BACKGROUND Type 2 diabetes mellitus(T2DM)is a chronic metabolic syndrome characterized by insulin resistance and hyperglycemia that may lead to endothelial dysfunction,reduced functional capacity and exercise intolera...BACKGROUND Type 2 diabetes mellitus(T2DM)is a chronic metabolic syndrome characterized by insulin resistance and hyperglycemia that may lead to endothelial dysfunction,reduced functional capacity and exercise intolerance.Regular aerobic exercise has been promoted as the most beneficial non-pharmacological treatment of cardiovascular diseases.High intensity interval training(HIIT)seems to be superior than moderate-intensity continuous training(MICT)in cardiovascular diseases by improving brachial artery flow-mediated dilation(FMD)and cardiorespiratory fitness to a greater extent.However,the beneficial effects of HIIT in patients with T2DM still remain under investigation and number of studies is limited.AIM To evaluate the effectiveness of high intensity interval training on cardiorespiratory fitness and endothelial function in patients with T2DM.METHODS We performed a search on PubMed,PEDro and CINAHL databases,selecting papers published between December 2012 and December 2022 and identified published randomized controlled trials(RCTs)in the English language that included community or outpatient exercise training programs in patients with T2DM.RCTs were assessed for methodological rigor and risk of bias via the Physiotherapy Evidence Database(PEDro).The primary outcome was peak VO_(2 ) and the secondary outcome was endothelial function assessed either by FMD or other indices of microcirculation.RESULTS Twelve studies were included in our systematic review.The 12 RCTs resulted in 661 participants in total.HIIT was performed in 310 patients(46.8%),MICT to 271 and the rest 80 belonged to the control group.Peak VO_(2 ) increased in 10 out of 12 studies after HIIT.Ten studies compared HIIT with other exercise regimens(MICT or strength endurance)and 4 of them demonstrated additional beneficial effects of HIIT over MICT or other exercise regimens.Moreover,4 studies explored the effects of HIIT on endothelial function and FMD in T2DM patients.In 2 of them,HIIT further improved endothelial function compared to MICT and/or the control group while in the rest 2 studies no differences between HIIT and MICT were observed.CONCLUSION Regular aerobic exercise training has beneficial effects on cardiorespiratory fitness and endothelial function in T2DM patients.HIIT may be superior by improving these parameters to a greater extent than MICT.展开更多
Neuropathy is nerve damage that can cause chronic neuropathic pain, which is challenging to cure and has a significant financial burden. Exercise therapies, including High-Intensity Interval Training (HIIT) and steady...Neuropathy is nerve damage that can cause chronic neuropathic pain, which is challenging to cure and has a significant financial burden. Exercise therapies, including High-Intensity Interval Training (HIIT) and steady-state cardio, are being explored as potential treatments for neuropathic pain. This systematic review compares the effectiveness of HIIT and steady-state cardio for improving function in neurological patients. This article provides an overview of the systematic review conducted on the effects of exercise on neuropathic patients, with a focus on high-intensity interval training (HIIT) and steady-state cardio. The authors conducted a comprehensive search of various databases, identified relevant studies based on predetermined inclusion criteria, and used the EPPI automation application to process the data. The final selection of studies was based on validity and relevance, with redundant articles removed. The article reviews four studies that compare high-intensity interval training (HIIT) to moderate-intensity continuous training (MICT) on various health outcomes. The studies found that HIIT can improve aerobic fitness, cerebral blood flow, and brain function in stroke patients;lower diastolic blood pressure more than MICT and improve insulin sensitivity and skeletal muscle mitochondrial content in obese individuals, potentially helping with the prevention and management of type 2 diabetes. In people with multiple sclerosis, acute exercise can decrease the plasma neurofilament light chain while increasing the flow of the kynurenine pathway. The available clinical and preclinical data suggest that further study on high-intensity interval training (HIIT) and its potential to alleviate neuropathic pain is justified. Randomized controlled trials are needed to investigate the type, intensity, frequency, and duration of exercise, which could lead to consensus and specific HIIT-based advice for patients with neuropathies.展开更多
