IMR Press / RCM / Volume 24 / Issue 1 / DOI: 10.31083/j.rcm2401020
Open Access Original Research
Low-Volume and High-Intensity Aerobic Interval Training May Attenuate Dysfunctional Ventricular Remodeling after Myocardial Infarction: Data from the INTERFARCT Study
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1 Department of Physiology, Faculty of Medicine, University of the Basque Country (UPV/EHU), Leioa, 48940 Bizkaia, Basque Country, Spain
2 Primary Care Administration of Burgos, Salud Castilla y Leon (Sacyl), 09267 Burgos, Spain
3 Department of Physiology, Faculty of Pharmacy, University of the Basque Country (UPV/EHU), Vitoria-Gasteiz, 01006 Alava/Araba, Basque Country, Spain
4 Department of Physical Education and Sport, Faculty of Education and Sport, Physical Activity and Sport Sciences Section, University of the Basque Country (UPV/EHU), 01007 Vitoria-Gasteiz, Alava, Basque Country, Spain
5 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), Vitoria-Gasteiz, 01007 Araba/Álava, Basque Country, Spain
6 Bioaraba Health Research Institute, Physical Activity, Exercise, and Health group, 01007 Vitoria-Gasteiz, Basque Country, Spain
*Correspondence: (Sara Maldonado-Martín)
Academic Editors: Alessandro Zorzi, Peter H. Brubaker and Kazuhiro P. Izawa
Rev. Cardiovasc. Med. 2023, 24(1), 20;
Submitted: 22 September 2022 | Revised: 29 November 2022 | Accepted: 12 December 2022 | Published: 11 January 2023
(This article belongs to the Special Issue Cardiac Rehabilitation—Volume 2)
Copyright: © 2023 The Author(s). Published by IMR Press.
This is an open access article under the CC BY 4.0 license.

Background: Aerobic high-intensity interval training (HIIT) has demonstrated benefits for ventricular remodeling after myocardial infarction (MI) through various mechanisms. Despite this, the optimal training volume is not well known. The present study aimed to assess the effects of different (low vs. high volume) aerobic HIIT compared to an attentional control (AC) group on echocardiographic and biochemical indicators of left ventricular (LV) remodeling in adults after MI. Methods: Randomized clinical trial conducted on post-MI patients with preserved ventricular function. Participants were assigned to three study groups. Two groups performed HIIT 2 d/week, one group with low-volume HIIT (20 min, n = 28) and another with high-volume HIIT (40 min, n = 28). A third group was assigned to AC (n = 24) with recommendations for unsupervised aerobic training. Left ventricular echocardiographic parameters and cardiac biomarker levels (N-terminal pro-b-type natriuretic peptide, NT-proBNP; soluble growth stimulation expressed gene 2, ST2; troponin T; and creatine kinase) were assessed at baseline and after the intervention (16 weeks). Results: Eighty participants (58.4 ± 8.3 yrs, 82.5% male) were included. Both low- and high-volume HIIT showed increases (p < 0.05) in left ventricular end-diastolic diameter (1.2%, 2.6%), and volume (1.1%, 1.3%), respectively. Interventricular septal and posterior walls maintained their thickness (p = 0.36) concerning the AC. Significant (p < 0.05) gain in diastolic function was shown with the improvements in E (–2.1%, –3.3%), e’ waves (2.2%, 5.5%), and the deceleration time (2.1%, 2.9%), and in systolic function with a reduction in global longitudinal strain (–3.2%, –4.7%), respectively. Significant (p < 0.05) reductions of N-terminal pro-B-type natriuretic peptide (NT-proBNP) (–4.8%, –11.1%) and of ST2 (–21.7%, –16.7%)were found in both HIIT groups respectively compared to the AC group. Creatine kinase elevation was shown only in high-volume HIIT (19.3%, p < 0.01). Conclusions: Low-volume HIIT is proposed as a clinically time-efficient and safer strategy to attenuate dysfunctional remodeling by preventing wall thinning and improving LV function in post-MI patients.

high-intensity interval training
cardiac remodeling
coronary heart disease
secondary prevention
Graphical Abstract
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Fig. 1.
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