INTRODUCTION: Adults with repaired Tetralogy of Fallot (ToF) have impaired exercise capacity, vascular and cardiac autonomic function, and quality of life (QoL). Specific effects of high-intensity interval or moderate continuous exercise training on these parameters in adults with repaired ToF remain unknown. METHODS AND RESULTS: Thirty adults with repaired ToF were randomized to either high-intensity interval, moderate intensity continuous training (36 sessions, 2 to 3 times a week) or usual care (no supervised exercise). Exercise capacity, flow-mediated vasodilation, pulse wave velocity, NT-proBNP and fibrinogen levels, heart rate variability and recovery, and QoL (SF-36 questionnaire) were determined at baseline and after the intervention period. Twenty-seven patients (mean age 39 +/- 9 years, 63% females, 9 from each group) completed this pilot study. Both training groups improved in at least some parameters of cardiovascular health compared to no exercise. Interval-but not continuous-training improved VO2peak (21.2 to 22.9 ml/kg/min, p = 0.004), flow-mediated vasodilation (8.4 to 12.9%, p = 0.019), pulse wave velocity (5.4 to 4.8m/s, p = 0.028), NT-proBNP (202 to 190 ng/L, p = 0.032) and fibrinogen levels (2.67 to 2.46 g/L, p = 0.018). Conversely, continuous-but not interval-training improved heart rate variability (low-frequency domain, 0.32 to 0.22, p = 0.039), heart rate recovery after 2 min post-exercise (40 to 47 beats, p = 0.023) and mental domain of SF-36 (87 to 95, p = 0.028). CONCLUSION: Both interval and continuous exercise training modalities were safe. Interval training seems more efficacious in improving exercise capacity, vascular function, NT-proBNP and fibrinogen levels, while continuous training seems more efficacious in improving cardiac autonomic function and QoL. (ClinicalTrials.gov NCT02643810).

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