HIIT Programs for Cardiac Rehabilitation

Overseen By Jenna-Lee Taylor, PhD

Age: 18+

Sex: Any

Trial Phase: Academic

Sponsor: Mayo Clinic

Disqualifiers: Coronary bypass, Heart transplant, others

No Placebo Group All trial participants will receive the active study treatment (no placebo)

Compensation: Varies

Number of Visits: Unknown

Duration: 12 weeks

30 Participants Needed

Trial Summary

What is the purpose of this trial?

The purpose of the study is to examine the effect of two different high intensity interval training (HIIT) prescription approaches on improving fitness, heart function, and the ability of the body's muscles to receive oxygen.

Will I have to stop taking my current medications?

The trial information does not specify whether you need to stop taking your current medications. It's best to discuss this with the trial coordinators or your doctor.

What data supports the effectiveness of the treatment Constant High Intensity Interval Training (CON-HIIT) and Progressive High Intensity Interval Training (PRO-HIIT) for cardiac rehabilitation?

Research shows that high-intensity interval training (HIIT) is a safe and effective alternative to moderate-intensity continuous training for improving heart health in older patients with cardiovascular disease. Studies have found that HIIT can lead to greater improvements in cardiorespiratory fitness compared to moderate-intensity training. ^{1 2 3 4 5}

Is high-intensity interval training (HIIT) safe for cardiac rehabilitation?

Research shows that HIIT is generally safe for cardiac rehabilitation, with a low rate of major adverse cardiovascular events. In a study of 1117 participants, only one major cardiovascular event occurred per 17,083 training sessions, and minor events were mostly musculoskeletal complaints. ^{3 4 6 7 8}

How does the HIIT treatment for cardiac rehabilitation differ from other treatments?

The HIIT treatment for cardiac rehabilitation is unique because it involves short bursts of high-intensity exercise followed by rest, which can improve heart and lung fitness more effectively than traditional continuous exercise. This approach is still being studied to determine the best way to use it for heart conditions like coronary artery disease and heart failure. ^{2 4 8 9 10}

Research Team

Amanda R Bonikowske, PhD

Principal Investigator

Mayo Clinic

Eligibility Criteria

This trial is for adults over 18 who speak English and can consent to participate. It's specifically for those with certain heart conditions like acute coronary syndrome or stable angina, who are recommended non-surgical cardiac rehab. People post-heart surgery, with heart devices, or unable to do structured exercise aren't eligible.

Inclusion Criteria

I need heart rehab for a condition that didn't require surgery.

Able to provide consent

English speaking

Exclusion Criteria

Patients who are unable to engage in a regularly structured exercise training program as part of a clinically indicated center-based outpatient cardiac rehabilitation program are not eligible

I was referred to cardiac rehab after heart surgery or because I have a ventricular assist device.

Patients unable/unwilling to provide informed consent will not be enrolled

Timeline

Screening

Participants are screened for eligibility to participate in the trial

2-4 weeks

Treatment

Participants undergo a 12-week high-intensity interval training (HIIT) program with either progressive or standard-care interval training approaches

12 weeks

Weekly sessions

Follow-up

Participants are monitored for changes in cardiorepiratory fitness, oxygen uptake, and other health metrics

4 weeks

Treatment Details

Interventions

• Constant High Intensity Interval Training (CON-HIIT)
• Progressive High Intensity Interval Training (PRO-HIIT)

Trial Overview The study compares two types of high-intensity interval training (HIIT) in cardiac rehab: Constant HIIT (CON-HIIT) and Progressive HIIT (PRO-HIIT). The goal is to see which one better improves fitness levels, heart function, and muscle oxygen uptake.

Participant Groups

Group I: Progressive interval-training group Experimental Treatment 1 Intervention

Subjects will complete an interval-training program during which the number of intervals and the duration of each interval are changed across the 12-week cardiac rehabilitation program.

Group II: Standard-care interval-training group Active Control 1 Intervention

Subjects will complete a standard interval-training program that remains constant for the entire 12 weeks of cardiac rehabilitation.

Who Is Running the Clinical Trial?