Aerobic capacity, which is expressed as peak oxygen consumption (VO2peak), is well-known to be an independent predictor of all-cause mortality and cardiovascular prognosis. This is true even for people with various co...Aerobic capacity, which is expressed as peak oxygen consumption (VO2peak), is well-known to be an independent predictor of all-cause mortality and cardiovascular prognosis. This is true even for people with various coronary risk factors and cardiovascular diseases. Although exercise training is the best method to improve VO2peak, the guidelines of most academic societies recommend 150 or 75 min of moderate- or vigorous- intensity physical activities, respectively, every week to gain health benefits. For general health and primary and secondary cardiovascular prevention, high-intensity interval training (HIIT) has been recognized as an efficient exercise protocol with short exercise sessions. Given the availability of the numerous HIIT protocols, which can be classified into aerobic HIIT and anaerobic HIIT [usually called sprint interval training (SIT)], professionals in health-related fields, including primary physicians and cardiologists, may find it confusing when trying to select an appropriate protocol for their patients. This review describes the classifications of aerobic HIIT and SIT, and their differences in terms of effects, target subjects, adaptability, working mechanisms, and safety. Understanding the HIIT protocols and adopting the correct type for each subject would lead to better improvements in VO2peak with higher adherence and less risk.展开更多
BACKGROUND Femoral and tibial stress injuries are commonly found in long distance running athletes.Stress fractures have rarely been reported in athletes performing high intensity interval training(HIIT)exercise.The o...BACKGROUND Femoral and tibial stress injuries are commonly found in long distance running athletes.Stress fractures have rarely been reported in athletes performing high intensity interval training(HIIT)exercise.The objective of this study was to report a case of a patient who presented with medial tibial stress syndrome and femoral neck stress fracture after performing HIIT exercises.CASE SUMMARY A 26 year old female presented with bilateral medial tibial pain.She had been performing HIIT exercise for 45 min,five times weekly,for a seven month period.Her tibial pain was gradual in onset,and was now severe and worse on exercise,despite six weeks of rest.Magnetic resonance imaging(MRI)revealed bilateral medial tibial stress syndrome.As she was taking norethisterone for birth control,a dual energy X-ray absorbitometry scan was performed which demonstrated normal bone mineral density of her lumbar spine and femoral neck.She was managed conservatively with analgesia and physiotherapy,but continued to exercise against medical advice.She presented again six months later with severe right hip pain.MRI of her right hip demonstrated an incomplete stress fracture of her subtrochanteric region.Her symptoms resolved with strict rest and physiotherapy.CONCLUSION HIIT may cause stress injury of the tibia and femur in young individuals.展开更多
Objective: This systematic review aimed to critically analyze the literature to determine how high-intensity intermittent training(HIIT) affects recreational endurance runners in the short-and long-term.Methods: Elect...Objective: This systematic review aimed to critically analyze the literature to determine how high-intensity intermittent training(HIIT) affects recreational endurance runners in the short-and long-term.Methods: Electronic databases were searched for literature dating from January 2000 to October 2015. The search was conducted using the key words "high-intensity intermittent training" or "high-intensity interval exercise" or "interval running" or "sprint interval training" and "endurance runners" or "long distance runners". A systematic approach was used to evaluate the 783 articles identified for initial review. Studies were included if they investigated HIIT in recreational endurance runners. The methodological quality of the studies was evaluated using the Physiotherapy Evidence Database(PEDro) scale(for intervention studies) and the modified Downs and Black Quality Index(for cross-sectional studies).Results: Twenty-three studies met the inclusionary criteria for review. The results are presented in 2 parts: cross-sectional(n = 15) and intervention studies(n = 8). In the 15 cross-sectional studies selected, endurance runners performed at least 1 HIIT protocol, and the acute impact on physiological, neuromuscular, metabolic and/or biomechanical variables was assessed. Intervention studies lasted a minimum of 4 weeks, with 10 weeks being the longest intervention period, and included 2 to 4 HIIT sessions per week. Most of these studies combined HIIT sessions with continuous run(CR) sessions; 2 studies' subjects performed HIIT exclusively.Conclusion: HIIT-based running plans(2 to 3 HIIT sessions per week, combining HIIT and CR runs) show athletic performance improvements in endurance runners by improving maximal oxygen uptake and running economy along with muscular and metabolic adaptations. To maximize the adaptations to training, both HIIT and CR must be part of training programs for endurance runners.展开更多
