The effect of high intensity interval training on patients with heart transplantation: a systematic review

Abstract

Abstract Funding Acknowledgements Type of funding sources: None. BACKGROUND Exercise rehabilitation after heart transplant is of major importance in order to improve physical capacity and prognosis.High-intensity interval training (HIIT) has repeatedly proven to be a highly efficient form of exercise for improving the physical capacity of both normal subjects and patients with coronary artery diseases (CAD) and heart failure. In contrast to the chronotropic response of a normal heart to exercise, a newly transplanted heart is denervated, which causes higher resting heart rate (HR) and reduced heart response (chronotropic incompetence). The HR response during exercise is mainly controlled by catecholamine’s from the adrenal glands, resulting in a significantly slower increase of the HR at onset of exercise, a reduced peak HR, and a delayed return towards resting values after cessation of exercise. A study conducted in 2013 concluded that high-intensity, aerobic training, especially interval-based training, is a favourable type of exercise that yields improvements in both peripheral and central factors.The review was conducted to determine the effect of HIIT on heart transplant patients.I PURPOSE Heart transplant patients have benefitted from aerobic exercises, but the protocol is mostly focussed on moderate intensity exercises. Chronotropic incompetence and safety have been two issues while considering high intensity exercises in heart transplant patients.HIIT has been proved to be effective in coronary artery disease and heart failure patients. METHODOLOGY Criteria for considering these studies for the review PRISMA guidelines of systematic review used. Physiotherapy Evidence Database scale used for assessing risk of bias. GRADE System of evaluation used for data extraction and quality assessment. "Mesh" terms used to search the article. Various databases like PubMed, Scopus, Google scholar, Cochrane screened. Inclusion and exclusion criteria stated. Studies done between 2010-2020 taken.Out of all the studies screened, which 3 studies fulfilled the full text eligibility and were included in the systematic review. RESULTS The heart transplant patients demonstrated a great improvement in VO2 peak, anaerobic threshold, peak expiratory flow, extensor muscle capacity, general health, systolic blood pressure and endothelial function post HIIT. One of the screened studies compared HIIT with moderate intensity exercises in heart transplant patients and found out that patients receiving HIIT demonstrated better improvement that moderate intensity exercises.The studies also emphasised that long term and community based HIIT is effective in improving the overall quality of life of the patients. CONCLUSION According to the three studies reviewed in this article, HIIT proved to be effective as exercise intervention on heart transplant patients. Abstract Figure. Forms of HIIT Abstract Figure. Heart transplant