Effects of High Intensity Interval Training Rehabilitation Protocol after an Acute Coronary Syndrome on Myocardial Work and Atrial Strain
<i>Background and</i><i>Objectives</i><b>:</b> Current guidelines on cardiac rehabilitation (CR) suggest moderate-intensity physical activity after acute coronary syndrome (ACS). Recent report have shown that high-intensity interval training (HIIT) could be more e...
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| Format: | Article |
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MDPI AG
2022-03-01
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| Series: | Medicina |
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| Online Access: | https://www.mdpi.com/1648-9144/58/3/453 |
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| author | Antonello D’Andrea Andreina Carbone Federica Ilardi Mario Pacileo Cristina Savarese Simona Sperlongano Marco Di Maio Francesco Giallauria Vincenzo Russo Eduardo Bossone Eugenio Picano |
| author_facet | Antonello D’Andrea Andreina Carbone Federica Ilardi Mario Pacileo Cristina Savarese Simona Sperlongano Marco Di Maio Francesco Giallauria Vincenzo Russo Eduardo Bossone Eugenio Picano |
| author_sort | Antonello D’Andrea |
| collection | DOAJ |
| description | <i>Background and</i><i>Objectives</i><b>:</b> Current guidelines on cardiac rehabilitation (CR) suggest moderate-intensity physical activity after acute coronary syndrome (ACS). Recent report have shown that high-intensity interval training (HIIT) could be more effective than moderate-intensity continuous training (MCT) in improving cardiac performance. Our aim was to analyze the effects of HIIT protocol after ACS on advanced echocardiographic parameters of myocardial function. <i>Materials and Methods</i><b>:</b> In total, 75 patients with recent ACS, with or without ST segment elevation, were enrolled and compared with a control group of 50 age- and sex-comparable healthy subjects. Patients were randomized to perform a MCT training or HIIT-based rehabilitation program. A complete echocardiographic evaluation, including left ventricular (LV) and left atrial (LA) global longitudinal strain (GLS) and myocardial work (MW) through speckle-tracking analysis, was performed for all patients, before and after cardiac rehabilitation training. A cardiopulmonary exercise testing (CPET) was also performed at the end of the rehabilitation program. <i>Results:</i> Patients who followed the HIIT rehabilitation program showed improved LV diastolic function compared to the MCT group (E/e’: 3.4 ± 3.1 vs. 6.4 ± 2.8, respectively, <i>p</i> < 0.01). Similarly, LV systolic function showed significant improvement in the group of patients performing HIIT (ejection fraction: 53.1 ± 6.4 vs. 52.3 ± 5.4%, <i>p</i> < 0.01; GLS: −17.8 ± 3.8 vs. −15.4 ± 4.3, <i>p</i> < 0.01). In addition, LA strain was improved. MW efficiency was also increased in the HIIT group (91.1 ± 3.3 vs. 87.4 ± 4.1%, <i>p</i> < 0.01), and was closely related to peak effort measurements expressed in peak VO<sub>2</sub> by CPET. <i>Conclusions</i><b>:</b> In patients with recent ACS, the HIIT rehabilitation program determined reverse cardiac remodeling, with the improvement of diastolic and systolic function, assessed by standard echocardiography. In addition, cardiac deformation index as GLS, LA strain and MW efficiency improved significantly after HIIT, and were associated with functional capacity during effort. |
| first_indexed | 2024-03-09T13:23:17Z |
| format | Article |
| id | doaj.art-5c72e1bb81e240cab4903106165bdc43 |
| institution | Directory Open Access Journal |
| issn | 1010-660X 1648-9144 |
| language | English |
| last_indexed | 2024-03-09T13:23:17Z |
| publishDate | 2022-03-01 |
| publisher | MDPI AG |
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| series | Medicina |
| spelling | doaj.art-5c72e1bb81e240cab4903106165bdc432023-11-30T21:27:15ZengMDPI AGMedicina1010-660X1648-91442022-03-0158345310.3390/medicina58030453Effects of High Intensity Interval Training Rehabilitation Protocol after an Acute Coronary Syndrome on Myocardial Work and Atrial StrainAntonello D’Andrea0Andreina Carbone1Federica Ilardi2Mario Pacileo3Cristina Savarese4Simona Sperlongano5Marco Di Maio6Francesco Giallauria7Vincenzo Russo8Eduardo Bossone9Eugenio Picano10Unit of Cardiology, Department of Traslational Medical Sciences, University of Campania “Luigi Vanvitelli”, Monaldi Hospital, 80131 Naples, ItalyUnit of Cardiology, Department of Traslational Medical Sciences, University of Campania “Luigi Vanvitelli”, Monaldi Hospital, 80131 Naples, ItalyDepartment of Translational Medical Sciences, University of Naples Federico II, 80131 Naples, ItalyUnit of Cardiology