Increases in power output and maximal oxygen consumption(V_O2max)occur in response to sprint interval exercise(SIE),but common use of“all-out”intensities presents a barrier for many adults.Furthermore,lower-body SIE...Increases in power output and maximal oxygen consumption(V_O2max)occur in response to sprint interval exercise(SIE),but common use of“all-out”intensities presents a barrier for many adults.Furthermore,lower-body SIE is not feasible for all adults.We compared physiological and perceptual responses to supramaximal,but“nonall-out”SIE between leg and arm cycling exercise.Twenty-four active adults(mean±SD age:[25±7]y;cycling VO_(2)max:[39±7]mL·kg^(-1)·min^(-1))performed incremental exercise using leg(LCE)and arm cycle ergometry(ACE)to determine VO_(2)max and maximal work capacity(Wmax).Subsequently,they performed four 20 s bouts of SIE at 130% Wmax on the LCE or ACE at cadence=120-130 rev/min,with 2 min recovery between intervals.Gas exchange data,heart rate(HR),blood lactate concentration(BLa),rating of perceived exertion(RPE),and affective valence were acquired.Data showed significantly lower(p<0.001)absolute mean([1.24±0.31]L·min^(-1) vs.[1.59±0.34]L·min^(-1);d=1.08)and peak VO_(2)([1.79±0.48]L·min^(-1) vs.[2.10±0.44]L·min^(-1);d=0.70)with ACE versus LCE.However,ACE elicited significantly higher(p<0.001)relative mean([62%±9%]VO_(2)max vs.[57%±7%]VO_(2)max,d=0.63)and peak VO_(2)([88%±10%]VO_(2)max vs.[75%±10%]VO_(2)max,d?1.33).Post-exercise BLa was significantly higher([7.0±1.7]mM vs.[5.7±1.5]mM,p=0.024,d?0.83)for LCE versus ACE.There was no significant effect of modality on RPE or affective valence(p>0.42),and lowest affective valence recorded(2.0±1.8)was considered“good to fairly good”.Data show that non“all-out”ACE elicits lower absolute but higher relative HR and VO_(2) compared to LCE.Less aversive perceptual responses could make this non-all-out modality feasible for inactive adults.展开更多
Heart transplantation remains the gold standard in the treatment of end-stage heart failure(HF).Heart transplantation patients present lower exercise capacity due to cardiovascular and musculoskeletal alterations lead...Heart transplantation remains the gold standard in the treatment of end-stage heart failure(HF).Heart transplantation patients present lower exercise capacity due to cardiovascular and musculoskeletal alterations leading thus to poor quality of life and reduction in the ability of daily self-service.Impaired vascular function and diastolic dysfunction cause lower cardiac output while decreased skeletal muscle oxidative fibers,enzymes and capillarity cause arteriovenous oxygen difference,leading thus to decreased peak oxygen uptake in heart transplant recipients.Exercise training improves exercise capacity,cardiac and vascular endothelial function in heart transplant recipients.Pre-rehabilitation regular aerobic or combined exercise is beneficial for patients with end-stage HF awaiting heart transplantation in order to maintain a higher fitness level and reduce complications afterwards like intensive care unit acquired weakness or cardiac cachexia.All hospitalized patients after heart transplantation should be referred to early mobilization of skeletal muscles through kinesiotherapy of the upper and lower limbs and respiratory physiotherapy in order to prevent infections of the respiratory system prior to hospital discharge.Moreover,all heart transplant recipients after hospital discharge who have not already participated in an early cardiac rehabilitation program should be referred to a rehabilitation center by their health care provider.Although high intensity interval training seems to have more benefits than moderate intensity continuous training,especially in stable transplant patients,individualized training based on the abilities and needs of each patient still remains the most appropriate approach.Cardiac rehabilitation appears to be safe in heart transplant patients.However,long-term follow-up data is incomplete and,therefore,further high quality and adequately-powered studies are needed to demonstrate the long-term benefits of exercise training in this population.展开更多
