Abstract
High intensity interval training has been shown to be more effective than moderate intensity continuous training for improving maximal oxygen uptake (VO2max) in patients with coronary heart disease (CHD). However, no evidence supports the prescription of one specific protocol of high intensity interval exercise (HIIE) in this population. The purpose of this study was to compare the acute cardiopulmonary responses with four different single bouts of HIIE in order to identify the most optimal one in CHD patients. Nineteen stable CHD patients (17 males, 2 females, 65 ± 8 years) performed four different bouts of HIIE, all with exercise phases at 100% of maximal aerobic power (MAP), but which varied in interval duration (15 s for mode A and B and 60 s for mode C and D) and type of recovery (0% of MAP for modes A and C and 50% of MAP for modes B and D). A passive recovery phase resulted in a longer time to exhaustion compared to an active recovery phase, irrespective of the duration of the exercise and recovery periods (15 or 60 s, p < 0.05). Time to exhaustion also tended to be higher with mode A relative to mode C (p = 0.06). Despite differences in time to exhaustion between modes, time spent at a high percentage of VO2max was similar between HIIE modes except for less time spent above 90 and 95% of VO2max for mode C when compared with modes B and D. When considering perceived exertion, patient comfort and time spent above 80% of VO2max, mode A appeared to be the optimal HIIE session for these coronary patients.
Similar content being viewed by others
References
Balady GJ, Williams MA, Ades PA, Bittner V, Comoss P, Foody JM, Franklin B, Sanderson B, Southard D (2007) Core components of cardiac rehabilitation/secondary prevention programs: 2007 update: a scientific statement from the American Heart Association Exercise, Cardiac Rehabilitation, and Prevention Committee, the Council on Clinical Cardiology; the Councils on Cardiovascular Nursing, Epidemiology and Prevention, and Nutrition, Physical Activity, and Metabolism; and the American Association of Cardiovascular and Pulmonary Rehabilitation. Circulation 115:2675–2682
Billat LV (2001) Interval training for performance: a scientific and empirical practice. Special recommendations for middle- and long-distance running. Part I: aerobic interval training. Sports Med 31:13–31
Daniels J, Scardina N (1984) Interval training and performance. Sports Med 1:327–334
Davies CT (1968) Limitations to the prediction of maximum oxygen intake from cardiac frequency measurements. J Appl Physiol 24:700–706
Duncan GE, Howley ET, Johnson BN (1997) Applicability of VO2max criteria: discontinuous versus continuous protocols. Med Sci Sports Exerc 29:273–278
Duncker DJ, Bache RJ (2008) Regulation of coronary blood flow during exercise. Physiol Rev 88:1009–1086
Dupont G, Berthoin S (2004) Time spent at a high percentage of VO2max for short intermittent runs: active versus passive recovery. Can J Appl Physiol 29 Suppl:S3–S16
Dupont G, Blondel N, Lensel G, Berthoin S (2002) Critical velocity and time spent at a high level of VO2 for short intermittent runs at supramaximal velocities. Can J Appl Physiol 27:103–115
Dupont G, Blondel N, Berthoin S (2003a) Performance for short intermittent runs: active recovery vs. passive recovery. Eur J Appl Physiol 89:548–554
Dupont G, Blondel N, Berthoin S (2003b) Time spent at VO2max: a methodological issue. Int J Sports Med 24:291–297
Dupont G, Moalla W, Guinhouya C, Ahmaidi S, Berthoin S (2004) Passive versus active recovery during high-intensity intermittent exercises. Med Sci Sports Exerc 36:302–308
Fletcher GF, Balady GJ, Amsterdam EA, Chaitman B, Eckel R, Fleg J, Froelicher VF, Leon AS, Pina IL, Rodney R, Simons-Morton DA, Williams MA, Bazzarre T (2001) Exercise standards for testing and training: a statement for healthcare professionals from the American Heart Association. Circulation 104:1694–1740
Fritzsche RG, Switzer TW, Hodgkinson BJ, Coyle EF (1999) Stroke volume decline during prolonged exercise is influenced by the increase in heart rate. J Appl Physiol 86:799–805
Giannuzzi P, Saner H, Bjornstad H, Fioretti P, Mendes M, Cohen-Solal A, Dugmore L, Hambrecht R, Hellemans I, McGee H, Perk J, Vanhees L, Veress G (2003) Secondary prevention through cardiac rehabilitation: position paper of the Working Group on Cardiac Rehabilitation and Exercise Physiology of the European Society of Cardiology. Eur Heart J 24:1273–1278
