Resumo
O objetivo desta revisão foi comparar a influência do treinamento intervalado de alta intensidade (HIIT) com o treinamento contínuo de intensidade moderada (MICT) na capacidade aeróbica e em outras variáveis relevantes em pacientes com doença arterial coronariana (DAC). Realizamos uma revisão de estudos sistemáticos e metanálise no PubMed até 4 de junho de 2019. Foram identificados 22 artigos, dos quais 6 foram finalmente selecionados para esta revisão. A qualidade metodológica foi avaliada usando a ferramenta ‘Assessment of Multiple Systematic Reviews 2’ (AMSTAR-2). Todos os estudos analisaram os efeitos de HIIT e MICT em pacientes adultos (faixa etária: 52-76 anos). A qualidade geral dos estudos incluídos foi moderadamente alta (AMSTAR-2). O HIIT mostrou uma maior melhora no pico de consumo de oxigênio e no pico de frequência cardíaca em comparação com o MICT. Esta revisão aporta evidências de que o HIIT apresenta melhorias clinicamente significativas na capacidade aeróbica em comparação com o MICT. Mais estudos são necessários para estabelecer conclusões consistentes dos efeitos do HIIT e MICT em outras variáveis relevantes.
Referências
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