Abstract
Purpose
Time spent closer to maximal effort during exercise is a potent stimulus for cardiorespiratory adaptations. The primary purpose was to determine which high-intensity interval exercise (HIIE) protocol provided the greatest physiological stimulus by comparing time spent ≥ 90% peak oxygen consumption (V̇O2peak) and heart rate reserve (HRR) in patients with coronary artery disease (CAD) in response to 3 HIIE protocols and the exercise standard of care, moderate-intensity continuous exercise (MICE). A secondary purpose was to assess protocol preference.
Methods
Fifteen patients with CAD (6 females, 67 ± 6 years) underwent measurements of V̇O2 and heart rate during MICE and three HIIE protocols all performed on a treadmill. The HIIE protocols included one with long intervals (4 × 4-min), short intervals (10 × 1-min), and an adapted version of the 4 × 4 [Toronto Rehabilitation Institute Protocol, (TRIP)]. Time spent ≥ 90% V̇O2peak and HRR were compared.
Results
Time spent ≥ 90% V̇O2peak was higher during 4 × 4 (6.3 ± 8.4 min) vs. MICE (1.7 ± 3.9 min; P = 0.001), while time spent ≥ 90% HRR was higher during 4 × 4 (6.0 ± 5.3 min) vs. MICE (0.1 ± 0.2 min; P < 0.001) and 10 × 1 (0.7 ± 0.8 min; P = 0.016). TRIP had similar responses as 10 × 1 and MICE. The 10 × 1 was the most preferred protocol and the 4 × 4 was the least preferred protocol.
Conclusion
Longer intervals (4 × 4) provided the greatest physiological stimulus compared to the exercise standard of care and shorter intervals. However, this protocol was least preferred which may impact exercise adherence. Although the physiological stimulus is important to maximize training adaptations, exercise preferences and attitudes should be considered.
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Abbreviations
- 4 × 4:
-
High-intensity interval protocol consisting of 4, 4-min intervals at 85–95% heart rate reserve separated by 3-min intervals at 60–70% heart rate reserve
- 10 × 1:
-
High-intensity interval protocol consisting of 10, 1-min intervals at 85–95% heart rate reserve separated by 1-min intervals at ≤ 20% heart rate reserve
- BMI:
-
Body mass index
- BP:
-
Blood pressure
- CAD:
-
Coronary artery disease
- HIIE:
-
High-intensity interval exercise
- HIIT:
-
High-intensity interval training
- HR:
-
Heart rate
- HRpeak:
-
Peak heart rate
- HRR:
-
Heart rate reserve
- MICE:
-
Moderate-intensity continuous exercise
- RPE:
-
Ratings of perceived exertion
- RPP:
-
Rate pressure product
- TRIP:
-
Toronto Rehabilitation Institute protocol
- V̇O2 :
-
Rate of oxygen uptake
- V̇O2peak:
-
Peak rate of oxygen uptake
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This work was supported by a Canadian Institutes of Health Research Operating Grant (MOP-130477) to J. M. Goodman.
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All authors conceived and designed the research study. VD conducted the experiments. KC and VD analyzed the data. KC, VD, and JG interpreted the data. KC wrote the manuscript and all authors reviewed and approved the manuscript.
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The study was completed with full ethical approval, according to the Declaration of Helsinki standards. The study protocol was reviewed and approved by the University Health Network and University of Toronto’s Research Ethics Boards (#16-5610-B).
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Currie, K.D., Dizonno, V., Oh, P.I. et al. Acute physiological responses to high-intensity interval exercise in patients with coronary artery disease. Eur J Appl Physiol 123, 737–747 (2023). https://doi.org/10.1007/s00421-022-05102-2
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DOI: https://doi.org/10.1007/s00421-022-05102-2