Gibbons RJ, Chatterjee K, Daley J, Douglas JS, Fihn SD, Gardin JM, Grunwald MA, Levy D, Lytle BW, O’Rourke RA, Schafer WP, Williams SV, Ritchie JL, Cheitlin MD, Eagle KA, Gardner TJ, Garson A Jr, Russell RO, Ryan TJ, Smith SC Jr (1999) ACC/AHA/ACP-ASIM guidelines for the management of patients with chronic stable angina: a report of the American College of Cardiology/American Heart Association Task Force on Practice Guidelines (Committee on Management of Patients with Chronic Stable Angina). J Am Coll Cardiol 33:2092–2197
Haseler LJ, Hogan MC, Richardson RS (1999) Skeletal muscle phosphocreatine recovery in exercise-trained humans is dependent on O2 availability. J Appl Physiol 86:2013–2018
Haskell WL, Lee IM, Pate RR, Powell KE, Blair SN, Franklin BA, Macera CA, Heath GW, Thompson PD, Bauman A (2007) Physical activity and public health: updated recommendation for adults from the American College of Sports Medicine and the American Heart Association. Med Sci Sports Exerc 39:1423–1434
Juneau M, Roy N, Nigam A, Tardif J, Larivée L (2008) Exercise training above the ischemic threshold and myocardial damage. Can J Cardiol (in press)
Noel M, Jobin J, Marcoux A, Poirier P, Dagenais GR, Bogaty P (2007) Can prolonged exercise-induced myocardial ischaemia be innocuous? Eur Heart J 28:1559–1565
Reindell H, Roskamm H (1959) Ein Beitrag zu den physiologischen Grundlagen des Intervall training unter besonderer Berück- sichtigung des Kreilaufes. Schweiz Z Sportmed:1–8
Rognmo O, Hetland E, Helgerud J, Hoff J, Slordahl SA (2004) High intensity aerobic interval exercise is superior to moderate intensity exercise for increasing aerobic capacity in patients with coronary artery disease. Eur J Cardiovasc Prev Rehabil 11:216–222
Saltin B, Essen B, Pedersen P (1976) Intermittent exercise: its physiology and some practical applications. In: Joekle E, Anand R, Stoboy H (eds) Advances in exercise physiology medicine sport series. Karger Publishers, Basel, pp 23–51
Taylor RS, Brown A, Ebrahim S, Jolliffe J, Noorani H, Rees K, Skidmore B, Stone JA, Thompson DR, Oldridge N (2004) Exercise-based rehabilitation for patients with coronary heart disease: systematic review and meta-analysis of randomized controlled trials. Am J Med 116:682–692
Thevenet D, Tardieu M, Zouhal H, Jacob C, Abderrahman BA, Prioux J (2007) Influence of exercise intensity on time spent at high percentage of maximal oxygen uptake during an intermittent session in young endurance-trained athletes. Eur J Appl Physiol 102:19–26
Tomai F (2002) Warm up phenomenon and preconditioning in clinical practice. Heart 87:99–100
Tomai F, Crea F, Danesi A, Perino M, Gaspardone A, Ghini AS, Cascarano MT, Chiariello L, Gioffre PA (1996) Mechanisms of the warm-up phenomenon. Eur Heart J 17:1022–1027
Warburton DE, McKenzie DC, Haykowsky MJ, Taylor A, Shoemaker P, Ignaszewski AP, Chan SY (2005) Effectiveness of high-intensity interval training for the rehabilitation of patients with coronary artery disease. Am J Cardiol 95:1080–1084
Wenger HA, Bell GJ (1986) The interactions of intensity, frequency and duration of exercise training in altering cardiorespiratory fitness. Sports Med 3:346–356
Wisloff U, Stoylen A, Loennechen JP, Bruvold M, Rognmo O, Haram PM, Tjonna AE, Helgerud J, Slordahl SA, Lee SJ, Videm V, Bye A, Smith GL, Najjar SM, Ellingsen O, Skjaerpe T (2007) Superior cardiovascular effect of aerobic interval training versus moderate continuous training in heart failure patients: a randomized study. Circulation 115:3086–3094
Yoshida T, Watari H, Tagawa K (1996) Effects of active and passive recoveries on splitting of the inorganic phosphate peak determined by 31P-nuclear magnetic resonance spectroscopy. NMR Biomed 9:13–19
Acknowledgment
Thibaut Guiraud is funded by the ÉPIC foundation.
Conflict of interest statement
None.
Author information
Authors and Affiliations
Corresponding author
Additional information
Communicated by Susan Ward.
All authors participated in the conception of the study, the supervision of the tests, and the writing of the manuscript.
Rights and permissions
About this article
Cite this article
Guiraud, T., Juneau, M., Nigam, A. et al. Optimization of high intensity interval exercise in coronary heart disease. Eur J Appl Physiol 108, 733–740 (2010). https://doi.org/10.1007/s00421-009-1287-z
Accepted:
Published:
Issue Date:
DOI: https://doi.org/10.1007/s00421-009-1287-z