Comparative analysis of aerobic cardiorespiratory training of high and moderate intensity in cardiac surgery profile patients

Cover Page

Cite item

Full Text

Abstract

Aim. The aim of our study was to conduct a comparative analysis of aerobic high-intensity interval training and constant moderate intensity training in cardiac rehabilitation of adult patients after open-heart surgery, namely after coronary artery bypass grafting (CABG).

Material and methods. 137 patients after CABG were included in the study. 90.4% of patients were consider as class I of chronic heart failure after surgery. Cardiorespiratory trainings were initiate in 4 weeks after surgery, using cycling by veloergometers. Two groups were compare according to rehabilitation programs: one carried out constant aerobic trainings of moderate and medium intensity, and the other, aerobic high-intensity interval trainings. Supervised trainings were carry out for 150 minutes per week. Total length of trainings was 4–7 weeks. Long-term trainings were distantly monitore.

Results. Ergospirometric results as well as results of echocardiography were significantly improve after training course. These results were more significant in high-intensity interval training group, compared to moderate intensity-training group. VO2, heart rate and training power significantly improved. Body mass index significantly diminished in high-intensity interval training group, compared to moderate intensity-training group. In 7 weeks after training ominously decreased blood triglycerides and increased high-density lipoproteins.

Conclusion. Cardiorespiratory trainings ameliorate mitochondrial biogenesis, carbohydrate and lipid metabolism, promote to reduce abdominal obesity and other crucial risk factors of coronary patients. Aerobic high-intensity interval cardiac trainings are as safe as moderate intensity cardiac trainings, and in some issues, they outperform moderate intensity cardiac trainings.

About the authors

Tea T. Kakuchaya

Bakulev National Medical Research Center for Cardiovascular Surgery

Author for correspondence.
Email: ttkakuchaya@mail.ru
ORCID iD: 0000-0001-9383-2073

D. Sci. (Med.), Prof.

Russian Federation, Moscow

Tamara G. Dzhitava

Bakulev National Medical Research Center for Cardiovascular Surgery

Email: ttkakuchaya@mail.ru
ORCID iD: 0000-0002-6141-2231

Cand. Sci. (Med.)

Russian Federation, Moscow

Nona V. Pachuashvili

Bakulev National Medical Research Center for Cardiovascular Surgery

Email: ttkakuchaya@mail.ru
ORCID iD: 0000-0002-0076-775X

Cand. Sci. (Med.)

Russian Federation, Moscow

Arzhana M. Kuular

Bakulev National Medical Research Center for Cardiovascular Surgery

Email: ttkakuchaya@mail.ru
ORCID iD: 0000-0002-2133-9674

Cand. Sci. (Med.)

Russian Federation, Moscow

Irina I. Domracheva

Bakulev National Medical Research Center for Cardiovascular Surgery

Email: ttkakuchaya@mail.ru
ORCID iD: 0000-0002-7774-8311

Res. Assist.

