Exercício intermitente de alta intensidade como alternativa na reabilitação cardiovascular: uma metanálise / High intensity intermittent training as an alternative in cardiovascular rehabilitation: a meta-analysis

RESUMO

O objetivo desta metanálise testar a hipótese de que exercícios intermitentes de alta intensidade (HIIT) apresentam efeito superior ao exercício contínuo de intensidade moderada (MICE) sobre o VO2pico, FCpico, fração de ejeção do ventrículo esquerdo (LVEF) e dilatação arterial fluxo-mediada (FMD) em pacientes com infarto agudo do miocárdio (IAM), doença arterial coronariana (DAC) e insuficiência cardíaca (IC). As bases de dados eletrônicas PubMed, EBSCOhost e Science Direct foram acessadas, além de buscas nas referências dos próprios artigos. Incluíram-se 12 artigos com total de 239 pacientes que realizaram sessões de HIIT (61,88±5,88 anos) e de 276 que realizaram MICE (62,43±4,85 anos). Verificou-se efeito favorável ao HIIT em comparação ao MICE no VO2pico (Z=8,22; p<0,0001) e LVEF (Z=3,25; p=0,001), porém sem diferença na FCpico (Z = 1,15; p=0,24) e FMD (z=0,12; p=0,9). Pode-se concluir que o HIIT proporciona benefícios senão superiores, ao menos equivalentes em ganhos fisiológicos relacionados à morbidade e mortalidade de pessoas com problemas cardiovasculares.

ABSTRACT

The purpose of this meta-analysis was to review systematically the literature and quantify the effect size of interventions with continuous and intermittent exercise in patients with acute myocardial infarction (AMI), coronary heart disease (CHD) and heart failure (HF). The hypothesis tested was that high-intensity intermittent exercise (HIIT) offers superior effect related to continuous exercise of moderate intensity (MICE) on VO2max, HRpeak, left ventricular ejection fraction (LVEF) and flow-mediated arterial dilation (FMD) in these patients. Electronic databases PubMed, EBSCOhost and Science Direct were accessed, as well as searches in references of the articles themselves. Twelve articles were included in the analyses and, after searches and evaluations of retrieved studies, 75% had scored ≥ 7 points in PEDro scale. Were extracted information of 239 patients who underwent sessions of HIIT (61.88 ± 5.89 years) and 276 who performed sessions of MICE (62.43 ± 4.85 years). Dose response effect was found in favour of HIIT compared to MICE in VO2max (Z = 8.22; p < 0.0001) and LVEF (Z = 3.25; p = 0.001), however there was no difference in respect of HRpeak (Z = 1.15; p = 0.24) and FMD (z = 0.12; p = 0.9). Thus, we conclude that HIIT provides higher, or at least equivalent, benefits in physiological gains related to morbidity and mortality in people with cardiovascular problems.