Institute of Physiology, Medical University of Vienna, Wien, Austria.
Institute of Sport Science, University of Vienna, Centre of Sports Science and University Sports, Wien, Austria.
Heart. 2020 Jan;106(1):69-79. doi: 10.1136/heartjnl-2019-315130. Epub 2019 Jul 17.
To compare effects of moderate-intensity continuous training (MICT) and high-intensity interval training (HIIT) on platelet function in patients undergoing cardiac rehabilitation, as hyper-reactive platelets are involved in atherogenesis and atherothrombosis.
In this single-centre parallel group randomised controlled trial, male patients after an acute coronary syndrome under dual antiplatelet therapy performed MICT or HIIT+MICT for 12 weeks. Main outcome was platelet reactivity measured by the half-maximal concentration (EC) of platelet agonist thrombin receptor-activating peptide-6 (TRAP-6) in terms of P-selectin expression. EC was determined at baseline, after 6 and 12 weeks, each time at physical rest and on exertion.
82 patients were randomised to MICT or HIIT+MICT. Mean (95% CI) baseline ECvalues at physical rest were 6.7 µM (6.3 µM to 7.0 µM) TRAP-6. After 6/12 weeks, 36/33 MICT and 34/28 HIIT+MICT patients were examined. HIIT+MICT patients had 0.9 µM (0.4 µM to 1.4 µM)/0.5 µM (-0.1 µM to 1.0 µM) higher ECvalues than MICT ones, and the propensity of their platelets to form aggregates with monocytes was significantly lower after 12 weeks. Short-term strenuous physical exertion was generally associated with platelet activation and an ECreduction of 0.7 µM (0.6 µM to 0.8 µM). HIIT+MICT patients tended to be fitter after 12 weeks. No serious harms were observed.
Including HIIT in cardiac rehabilitation seems to confer additional benefits compared with MICT alone, which should be confirmed in clinical trials with hard endpoints. Exertion-induced platelet activation and hyper-reactivity occur despite dual antiplatelet therapy.
NCT02930330; Results.
比较中等强度连续训练（MICT）和高强度间歇训练（HIIT）对接受心脏康复治疗的患者血小板功能的影响，因为高反应性血小板与动脉粥样硬化形成和动脉血栓形成有关。
在这项单中心平行组随机对照试验中，正在接受双联抗血小板治疗的急性冠状动脉综合征男性患者接受 MICT 或 HIIT+MICT 治疗 12 周。主要结局是通过血小板激动剂血栓素受体激活肽-6（TRAP-6）的半最大浓度（EC）测量血小板反应性，以 P-选择素表达为指标。在基线、6 周和 12 周时分别在静息和运动时测定 EC。
82 例患者被随机分配至 MICT 或 HIIT+MICT 组。静息时 TRAP-6 的基线 EC 值的平均值（95%置信区间）为 6.7µM（6.3µM 至 7.0µM）。6/12 周后，36/33 例 MICT 和 34/28 例 HIIT+MICT 患者接受了检查。HIIT+MICT 患者的 EC 值比 MICT 患者高 0.9µM（0.4µM 至 1.4µM）/0.5µM（-0.1µM 至 1.0µM），并且在 12 周后，其血小板与单核细胞形成聚集的倾向性明显降低。短期剧烈体力活动通常与血小板激活和 EC 值降低 0.7µM（0.6µM 至 0.8µM）相关。HIIT+MICT 患者在 12 周后身体更健康。未观察到严重不良事件。
与单独 MICT 相比，心脏康复中加入 HIIT 似乎具有额外的益处，这需要在具有硬终点的临床试验中得到证实。尽管进行了双联抗血小板治疗，但仍会发生运动诱导的血小板激活和高反应性。
NCT02930330；结果。