Russian Federation, Moscow

Nino E. Zakaraya

Bakulev National Medical Research Center for Cardiovascular Surgery

Email: ttkakuchaya@mail.ru
ORCID iD: 0000-0002-7604-5278

Res. Officer

Russian Federation, Moscow

References

  1. Barcroft H, Dornhorst AC. Blood flow through human calf during rhythmic exercise. J Physiol. 1949;109(3-4):402-11. doi: 10.1113/jphysiol.1949.sp004403
  2. Guyton AC, Jones CE, Coleman TB. Circulatory Physiology: Cardiac Output and ITS Regulation. Philadelphia: WB Saunders Co, 1973.
  3. Ponikowski P, Voors AA, Anker SD, et al. 2016 ESC Guidelines for the diagnosis and treatment of acute and chronic heart failure: The Task Force for the diagnosis and treatment of acute and chronic heart failure of the European Society of Cardiology (ESC). Developed with the special contribution of the Heart Failure Association (HFA) of the ESC. Eur J Heart Fail. 2016;18:891-975. doi: 10.1002/ejhf.592
  4. Nilsson BB, Westheim A, Risberg MA. Long-term effects of a group-based high-intensity aerobic interval-training program in patients with chronic heart failure. Am J Cardiol. 2008;102(9):1220-4. doi: 10.1016/j.amjcard.2008.06.046
  5. Piña IL, Apstein CS, Balady GJ, et al. Exercise and heart failure: a statement from the American Heart Association Committee on Exercise, Rehabilitation, and Prevention. Circulation. 2003;107(8):1210-25. doi: 10.1161/01.cir.0000055013.92097.40
  6. O’Connor CM, Whellan DJ, Lee KM, et al. Efficacy and Safety of Exercise Training in Patients With Chronic Heart Failure: HF-ACTION Randomized Controlled Trial. JAMA. 2009;301(14):1439-50. doi: 10.1001/jama.2009.454
  7. Benito B, Nattel S. Exercise training as a treatment for heart failure: Potential mechanisms and clinical implications. J Physiol. 2009;587(Pt. 21):5011-3. doi: 10.1113/jphysiol.2009.181339
  8. Niebauer J. Is There a Role for Cardiac Rehabilitation After Coronary Artery Bypass Grafting? Treatment After Coronary Artery Bypass Surgery Remains Incomplete Without Rehabilitation. Circulation. 2016;133:2529-37. doi: 10.1161/CIRCULATIONAHA.116.021348
  9. Современные аспекты кардиореабилитации. Под ред. Т.Т. Какучая. М.: НЦССХ им. А.Н. Бакулева, 2015 [Sovremennye aspekty kardioreabilitatsii. Ed. TT Kakuchaia. Moscow: NTsSSKh im. A.N. Bakuleva, 2015 (in Russian)].
  10. Кардиореабилитация и вторичная профилактика. Под ред. Д.М. Аронова. М.: ГЭОТАР-Медиа, 2021 [Kardioreabilitatsiia i vtorichnaia profilaktika. Ed. DM Aronov. Moscow: GEOTAR-Media, 2021 (in Russian)].
  11. Guiraud T, Nigam A, Gremeaux V, et al. High-intensity interval training in cardiac rehabilitation. Sports Med. 2012;42(7):587-605. doi: 10.2165/11631910-000000000-00000
  12. Juneau M, Hayami D, Gayda M, et al. Provocative issues in heart disease prevention. Can J Cardiol. 2014;30(Suppl. 12):S401-9. doi: 10.1016/j.cjca.2014.09.014
  13. Wewege MA, Ahn D, Yu J, et al. High-Intensity Interval Training for Patients With Cardiovascular Disease – Is It Safe? A Systematic Review. J Am Heart Assoc. 2018;7:e009305. doi: 10.1161/JAHA.118.009305
  14. Moholdt TT, Amundsen BH, Rustad LA, et al. Aerobic interval training versus continuous moderate exercise after coronary artery bypass surgery: a randomized study of cardiovascular effects and quality of life. Am Heart J. 2009;158(6):1031-7. doi: 10.1016/j.ahj.2009.10.003
  15. Keteyian SJ, Hibner BA, Bronsteen K, et al. Greater improvement in cardiorespiratory fitness using higher-intensity interval training in the standard cardiac rehabilitation setting. J Cardiopulm Rehabil Prev. 2014;34(2):98-105. doi: 10.1097/HCR.0000000000000049