One of the most important prognostic factors in heart failure patients is physical capacity. Patients with very poor physical performance and otherwise eligible, may be listed as candidates for heart transplantation(H...One of the most important prognostic factors in heart failure patients is physical capacity. Patients with very poor physical performance and otherwise eligible, may be listed as candidates for heart transplantation(HTx). After such surgery, life-long immunosuppression therapy is needed to prevent rejection of the new heart. The dark side of immunosuppression is the increased risk of infections, kidney failure, cancer and advanced atherosclerosis(cardiac allograft vasculopathy), with the two latter conditions as the main causes of later mortality. In a worldwide perspective, 50% of the HTx patients survive past 10 years. Poor aerobic capacity prior to graft deterioration is not only limited to the failing heart, but also caused by peripheral factors, such as limited function in the skeletal muscles and in the blood vessels walls. Exercise rehabilitation after HTx is of major importance in order to improve physical capacity and prognosis. Effects of high-intensity interval training(HIT) in HTx recipients is a growing field of research attracting worldwide focus and interest. Accumulating evidence has shown that HIT is safe and efficient in maintenance HTx recipients; with superior effects on physical capacity compared to conventional moderate exercise. This article generates further evidence to the field by summarizing results from a decade of research performed at our center supported by a broad, but not strict formal, literature review. In short, this article demonstrates a strong association between physical capacity measured after HTx and long-term survival. It describes the possible "HITeffect" with increased levels of inflammatory mediators of angiogenesis. It also describes long-term effects of HIT; showing a positive effect in development of anxiety symptoms despite that the improved physical capacity was not sustained, due to downregulation ofexercise and intensity. Finally, our results are linked to the ongoing HITTS study, which investigates safety and efficiency of HIT in de novo HTx recipients. Together with previous results, this study may have the potential to change existing guidelines and contribute to a better prognosis for the HTx population as a whole.展开更多
文摘BACKGROUND Type 2 diabetes mellitus(T2DM)is a chronic metabolic syndrome characterized by insulin resistance and hyperglycemia that may lead to endothelial dysfunction,reduced functional capacity and exercise intolerance.Regular aerobic exercise has been promoted as the most beneficial non-pharmacological treatment of cardiovascular diseases.High intensity interval training(HIIT)seems to be superior than moderate-intensity continuous training(MICT)in cardiovascular diseases by improving brachial artery flow-mediated dilation(FMD)and cardiorespiratory fitness to a greater extent.However,the beneficial effects of HIIT in patients with T2DM still remain under investigation and number of studies is limited.AIM To evaluate the effectiveness of high intensity interval training on cardiorespiratory fitness and endothelial function in patients with T2DM.METHODS We performed a search on PubMed,PEDro and CINAHL databases,selecting papers published between December 2012 and December 2022 and identified published randomized controlled trials(RCTs)in the English language that included community or outpatient exercise training programs in patients with T2DM.RCTs were assessed for methodological rigor and risk of bias via the Physiotherapy Evidence Database(PEDro).The primary outcome was peak VO_(2 ) and the secondary outcome was endothelial function assessed either by FMD or other indices of microcirculation.RESULTS Twelve studies were included in our systematic review.The 12 RCTs resulted in 661 participants in total.HIIT was performed in 310 patients(46.8%),MICT to 271 and the rest 80 belonged to the control group.Peak VO_(2 ) increased in 10 out of 12 studies after HIIT.Ten studies compared HIIT with other exercise regimens(MICT or strength endurance)and 4 of them demonstrated additional beneficial effects of HIIT over MICT or other exercise regimens.Moreover,4 studies explored the effects of HIIT on endothelial function and FMD in T2DM patients.In 2 of them,HIIT further improved endothelial function compared to MICT and/or the control group while in the rest 2 studies no differences between HIIT and MICT were observed.CONCLUSION Regular aerobic exercise training has beneficial effects on cardiorespiratory fitness and endothelial function in T2DM patients.HIIT may be superior by improving these parameters to a greater extent than MICT.
