高强度间歇训练对冠状动脉粥样斑块产生有益影响：一项随机试验。

High-intensity interval training induces beneficial effects on coronary atheromatous plaques: a randomized trial.

作者信息

Vesterbekkmo Elisabeth Kleivhaug, Aksetøy Inger-Lise Aamot, Follestad Turid, Nilsen Hans Olav, Hegbom Knut, Wisløff Ulrik, Wiseth Rune, Madssen Erik

机构信息

Clinic of Cardiology, St. Olavs University Hospital, Prinsesse Kristinas gate 3, N-7030 Trondheim, Norway.

Department of Circulation and Medical Imaging at Norwegian University of Science and Technology, Prinsesse Kristinas gate 3, N-7030 Trondheim, Norway.

出版信息

Eur J Prev Cardiol. 2023 Mar 27;30(5):384-392. doi: 10.1093/eurjpc/zwac309.

DOI:10.1093/eurjpc/zwac309

PMID:36562212

Abstract

AIMS

Coronary atheroma volume is associated with risk of coronary events in coronary artery disease (CAD). Exercise training is a cornerstone in primary and secondary prevention of CAD, but the effect of exercise on coronary atheromatous plaques is largely unknown. We assessed the effect of 6 months supervised high-intensity interval training (HIIT) on coronary plaque geometry using intravascular ultrasound in patients with stable CAD following percutaneous coronary intervention (PCI).

METHODS AND RESULTS

Sixty patients were randomized to two sessions of weekly supervised HIIT at 85-95% of peak heart rate (n = 30) or to follow contemporary preventive guidelines (control group, n = 30). The study endpoints were change in percent atheroma volume (PAV) and total atheroma volume (TAV) normalized for segment length (TAVnorm) at 6-month follow-up. The change in average PAV for matched coronary segments from baseline to follow-up showed a significant between-group difference (-1.4, 95% CI: -2.7 to -0.1, P = 0.036). There was a significant reduction in the HIIT group (-1.2, 95% CI: -2.1 to -0.2, P = 0.017) while not in the control group (0.2, 95% CI: -0.7 to 1.1, P = 0.616). TAVnorm was reduced (-9 mm3, 95% CI: -14.7 to -3.4, P = 0.002) after HIIT, with a significant between-group difference (-12.0 mm3, 95% CI: -19.9 to -4.2, P = 0.003).

CONCLUSION

In patients with established CAD, a regression of atheroma volume was observed in those undergoing 6 months of supervised HIIT compared with patients following contemporary preventive guidelines. Our study indicates that HIIT counteracts atherosclerotic coronary disease progression and reduces atheroma volume in residual coronary atheromatous plaques following PCI.

摘要

目的

冠状动脉粥样硬化斑块体积与冠状动脉疾病（CAD）患者发生冠状动脉事件的风险相关。运动训练是CAD一级和二级预防的基石，但运动对冠状动脉粥样硬化斑块的影响在很大程度上尚不清楚。我们使用血管内超声评估了6个月有监督的高强度间歇训练（HIIT）对经皮冠状动脉介入治疗（PCI）后稳定型CAD患者冠状动脉斑块几何形态的影响。

方法与结果

60例患者被随机分为两组，一组每周进行两次有监督的HIIT，运动强度为峰值心率的85%-95%（n = 30），另一组遵循当代预防指南（对照组，n = 30）。研究终点为6个月随访时粥样硬化斑块体积百分比（PAV）和按节段长度标准化的总粥样硬化斑块体积（TAVnorm）的变化。从基线到随访，匹配冠状动脉节段的平均PAV变化显示出显著的组间差异（-1.4，95%CI：-2.7至-0.1，P = 0.036）。HIIT组有显著降低（-1.2，95%CI：-2.1至-0.2，P = 0.017），而对照组未降低（0.2，95%CI：-0.7至1.1，P = 0.616）。HIIT后TAVnorm降低（-9 mm3，95%CI：-14.7至-3.4，P = 0.002），组间差异显著（-12.0 mm3，95%CI：-19.9至-4.2，P = 0.003）。