Abstract
BackgroundAerobic exercise training is associated with beneficial ventricular remodeling and an improvement in cardiac biomarkers in chronic stable heart failure. High‐intensity interval training (HIIT) is a time‐efficient method to improve V˙O2peak in stable coronary heart disease patients. This pilot study aimed to compare the effect of HIIT on ventricular remodeling in patients with a recent acute myocardial infarction (AMI).MethodsNineteen post‐AMI patients were randomized to either HIIT (n = 9) or usual care (n = 10). A cardiopulmonary exercise test (CPET), transthoracic echocardiography, and cardiac biomarker assessment (ie, N‐terminal pro B‐type natriuretic peptide levels and G protein‐coupled receptor kinase 2 expression) were performed before and after a 12‐week training intervention. CPET parameters including oxygen uptake efficiency slope (OUES) and V˙O2 at the first ventilatory threshold (V˙O2 VT1) were calculated. left ventricular (LV) structural and functional echocardiographic parameters including myocardial strain imaging were assessed.Results V˙O2peak and OUES improved solely in the HIIT group (P < .05 for group/time, respectively). There was a significant training effect for the improvement of peak work load in both groups (P < .05). O2 pulse and V˙O2 at VT1 both improved only in the HIIT group (P < .05 for time, no interaction). HIIT improved radial strain and pulsed‐wave tissue Doppler imaging derived e′ (P < .05 for time, no interaction). Cardiac biomarkers did not change in either group.ConclusionsIn post‐AMI patients, HIIT lead to significant improvements in prognostic CPET parameters compared to usual care. HIIT was associated with favorable ventricular remodeling regarding certain echocardiographic parameters of LV function.
Highlights
Aerobic exercise training is associated with beneficial ventricular remodeling and an improvement in cardiac biomarkers in chronic stable heart failure
Cardiac β-adrenergic receptor (β-AR) signal dysregulation represents a hallmark abnormality potentially leading to left ventricular (LV) remodeling post-acute myocardial infarction (AMI) and progression to heart failure. β-AR kinase (GRK2) is the most abundant G protein-coupled receptor kinase expressed in the heart.[7]
To the best of our knowledge, the effect of High-intensity interval training (HIIT) on cardiac remodeling including advanced echocardiography and G protein-coupled receptor kinase 2 (GRK2) expression has not yet been studied in patients with a recent AMI. This pilot investigation aimed to evaluate the effect of HIIT on cardiopulmonary exercise test (CPET) variables, left ventricular remodeling, and GRK2 expression in coronary heart disease (CHD) patients who recently suffered an AMI
Summary
Acute myocardial infarction (AMI) can induce changes in left ventricular (LV) topography (ie, ventricular remodeling) and is a major contributor in the development of heart failure despite advances in coronary revascularization and optimal medical therapy.[1]. To the best of our knowledge, the effect of HIIT on cardiac remodeling including advanced echocardiography (ie, myocardial strain imaging) and GRK2 expression has not yet been studied in patients with a recent AMI. This pilot investigation aimed to evaluate the effect of HIIT on cardiopulmonary exercise test (CPET) variables, left ventricular remodeling, and GRK2 expression in CHD patients who recently suffered an AMI. We hypothesized that HIIT would result in a higher V_ O2peak improvement and a more favorable cardiac remodeling with a substantial reduction in GRK2 expression compared to a usual care group
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