Six-month outcomes of a high intensity exercise programme in young patients with hypertrophic cardiomyopathy: The SAFE-HCM trial

2021 ◽  
Vol 28 (Supplement_1) ◽  
Author(s):  
J Basu ◽  
S Jayakumar ◽  
C Miles ◽  
G Parry-Williams ◽  
H Maclachlan ◽  
...  
Keyword(s):  
Hypertrophic Cardiomyopathy ◽  
High Intensity ◽  
Young Patients ◽  
Exercise Adherence ◽  
Exercise Programme ◽  
Exercise Group ◽  
Moderate Intensity ◽  
Psychological Benefits ◽  
Significant Difference

Abstract Funding Acknowledgements Type of funding sources: Other. Main funding source(s): Cardiac Risk in the Young Background Moderate intensity exercise training in older patients with hypertrophic cardiomyopathy (HCM) can improve functional capacity, without significant harm. However, younger patients are attracted to high intensity training (HIT) regimes. The SAFE-HCM study demonstrated that an individually tailored, HIT programme in young patients with HCM was feasible, and provided both health and psychological benefits, without an increase in the burden of arrhythmia. Purpose To assess whether observed benefits of a HIT programme in young patients with HCM are sustained at 6 months. Methods Eighty patients with HCM (45.7y+/-8.6) underwent baseline clinical and psychological assessment. Individuals were randomised to a 12-week HIT programme (n = 40) or usual care (n = 40). Baseline evaluation was repeated at 12 weeks (T12). Feasibility, safety, health and psychological benefits were assessed. At 12-weeks individuals were encouraged to continue with the frequency and intensity of physical activity (PA) achieved at the end of the cardiac rehabilitation programme. Participants in the exercise arm were invited to follow-up at 6 months (T6m). Results The majority (83%) of participants completed the 12-week study. At T12 there was no significant difference between groups in the composite arrhythmia safety outcome (p = 0.99). The indices of exercise capacity were significantly improved in the exercise compared to the control group; peak VO2 (+3.7ml/kg/min [CI 1.1,6.3], p = 0.006), VO2/kg at anaerobic threshold (VO2/kgAT) (+2.44ml/kg/min [CI 0.6,4.2], p = 0.009), time to AT (+115s [CI 54.3,175.9], p < 0.001) and exercise time (max ET) (+108s [CI 33.7,182.2], p = 0.005). The exercise group also demonstrated greater reduction in systolic BP (-7.3mmHg [CI -11.7,-2.8], p = 0.002), BMI (-0.8kg/m2 [CI-1.1,-0.4], p < 0.001), anxiety (-2.6 [CI-3.6,-1.6], p= <0.001) and depression (-1.1 [CI -2.0,-0.2], p = 0.015) scores. At T6m patient reported exercise adherence was comparable to baseline PA in 33/34 of the exercise group attending for follow up. Most exercise gains dissipated with the exception of time to AT (p = 0.002), max ET (p = 0.003), VO2/kgAT (p = 0.04) and anxiety score (p < 0.001) (Figure 1). There were no sustained episodes of atrial or ventricular arrhythmias. The incidence of NSVT did not differ between time points (p = 0.09). Conclusion A 12-week HIT programme in young patients with HCM offers considerable gains in fitness and psychological outcomes, with no increase in arrhythmic burden. At T6m exercise levels as well as most physiological adaptations and health benefits returned to baseline, as seen in other studies when formal participation in an exercise programme comes to an end. This highlights the importance of the implementation of strategies to encourage ongoing engagement in PA. Potential solutions include identification of barriers to exercise, as well as adoption of novel tele-rehabilation approaches. Abstract Figure 1 Sustained benefits at T6m

Safety and outcomes of a structured exercise programme in young patients with hypertrophic cardiomyopathy: the SAFE-HCM trial

2020 ◽  
Vol 41 (Supplement_2) ◽  
Author(s):  
J Basu ◽  
P Poveda Velazquez ◽  
G Parry-Williams ◽  
C Miles ◽  
F Tilby-Jones ◽  
...  
Keyword(s):  
High Intensity ◽  
Young Patients ◽  
Exercise Programme ◽  
Exercise Group ◽  
High Intensity Exercise ◽  
Moderate Intensity ◽  
Educational Materials ◽  
Moderate Intensity Exercise ◽  
Significant Difference ◽  
Exercise Induced