and Intensive Coronary Care, “Umberto I” Hospital, 84014 Nocera Inferiore, ItalyUnit of Cardiology and Intensive Coronary Care, “Umberto I” Hospital, 84014 Nocera Inferiore, ItalyUnit of Cardiology, Department of Traslational Medical Sciences, University of Campania “Luigi Vanvitelli”, Monaldi Hospital, 80131 Naples, ItalyUnit of Cardiology, “Eboli Hospital (ASL Salerno)”, 84025 Eboli, ItalyDepartment of Translational Medical Sciences, University of Naples Federico II, 80131 Naples, ItalyUnit of Cardiology, Department of Traslational Medical Sciences, University of Campania “Luigi Vanvitelli”, Monaldi Hospital, 80131 Naples, ItalyCardiac Rehabilitation Unit, Cardarelli Hospital, 80131 Naples, ItalyInstitute of Clinical Physiology, CNR, 56127 Pisa, Italy<i>Background and</i><i>Objectives</i><b>:</b> Current guidelines on cardiac rehabilitation (CR) suggest moderate-intensity physical activity after acute coronary syndrome (ACS). Recent report have shown that high-intensity interval training (HIIT) could be more effective than moderate-intensity continuous training (MCT) in improving cardiac performance. Our aim was to analyze the effects of HIIT protocol after ACS on advanced echocardiographic parameters of myocardial function. <i>Materials and Methods</i><b>:</b> In total, 75 patients with recent ACS, with or without ST segment elevation, were enrolled and compared with a control group of 50 age- and sex-comparable healthy subjects. Patients were randomized to perform a MCT training or HIIT-based rehabilitation program. A complete echocardiographic evaluation, including left ventricular (LV) and left atrial (LA) global longitudinal strain (GLS) and myocardial work (MW) through speckle-tracking analysis, was performed for all patients, before and after cardiac rehabilitation training. A cardiopulmonary exercise testing (CPET) was also performed at the end of the rehabilitation program. <i>Results:</i> Patients who followed the HIIT rehabilitation program showed improved LV diastolic function compared to the MCT group (E/e’: 3.4 ± 3.1 vs. 6.4 ± 2.8, respectively, <i>p</i> < 0.01). Similarly, LV systolic function showed significant improvement in the group of patients performing HIIT (ejection fraction: 53.1 ± 6.4 vs. 52.3 ± 5.4%, <i>p</i> < 0.01; GLS: −17.8 ± 3.8 vs. −15.4 ± 4.3, <i>p</i> < 0.01). In addition, LA strain was improved. MW efficiency was also increased in the HIIT group (91.1 ± 3.3 vs. 87.4 ± 4.1%, <i>p</i> < 0.01), and was closely related to peak effort measurements expressed in peak VO<sub>2</sub> by CPET. <i>Conclusions</i><b>:</b> In patients with recent ACS, the HIIT rehabilitation program determined reverse cardiac remodeling, with the improvement of diastolic and systolic function, assessed by standard echocardiography. In addition, cardiac deformation index as GLS, LA strain and MW efficiency improved significantly after HIIT, and were associated with functional capacity during effort.https://www.mdpi.com/1648-9144/58/3/453strainmyocardial workrehabilitationcardiopulmonary testacute coronary syndromechronic coronary syndrome |
| spellingShingle | Antonello D’Andrea Andreina Carbone Federica Ilardi Mario Pacileo Cristina Savarese Simona Sperlongano Marco Di Maio Francesco Giallauria Vincenzo Russo Eduardo Bossone Eugenio Picano Effects of High Intensity Interval Training Rehabilitation Protocol after an Acute Coronary Syndrome on Myocardial Work and Atrial Strain Medicina strain myocardial work rehabilitation cardiopulmonary test acute coronary syndrome chronic coronary syndrome |
| title | Effects of High Intensity Interval Training Rehabilitation Protocol after an Acute Coronary Syndrome on Myocardial Work and Atrial Strain |
| title_full | Effects of High Intensity Interval Training Rehabilitation Protocol after an Acute Coronary Syndrome on Myocardial Work and Atrial Strain |
| title_fullStr | Effects of High Intensity Interval Training Rehabilitation Protocol after an Acute Coronary Syndrome on Myocardial Work and Atrial Strain |
| title_full_unstemmed | Effects of High Intensity Interval Training Rehabilitation Protocol after an Acute Coronary Syndrome on Myocardial Work and Atrial Strain |
| title_short | Effects of High Intensity Interval Training Rehabilitation Protocol after an Acute Coronary Syndrome on Myocardial Work and Atrial Strain |
| title_sort | effects of high intensity interval training rehabilitation protocol after an acute coronary syndrome on myocardial work and atrial strain |
| topic | strain myocardial work rehabilitation cardiopulmonary test acute coronary syndrome chronic coronary syndrome |
| url | https://www.mdpi.com/1648-9144/58/3/453 |
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