Research Progress of High-intensity Interval Training in Cardiac Rehabilitation of Patients with Acute Coronary Syndrome / 中国医学科学院学报

Acute coronary syndrome (ACS),with increasing mortality year by year,has become a major public health problem in China.Exercise rehabilitation as an important part of the out-of-hospital rehabilitation for the patients with heart diseases can further reduce the mortality of patients on the basis of drug treatment.The available studies have proved that high-intensity interval training (HIIT) is more effective and efficient than moderate-intensity continuous training (MICT) such as walking and jogging on chronic cardiovascular diseases such as heart failure,stable coronary heart disease,and hypertension and has high security.According to the latest research,HIIT can reduce the platelet response,mitigate myocardial ischemia-reperfusion injury,and increase the exercise compliance of ACS patients more significantly than MICT.Moreover,it does not increase the risk of thrombotic adverse events or malignant arrhythmia.Therefore,HIIT is expected to become an important part of exercise prescription in out-of-hospital cardiac rehabilitation strategy for the patients with ACS.

Efectos del entrenamiento por intervalos vs entrenamiento continuo sobre capacidad aeróbica en pacientes con enfermedad de las arterias coronarias / Effects of interval training vs of interval training vs continuous training on aerobic capacity in patients with coronary artery disease

Resumen El objetivo de esta revisión fue comparar la influencia del entrenamiento por intervalos de alta intensidad (HIIT) con el entrenamiento continuo de moderada intensidad (MICT) sobre la capacidad aeróbica y otras variables relevantes en pacientes con enfermedad de las arterias coronarias (EAC). Realizamos una revisión de estudios sistemáticos y metaanálisis en PubMed hasta el 04 de junio de 2019. Se identificaron un total de 22 artículos, de los cuales 6 se seleccionaron finalmente para esta revisión. La calidad metodológica se evaluó utilizando la herramienta 'Assessment of Multiple Systematic Reviews 2' (AMSTAR-2). Todos los estudios analizaron los efectos del HIIT y MICT en pacientes adultos (rango edad media: 52-76 años). La calidad general de los estudios incluidos fue moderada-alta (AMSTAR-2). El HIIT presentó mayores mejorías sobre el consumo de oxígeno pico y la frecuencia cardíaca pico en comparación al MICT. Esta revisión agrega evidencia adicional que el HIIT presenta mejoras clínicamente significativas sobre la capacidad aeróbica en comparación al MICT. Son necesarios más estudios que permitan establecer conclusiones consistentes de los efectos del HIIT y MICT sobre otras variables relevantes.

Abstract The aim of this review was to compare the influence of high-intensity interval training (HIIT) with moderate-intensity continuous training (MICT) on aerobic capacity and other relevant variables in patients with coronary artery disease (EAC). We reviewed the systematic studies and meta-analysis in PubMed up to June 4th, 2019. A total of 22 articles were identified, of which 6 were selected for this review. The methodological quality was evaluated using the Assessment of Multiple Systematic Reviews 2 (AMSTAR-2) tool. The studies selected analyzed HIIT and MICT effects in adult patients (average ages ranging between 52-76). The overall quality of the included studies was moderate-high (AMSTAR-2). HIIT showed greater improvements over peak oxygen consumption and peak heart rate compared to MICT. This review adds further evidence that HIIT presents clinically significant improvements in aerobic capacity compared to MICT. Further studies are needed to establish consistent conclusions about the effects of HIIT and MICT on other relevant variables.

Resumo O objetivo desta revisão foi comparar a influência do treinamento intervalado de alta intensidade (HIIT) com o treinamento contínuo de intensidade moderada (MICT) na capacidade aeróbica e em outras variáveis relevantes em pacientes com doença arterial coronariana (DAC). Realizamos uma revisão de estudos sistemáticos e metanálise no PubMed até 4 de junho de 2019. Foram identificados 22 artigos, dos quais 6 foram finalmente selecionados para esta revisão. A qualidade metodológica foi avaliada usando a ferramenta 'Assessment of Multiple Systematic Reviews 2' (AMSTAR-2). Todos os estudos analisaram os efeitos de HIIT e MICT em pacientes adultos (faixa etária: 52-76 anos). A qualidade geral dos estudos incluídos foi moderadamente alta (AMSTAR-2). O HIIT mostrou uma maior melhora no pico de consumo de oxigênio e no pico de frequência cardíaca em comparação com o MICT. Esta revisão aporta evidências de que o HIIT apresenta melhorias clinicamente significativas na capacidade aeróbica em comparação com o MICT. Mais estudos são necessários para estabelecer conclusões consistentes dos efeitos do HIIT e MICT em outras variáveis relevantes.

