The Impact of Aerobic Training Periodisation on Global and Regional Right Ventricular Strain in Coronary Heart Disease

Objective:Linear aerobic training periodisation (LP) is recommended in patients with coronary heart disease (CHD). However, the effects of training periodisation on right heart mechanics in CHD patients have never been examined. This study aimed to explore the effects of LP and non-linear periodisation (NLP) on right heart mechanics. Methods: We prospectively randomised CHD patients to 12 weeks aerobic training with LP or NLP. Whereas there was a weekly increase in energy expenditure with LP, there was a steeper increase during the first 3 weeks followed by a decrease the fourth week with NLP. Echocardiography at baseline and after the training period was performed to assess right ventricular free wall (RVFW) and right atrial strain. Results: Thirty CHD patients were included (NLP, n=16; LP, n=14). Traditional right and left heart parameters showed no significant time effect. There was a decrease of RVFW strain with time in both groups (+1.3±0.9% with NLP, and +1.5±0.8% with LP; p=0.033). Mid-ventricular RVFW strain changed significantly with time (+2.0±1.3% with NLP, and from +2.3±1.2% with LP; p=0.025). There was no time effect on right atrial strain. Conclusions: In stable CHD patients, LP and NLP resulted in right ventricular strain decrements with a segment-specific pattern. This study was registered on ClinicalTrials.gov (identifier number: NCT03414996). Novelty: • In stable coronary heart disease patients, both linear and non-linear aerobic training periodisation programs result in right ventricular strain decrements with time, particularly in the mid-ventricular segment • Traditional right and left heart parameters, and right atrial strain showed no significant time effect in both 12 weeks aerobic training periodisation programs