Abstract 15459: High Intensity Interval Training versus Moderate Continuous Training in Patients With Heart Failure With Preserved Ejection Fraction: A Systematic Review and Meta-Analysis

Abstract

Introduction: Heart failure with preserved ejection fraction (HFpEF) is a common condition with one of its characteristics being exercise intolerance, which contributes to poor quality of life and clinical outcomes. High-intensity interval training (HIIT) is an innovative training approach, but its impact on patients with HFpEF is uncertain. We pooled data from all relevant studies reporting results of HIIT versus moderate continuous training (MCT) on cardiopulmonary exercise outcomes in patients with HFpEF. Methods: PubMed and SCOPUS were queried until February, 2022 for all randomized controlled trials (RCT) comparing the effects of HIIT versus MCT on outcomes such as peak oxygen consumption (peak VO 2 ), respiratory exchange ratio (RER), and minute ventilation / carbon dioxide production (VE/CO 2 )> slope. A random-effects model was used and weighted mean differences (WMDs) were reported with 95% confidence intervals (CI). Heterogeneity across studies was evaluated using the Higgins I 2 statistic. Results: Three RCTs (n = 150) were included in our analysis. The mean training duration was 23 weeks (range: 4 - 52 weeks). Pooled analysis demonstrated that HIIT significantly improved peak VO 2 (WMD = 1.46 mL.kg -1 .min -1 (0.88, 2.05); p <0.00001; I 2 =0%; Figure 1a), as compared to MCT in patients with HFpEF. However, no significant differences were demonstrated between HIIT and MCT, for RER (WMD = -0.10 (-0.32, 0.12); p =0.38; I 2 =0%; Figure 1b), and VE/CO 2 slope (WMD = 0.62 (-1.99, 3.24); p =0.64; I 2 =67%; Figure 1c). Conclusions: Our study demonstrates that HIIT, compared to MCT, had a significant impact on improving peak VO 2 , without evidence of significant benefits on VE/CO 2 slope. Larger trials of exercise training in HFpEF may consider peak VO 2 as a key outcome measure in addition to clinical events. Nevertheless, these improvements in peak VO 2 with HIIT could translate into improvements in quality of life and clinical outcomes in patients with HFpEF.