Nytrøen Kari, Rolid Katrine, Yardley Marianne, Gullestad Lars
Department of Cardiology, Oslo University Hospital Rikshospitalet, postbox 4950, Nydalen, 0424 Oslo, Norway.
Faculty of Medicine, University of Oslo, Postbox 1072 Blindern, 0316 Oslo, Norway.
BMC Sports Sci Med Rehabil. 2020 Jun 4;12:35. doi: 10.1186/s13102-020-00180-1. eCollection 2020.
Little is known about the effect of exercise in young heart transplant recipients, and results on group level is lacking. This study summarizes the findings of the youngest participants in two previous randomized controlled trials.
This is a hypothesis-generating study reporting the main results from the youngest participants in two larger randomized controlled trials investigating the effect of high-intensity interval training (HIT). The article summarizes the main results from 28 young participants (< 40 year of age) who have participated in two previous studies which evaluated the effect of HIT vs. controls in adult heart transplant recipients. One of the studies included de novo heart transplant recipients and the other included maintenance heart transplant recipients.All study tests were performed in-hospital, in the specialist health care setting, but the exercise intervention was carried out locally, in cooperation with the primary health care. In both studies the exercise intervention lasted for 9-12 months. In one study, HIT (85-95% of peak effort) was compared to controls (no specific intervention), and in the other study HIT was compared to moderate, continuous exercise (MICT 60-80% of peak effort). The main outcome measure was peak oxygen uptake (VO) and a secondary endpoint was muscle strength.
The summarized findings from the youngest heart transplant recipients in these two studies demonstrated mainly that the improvement in peak oxygen uptake among the younger recipients (< 40 years) was much larger (4.7 vs. 1.2 ml/kg/min and 7.0 vs. 2.2 ml/kg/min) compared to the improvement among the older recipients (≥ 40 years), and in accordance with results from adult heart transplant populations: HIT, compared to MICT, induced the largest improvement in peak oxygen consumption, also in the younger heart transplant recipients.
These results suggest that young heart transplant recipients have a greater effect of HIT than of MICT and may also suggest that younger recipients benefit more from high-intensity interval training than their older co-patients. However, larger randomized studies focusing on the young heart transplant population is strongly needed to confirm this hypothesis.
Clinical trial registrations: NCT01796379 and NCT01091194.
关于运动对年轻心脏移植受者的影响知之甚少,且缺乏群体水平的研究结果。本研究总结了前两项随机对照试验中最年轻参与者的研究结果。
这是一项探索性研究,报告了两项更大规模的随机对照试验中最年轻参与者的主要结果,这两项试验旨在研究高强度间歇训练(HIT)的效果。本文总结了28名年轻参与者(<40岁)的主要结果,这些参与者参与了之前的两项研究,这两项研究评估了HIT与对照组对成年心脏移植受者的影响。其中一项研究纳入了初次心脏移植受者,另一项研究纳入了维持期心脏移植受者。所有研究测试均在医院的专科医疗环境中进行,但运动干预是与初级医疗保健机构合作在当地开展的。在两项研究中,运动干预均持续9至12个月。在一项研究中,将HIT(峰值努力的85-95%)与对照组(无特定干预)进行比较,在另一项研究中,将HIT与中等强度持续运动(MICT,峰值努力的60-80%)进行比较。主要结局指标是峰值摄氧量(VO),次要终点是肌肉力量。
这两项研究中最年轻心脏移植受者的总结结果主要表明,与年长受者(≥40岁)相比,年轻受者(<40岁)的峰值摄氧量改善幅度更大(分别为4.7 vs. 1.2 ml/kg/min和7.0 vs. 2.2 ml/kg/min),并且与成年心脏移植人群的结果一致:与MICT相比,HIT在年轻心脏移植受者中也能使峰值耗氧量得到最大程度的改善。
这些结果表明,年轻心脏移植受者从HIT中获得的益处大于MICT,也可能表明年轻受者比年长的同病患者从高强度间歇训练中获益更多。然而,迫切需要开展更多针对年轻心脏移植人群的随机研究来证实这一假设。
临床试验注册编号:NCT01796379和NCT01091194。