Keywords
coronary artery disease
moderate-intensity continuous training
high-intensity interval training
cardiac rehabilitation
capacidad aeróbica
enfermedad de las arterias coronarias
entrenamiento continuo de moderada intensidad
entrenamiento por intervalos de alta intensidad
rehabilitación cardíaca
capacidade aeróbica
doença arterial coronariana
treinamento contínuo de intensidade moderada
treinamento intervalado de alta intensidade
reabilitação cardíaca
How to Cite
Abstract
The aim of this review was to compare the influence of high-intensity interval training (HIIT) with moderate-intensity continuous training (MICT) on aerobic capacity and other relevant variables in patients with coronary artery disease (EAC). We reviewed the systematic studies and meta-analysis in PubMed up to June 4th, 2019. A total of 22 articles were identified, of which 6 were selected for this review. The methodological quality was evaluated using the Assessment of Multiple Systematic Reviews 2 (AMSTAR-2) tool. The studies selected analyzed HIIT and MICT effects in adult patients (average ages ranging between 52-76). The overall quality of the included studies was moderate-high (AMSTAR-2). HIIT showed greater improvements over peak oxygen consumption and peak heart rate compared to MICT. This review adds further evidence that HIIT presents clinically significant improvements in aerobic capacity compared to MICT. Further studies are needed to establish consistent conclusions about the effects of HIIT and MICT on other relevant variables.
References
Anderson, L., Oldridge, N., Thompson, D. R., Zwisler, A.-D., Rees, K., Martin, N., y Taylor, R. S. (2016). Exercise-Based Cardiac Rehabilitation for Coronary Heart Disease: Cochrane Systematic Review and Meta-Analysis. Journal of the American College of Cardiology, 67(1), 1–12. doi: https://doi.org/10.1016/j.jacc.2015.10.044
Ballesta García, I., Rubio Arias, J. Á., Ramos Campo, D. J., Martínez González-Moro, I., y Carrasco Poyatos, M. (2019). High-intensity Interval Training Dosage for Heart Failure and Coronary Artery Disease Cardiac Rehabilitation. A Systematic Review and Meta-analysis. Revista Espanola de Cardiologia, 72(3), 233–243. doi: https://doi.org/10.1016/j.rec.2018.02.015
Clark, A. M., Hartling, L., Vandermeer, B., y McAlister, F. A. (2005). Meta-analysis: secondary prevention programs for patients with coronary artery disease. Annals of Internal Medicine, 143(9), 659–672. doi: https://doi.org/10.7326/0003-4819-143-9-200511010-00010
Conraads, V. M., Pattyn, N., De Maeyer, C., Beckers, P. J., Coeckelberghs, E., Cornelissen, V. A., … Vanhees, L. (2015). Aerobic interval training and continuous training equally improve aerobic exercise capacity in patients with coronary artery disease: The SAINTEX-CAD study. International Journal of Cardiology, 179, 203–210. doi: https://doi.org/10.1016/J.IJCARD.2014.10.155
Cornish, A. K., Broadbent, S., y Cheema, B. S. (2011). Interval training for patients with coronary artery disease: a systematic review. European Journal of Applied Physiology, 111(4), 579–589. doi: https://doi.org/10.1007/s00421-010-1682-5
*Elliott, A. D., Rajopadhyaya, K., Bentley, D. J., Beltrame, J. F., y Aromataris, E. C. (2015). Interval training versus continuous exercise in patients with coronary artery disease: a meta-analysis. Heart, Lung & Circulation, 24(2), 149–157. doi: https://doi.org/10.1016/j.hlc.2014.09.001
Fox, K., Borer, J. S., Camm, A. J., Danchin, N., Ferrari, R., Lopez Sendon, J. L., … Heart Rate Working Group. (2007). Resting Heart Rate in Cardiovascular Disease. Journal of the American College of Cardiology, 50(9), 823–830. doi: https://doi.org/10.1016/j.jacc.2007.04.079
*Gomes-Neto, M., Duraes, A. R., dos Reis, H. F., Neves, V. R., Martinez, B. P., y Carvalho, V. O. (2017). High-intensity interval training versus moderate-intensity continuous training on exercise capacity and quality of life in patients with coronary artery disease: A systematic review and meta-analysis. European Journal of Preventive Cardiology, 24(16), 1696–1707. doi: https://doi.org/10.1177/2047487317728370
Guiraud, T., Juneau, M., Nigam, A., Gayda, M., Meyer, P., Mekary, S., … Bosquet, L. (2010). Optimization of high intensity interval exercise in coronary heart disease. European Journal of Applied Physiology, 108(4), 733–740. doi: https://doi.org/10.1007/s00421-009-1287-z
Guiraud, T., Nigam, A., Gremeaux, V., Meyer, P., Juneau, M., y Bosquet, L. (2012). High-intensity interval training in cardiac rehabilitation. Sports Medicine (Auckland, N.Z.), 42(7), 587–605. doi: https://doi.org/10.2165/11631910-000000000-00000
*Hannan, A. L., Hing, W., Simas, V., Climstein, M., Coombes, J. S., Jayasinghe, R., … Furness, J. (2018). High-intensity interval training versus moderateintensity continuous training within cardiac rehabilitation: a systematic review and meta-analysis. Open Access Journal of Sports Medicine, 9, 1–17. doi: https://doi.org/10.2147/OAJSM.S150596
