PURPOSE: Epicardial (EAT) and pericardial (PAT) fat masses and myocardial triglyceride content (MTC) are enlarged in obesity and insulin resistance. We studied whether the high-intensity interval training (HIIT) and moderate-intensity continuous training (MICT) similarly decrease ectopic fat in and around the heart and whether the decrease is similar in healthy subjects and subjects with defective glucose tolerance (DGT). METHODS: A total of 28 healthy men (body mass index 20.7 to 30.0 kg/m2, age 40 to 55 yr) and 16 men with DGT (body mass index 23.8 to 33.5 kg/ms, age 43 to 53 yr) were randomized into HIIT and MICT interventions for 2 wk. EAT and PAT were determined by computed tomography and MTC by H-MRS. RESULTS: At baseline, DGT subjects had impaired aerobic capacity and insulin sensitivity and higher levels of whole body fat, visceral fat, PAT, and EAT (p < 0.05, all) compared with healthy subjects. In the whole group, HIIT increased aerobic capacity (HIIT 6%, MICT 0.3%; time x training p = 0.007) and tended to improve insulin sensitivity (HIIT 24%, MICT 8%) as well as reduce MTC (HIIT -42%, MICT +23%) (time x training p = 0.06, both) more efficiently compared with MICT, and without differences in the training response between the healthy and the DGT subjects. However, both training modes decreased EAT (-5%) and PAT (-6%) fat (time p < 0.05) and not differently between the healthy and the DGT subjects. CONCLUSION: Whole body fat, visceral fat, PAT, and EAT masses are enlarged in DGT. Both HIIT and MICT effectively reduce EAT and PAT in healthy and DGT subjects, whereas HIIT seems to be superior as regards improving aerobic capacity, whole-body insulin sensitivity, and MTC.

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