Background
Methods/design
Study design
Participants and selection criteria
Inclusion criteria |
- MI type I: Spontaneous MI [1], with and without ST elevation |
- Effective revascularization treatment (coronary artery bypass grafting or percutaneous coronary intervention) |
- Age ≥ 18 years, clinically stable on sinus rhythm |
- Between six months and two years after the MI |
- Left ventricular ejection fraction > 50% |
- Time availability (45 min, two days a week for 16 weeks) to carry out the exercise program |
Exclusion criteria |
- Unstable coronary artery disease, uncontrolled hypertension, malignant ventricular arrhythmia, atrial fibrillation, exercise-induced ischemia, and ventricular failure during exercise |
- Other significant medical conditions including, but not limited to: chronic or recurrent respiratory, gastrointestinal, neuromuscular, neurological, or psychiatric conditions; musculoskeletal problems interfering with exercise; severe kidney disease (creatinine clearance < 30 mL/min, calculated in accordance with Modification of Diet in Renal Disease equation [MDRD]), autoimmune or collagen vascular diseases; immunodeficiency diseases or a positive human immunodeficiency virus test; anemia (hemoglobin < 12 g/dL), bleeding disorders, chronic thrombotic disorders, or hypercoagulable states; malignancies in the past five years, with the exception of skin cancer therapeutically controlled; endocrine and metabolic disorders, including type 1 diabetes; moderate to severe peripheral artery disease (> IIa in Fontaine’s classification); any other medical condition or disease that is life-threatening or that can interfere with or be aggravated by exercise |
- Any other co-morbidity with life expectancy < 1 year |
- Could not perform a valid baseline exercise test - Obesity > 35 kg/m2 |
- Pregnancy or breastfeeding |
- Plans to be out of the city > 2 weeks |
Measurements
Anthropometry and body composition
Lifestyle and health behavior
Cardiovascular measurements at rest
Physical fitness
Biochemical profile
Mediterranean diet pattern
Intervention/attention control
Exercise intervention program
High-intensity interval | Moderate-intensity interval | High-intensity interval | Moderate-intensity interval | |||||
---|---|---|---|---|---|---|---|---|
HV-HIIT treadmill | LV-HIIT treadmill | |||||||
Weeks | Volume (min) | Intensity (%HRres) | Volume (min) | Intensity (%HRres) | Volume (min) | Intensity (%HRres) | Volume (min) | Intensity (%HRres) |
1–2 | 8 | 85 | 12 | 65 | 8 | 85 | 12 | 65 |
3–4 | 12 | 85 | 13 | 65 | 8 | 85 | 12 | 65 |
5–6 | 16 | 90 | 14 | 70 | 8 | 90 | 12 | 70 |
7–8 | 16 | 90 | 19 | 70 | 8 | 90 | 12 | 70 |
9–10 | 16 | 95 | 24 | 75 | 8 | 95 | 12 | 75 |
11–12 | 16 | 95 | 24 | 75 | 8 | 95 | 12 | 75 |
13–16 | 16 | 95 | 24 | 75 | 8 | 95 | 12 | 75 |
HV-HIIT bike | LV-HIIT bike | |||||||
Weeks | Volume (min) | Intensity (%HRres) | Volume (min) | Intensity (%HRres) | Volume (min) | Intensity (%HRres) | Volume (min) | Intensity (%HRres) |
1–2 | 2–2:30 | 85 | 17:30 | 65 | 2–2:30 | 85 | 17:30 | 65 |
3–4 | 3–3:30 | 85 | 21:30 | 65 | 3–3:30 | 85 | 16:30 | 65 |
5–6 | 4–4:30 | 90 | 25:30 | 70 | 4 | 90 | 16 | 70 |
7–8 | 5–5:30 | 90 | 29:30 | 70 | 4 | 90 | 16 | 70 |
9–10 | 6–6:30 | 95 | 33:30 | 75 | 4 | 95 | 16 | 75 |
11–12 | 7–7:30 | 95 | 32:30 | 75 | 4 | 95 | 16 | 75 |
13–16 | 8 | 95 | 32 | 75 | 4 | 95 | 16 | 75 |
High-intensity interval training protocol on the treadmill
High-intensity interval training protocol on the bike
Participant withdrawal
Data analysis
Discussion
-
Does LV-HIIT provide similar benefits compared to HV-HIIT and is it associated with a lower risk of all-cause mortality in population after MI, being able to confirm that “less is more”?
-
Which combination of treatment (Mediet recommendations + physical activity recommendation vs Mediet recommendations + supervised exercise) is most valuable in reducing cardiovascular risk in patients after MI?