Mayo Clinic

Lead Sponsor

Trials

3,427

Recruited

3,221,000+

Findings from Research

In a study of 238 patients undergoing cardiac rehabilitation after acute coronary syndrome, exercise intensity significantly increased over 8 weeks, indicating improved functional capacity.

Patients experienced lower perceived exertion and heart rates at higher exercise intensities, suggesting that they could handle more intense workouts without feeling as fatigued, which is beneficial for their recovery.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

Progression of aerobic exercise intensity in a cardiac rehabilitation program. Amorim, H., Cadilha, R., Parada, F., et al.[2021]

Higher-intensity interval training (HIIT) was safely integrated into a standard cardiac rehabilitation program for 39 patients, with no hospitalizations reported during or after exercise, indicating its safety for patients with stable coronary heart disease.

HIIT led to a significantly greater improvement in peak oxygen uptake (3.6 mL·kg⁻¹·min⁻¹) compared to moderate-intensity continuous training (1.7 mL·kg⁻¹·min⁻¹), demonstrating its efficacy in enhancing cardiorespiratory fitness.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

Greater improvement in cardiorespiratory fitness using higher-intensity interval training in the standard cardiac rehabilitation setting. Keteyian, SJ., Hibner, BA., Bronsteen, K., et al.[2022]

In a study of 81 heart disease patients with very high cardiovascular risk, both moderate and high-intensity interval training (MIIT and HIIT) were found to be safe, with no adverse outcomes reported during the training.

While there were no statistically significant differences in overall exercise improvements between the training types, the HIIT group showed a trend towards greater improvements in exercise tolerance, suggesting it may be more effective than continuous moderate intensity training (MICT).

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

Safety and improvement in exercise tolerance with interval training vs moderate-intensity continuous training in heart disease patient of very high cardiovascular risk. Pineda-García, AD., Lara-Vargas, JA., Ku-González, A., et al.[2022]

Low-volume high-intensity interval training (HIIT) is a feasible and well-tolerated option for patients with chronic heart failure, showing similar improvements in cardiorespiratory fitness and functional capacity compared to continuous aerobic exercise over a 6-month period.

Both training methods resulted in significant improvements in peak oxygen uptake and functional measures like sit-to-stand and gait speed, but neither method led to changes in quality of life or heart rate variability, indicating that while HIIT is effective, it does not outperform traditional aerobic training.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

Low-volume high-intensity interval training vs continuous aerobic cycling in patients with chronic heart failure: a pragmatic randomised clinical trial of feasibility and effectiveness. Koufaki, P., Mercer, TH., George, KP., et al.[2022]

High-intensity interval training (HIIT) is a safe and effective alternative to traditional moderate-intensity training for older patients with cardiovascular disease (CVD), particularly in cardiac rehabilitation settings.

HIIT can lead to significant improvements in peak oxygen uptake (Vo2) and overall cardiovascular health in older adults with conditions like coronary artery disease and heart failure.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

High-Intensity Interval Training in Cardiac Rehabilitation. Dun, Y., Smith, JR., Liu, S., et al.[2020]

High-intensity interval training (HIIT) is as effective, if not more so, than traditional moderate-intensity continuous training (MICT) for patients with cardiovascular disease, based on a systematic review of 23 studies involving 1117 participants.

The safety profile of HIIT in cardiac rehabilitation is promising, with only one major cardiovascular adverse event reported per 17,083 training sessions, indicating that HIIT can be safely implemented in this population.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

High-Intensity Interval Training for Patients With Cardiovascular Disease-Is It Safe? A Systematic Review. Wewege, MA., Ahn, D., Yu, J., et al.[2021]

A scoping review of 69 studies on high-intensity interval training (HIIT) in older adults found that HIIT protocols are generally well-tolerated and can provide significant health benefits, particularly in improving cardiorespiratory fitness.