Abstract Background Contemporary studies in hypertrophic cardiomyopathy (HCM) suggest that moderate intensity exercise can improve cardiorespiratory fitness without raising significant safety concerns. Although low/moderate intensity exercise may be appropriate for older HCM patients, it is unlikely to attract younger, often asymptomatic patients, who wish to engage in higher intensity regimes. Purpose To assess the feasibility, safety and outcomes of an individually tailored, high intensity exercise programme in young patients with HCM. Methods In this RCT, 80 patients with HCM, aged 16–60 (mean 45.7, [SD8.6]) underwent baseline testing with ECG, echocardiography, blood testing, exercise testing, 48-hour ECG and psychological assessment. Individuals were randomised to a 12-week supervised exercise programme (HRR increased from 70–85%) (n=40) or usual activity (n=40). Baseline investigations were repeated at 12 weeks. Feasibility was assessed by a) recruitment, adherence and retention rates; b) staffing ratios and logistics; c) acceptability of the intervention/educational materials. Safety was assessed as a composite of 1) cardiovascular death, 2) cardiac arrest, 3) device therapy, 4) exercise induced syncope, 5) sustained/non-sustained (NS) ventricular tachycardia (VT) or 6) sustained atrial arrhythmias. Secondary outcomes included health and psychological benefits. Results 67 individuals (82.5%) completed the study. Reasons for refusal included travel, work and family commitments. The majority (64.7%) of exercising individuals progressed to 85%HRR. Resource requirements were similar to other programmes. All individuals felt supported, more confident to exercise, and found educational materials clear and informative. There was no significant difference between groups for the composite safety outcome. One individual experienced exercise induced syncope due to ventricular standstill (exercise) and another sustained VT (control). Both required device implantation. There was no significant difference between groups in episodes of NSVT (p=0.573) or ectopic burden (p=0.729). At 12 weeks, exercise group participants demonstrated greater activity levels (+1.1 hours [CI 0.2–2.1], p=0.024). The change in peak aerobic capacity (+255.2ml/min [CI 93.2–417.1], p=0.003), time to anaerobic threshold (AT) (+115s [CI 54.2–176.0], p<0.001), total exercise time (+108.1s [CI 33.1–183.0], p=0.005) and oxygen uptake at AT (+2.44ml/kg/min [CI 0.6–4.2], p=0.009) were all significantly greater in the exercise group. HADS anxiety (p<0.001) and depression (p=0.017) scores demonstrated the greatest reduction in the exercise group. Conclusions A high intensity exercise programme is feasible in young patients with HCM, with considerable gains in cardiorespiratory fitness and psychological outcomes. Importantly, arrhythmia burden was not increased in the exercise group. Further research is still required to assess the long-term safety of high intensity exercise in the HCM population. Funding Acknowledgement Type of funding source: Other. Main funding source(s): Cardiac Risk in the Young

scholarly journals Exercisers’ Affective and Enjoyment Responses: A Meta-Analytic and Meta-Regression Review

2021 ◽  
pp. 003151252110242
Author(s):  
Vagner Deuel de Oliveira Tavares ◽  
Felipe Barreto Schuch ◽  
Gavin Tempest ◽  
Gaynor Parfitt ◽  
Leônidas Oliveira Neto ◽  
...  
Keyword(s):  
High Intensity ◽  
Meta Analysis ◽  
Exercise Adherence ◽  
Interval Training ◽  
Affective Responses ◽  
Moderate Intensity ◽  
Continuous Training ◽  
Post Exercise ◽  
Significant Difference ◽  
Meta Regression

Affective responses and enjoyment of exercise mediate exercise adherence, but previous research findings have failed to examine nuances that may moderate this relationship. We examined the effects of exercise on affective and enjoyment responses during and post exercise through a systematic literature review and meta-regression analysis. We searched major databases up to July 9, 2020 for studies evaluating healthy adults’ acute and chronic responses to exercise, using either of The Feeling Scale or Physical Activity Enjoyment Scales. We calculated effect size (ES) values of 20 unique studies (397 participants; 40% females) as standardized differences in the means and expressed them as Hedges’ g, together with the 95% confidence interval (95%CI). Among acute studies examining affective responses, we found a greater positive effect post exercise for continuous training (CT) compared to high intensity interval training (HIIT) ( g = −0.61; 95%CI = −1.11, −0.10; p < .018), but there was no significant difference between these modes for effects during exercise. Subgroup analyses revealed that moderate, and not high intensity, CT, compared to HIIT, resulted in significantly greater positive affective responses ( g = −1.09; 95%CI = −1.88, −0.30; p < .006). In contrast, enjoyment was greater for HIIT, compared to CT ( g = 0.75; 95%CI = 0.17, −1.13; p = .010), but CT intensity did not influence this result. Among chronic studies, there was greater enjoyment following HIIT compared to CT, but these studies were too few to permit meta-analysis. We concluded that an acute bout of moderate intensity CT is more pleasurable, when measured post exercise than HIIT, but enjoyment is greater following HIIT, perhaps due to an interaction between effort, discomfort, time efficiency and constantly changing stimuli.