Kodama, S., Saito, K., Tanaka, S., Maki, M., Yachi, Y., Asumi, M., … Sone, H. (2009). Cardiorespiratory fitness as a quantitative predictor of all-cause mortality and cardiovascular events in healthy men and women: a meta-analysis. JAMA, 301(19), 2024–2035. doi: https://doi.org/10.1001/jama.2009.681
Kraal, J. J., Vromen, T., Spee, R., Kemps, H. M. C., y Peek, N. (2017). The influence of training characteristics on the effect of exercise training in patients with coronary artery disease: Systematic review and meta-regression analysis. International Journal of Cardiology, 245, 52–58. doi: https://doi.org/10.1016/j.ijcard.2017.07.051
*Liou, K., Ho, S., Fildes, J., y Ooi, S.-Y. (2016). High Intensity Interval versus Moderate Intensity Continuous Training in Patients with Coronary Artery Disease: A Meta-analysis of Physiological and Clinical Parameters. Heart, Lung y Circulation, 25(2), 166–174. doi: https://doi.org/10.1016/j.hlc.2015.06.828
Medina‐Inojosa, J. R., Somers, V. K., Thomas, R. J., Jean, N., Jenkins, S. M., Gomez‐Ibarra, M. A., … Lopez‐Jimenez, F. (2018). Association Between Adiposity and Lean Mass With Long‐Term Cardiovascular Events in Patients With Coronary Artery Disease: No Paradox. Journal of the American Heart Association, 7(10). doi: https://doi.org/10.1161/JAHA.117.007505
Mezzani, A., Hamm, L. F., Jones, A. M., McBride, P. E., Moholdt, T., Stone, J. A., … Canadian Association of Cardiac Rehabilitation. (2013). Aerobic exercise intensity assessment and prescription in cardiac rehabilitation: a joint position statement of the European Association for Cardiovascular Prevention and Rehabilitation, the American Association of Cardiovascular and Pulmonary Rehabilitat. European Journal of Preventive Cardiology, 20(3), 442–467. doi: https://doi.org/10.1177/2047487312460484
Moher, D., Liberati, A., Tetzlaff, J., Altman, D. G., y Group, T. P. (2009). Preferred Reporting Items for Systematic Reviews and Meta-Analyses: The PRISMA Statement. PLoS Medicine, 6(7), e1000097. doi: https://doi.org/10.1371/journal.pmed.1000097
Moholdt, T., Madssen, E., Rognmo, Ø., y Aamot, I. L. (2014). The higher the better? Interval training intensity in coronary heart disease. Journal of Science and Medicine in Sport, 17(5), 506–510. doi: https://doi.org/10.1016/j.jsams.2013.07.007
Montalescot, G., Sechtem, U., Achenbach, S., Andreotti, F., Arden, C., Budaj, A., … Yildirir, A. (2013). 2013 ESC guidelines on the management of stable coronary artery disease. European Heart Journal, 34(38), 2949–3003. doi: https://doi.org/10.1093/eurheartj/eht296
*Pattyn, N., Beulque, R., y Cornelissen, V. (2018). Aerobic Interval vs. Continuous Training in Patients with Coronary Artery Disease or Heart Failure: An Updated Systematic Review and Meta-Analysis with a Focus on Secondary Outcomes. Sports Medicine, 48(5), 1189–1205. doi: https://doi.org/10.1007/s40279-018-0885-5
*Pattyn, N., Coeckelberghs, E., Buys, R., Cornelissen, V. A., y Vanhees, L. (2014). Aerobic Interval Training vs. Moderate Continuous Training in Coronary Artery Disease Patients: A Systematic Review and Meta-Analysis. Sports Medicine, 44(5), 687–700. doi: https://doi.org/10.1007/s40279-014-0158-x
Piepoli, M. F., Ugo, C., Carré, F., Heuschmann, P., Hoffmann, U., Verschuren, M., … Schmid, J.-P. (2010). Secondary prevention through cardiac rehabilitation: physical activity counselling and exercise training: key components of the position paper from the Cardiac Rehabilitation Section of the European Association of Cardiovascular Prevention and Rehabilitat. European Heart Journal, 31(16), 1967–1974. doi: https://doi.org/10.1093/eurheartj/ehq236
Ribeiro, P. A. B., Boidin, M., Juneau, M., Nigam, A., y Gayda, M. (2017). High-intensity interval training in patients with coronary heart disease: Prescription models and perspectives. Annals of Physical and Rehabilitation Medicine, 60(1), 50–57. doi: https://doi.org/10.1016/j.rehab.2016.04.004
Rognmo, Ø., Hetland, E., Helgerud, J., Hoff, J., y Slørdahl, S. A. (2004). High intensity aerobic interval exercise is superior to moderate intensity exercise for increasing aerobic capacity in patients with coronary artery disease. European Journal of Cardiovascular Prevention and Rehabilitation : Official Journal of the European Society of Cardiology, Working Groups on Epidemiology & Prevention and Cardiac Rehabilitation and Exercise Physiology, 11(3), 216–222. doi: https://doi.org/10.1097/01.hjr.0000131677.96762.0c
Rognmo, Ø., Moholdt, T., Bakken, H., Hole, T., Mølstad, P., Myhr, N. E., … Wisløff, U. (2012). Cardiovascular risk of high- versus moderate-intensity aerobic exercise in coronary heart disease patients. Circulation, 126(12), 1436–1440. doi: https://doi.org/10.1161/CIRCULATIONAHA.112.123117
Shea, B., Reeves, B. C., Wells, G., Thuku, M., Hamel, C., Moran, J., … Henry, D. A. (2017a). AMSTAR 2 : a critical appraisal tool for systematic reviews that include randomised or non-randomised studies of healthcare interventions , or both. BMJ, 1–9. doi: https://doi.org/10.1136/bmj.j4008
Shea, B., Reeves, B., Wells, G., Thuku, M., Hamel, C., Moran, J., … Henry, D. (2017b). AMSTAR Checklist.
