Mueller S; TUM University Hospital, Georg-Brauchle-Ring 56, 80992 Munich, Germany.
Kabelac M; Fegers-Wustrow I; Winzer EB; Gevaert AB; Beckers P;
Haller B; Edelmann F; Christle JW; Haykowsky MJ; Sachdev V; Kitzman DW;
Linke A; Adams V; Wisloff U; Pieske B; van Craenenbroeck E; Halle M
European Journal of Preventive Cardiology. 32(11):926-936, 2025 Aug 25.
AIMS: Exercise training (ET) is an effective therapy in heart failure with
preserved ejection fraction (HFpEF), but the influence of different ET
characteristics is unclear. We aimed to evaluate the associations between
ET frequency, duration, intensity [% heart rate reserve (%HRR)] and
estimated energy expenditure (EEE) with the change in peak oxygen
consumption (VO2) over 3 months of moderate continuous training (MCT,
5x/week) or high-intensity interval training (HIIT, 3x/week) in HFpEF.
METHODS AND RESULTS: ET duration and heart rate (HR) were recorded with a
smartphone application. EEE was calculated using the HR data during ET and
the individual HR-VO2 relationships during cardiopulmonary exercise
testing. Differences between groups and associations between ET
characteristics and peak VO2 change were assessed with linear regression
analyses. Peak VO2 improved by 9.2 +/- 13.2% after MCT and 8.7 +/- 15.9%
after HIIT (P = 0.67). The average EEE of 1 HIIT session was equivalent to
~1.42 MCT sessions and when adjusted for EEE, the mean difference between
MCT and HIIT was -0.1% (P = 0.98). For both MCT and HIIT, peak VO2 change
was positively associated with ET frequency (MCT: R2 = 0.103; HIIT: R2 =
0.149) and duration/week (MCT: R2 = 0.120; HIIT: R2 = 0.125; all P <
0.05). Average %HRR was negatively associated with peak VO2 change in MCT
(R2 = 0.101; P = 0.034), whereas no significant association was found in
HIIT (P = 0.234). Multiple regression analyses explained ~1/3 of the
variance in peak VO2 change.
CONCLUSION: In HFpEF, isocaloric HIIT and MCT seem to be equally
effective over 3 months. Within each mode, increasing ET frequency or
duration/week may be more effective to improve peak VO2 than increasing ET
intensity. Copyright © The Author(s) 2024. Published by Oxford
University Press on behalf of the European Society of Cardiology.