Advance in High-intensity Interval Training for Acute Myocardial Infarction post Percutaneous Coronary Intervention (review) / 中国康复理论与实践

For the low-risk or stable patients with acute myocardial infarction post percutaneous coronary intervention, compared with moderate-intensity continuous training, high-intensity interval training (HIIT) can better enhance aerobic capacity and protect the cardiovascular system by significantly lowering the inflammatory response, improving endothelial function as well as reversing the progress of ventricular remodeling. HIIT is safety and the patients are more compliant. However, further research is needed on the application of high-risk patients. The standard protocol of HIIT according to the risk stratification also requires further discussion.

Effects of High Intensity Interval Training on the Activity of the Myocardial Mitochondrial Respiratory Chain Complex of Rats / 中国运动医学杂志

Objective To explore the heart function and activity of the mitochondrial respiratory chain complex of rats with myocardial hypertrophy induced by the long-term high-intensity interval training(HIIT).Methods Ninety Wistar rats were randomly divided into an HIIT group,a moderate intensity continuous training(MICT) group and a rest control(RC) group,with each group allocated three subgroups according to the observation time(2,6 and 10 weeks),9 groups altogether(n=10 in each group).Each group was given intervention as their names implied.Then,the heart function was measured using the ultrasoundcardiogram,and the body weight as well as the weight of the heart was weighted.The myocardium mitochondria were extracted using the differential centrifugation after homoge nation to detect the activity of the myocardial and mitochondrial citrate synthase (CS),the activities of the respiratory chain complex C Ⅰ ～CⅣ as well as myocardial protein expression of peroxisome proliferator-activated receptor gamma coactivator 1α (PGC-1 α),α-myosin heavy chain (α-MHC),β-MHC,atrial natriuretic factor(ANF) and brain natriuretic peptide(BNP).Results The myocardial hypertrophy was found in HIIT and MICT groups after 1-week and 9-week intervention respectively.At the 2nd and 10th week,no significant differences were found in the heart function,respiratory chain complex activity and protein expression of all three groups(P＞0.05).At the 6th week,the left ventricular ejection fraction,left ventricular fractional shortening,myocardial α-MHC protein expression,and the activities of respiratory chain complex C Ⅰ,C Ⅲ and C Ⅳ of HIIT group were significantly lower while the myocardial β-MHC and BNP protein expression were significantly higher than those of RC and MICT groups(P＜0.05).Conclusion Long-term HIIT but not MICT can induce temporarily pathological myocardial hypertrophy and reduced heart function in Wistar rats,and the mechanism might be related to the downregulation of the myocardial mitochondrial respiratory chain complex activity.

Comparative Study of the Effect of High Intensity Interval Training and Moderate Intensity Continuous Training on Metabolic Phenotype in C57BL/6 Mice / 中国运动医学杂志

Objective To examine the effect of high intensity interval training(HIIT) and moderate intensity continuous training(MICT) on the body component,serum globular adiponectin and skeletal muscle autophagy in C57BL/6 mice.Methods Thirty-six four-week-old C57BL/6 mice were randomly assigned to the control group,MICT group and HIIT groups.The MICT group underwent 60 minutes' aerobic continuous treadmill training at 12 m/min(75％ VO2max) once a day,5 times/week for 6 weeks,while the HIIT group exercised for 1min at 20 m/min(85％ VO2max) followed by 1 min at 8 m/min (50％ VO2max) for alternating 12 cycles.The body weight,body mass index(BMI),total body water,fat mass and citrate synthase(CS) of the quadriceps femoris were measured using ImpediVET experimental animal body composition analyzer.Mice were sacrificed after the analysis,and the level of serum gAcrp30 was detected using the enzyme linked immunosorbent assay.Western blotting was used to detect the expression of pAMPK-Thr172,LC3II/I,Beclin1 and p62 protein in skeletal muscle tissues.Results After 6-week exercise,the body weight of MICT and HIIT mice decreased significantly compared with the sedentary control group.BMI and fat mass of the HIIT group were significantly lower than the control group,but there were no significant differences between the MICT and control groups in the above two measurements.The activity of CS and serum gAcrp30 in HIIT group was significantly higher than the control group.Moreover,the expression of pAMPK-Thr172,LC3II/I and Beclin1 increased significantly in the skeletal muscle after HIIT intervention while the expression of p62 decreased compared with the control group.Conclusion Compared with the MICT,HIIT has more significant effects to reduce body fat and BMI,and activate the autophagy of skeletal muscles.