  16. Pattyn N, Coeckelberghs E, Buys R, et al. Aerobic interval training vs. moderate continuous training in coronary artery disease patients: a systematic review and meta-analysis. Sports Med. 2014;44(5):687-700. doi: 10.1007/s40279-014-0158-x
  17. Pescatello L, Arena R, Riebe D, Thompson P. General Principles of Exercise Prescription. In: ACSM’s Guidelines for Exercise Testing and Prescription. 9th ed. Philadelphia: Wolters Kluwer Health/Lippincott Williams & Wilkins, 2013; p. 166-77.
  18. Бокерия Л.А., Аронов Д.М., и др. Российские клинические рекомендации. Коронарное шунтирование больных ишемической болезнью сердца: реабилитация и вторичная профилактика. CardioСоматика. 2016;7(3-4):5-71 [Bokeriya LA, Aronov DM, et al. Russian clinical guidelines. Coronary artery bypass grafting in patients with ischemic heart disease: rehabilitation and secondary prevention. Cardiosomatics. 2016;7(3-4):5-71 (in Russian)]. doi: 10.26442/CS45210
  19. Пачуашвили Н.В. Эффективность современных аэробных интервальных физических тренировок в реабилитации взрослых больных после операций на открытом сердце. Дис. … канд. мед. наук. М., 2019 [Pachuashvili NV. Effektivnost' sovremennykh aerobnykh interval'nykh fizicheskikh trenirovok v reabilitatsii vzroslykh bol'nykh posle operatsii na otkrytom serdtse. Dis. … kand. med. nauk. Moscow, 2019 (in Russian)].
  20. Conraads VM, Pattyn N, De Maeyer C, et al. Aerobic interval training and continuous training equally improve aerobic exercise capacity in patients with coronary artery disease: The SAINTEX-CAD study. Int J Cardiol. 2015;179:203-10. doi: 10.1016/j.ijcard.2014.10.155
  21. Price KJ, Gordon BA, Bird SR, Benson AC. A review of guidelines for cardiac rehabilitation exercise programmes: is there an international consensus? Eur J Prev Cardiol. 2016;23(16):1715-33. doi: 10.1177/2047487316657669
  22. Hannan AL, Hing W, Simas V, et al. High-intensity interval training versus moderate-intensity continuous training within cardiac rehabilitation: a systematic review and meta-analysis. Open Access J Sports Med. 2018;9:1-17. doi: 10.2147/OAJSM.S150596
  23. Dibben GO, Dalal HM, Taylor RS, et al. Cardiac rehabilitation and physical activity: systematic review and meta-analysis. Heart. 2018;104(17):1394-402. doi: 10.1136/heartjnl-2017-312832
  24. Wickramasinghe CD, Ayers CR, Das S, et al. Prediction of 30-year risk for cardiovascular mortality by fitness and risk factor levels: the Cooper Center Longitudinal Study. Circ Cardiovasc Qual Outcomes. 2014;7:597-602. doi: 10.1161/CIRCOUTCOMES.113.000531
  25. Radford NB, DeFina LF, Leonard D, et al. Cardiorespiratory fitness, coronary artery calcium, and cardiovascular disease events in a cohort of generally healthy middle-age men: results from the Cooper Center Longitudinal Study. Circulation. 2018;137:1888-95. doi: 10.1161/CIRCULATIONAHA.117.032708
  26. Thompson PD, Franklin BA, Balady GJ, et al.; American Heart Association Council on Nutrition, Physical Activity, and Metabolism; American Heart Association Council on Clinical Cardiology; American College of Sports Medicine. Exercise and acute cardiovascular events placing the risks into perspective: a scientific statement from the American Heart Association Council on Nutrition, Physical Activity, and Metabolism and the Council on Clinical Cardiology. Circulation. 2007;115:2358-68. doi: 10.1161/CIRCULATIONAHA.107.181485
  27. Cobb LA, Weaver WD. Exercise: a risk for sudden death in patients with coronary heart disease. J Am Coll Cardiol. 1986;7:215-9. doi: 10.1016/s0735-1097(86)80284-4