scholarly journals 3 Safety and outcomes of a high intensity exercise programme in young patients with hypertrophic cardiomyopathy: the safe-HCM study

2021 ◽  
Author(s):  
Joyee Basu ◽  
Shruti Jayakumar ◽  
Christopher Miles ◽  
Gemma Parry-Williams ◽  
Hamish MacLachlan ◽  
...  
Keyword(s):  
Hypertrophic Cardiomyopathy ◽  
High Intensity ◽  
Young Patients ◽  
Exercise Programme ◽  
High Intensity Exercise

Comparison of High-Intensity Training Versus Moderate-Intensity Continuous Training on Cardiorespiratory Fitness and Body Fat Percentage in Persons With Overweight or Obesity: A Systematic Review and Meta-Analysis of Randomized Controlled Trials

2021 ◽  
pp. 1-14
Author(s):  
Nivash Rugbeer ◽  
Demitri Constantinou ◽  
Georgia Torres
Keyword(s):  
Body Fat ◽  
High Intensity ◽  
Mean Difference ◽  
Moderate Intensity ◽  
Body Fat Percentage ◽  
Fat Percentage ◽  
Continuous Training ◽  
High Intensity Training ◽  
Significant Difference ◽  
Intensity Training

Background: High-intensity training is comprised of sprint interval training (SIT) and high-intensity interval training (HIIT). This study compared high-intensity training with moderate-intensity continuous training (MICT) on cardiorespiratory fitness (CRF) and body fat percentage for overweight or obese persons. Methods: A systematic search of randomized controlled trials using the health science databases occurred up to April, 2020. Twenty-six studies were included for complete analysis. A total of 784 participations were analyzed. The unstandardized mean difference for each outcome measurement was extracted from the studies and pooled with the random effects model. Results: MICT was significantly better at improving CRF compared with SIT (mean difference = −0.92; 95% confidence interval, −1.63 to −0.21; P = .01; I2 = 10%). Furthermore, there was no significant difference between MICT versus HIIT on CRF (mean difference = −0.52; 95% confidence interval, −1.18 to 0.13; P = .12; I2 = 23%). There was no significant difference in body fat percentage between MICT versus HIIT and MICT versus SIT. Conclusions: MICT was significantly better at improving CRF than SIT in overweight or obese persons.

Abstract 14433: High Intensity Exercise Training Safely Increases Cardiorespiratory Fitness in Patients With Hypertrophic Cardiomyopathy

Circulation ◽  
2020 ◽  
Vol 142 (Suppl_3) ◽  
Author(s):  
Katrin A Dias ◽  
James P Macnamara ◽  
Christopher M Hearon ◽  
Mitchel Samels ◽  
Aslan Turer ◽  
...  
Keyword(s):  
Hypertrophic Cardiomyopathy ◽  
Cardiorespiratory Fitness ◽  
High Intensity ◽  
Training Session ◽  
Interval Training ◽  
High Intensity Exercise ◽  
Moderate Intensity ◽  
Moderate Intensity Exercise ◽  
Wide Complex Tachycardia ◽  
High Intensity Interval

Introduction: Patients with hypertrophic cardiomyopathy (HCM) are excluded from high intensity activities due to perceived fear of sudden cardiac death. Observational data from athletes with HCM suggest that engaging in high intensity exercise (HIE) may be safe and is associated with higher cardiorespiratory fitness. Whether HIE can safely elicit a superior increase in fitness compared to moderate intensity exercise in patients with HCM is unclear. Methods: Nine HCM patients (49 ± 7 years, 3 female) were assessed for maximal oxygen uptake (VO 2 max, Douglas Bag method), cardiac output (Q c , acetylene rebreathing), and peripheral oxygen extraction (av-O 2 diff, Fick equation) before randomization and after 5 months of MIE or HIE training. Patients completed 3-4 sessions of MIE each week, while the HIE group also incorporated 1-2 supervised high intensity interval training sessions/week from month 3 onwards. Arrhythmias were monitored via pre-existing implantable cardiac defibrillators or implantable loop recorders placed prior to training. Results: Five months of MIE increased absolute VO 2 max by 3% and relative VO 2 max by 4%, while HIE consistently increased absolute VO 2 max by 6% and relative VO 2 max by 5% (Figure). Maximal Q c did not change after MIE but increased in all HIE patients (+1.2L/min, 95% CI -1.4 to 3.9), while maximal av-O 2 diff remained stable in both groups. Training compliance was 84 ± 15% in HIE and 93 ± 11% in MIE. There were no serious exercise-related adverse events in either group though two HIE subjects had arrhythmias at rest: 1) 14-beat run of wide complex tachycardia of uncertain mechanism given underlying conduction disease prior to a training session, and 2) 11 beats of non-sustained ventricular tachycardia prior to post exercise testing. Conclusions: Preliminary findings show that five months of HIE safely and consistently increased cardiorespiratory fitness in patients with HCM, though overall the improvements were comparable to MIE.

