High-Intensity Interval Training in Patients with Pulmonary Embolism: A Randomized Controlled Trial.

PURPOSE: High-intensity interval training (HIIT) appears to be safe and effective in cardiovascular diseases. However, there is a paucity of data on the effect of HIIT for patients with acute pulmonary embolism (PE). The present randomized controlled trial (RCT) therefore examined the efficiency and safety of HIIT in patients with acute PE. METHODS: In single-center parallel open-label RCT, 24 patients (5 women) discharged recently with a diagnosis of intermediate-high-risk acute PE were randomized (1:1) to supervised HIIT (n = 12) or control (n = 12) group. The primary outcomes were exercise capacity evaluated in terms of the estimated maximal oxygen uptake (eV˙O2max), lung function (forced expiratory volume in 1 s [FEV1]), right ventricular (RV) function (RV/left ventricular diameter [LV] ratio), and health-related quality of life (HRQoL). Safety was the secondary outcome. RESULTS: Eight weeks of HIIT improved eV˙O2max (+65%, P < 0.001), FEV1 (%) (+17%, P = 0.031), and RV/LV ratio diameter (-27%, P = 0.005), as well as HRQoL. All patients in the HIIT group tolerated exercise training without serious adverse events. The control group did not improve (P > 0.05) eV˙O2max, RV/LV ratio diameter, or HRQoL; however, FEV1 (%) was slightly reduced (-6%, P = 0.030). CONCLUSIONS: The present RCT of a tailored center-based HIIT intervention provides preliminary evidence that this intervention could improve exercise capacity, lung function, RV function, and HRQoL without serious adverse events, which could provide marked clinical benefits after PE. Further larger multicenter randomized controlled studies are needed to confirm these promising findings.

Effects of a Cardiac Rehabilitation Program Versus Usual Care on Cardiopulmonary Function in Patients With Cardiac Syndrome X.

PURPOSE: Because of uncertainty in the pathophysiological process, the treatment of cardiac syndrome X (CSX) is still under study. Addressing the effects of cardiac rehabilitation (CR) can help promote the prescription of this modality as an adjuvant therapy for these patients. METHODS: This study was performed on 30 patients with effort-induced angina pectoris using a positive exercise test and/or myocardial perfusion scan in the absence of obvious stenosis or a stenosis of <50% on coronary angiography. The patients were divided into the CR and usual care (UC) groups and underwent cardiopulmonary exercise testing with gas exchange analysis before and after the study. The Duke Treadmill Score was used to compare prognosis and survival estimates of patients. RESULTS: An increase in peak oxygen uptake ((Equation is included in full-text article.)O2) was significantly higher in the CR group than in the control group (P = .017). Resting (Equation is included in full-text article.)O2 was also increased in the CR group, but its difference with the UC group was not statistically significant. Resting O2 pulse was increased in the CR group, which significantly differed between groups (P = .041). Exercise test duration and the Duke Treadmill Score significantly increased in the CR group as compared with the UC group (P = .003 and P = .002, respectively). Also, recovery heart rate in the first minute was significantly improved in CR group. CONCLUSION: Adding a 4-wk course of CR to UC for patients with CSX not only increased the Duke Treadmill Score and exercise test duration but also improved the resting O2 pulse, peak (Equation is included in full-text article.)O2, and first-minute recovery heart rate.