Smart, N. A., Dieberg, G., y Giallauria, F. (2013). Intermittent versus continuous exercise training in chronic heart failure: A meta-analysis. International Journal of Cardiology, 166(2), 352–358. doi: https://doi.org/10.1016/j.ijcard.2011.10.075
Taylor, J. L., Holland, D. J., Spathis, J. G., Beetham, K. S., Wisløff, U., Keating, S. E., y Coombes, J. S. (2019). Guidelines for the delivery and monitoring of high intensity interval training in clinical populations. Progress in Cardiovascular Diseases, 62(2), 140–146. doi: https://doi.org/10.1016/j.pcad.2019.01.004
Thompson, P. D., Franklin, B. A., Balady, G. J., Blair, S. N., Corrado, D., Estes, N. A. M., … American College of Sports Medicine. (2007). Exercise and acute cardiovascular events placing the risks into perspective: a scientific statement from the American Heart Association Council on Nutrition, Physical Activity, and Metabolism and the Council on Clinical Cardiology. Circulation, 115(17), 2358–2368. doi: https://doi.org/10.1161/CIRCULATIONAHA.107.181485
Thompson, P., y Williams, P. (2014). Increased cardiovascular disease mortality associated with excessive exercise in heart attack survivors. Mayo Clinic Proceedings, 89(9), 1187–1194. doi: https://doi.org/10.1016/j.mayocp.2014.05.006
Valkeinen, H., Aaltonen, S., y Kujala, U. M. (2010). Effects of exercise training on oxygen uptake in coronary heart disease: a systematic review and meta-analysis. Scandinavian Journal of Medicine & Science in Sports, 20(4), 545–555. doi: https://doi.org/10.1111/j.1600-0838.2010.01133.x
Vanhees, L., Geladas, N., Hansen, D., Kouidi, E., Niebauer, J., Reiner, Ž., … Vanuzzo, D. (2012). Importance of characteristics and modalities of physical activity and exercise in the management of cardiovascular health in individuals with cardiovascular risk factors: recommendations from the EACPR (Part II). European Journal of Preventive Cardiology, 19(5), 1005–1033. doi: https://doi.org/10.1177/1741826711430926
Wisløff, U., Støylen, A., Loennechen, J. P., Bruvold, M., Rognmo, Ø., Haram, P. M., … Skjærpe, T. (2007). Superior Cardiovascular Effect of Aerobic Interval Training Versus Moderate Continuous Training in Heart Failure Patients. Circulation, 115(24), 3086–3094. doi: https://doi.org/10.1161/CIRCULATIONAHA.106.675041
Woodruffe, S., Neubeck, L., Clark, R. A., Gray, K., Ferry, C., Finan, J., … Briffa, T. G. (2015). Australian Cardiovascular Health and Rehabilitation Association (ACRA) core components of cardiovascular disease secondary prevention and cardiac rehabilitation 2014. Heart, Lung & Circulation, 24(5), 430–441. doi: https://doi.org/10.1016/j.hlc.2014.12.008
World Health Organization [WHO] (2011). Global Atlas on cardiovascular disease prevention and control. Geneva: World Health Organization, World Heart Federation, World Stroke Organization. Retrieved from https://www.who.int/cardiovascular_diseases/publications/atlas_cvd/en/
World Health Organization [WHO]. (2016a). Cardiovascular diseases 2016. Retrieved April 1, 2019, from https://www.who.int/es/news-room/fact-sheets/detail/cardiovascular-diseases-(cvds)
World Health Organization [WHO]. (2016b). WHO | Top 10 causes of death 2016. Retrieved April 1, 2019, from https://www.who.int/news-room/fact-sheets/detail/the-top-10-causes-of-death
Xie, B., Yan, X., Cai, X., y Li, J. (2017). Effects of High-Intensity Interval Training on Aerobic Capacity in Cardiac Patients: A Systematic Review with Meta-Analysis. BioMed Research International, 2017, 1–16. doi: https://doi.org/10.1155/2017/5420840