High-intensity interval running is perceived to be more enjoyable than moderate-intensity continuous exercise: Implications for exercise adherence

2011 ◽  
Vol 29 (6) ◽  
pp. 547-553 ◽  
Author(s):  
Jonathan D. Bartlett ◽  
Graeme L. Close ◽  
Don P. M. MacLaren ◽  
Warren Gregson ◽  
Barry Drust ◽  
...  
Keyword(s):  
High Intensity ◽  
Exercise Adherence ◽  
Moderate Intensity ◽  
Continuous Exercise ◽  
High Intensity Interval

scholarly journals PO-098 Effect of HIIT on mitochondrial telomerase of skeletal muscle in aged rats

2018 ◽  
Vol 1 (3) ◽  
Author(s):  
Yiyi Liu ◽  
Hao Su ◽  
Zhongye Jiang ◽  
Tianhao Wen ◽  
Jia Shao
Keyword(s):  
Skeletal Muscle ◽  
Oxygen Uptake ◽  
Intervention Group ◽  
Exercise Group ◽  
Moderate Intensity ◽  
Control Group ◽  
Moderate Intensity Exercise ◽  
Aging Rats ◽  
Age Related ◽  
Significant Difference

Objective The HIIT and moderate-intensity exercise are two different exercise models among the public fitness. In recent years, HIIT become more and more popular, unfortunately, there is a tremendous lack of research being done effects of mitochondrial reverse transcriptase (TERT) on age-related degeneration of skeletal muscle by HIIT. The purpose of this study was to compare the HIIT group and moderate-intensity group, and research difference of telomerase expression and cardiopulmonary endurance between the exercise group and the quiet control group was discussed. Methods  fifty-nine male Wistar rats were divided into three groups at random: control group (Q=19), moderate-intensity intervention group (M=20), and HIIT intervention group (H=20). The rats in Q group did not any exercise, and the rats in M group developed the exercise with 60% VO2max intensity for 8 weeks. H group did a training program for an 8-week exercise with alternating 40%, 60%, and 80% VO2max intensities. The rats in the experimental group were exercised for 50 minutes every day and trained for 5 days per week. After the baseline value group was sampled, each group of rats was selected after the training reached the specified number of weeks (4 and 8 weeks), and the maximum oxygen uptake test was performed before the material was taken. Single factor analysis of variance were used to assess differences in VO2max, and expression of protein between conditions. Results It was found that H group VO2max was significantly higher than M group and Q group (P<0.05). At same time, the mTERT expression of the M group at the 4th week was significantly higher than that of the Q group (P<0.05). The mTERT expression in group H was significantly higher than that in group Q at week 8 (P<0.05).There was no significant difference between the H group and the Q group at 8th week (P<0.05). Conclusions 1. HIIT exercise lasting for 8 weeks can effectively inhibit the decrease of maximal oxygen uptake in aging rats compared with moderate exercise. 2. HIIT training for 8 weeks promotes the expression of mTERT; 3. The maintenance of VO2max in aging rats may be related to the enhancement of mitochondrial antioxidant function by HIIT-promoted TERT to mitochondrial translocation.

scholarly journals PO-271 Effects of accumulated exercise with different intensities on insulin resistance in mice

2018 ◽  
Vol 1 (5) ◽  
Author(s):  
Yuli Zhang ◽  
Songtao Wang ◽  
Fei Liang ◽  
Xiangyu Shuai ◽  
Weibao Liang ◽  
...  
Keyword(s):  
Insulin Resistance ◽  
Body Weight ◽  
High Intensity ◽  
Exercise Intervention ◽  
Exercise Program ◽  
Exercise Group ◽  
The Body ◽  
Moderate Intensity ◽  
Control Group ◽  
Continuous Exercise

