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High-intensity interval training and cardiac autonomic control in individuals with metabolic syndrome: a randomised trial
Ramos JS, Dalleck LC, Borrani F, Beetham KS, Mielke GI, Dias KA, Wallen MP, Keating SE, Fassett RG, Coombes JS
International Journal of Cardiology 2017 Oct 15;245:245-252
clinical trial
5/10 [Eligibility criteria: Yes; Random allocation: Yes; Concealed allocation: No; Baseline comparability: Yes; Blind subjects: No; Blind therapists: No; Blind assessors: Yes; Adequate follow-up: No; Intention-to-treat analysis: No; Between-group comparisons: Yes; Point estimates and variability: Yes. Note: Eligibility criteria item does not contribute to total score] *This score has been confirmed*

BACKGROUND: Insulin resistance has been postulated to play a central role in the co-appearance of various cardiovascular disease risk factors constituting the metabolic syndrome (MetS). There is evidence that altered cardiac autonomic function (CAF) may precede the onset of insulin resistance. Exercise training has been shown to improve CAF in different populations, yet little is known regarding the exercise dose response for CAF. The aim of this study was to investigate the impact of different volumes of high-intensity interval training (HIIT) and traditional moderate-intensity continuous training (MICT) on CAF in participants with MetS. METHODS: Individuals with MetS (n = 56) were randomised into the following 16-week training interventions: (i) MICT (n = 16, 30 min at 60 to 70%HRpeak, 5x/week); (ii) 4HIIT (n = 19, 4x4 min bouts at 85 to 95% HRpeak, interspersed with 3 min of active recovery at 50 to 70% HRpeak, 3x/week); or (iii) 1HIIT (n = 21, 1x4 min bout at 85 to 95% HRpeak, 3x/week). R-R interval recorded for 5 min in a supine position at pre- and post-intervention was used to derive linear (SDNN, RMSSD, pNN50, LF, HF, LF/HF) and non-linear (SD1, SD2, alpha1, alpha2, SampEn) heart rate variability (HRV) indices as measures of CAF. Group x time interaction effects were examined (ANCOVA) and Eta squared (eta2) interaction effect sizes calculated. RESULTS: While there were no significant between-group differences in CAF indices, there were small-to-medium group x time interaction effects on SDNN (F[2,52] = 0.70, p = 0.50, partial-eta2 = 0.02), RMSSD (F[2,52] = 1.35, p = 0.27, partial-eta2 = 0.03), HF power (F[2,52] = 1.27, p = 0.29, partial-eta2 = 0.03), SD1 (F[2,52] = 0.47, p = 0.63, eta2 = 0.01), and SD2 (F[2,52] = 0.41, p = 0.67, partial-eta2 = 0.01). The following represent the relative percentage increases across these variables for 4HIIT, MICT, and 1HIIT respectively (SDNN +30%, +17%, 9%; RMSSD +30%, +22%, -2%; HF power +69%, +18%, +7%; SD1 +30%, +22%,-2%; SD2 +22%, +14%, 4%). CONCLUSIONS: There were no significant between-group differences for the effects of exercise dose on CAF indices, however; high-volume HIIT demonstrated the greatest magnitude of effect for improving CAF in individuals with MetS.

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