Aerobic Interval Training vs. Moderate Continuous Training in Coronary Artery Disease Patients: A Systematic Review and Meta-Analysis
- 2.1k Downloads
Exercise training improves exercise capacity (peakVO2), which is closely related to long-term survival in cardiac patients. However, it remains unclear which type and intensity of exercise is most effective for improving exercise tolerance and body weight. Individual studies suggest that aerobic interval training (AIT) might increase peakVO2 more in this population.
We conducted a meta-analysis to summarize the effects of AIT compared with moderate continuous training (MCT) on peakVO2, submaximal exercise capacity, and body weight in patients with coronary artery disease (CAD) with preserved and/or reduced left ventricular ejection fraction (LVEF).
Data sources and study selection
A systematic search was conducted and we included randomized trials comparing AIT and MCT in CAD patients lasting at least 4 weeks, reporting peakVO2 results, and published in a peer-reviewed journal up to May 2013. The primary outcome measure was peakVO2. Secondary outcomes were submaximal exercise capacity parameters and body weight.
Random- and fixed-effects models were used and data were reported as weighted means and 95 % confidence intervals (CIs).
Nine study groups were included, involving 206 patients (100 AIT, 106 MCT). Overall, AIT resulted in a significantly larger increase in peakVO2 [+1.60 mL/kg/min (95 % CI 0.18–3.02; p = 0.03)] compared with MCT. MCT seemed to be more effective in reducing body weight (−0.78 kg; 95 % CI −0.01 to 1.58; p = 0.05).
The small number of studies might have affected the power to reach significance for the secondary outcomes.
In CAD patients with preserved and/or reduced LVEF, AIT is superior to MCT for improving peakVO2, while MCT seems to be more effective in reducing body weight. However, large, well-designed, randomized controlled trials are warranted to confirm these findings.
KeywordsLeave Ventricular Ejection Fraction Exercise Training Cardiac Rehabilitation Coronary Artery Disease Patient High Intensity Exercise
L.V. is the holder of the faculty chair ‘Lifestyle and Health’ at the University of Applied Sciences, Utrecht, the Netherlands. V.A.C. is supported as a postdoctoral fellow by Research Foundation Flanders (FWO). However, no specific sources of funding were used to assist in the preparation of this review.
The authors have no potential conflicts of interest that are directly relevant to the content of this review. All authors also take responsibility for all aspects of the reliability and freedom from bias of the data presented and their discussed interpretation.
The abstract of this manuscript was accepted for oral presentation at the Congress of the European Society of Hypertension (ESH; Milan, 14–18 June 2013) and at the Congress of the European Society of Cardiology (ESC; Amsterdam, 31 August–4 September 2013).
Conflict of interest
- 1.Nichols M, Townsend N, Scarborough P, et al. European cardiovascular disease statistics: Edition 2012. http://www.ehnheart.org/cvd-statistics/cvd-statistics-2012.html. Accessed 1 Nov 2012.
- 8.Vanhees L, Rauch B, Piepoli M, on behalf of the writing group of the EACPR, et al. Importance of characteristics and modalities of physical activity and exercise in the management of cardiovascular health in individuals with cardiovascular disease (part III). Eur J Prev Cardiol. 2012;19(6):1333–56.CrossRefPubMedGoogle Scholar
- 23.Vanhees L, Geladas N, Hansen D, on behalf of the writing group of the EACPR, et al. Importance of characteristics and modalities of physical activity and exercise in the management of cardiovascular health in individuals with cardiovascular risk factors: recommendations from the EACPR (part II). Eur J Prev Cardiol. 2012;19(5):1005–33.CrossRefPubMedGoogle Scholar
- 24.The George Institute for Global Health and the University of Sydney. Physiotherapy Evidence Database; 2012. http://www.pedro.org.au/english/downloads/pedro-scale/. Accessed 18 Oct 2012.
- 41.Mezzani A, Agostoni P, Cohen-Solal A, et al. Standards for the use of cardiopulmonary exercise testing for the functional evaluation of cardiac patients: a report from the Exercise Physiology Section of the European Association for Cardiovascular Prevention and Rehabilitation. Eur J Cardiovasc Prev Rehabil. 2009;16(3):249–67.CrossRefPubMedGoogle Scholar
- 53.Thompson PD, Franklin BA, Balady GJ, et al. Exercise and acute cardiovascular events placing the risks into perspective: a scientific statement from the American Heart Association Council on Nutrition, Physical Activity, and Metabolism and the Council on Clinical Cardiology. Circulation. 2007;115(17):2358–68.CrossRefPubMedGoogle Scholar