Most research has focused on healthy older adults, highlighting a need for larger studies and more investigation into HIIT's effects on older adults with various health conditions.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

High-Intensity Interval Training in Older Adults: a Scoping Review. Marriott, CFS., Petrella, AFM., Marriott, ECS., et al.[2021]

In a 12-week cardiac rehabilitation program involving 82 male patients, high-intensity interval training (HIIT) combined with continuous endurance training (CET) led to greater reductions in ventilatory equivalents for oxygen (EqO2) and carbon dioxide (EqCO2) compared to CET alone, particularly at higher exercise intensities.

Both HIIT+CET and CET were equally effective in managing blood lactate levels, indicating that while HIIT may enhance certain aspects of exercise performance, it does not lead to increased lactate accumulation during high-intensity efforts.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

Effects of high-intensity interval training on trajectories of gas-exchange measures and blood lactate concentrations during cardiopulmonary exercise tests in cardiac rehabilitation-A randomized controlled trial. Heber, S., Gleiss, A., Kuzdas-Sallaberger, M., et al.[2023]

High-interval intensity training (HIT) significantly improves peak VO2 in patients with coronary artery disease (CAD) and heart failure (HF), with HF patients showing a greater increase in peak VO2 after training.

For optimal results in HF patients, recovery intervals should be active and maintained between 40% and 60% of peak VO2, and training frequency should be at least 3 days per week, while CAD patients benefit from a minimum of 2 days per week.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

High-intensity Interval Training Dosage for Heart Failure and Coronary Artery Disease Cardiac Rehabilitation. A Systematic Review and Meta-analysis. Ballesta García, I., Rubio Arias, JÁ., Ramos Campo, DJ., et al.[2019]

In a study involving 382 patients with coronary artery disease, low-volume high-intensity interval training (HIIT) significantly improved cardiorespiratory fitness more than moderate-intensity steady-state (MISS) exercise over an 8-week period, with an average increase of 2.37 mL.kg-1.min-1 for HIIT compared to 1.32 mL.kg-1.min-1 for MISS.

The study found that low-volume HIIT is safe and well-tolerated, with only one serious adverse event possibly related to HIIT, suggesting it can be a beneficial alternative or addition to traditional exercise programs in cardiac rehabilitation.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

High-intensity interval training in cardiac rehabilitation: a multi-centre randomized controlled trial. McGregor, G., Powell, R., Begg, B., et al.[2023]

References

1. Spain pubmed.ncbi.nlm.nih.gov

Progression of aerobic exercise intensity in a cardiac rehabilitation program. [2021]

2. United States pubmed.ncbi.nlm.nih.gov

Greater improvement in cardiorespiratory fitness using higher-intensity interval training in the standard cardiac rehabilitation setting. [2022]

3. Mexico pubmed.ncbi.nlm.nih.gov

Safety and improvement in exercise tolerance with interval training vs moderate-intensity continuous training in heart disease patient of very high cardiovascular risk. [2022]

4. Sweden pubmed.ncbi.nlm.nih.gov

Low-volume high-intensity interval training vs continuous aerobic cycling in patients with chronic heart failure: a pragmatic randomised clinical trial of feasibility and effectiveness. [2022]

5. United States pubmed.ncbi.nlm.nih.gov

High-Intensity Interval Training in Cardiac Rehabilitation. [2020]

6. England pubmed.ncbi.nlm.nih.gov

High-Intensity Interval Training for Patients With Cardiovascular Disease-Is It Safe? A Systematic Review. [2021]

7. Switzerland pubmed.ncbi.nlm.nih.gov

High-Intensity Interval Training in Older Adults: a Scoping Review. [2021]

8. Denmark pubmed.ncbi.nlm.nih.gov

Effects of high-intensity interval training on trajectories of gas-exchange measures and blood lactate concentrations during cardiopulmonary exercise tests in cardiac rehabilitation-A randomized controlled trial. [2023]

9. Spain pubmed.ncbi.nlm.nih.gov

High-intensity Interval Training Dosage for Heart Failure and Coronary Artery Disease Cardiac Rehabilitation. A Systematic Review and Meta-analysis. [2019]

10. England pubmed.ncbi.nlm.nih.gov

High-intensity interval training in cardiac rehabilitation: a multi-centre randomized controlled trial. [2023]