High intensity interval training decreases progression of cardiac allograft vasculopathy in heart transplant recipients - a randomized controlled trial

Abstract

Purpose: Cardiac allograft vasculopathy (CAV) is a progressive form of atherosclerosis occurring in heart transplant (HTx) recipients, leading to increased morbidity and mortality. Given the atheroprotective effect of exercise on traditional atherosclerosis, we hypothesized that high intensity interval training (HIIT) would reduce the progression of CAV among HTx recipients Methods: Forty-three (mean±SD age 51±16 years, 67% males, time post HTx 4.0±2.2 years) clinically stable HTx recipients > 18 years old, were randomized to either HIIT or control group (standard care) for one year. The effect of traing on CAV progression was assessed by intravascular ultrasound (IVUS). Results: IVUS analysis revealed a significantly less mean increase [95% CI] in percent atheroma volume (PAV) of 0.9 [-0.3, 1.9] % in the HIIT group as compared to the control group: 2.5 [1.6, 3.5] % (p=0.021). Similarly, mean increase [95% CI] in maximal intimal thickness (MIT) was 0.02 [-0.01, 0.04] mm in the HIIT group versus 0.05 [0.03, 0.08] mm in the control group (p=0.054). Qualitative plaque progression (virtual histology parameters) and inflammatory activity (biomarkers) were similar between the two groups during the study period. ![Figure][1] Change in percent atheroma volume (PAV%) Conclusions: HIIT among maintenance HTx recipients resulted in a significantly impaired rate of CAV progression. Further and larger studies should examine if exercise rehabilitation strategies should be included as part of CAV management protocols. [1]: pending:yes