Objective The aim of this study was to investigate the effect of 8-week moderate-intensity and high-intensity accumulated exercise on insulin resistance in mice, compared with the moderate intensity continuous exercise with equal workload, which will provide an experimental reference for seeking a more reasonable and effective exercise program to break sedentary behavior and improve metabolic diseases such as IR. Methods Eighty 4-week-old C57BL/6J mice were randomly divided into normal diet group (group C) and high-fat diet group (group H), fed with different diet. At the 10th weekend, insulin resistance model was judged by OGTT curve (AUC) and fasting blood glucose. All mice with insulin resistance were randomly divided into four groups: IR control group (IC), IR moderate-intensity continuous exercise group (IE), IR moderate-intensity accumulated exercise group (IM), IR high-intensity accumulated exercise group (IH), retained normal diet control group (C), with 12 mice for each group. All groups were fed with normal feed. The three exercise-related group performed an 8-week’s treadmill exercise program with equal workload (involve preparation and relaxation activities,0°platform slope, 5 days/week). For IE group, mice run 50min continuously with the velocity of 11m/min. For IM group，mice exercised 12.5 min per session, total 4 sessions per day, with 3-hour’s interval and the velocity of 11m/min. The IH group performed an alike exercise program with IM group, except the running speed (19m/min) and exercise time (7.5min). On the 8th weekend of exercise, FBG, OCTT, FINS, HOME- IR, and ISI were tested for each groups. Results 1. Compared with group C, body weight, FBG and OGTT-AUC were significantly increased in group H (P<0.05 or P<0.01). 76% mice were induced to insulin resistance successfully.  2. Before and after exercise intervention of 8 weeks, there were no significant changes in body weight and OGTT-AUC, while the FBG was significantly increased in IC group (P<0.05). Body weight, FBG, and OGTT-AUC significantly decreased in IE group, IM group and IH group (P<0.05 or P<0.01). 3. After 8 weeks of exercise intervention, the FBG in the IE group, IM group, and IH group were significantly lower than that in C group (P<0.05 or P<0.01). Compared with the IC group, the FBG, FINS, OGTT-AUC, and HOME-IR in IM group, IH group and IE group were lower than those in the IC group (P<0.05 or P<0.01). Compared with the IE group, the body weight and HOME-IR index of IH group were significantly lower than those in IE group (P<0.01). Compared with IH group, the HOME-IR in IH group was lower than that in IM group (P<0.05); There was no significant difference between IM group and IE group. Conclusions 1. Chronic moderate-intensity continuous exercise, moderate-intensity accumulated exercise, and high-intensity accumulated exercise all can effectively improve the glucose metabolism and insulin resistance in IR mice. 2.Compared with moderate-intensity accumulated exercise and moderate-intensity continuous exercise, the high-intensity accumulated exercise with equal workload is more effective in reducing the body weight and improving insulin resistance in IR mice.  

scholarly journals Cognitive effectiveness of high-intensity interval training for individuals with methamphetamine dependence: a study protocol for randomised controlled trial

Trials ◽  
2021 ◽  
Vol 22 (1) ◽  
Author(s):  
Shen Menglu ◽  
Yang Suyong ◽  
Wang Xiaoyan ◽  
Wolfgang I. Schöllhorn ◽  
Zhu Dong
Keyword(s):  
Cognitive Functions ◽  
High Intensity ◽  
Interval Training ◽  
Moderate Intensity ◽  
Good Effect ◽  
High Intensity Interval Training ◽  
Link Type ◽  
Short Period ◽  
High Intensity Interval

Abstract Introduction Cognitive deficit is a common syndrome of methamphetamine (MA) dependence. It is related to decision-making, control ability, and social functioning. High-intensity interval training (HIIT) is a training technique that requires people to work out at full intensity during a short period. Many studies have already shown the potential effects of HIIT on cognitive functions. The purpose of this trial is to evaluate the cognitive effects of HIIT on individuals with MA dependence. Methods and analysis A total of 240 individuals with MA dependence will be randomly assigned to the HIIT group, moderate-intensity continuous training (MICT) group and control (CON) group. HIIT will consist of a 24-min HIIT exercise on a treadmill. MICT will consist of a 1-h body–mind exercise. CON will be their traditional intervention. The experimental period will be 12 months with 3 interventions weekly for the first 6 months and follow-up for the next 6 months. All subjects will be given cognitive tests at baseline, after intervention and at follow-up. Cognitive performances will be compared by a mixed-model analysis for repeated measures. Discussion HIIT training may reduce illicit drug cravings amongst individuals with MA dependence; hence, HIIT may have a good effect on the cognitive functions, such as memory and executive function, of individuals with MA dependence. Trial registration Chinese Clinical Trial Registry ChiCTR2000032492. Registered on April 30, 2020 (http://www.chictr.org.cn/edit.aspx?pid=52127&htm=4)

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