Sandberg C, Hedström M, Wadell K, Dellborg M, Ahnfelt A,
Zetterström AK, Öhrn A, Johansson B.
Congenit Heart Dis. 2018 Mar;13(2):254-262.
OBJECTIVE: The beneficial effects of exercise training in acquired heart failure
and coronary artery disease are well known and have been implemented in current
treatment guidelines. Knowledge on appropriate exercise training regimes for
adults with congenital heart disease is limited, thus further studies are needed.
The aim of this study was to examine the effect of home-based interval exercise
training on maximal endurance capacity and peak exercise capacity.
DESIGN: Randomized controlled trial.
METHODS: Twenty-six adults with complex congenital heart disease were recruited
from specialized units for adult congenital heart disease. Patients were
randomized to either an intervention group-12 weeks of home-based interval
exercise training on a cycle ergometer (n = 16), or a control group (n = 10). The
latter was instructed to maintain their habitual physical activities. An
incremental cardiopulmonary exercise test and a constant work rate
cardiopulmonary exercise test at 75% of peak workload were performed
preintervention and postintervention.
RESULTS: Twenty-three patients completed the protocol and were followed
(intervention n = 13, control n = 10). Postintervention exercise time at constant
work rate cardiopulmonary exercise test increased in the intervention group
compared to controls (median[range] 12[-4 to 52]min vs 0[-4 to 5]min, P = .001).
At incremental cardiopulmonary exercise test, peak VO2 increased 15% within the
intervention group (P = .019) compared to 2% within the control group (P = .8).
However, in comparison between the groups no difference was found (285[-200 to
535] ml/min vs 17[-380 to 306] ml/min, P = .10). In addition, peak workload at
incremental cardiopulmonary exercise test increased in the intervention group
compared to controls (20[-10 to 70]W vs 0[-20 to 15]W, P = .003).
CONCLUSION: Home-based interval exercise training increased endurance capacity
and peak exercise capacity in adults with complex congenital heart disease.
Aerobic endurance might be more relevant than peak oxygen uptake with regard to
daily activities, and therefore a more clinically relevant measure to evaluate.