心肌梗死后患者进行低强度和高强度间歇训练的血管内皮适应。
Vascular-endothelial adaptations following low and high volumes of high-intensity interval training in patients after myocardial infarction.
机构信息
Department of Physical Education and Sport, Faculty of Education and Sport-Physical Activity and Sport Sciences Section, University of the Basque Country (UPV/EHU), Vitoria-Gasteiz, Araba, Spain.
GIzartea, Kirola eta Ariketa Fisikoa Ikerkuntza Taldea (GIKAFIT), Society, Sports, and Physical Exercise Research Group, Department of Physical Education and Sport, Faculty of Education and Sport-Physical Activity and Sport Sciences Section, University of the Basque Country (UPV/EHU), Portal de Lasarte, 71, Vitoria-Gasteiz, Araba 01007, Spain.
出版信息
Ther Adv Cardiovasc Dis. 2024 Jan-Dec;18:17539447241286036. doi: 10.1177/17539447241286036.
BACKGROUND
Determinants of coronary artery disease, such as endothelial dysfunction and oxidative stress, could be attenuated by high-intensity aerobic interval exercise training (HIIT). However, the volume of this type of training is not well established.
OBJECTIVE
To assess the impact of two volumes of HIIT, low (LV-HIIT, <10 min at high intensity) and high (HV-HIIT, >10 min at high intensity), on vascular-endothelial function in individuals after an acute myocardial infarction (AMI).
MATERIALS AND METHODS
Clinical trial in 80 AMI patients (58.4 ± 8.3 years, 82.5% men) with three study groups: LV-HIIT ( = 28) and HV-HIIT ( = 28) with two sessions per week for 16 weeks and control group (CG, = 24) with unsupervised physical activity recommendations. Endothelial function (brachial flow-mediated dilation, FMD), atherosclerosis (carotid intima-media thickness ultrasound, cIMT), and levels of oxidized low-density lipoprotein (ox-LDL) as a marker of oxidative stress were determined before and after the intervention period.
RESULTS
After the intervention, in the exercise groups, there was an increase in FMD (LV-HIIT, ↑58.8%; HV-HIIT, ↑94.1%; < 0.001) concurrently with a decrease in cIMT (LV-HIIT, ↓3.0%; HV-HIIT, ↓3.2%; = 0.019) and LDLox (LV-HIIT, ↓5.2%; HV-HIIT, ↓8.9%; < 0.001), with no significant changes in the CG. Furthermore, a significant inverse correlation was observed between ox-LDL and endothelial function related to the volume of HIIT training performed (LV-HIIT: = -0.376, = 0.031; HV-HIIT: = -0.490, < 0.004), with no significance in the CG ( = 0.021, = 0.924).
CONCLUSION
In post-AMI patients, HIIT may lead to a volume-dependent enhancement in endothelial function, attributed to a decrease in oxidative stress, with added beneficial effects in reducing vascular wall thickness. An LV-HIIT program, with less than 10 min at high intensity per session, has proven enough efficiency to initiate favorable vascular-endothelial adaptations, potentially reducing cardiovascular risk among patients with coronary artery disease.
TRIAL REGISTRATION
INTERFARCT, ClinicalTrials.gov: NCT02876952.
背景
高强度间歇有氧训练（HIIT）可以减轻冠心病的发病机制，如内皮功能障碍和氧化应激。然而，这种训练的量效关系尚未明确。
目的
评估两种 HIIT 训练量，低强度 HIIT（LV-HIIT，<10 分钟高强度）和高强度 HIIT（HV-HIIT，>10 分钟高强度）对急性心肌梗死（AMI）后血管内皮功能的影响。
材料和方法
这是一项临床试验，共纳入 80 名 AMI 患者（58.4±8.3 岁，82.5%为男性），分为三组：LV-HIIT（n=28）和 HV-HIIT（n=28），每周进行两次训练，共 16 周；对照组（CG，n=24）接受非监督的体育活动建议。在干预前后，通过肱动脉血流介导的舒张功能（FMD）、颈动脉内膜中层厚度超声（cIMT）和氧化型低密度脂蛋白（ox-LDL）水平评估内皮功能、动脉粥样硬化和氧化应激。
结果
干预后，运动组的 FMD 增加（LV-HIIT，↑58.8%；HV-HIIT，↑94.1%；<0.001），同时 cIMT（LV-HIIT，↓3.0%；HV-HIIT，↓3.2%；=0.019）和 LDLox（LV-HIIT，↓5.2%；HV-HIIT，↓8.9%；<0.001）降低，而 CG 组无明显变化。此外，ox-LDL 与 HIIT 训练量呈负相关（LV-HIIT：r=-0.376，p=0.031；HV-HIIT：r=-0.490，p<0.004），而 CG 组无相关性（r=0.021，p=0.924）。
结论
在 AMI 后患者中，HIIT 可能会导致内皮功能的量效依赖性增强，这归因于氧化应激的降低，同时还具有降低血管壁厚度的额外有益作用。一项 LV-HIIT 计划，每次训练的高强度时间少于 10 分钟，已经证明了足够的效率，可以引发有利的血管内皮适应，从而降低冠心病患者的心血管风险。
试验注册
INTERFARCT，ClinicalTrials.gov：NCT02876952。
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