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High-intensity interval training versus moderate-intensity continuous training in patients with heart failure: a systematic review and meta-analysis

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Abstract

The effects of high-intensity interval training (HIIT) in patients with heart failure (HF) remain controversial. This systematic review and meta-analysis aimed to examine the efficacy of HIIT versus moderate-intensity continuous aerobic training (MCT) on exercise tolerance in patients with HF. We searched for studies published up to 4 March 2022 in Embase, MEDLINE, PubMed, and the Cochrane Library with no limitations on data, language, or publication status. We included randomized controlled trials comparing the efficacy of HIIT and MCT on peak oxygen uptake (VO2), as a measure of exercise tolerance. We pooled the data on peak VO2, compared HIIT to MCT, and conducted a sub-analysis if there was heterogeneity in the result. We identified 15 randomized controlled trials with 557 patients. Our meta-analysis showed that participants who underwent HIIT achieved a significantly higher peak VO2 than those who underwent MCT (mean difference 1.46 ml/kg/min, 95% confidence interval 0.39 to 2.53; participants = 557; studies = 15; I2 = 65.7%; very low-quality evidence). The meta-regression analysis, conducted as a sub-analysis to explore possible causes of heterogeneity, revealed that the difference in peak VO2 between HIIT and MCT was inversely associated with body mass index (r =  − 0.508, p = 0.028, 95% confidence interval − 0.95 to − 0.07). Our systematic review showed that HIIT achieved a higher peak VO2 than MCT in patients with HF. In addition, HIIT may be more effective in improving exercise tolerance in patients with low body mass index.

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Acknowledgements

We would like to thank Editage (www.editage.com) for English language editing.

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Authors and Affiliations

  1. Berlin Institute of Health Center for Regenerative Therapies (BCRT), Charité – Universitätsmedizin Berlin, Berlin, Germany

    Masatsugu Okamura

  2. Department of Rehabilitation Medicine, Yokohama City University School of Medicine, Yokohama, Japan

    Masatsugu Okamura

  3. Department of Rehabilitation, Osaka Metropolitan University Hospital, Osaka, Japan

    Masashi Shimizu

  4. Department of Rehabilitation, Shinshu University Hospital, Matsumoto, Japan

    Shuhei Yamamoto

  5. Department of Respiratory Medicine, Iida Municipal Hospital, Iida, Japan

    Kenichi Nishie

  6. Department of Medical Science and Cardiorenal Medicine, Yokohama City University School of Medicine, 3-9 Fukuura, Kanazawa-Ward, Yokohama, 236-0004, Japan

    Masaaki Konishi

  7. Department of Cardiology, Yokohama City University School of Medicine, 3-9 Fukuura, Kanazawa-ku, Yokohama, 236-0004, Japan

    Masaaki Konishi

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  1. Masatsugu Okamura
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All authors, M.O., M.S., S.Y., K.N., and M.K., made substantial contributions to the conception and design, acquisition of data, or analysis and interpretation of data AND; drafted the article or revised it critically for important intellectual content AND; gave final approval of the version to be published AND; agreed to be accountable for all aspects of the work in ensuring that questions related to the accuracy or integrity of any part of the work are appropriately investigated and resolved.

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Correspondence to Masaaki Konishi.

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Okamura, M., Shimizu, M., Yamamoto, S. et al. High-intensity interval training versus moderate-intensity continuous training in patients with heart failure: a systematic review and meta-analysis. Heart Fail Rev 28, 1113–1128 (2023). https://doi.org/10.1007/s10741-023-10316-3

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