  28. Levinger I, Shaw CS, Stepto NK, et al. What doesn’t kill you makes you fitter: a systematic review of high-intensity interval exercise for patients with cardiovascular and metabolic diseases. Clin Med Insights Cardiol. 2015;9:53-63. doi: 10.4137/CMC.S26230
  29. Rognmo Ø, Moholdt T, Bakken H, et al. Cardiovascular risk of high-versus moderate-intensity aerobic exercise in coronary heart disease patients. Circulation. 2012;126:1436-40. doi: 10.1161/CIRCULATIONAHA.112.123117
  30. Quindry JC, Franklin BA, Chapman M, et al. Benefits and risks of high-intensity interval training in patients with coronary artery disease. Am J Cardiol. 2019;123:1370-7. doi: 10.1016/j.amjcard.2019.01.008
  31. Williams PT, Thompson PD. Increased cardiovascular disease mortality associated with excessive exercise in heart attack survivors. Mayo Clin Proc. 2014;89:1187-94. doi: 10.1016/j.mayocp.2014.05.006
  32. Keteyian SJ, Leifer ES, Houston-Miller N, et al.; HFACTION Investigators. Relation between volume of exercise and clinical outcomes in patients with heart failure. J Am Coll Cardiol. 2012;60(19):1899-905. doi: 10.1016/j.jacc.2012.08.958
  33. Wannamethee SG, Shaper AG. Physical activity and cardiovascular disease. Semin Vasc Med. 2002;2(3):257-66. doi: 10.1055/s-2002-35400
  34. Mons U, Hahmann H, Brenner H. A reverse J-shaped association of leisure time physical activity with prognosis in patients with stable coronary heart disease: evidence from a large cohort with repeated measurements. Heart. 2014;100(13):1043-9. doi: 10.1136/heartjnl-2013-305242
  35. Stewart RAH, Held C, Hadziosmanovic N, et al.; STABILITY Investigators. Physical activity and mortality in patients with stable coronary heart disease. J Am Coll Cardiol. 2017;70(14):1689-700. doi: 10.1016/j.jacc.2017.08.017
  36. Moholdt T, Wisløff U, Nilsen TIL, Slørdahl SA. Physical activity and mortality in men and women with coronary heart disease: a prospective population-based cohort study in Norway (the HUNT study). Eur J Cardiovasc Prev Rehabil. 2008;15:639-45. doi: 10.1097/HJR.0b013e3283101671
  37. Chief Medical Officers. Start active, stay active. A report on physical activity for health from four home countries, 2011. Available at: https://www.gov.uk/goverment/uploads/system/uploads/attachment_data/file/830943/withdrawn_dh_128210.pdf. Accessed: 22.07.2021.
  38. Thomas RJ, Beatty AL, Beckie TM, et al. Home-based cardiac rehabilitation: a scientific statement from the American Association of Cardiovascular and Pulmonary Rehabilitation, the American Heart Association, and the American College of Cardiology. Circulation. 2019;140:e69-e89. doi: 10.1161/CIR.0000000000000663
  39. Belardinelli R, Georgiou D, Cianci G, Purcaro A. 10-year exercise training in chronic heart failure: a randomized controlled trial. J Am Coll Cardiol. 2012;60(16):1521-8. doi: 10.1016/j.jacc.2012.06.036

Supplementary files

Supplementary Files
Action
1. JATS XML
2. Fig. 1. Rapid ramp test model and training with an intensity of 50٪ of maximum.

Download (61KB)
3. Fig. 2. 4×4 program: four lots of 4-minute high intensity interval training (HIIT) broken up by 3-minute pauses – "Scandinavian model" (٪ of the maximum heart rate).

Download (61KB)
4. Fig. 3. Change in VO2max with HIIT and MICT in 3 and 7 weeks.

Download (66KB)

Copyright (c) 2021 Eco-Vector

Creative Commons License
This work is licensed under a Creative Commons Attribution-NonCommercial-ShareAlike 4.0 International License.

This website uses cookies

You consent to our cookies if you continue to use our website.

About Cookies