Dall Christian H, Gustafsson Finn, Christensen Stefan B, Dela Flemming, Langberg Henning, Prescott Eva
Department of Cardiology, Bispebjerg Hospital, University of Copenhagen; Institute of Sports Medicine Copenhagen (ISMC/MRRU).
Department of Cardiology, Heart Centre, Rigshospitalet, University of Copenhagen.
J Heart Lung Transplant. 2015 Aug;34(8):1033-41. doi: 10.1016/j.healun.2015.02.001. Epub 2015 Feb 7.
Growing evidence in long-term treatment of heart transplant (HTx) recipients indicates effects of high-intensity interval training (HIIT) on several parameters, including oxygen uptake, vascular function and psychological distress. In this study we compare the effect of HIIT vs continued moderate training (CON) on vascular function, biomarkers and health-related quality of life (HRQoL) in HTx recipients.
A randomized, controlled crossover trial of stable HTx recipients >12 months after transplantation was done on patients with 12 weeks of HIIT or 12 weeks of CON, followed by a 5-month washout and crossover. Outcomes included endothelial function, arterial stiffness, biomarkers, HRQoL and markers of anxiety and depression.
Sixteen HTx recipients (mean age 52 years, 75% male) completed the study. HIIT increased VO(2peak) more than CON (between-group difference, p < 0.001). The physical component score of the 36-item Short Form (SF-36) was increased significantly in HIIT patients (p = 0.02) and borderline increased in CON patients (p = 0.07), whereas there was no significant effect of exercise on the mental component. Depression score decreased significantly in HIIT patients (p = 0.04) with no change in CON patients (p = 0.75), whereas anxiety score decreased significantly in both HIIT (p < 0.01) and CON (p < 0.05) patients. There were no between-group differences in any of the measures (all p > 0.05). Arterial stiffness and biomarkers were not changed, nor did endothelial function change after HIIT (p = 0.08) or CON (p = 0.68).
HIIT and CON are both well tolerated and induce similar improvements in physical components of HRQoL and in markers of anxiety. Effects of either training modality on vascular function and biomarkers could not be confirmed.
越来越多的证据表明，高强度间歇训练（HIIT）对心脏移植（HTx）受者的长期治疗效果体现在多个参数上，包括摄氧量、血管功能和心理困扰。在本研究中，我们比较了HIIT与持续中等强度训练（CON）对HTx受者血管功能、生物标志物和健康相关生活质量（HRQoL）的影响。
对移植后超过12个月的稳定HTx受者进行了一项随机对照交叉试验，患者分别接受12周的HIIT或12周的CON训练，随后经过5个月的洗脱期并进行交叉。观察指标包括内皮功能、动脉僵硬度、生物标志物、HRQoL以及焦虑和抑郁标志物。
16名HTx受者（平均年龄52岁，75%为男性）完成了研究。HIIT比CON更能提高峰值摄氧量（VO₂peak）（组间差异，p < 0.001）。36项简短健康调查问卷（SF - 36）的身体成分得分在HIIT患者中显著提高（p = 0.02），在CON患者中接近显著提高（p = 0.07），而运动对心理成分没有显著影响。HIIT患者的抑郁得分显著降低（p = 0.04），CON患者无变化（p = 0.75），而HIIT（p < 0.01）和CON（p < 0.05）患者的焦虑得分均显著降低。各项指标在组间均无差异（所有p > 0.05）。动脉僵硬度和生物标志物没有变化，HIIT（p = 0.08）或CON（p = 0.68）后内皮功能也未改变。
HIIT和CON的耐受性都很好，并且在HRQoL的身体成分和焦虑标志物方面诱导了相似的改善。两种训练方式对血管功能和生物标志物的影响均未得到证实。
