BACKGROUND: Cardiac rehabilitation (CR) is an evidence-based therapy in chronic heart failure (CHF). There is still debate about the optimal training protocol in CHF. The use of high intensity interval training (HIIT) supplemented with peripheral (PRT) and inspiratory resistance training (IRT) might be more beneficial because of the higher impact on the peripheral and inspiratory muscles, with less symptoms of dyspnoea and lower amount of dropouts as a result. We compared our standard exercise-based CR programme, mainly consisting of moderate intensity interval training to a programme combining HIIT, PRT and IRT (resistance training supplemented HIIT (RHIIT) programme). DESIGN: Randomised controlled pilot study. METHODS: Twenty patients with CHF were randomised on a 1:1 basis to the standard or RHIIT programme. At baseline and after 3 months, peak exercise capacity (VO2peak), peripheral (QF) and inspiratory respiratory muscle strength (MIP), quality of life (QOL) and physical activity were measured. RESULTS: The RHIIT programme resulted in a significantly larger improvement in QF (deltaQF RHIIT programme 19.3 +/- 11.8 versus standard programme -6.89 +/- 19.0 Nm (p < 0.01)) and MIP (deltaMIP RHIIT programme -44.9 +/- 29.9 versus standard programme 0.56 +/- 19.4 cmH2O (p < 0.01)). Both programmes equally improved in VO2peak (p = 0.91), whereas ventilatory efficiency and physical activity remained stable. CONCLUSION: HIIT supplemented with PRT and IRT might be applicable as standard protocol in CHF. Larger studies are warranted to confirm our findings. The RHIIT programme resulted in similar training effects in VO2peak in a shorter training period. This might be beneficial in a chronic patient population such as CHF, where adherence is difficult.

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