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One-year aerobic interval training improves endothelial dysfunction in patients with atrial fibrillation: a randomized trial
Kim S, Lee S, Han D, Jeong I, Lee H-H, Koh Y, Chung SG, Kim K
Internal Medicine 2023 Sep;62(17):2465-2474
clinical trial
6/10 [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: Yes; Between-group comparisons: Yes; Point estimates and variability: Yes. Note: Eligibility criteria item does not contribute to total score] *This score has been confirmed*

OBJECTIVE: To evaluate the effects of one-year aerobic interval training on endothelial dysfunction in patients with atrial fibrillation. PATIENTS AND METHODS: Seventy-four patients with atrial fibrillation (53 men, 21 women; mean age 63 +/- 6 years old) were randomized into a 1-year continuous aerobic interval training (CT), 6-month detraining after 6 months of aerobic interval training (DT), or medical treatment only (MT) group. Aerobic interval training was performed 3 times a week for 1 year or 6 months, with an exercise intensity of 85% to 95% of the peak heart rate. The primary outcome was a change in biomarkers of endothelial dysfunction from baseline at six months or at the one-year follow-up. RESULTS: Six-month aerobic interval training reduced von Willebrand factor (CT 103.7 +/- 30.7 IU/dL and DT 106 +/- 31.2 IU/dL versus MT 145 +/- 47.7 IU/dL, p = 0.044). Improvements were maintained with continuous aerobic interval training; however, the values increased again to the baseline levels upon detraining (CT 84.3 +/- 39.1 IU/dL versus DT 122.2 +/- 27.5 IU/dL and MT 135.9 +/- 50.4 IU/dL, p = 0.002). Interleukin 1 beta levels decreased after 6 months of aerobic interval training (CT 0.59 +/- 0.1 pg/mL and DT 0.63 +/- 0.09 pg/mL versus MT 0.82 +/- 0.28 pg/mL, p = 0.031), and the improvement was maintained with continuous aerobic interval training and even after detraining (CT 0.58 +/- 0.08 pg/mL and DT: 0.62 +/- 0.09 pg/mL versus MT 0.86 +/- 0.28 pg/mL, p = 0.015). CONCLUSIONS: One-year aerobic interval training improves endothelial dysfunction in patients with atrial fibrillation and is primarily associated with the reduction in circulating thrombogenic and pro-inflammatory factors. A definitive way to sustain these improvements is the long-term continuation of aerobic training. Trial registration Clinical Research Information Service registration no. KCT0007264, registered on May 11, 2022. Retrospectively registered.

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