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Effects of high-intensity interval training on cardiac remodelling, function and coronary microcirculation in de novo heart transplant patients: a substudy of the HITTS randomised controlled trial [with consumer summary]
Rafique M, Solberg OG, Gullestad L, Bendz B, Murbraech K, Nytroen K, Rolid K, Lunde K
BMJ Open Sport & Exercise Medicine 2023;9(3):e001331
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*

OBJECTIVES: High-intensity interval training (HIT) improves peak oxygen consumption (VO2peak) in de novo heart transplant (HTx) recipients. It remains unclear whether this improvement early after HTx is solely dependent on peripheral adaptations, or due to a linked chain of central and peripheral adaptations. The objective of this study was to determine whether HIT results in structural and functional adaptations in the cardiovascular system. METHODS: Eighty-one de novo HTx recipients were randomly assigned to participate in either 9 months of supervised HIT or standard care exercise-based rehabilitation. Cardiac function was assessed by echocardiogram and the coronary microcirculation with the index of microcirculatory resistance (IMR) at baseline and 12 months after HTx. RESULTS: Cardiac function as assessed by global longitudinal strain was significantly better in the HIT group than in the standard care group (16.3 +/- 1.2% versus 15.6 +/- 2.2%, respectively, treatment effect -1.1% (95% CI -2.0% to -0.2%), p = 0.02), as was the end-diastolic volume (128.5 +/- 20.8 mL versus 123.4 +/- 15.5 mL, respectively, treatment effect 4.9 mL (95% CI 0.5 to 9.2 mL), p = 0.03). There was a non-significant tendency for IMR to indicate improved microcirculatory function (13.8 +/- 8.0 versus 16.8 +/- 12.0, respectively, treatment effect = -4.3 (95% CI -9.1 to 0.6), p = 0.08). CONCLUSION: When initiated early after HTx, HIT leads to both structural and functional cardiovascular adaptations. TRIAL REGISTRATION NUMBER: NCT01796379.

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