-356. DOI: 10.2340/16501977-1278.
[20] Kourek C, Alshamari M, Mitsiou G, et al. The acute and long-term effects of a cardiac rehabilitation program on endothelial progenitor cells in chronic heart failure patients: comparing two different exercise training protocols[J]. Int J Cardiol Heart Vasc, 2020, 32:100702. DOI: 10.1016/j.ijcha.2020.100702.
[21] 肖仁函,张树锋,李维,等.高强度间歇训练对射血分数保留的心力衰竭患者心肺功能和生活质量的影响[J].广西医学,2022,44(8):847-850. DOI:10.11675/j.issn.0253-4304. 2022.08.10.
[22] 曹甍,庄洁,全明辉,等.高强度间歇训练和中等强度持续训练对健康成人心肺适能影响的Meta分析[J].中国体育科技,2018,54(4):62-68. DOI:10.16470/j.csst.201804008.
[23] Zuchi C, Tritto I, Carluccio E, et al. Role of endothelial dysfunction in heart failure[J]. Heart Fail Rev, 2020, 25(1):21-30. DOI: 10.1007/s10741-019-09881-3.
[24] 孙淑娴,陈文生,李广平,等.循环内皮细胞对心力衰竭患者左室心功能及长期预后评价的临床价值[J].国际心血管病杂志,2015,42(6):422-425. DOI:10.3969/j.issn.1673- 6583.2015.06.015.
[25] 韦颖,莫昌干,韦利元,等.新型心脏康复训练对急性ST段抬高型心肌梗死患者PCI术后心功能及血管内皮功能的影响[J].国际医药卫生导报,2023,29(4):537-541. DOI:10.3760/cma.j.issn.1007-1245.2023.04.022.
[26] Deljanin Ilic M, Ilic S, Lazarevic G, et al. Impact of interval versus steady state exercise on nitric oxide production in patients with left ventricular dysfunction[J]. Acta Cardiol, 2009, 64(2):219-224. DOI: 10.2143/AC.64.2.2036141.
[27] Ferentinos P, Tsakirides C, Swainson M, et al. The impact of different forms of exercise on circulating endothelial progenitor cells in cardiovascular and metabolic disease[J]. Eur J Appl Physiol, 2022, 122(4):815-860. DOI: 10.1007/s00421-021-04876-1.
[28] Ramos JS, Dalleck LC, Tjonna AE, et al. The impact of high-intensity interval training versus moderate-intensity continuous training on vascular function: a systematic review and meta-analysis[J]. Sports Med, 2015, 45(5):679-692. DOI: 10.1007/s40279-015-0321-z.
[29] Papathanasiou JV, Petrov I, Tokmakova MP, et al. Group-based cardiac rehabilitation interventions. A challenge for physical and rehabilitation medicine physicians: a randomized controlled trial[J]. Eur J Phys Rehabil Med, 2020, 56(4):479-488. DOI: 10.23736/S1973-9087.20.06013-X.
[30] Araújo BTS, Leite JC, Fuzari HKB, et al. Influence of high-intensity interval training versus continuous training on functional capacity in individuals with heart failure: a systematic review and meta-analysis[J]. J Cardiopulm Rehabil Prev, 2019, 39(5):293-298. DOI: 10.1097/HCR.0000000000000424.
[31] Coletta AP, Cleland JG, Freemantle N, et al. Clinical trials update from the European Society of Cardiology Heart Failure meeting: SHAPE, BRING-UP 2 VAS, COLA II, FOSIDIAL, BETACAR, CASINO and meta-analysis of cardiac resynchronisation therapy[J]. Eur J Heart Fail, 2004, 6(5):673-676. DOI: 10.1016/j.ejheart.2004.07.007.
[32] Gripp F, Nava RC, Cassilhas RC, et al. HIIT is superior than MICT on cardiometabolic health during training and detraining[J]. Eur J Appl Physiol, 2021, 121(1):159-172. DOI: 10.1007/s00421-020-04502-6.
[33] Tucker WJ, Beaudry RI, Liang Y, et al. Meta-analysis of exercise training on left ventricular ejection fraction in heart failure with reduced ejection fraction: a 10-year update[J]. Prog Cardiovasc Dis, 2019, 62(2):163-171. DOI: 10.1016/j.pcad.2018.08.006.
[34] Besnier F, Labrunée M, Richard L, et al. Short-term effects of a 3-week interval training program on heart rate variability in chronic heart failure. A randomised controlled trial[J]. Ann Phys Rehabil Med, 2019, 62(5):321-328. DOI: 10.1016/j.rehab.2019.06.013.
[35] 杨玲,彭团辉,徐晓阳,等.终生HIIT和MICT运动对自然衰老小鼠运动能力和脂代谢的影响[J].广州体育学院学报,2022,42(3):23-33. DOI:10.13830/j.cnki.cn44-1129/g8.2022.03.004.
[36] 谭荣欢,李星,石红梅,等.中等强度持续训练与中强度间歇训练在慢性心力衰竭患者的应用[J].心脏杂志,2023,35(3):321-327.
[37] Coswig VS, Barbalho M, Raiol R, et al. Effects of high vs moderate-intensity intermittent training on functionality, resting heart rate and blood pressure of elderly women[J]. J Transl Med, 2020, 18(1):88. DOI: 10.1186/s12967-020-02261-8.
[38] 顾怡雯,邓磊,汪燕,等.有氧运动和抗阻运动对心衰大鼠心功能的影响[J].世界复合医学,2019,5(5):29-31. DOI:10.11966/j.issn.2095-994X.2019.05.05.10.
[39] 李孟娟,李真,张秀杰,等.«心力衰竭患者的心脏康复:JACC专家共识»解读[J].心血管病学进展,2022,43(8):747-752. DOI:10.16806/j.cnki.issn.1004-3934.2022.08.020.
[40] 马芳源, 杨璐瑶, 唐舒宁, 等. HIIT及抗阻训练延缓衰老大鼠骨骼肌萎缩的效果对比[C]//第十二届全国体育科学大会,日照, 2022. 运动生理生化分会第十二届全国体育科学大会论文摘要汇编墙报交流.
[41] 李敬翔. HIIT对高中生心肺功能的影响研究[D]. 南京:南京体育学院,2022. DOI:10.27247/d.cnki.gnjtc.2022.000081.
[42] 于莹.不同运动方式对慢性心衰病人的疗效观察[D]. 天津:天津医科大学,2017.