Pattyn Nele, Coeckelberghs Ellen, Buys Roselien, Cornelissen Véronique A, Vanhees Luc
Department of Rehabilitation Sciences, KU Leuven, Leuven, Tervuursevest 101, B 1501, 3001, Heverlee, Belgium,
Sports Med. 2014 May;44(5):687-700. doi: 10.1007/s40279-014-0158-x.
Exercise training improves exercise capacity (peakVO2), which is closely related to long-term survival in cardiac patients. However, it remains unclear which type and intensity of exercise is most effective for improving exercise tolerance and body weight. Individual studies suggest that aerobic interval training (AIT) might increase peakVO2 more in this population.
We conducted a meta-analysis to summarize the effects of AIT compared with moderate continuous training (MCT) on peakVO2, submaximal exercise capacity, and body weight in patients with coronary artery disease (CAD) with preserved and/or reduced left ventricular ejection fraction (LVEF).
A systematic search was conducted and we included randomized trials comparing AIT and MCT in CAD patients lasting at least 4 weeks, reporting peakVO2 results, and published in a peer-reviewed journal up to May 2013. The primary outcome measure was peakVO2. Secondary outcomes were submaximal exercise capacity parameters and body weight.
Random- and fixed-effects models were used and data were reported as weighted means and 95% confidence intervals (CIs).
Nine study groups were included, involving 206 patients (100 AIT, 106 MCT). Overall, AIT resulted in a significantly larger increase in peakVO2 [+1.60 mL/kg/min (95% CI 0.18-3.02; p = 0.03)] compared with MCT. MCT seemed to be more effective in reducing body weight (-0.78 kg; 95% CI -0.01 to 1.58; p = 0.05).
The small number of studies might have affected the power to reach significance for the secondary outcomes.
In CAD patients with preserved and/or reduced LVEF, AIT is superior to MCT for improving peakVO2, while MCT seems to be more effective in reducing body weight. However, large, well-designed, randomized controlled trials are warranted to confirm these findings.
运动训练可提高运动能力（峰值摄氧量），这与心脏病患者的长期生存率密切相关。然而，哪种类型和强度的运动对提高运动耐量和体重最有效仍不清楚。个别研究表明，有氧间歇训练（AIT）可能使该人群的峰值摄氧量增加更多。
我们进行了一项荟萃分析，以总结与中度持续训练（MCT）相比，有氧间歇训练（AIT）对左心室射血分数（LVEF）正常和/或降低的冠心病（CAD）患者的峰值摄氧量、次最大运动能力和体重的影响。
进行了系统检索，纳入了比较AIT和MCT的随机试验，试验对象为CAD患者，持续时间至少4周，报告了峰值摄氧量结果，并发表于截至2013年5月的同行评审期刊。主要结局指标为峰值摄氧量。次要结局为次最大运动能力参数和体重。
采用随机效应模型和固定效应模型，数据以加权均值和95%置信区间（CI）表示。
纳入9个研究组，共206例患者（100例AIT组，106例MCT组）。总体而言，与MCT相比，AIT使峰值摄氧量显著增加更多[+1.60 mL/kg/min（95%CI 0.18 - 3.02；p = 0.03）]。MCT在减轻体重方面似乎更有效（-0.78 kg；95%CI -0.01至1.58；p = 0.05）。
研究数量较少可能影响了次要结局达到显著性的检验效能。
在LVEF正常和/或降低的CAD患者中，AIT在提高峰值摄氧量方面优于MCT，而MCT在减轻体重方面似乎更有效。然而，需要大型、设计良好的随机对照试验来证实这些发现。