文摘Neuropathy is nerve damage that can cause chronic neuropathic pain, which is challenging to cure and has a significant financial burden. Exercise therapies, including High-Intensity Interval Training (HIIT) and steady-state cardio, are being explored as potential treatments for neuropathic pain. This systematic review compares the effectiveness of HIIT and steady-state cardio for improving function in neurological patients. This article provides an overview of the systematic review conducted on the effects of exercise on neuropathic patients, with a focus on high-intensity interval training (HIIT) and steady-state cardio. The authors conducted a comprehensive search of various databases, identified relevant studies based on predetermined inclusion criteria, and used the EPPI automation application to process the data. The final selection of studies was based on validity and relevance, with redundant articles removed. The article reviews four studies that compare high-intensity interval training (HIIT) to moderate-intensity continuous training (MICT) on various health outcomes. The studies found that HIIT can improve aerobic fitness, cerebral blood flow, and brain function in stroke patients;lower diastolic blood pressure more than MICT and improve insulin sensitivity and skeletal muscle mitochondrial content in obese individuals, potentially helping with the prevention and management of type 2 diabetes. In people with multiple sclerosis, acute exercise can decrease the plasma neurofilament light chain while increasing the flow of the kynurenine pathway. The available clinical and preclinical data suggest that further study on high-intensity interval training (HIIT) and its potential to alleviate neuropathic pain is justified. Randomized controlled trials are needed to investigate the type, intensity, frequency, and duration of exercise, which could lead to consensus and specific HIIT-based advice for patients with neuropathies.
文摘Aerobic capacity, which is expressed as peak oxygen consumption (VO2peak), is well-known to be an independent predictor of all-cause mortality and cardiovascular prognosis. This is true even for people with various coronary risk factors and cardiovascular diseases. Although exercise training is the best method to improve VO2peak, the guidelines of most academic societies recommend 150 or 75 min of moderate- or vigorous- intensity physical activities, respectively, every week to gain health benefits. For general health and primary and secondary cardiovascular prevention, high-intensity interval training (HIIT) has been recognized as an efficient exercise protocol with short exercise sessions. Given the availability of the numerous HIIT protocols, which can be classified into aerobic HIIT and anaerobic HIIT [usually called sprint interval training (SIT)], professionals in health-related fields, including primary physicians and cardiologists, may find it confusing when trying to select an appropriate protocol for their patients. This review describes the classifications of aerobic HIIT and SIT, and their differences in terms of effects, target subjects, adaptability, working mechanisms, and safety. Understanding the HIIT protocols and adopting the correct type for each subject would lead to better improvements in VO2peak with higher adherence and less risk.
文摘BACKGROUND Femoral and tibial stress injuries are commonly found in long distance running athletes.Stress fractures have rarely been reported in athletes performing high intensity interval training(HIIT)exercise.The objective of this study was to report a case of a patient who presented with medial tibial stress syndrome and femoral neck stress fracture after performing HIIT exercises.CASE SUMMARY A 26 year old female presented with bilateral medial tibial pain.She had been performing HIIT exercise for 45 min,five times weekly,for a seven month period.Her tibial pain was gradual in onset,and was now severe and worse on exercise,despite six weeks of rest.Magnetic resonance imaging(MRI)revealed bilateral medial tibial stress syndrome.As she was taking norethisterone for birth control,a dual energy X-ray absorbitometry scan was performed which demonstrated normal bone mineral density of her lumbar spine and femoral neck.She was managed conservatively with analgesia and physiotherapy,but continued to exercise against medical advice.She presented again six months later with severe right hip pain.MRI of her right hip demonstrated an incomplete stress fracture of her subtrochanteric region.Her symptoms resolved with strict rest and physiotherapy.CONCLUSION HIIT may cause stress injury of the tibia and femur in young individuals.
基金the University of Jaén for its support to the present study
文摘Objective: This systematic review aimed to critically analyze the literature to determine how high-intensity intermittent training(HIIT) affects recreational endurance runners in the short-and long-term.Methods: Electronic databases were searched for literature dating from January 2000 to October 2015. The search was conducted using the key words "high-intensity intermittent training" or "high-intensity interval exercise" or "interval running" or "sprint interval training" and "endurance runners" or "long distance runners". A systematic approach was used to evaluate the 783 articles identified for initial review. Studies were included if they investigated HIIT in recreational endurance runners. The methodological quality of the studies was evaluated using the Physiotherapy Evidence Database(PEDro) scale(for intervention studies) and the modified Downs and Black Quality Index(for cross-sectional studies).Results: Twenty-three studies met the inclusionary criteria for review. The results are presented in 2 parts: cross-sectional(n = 15) and intervention studies(n = 8). In the 15 cross-sectional studies selected, endurance runners performed at least 1 HIIT protocol, and the acute impact on physiological, neuromuscular, metabolic and/or biomechanical variables was assessed. Intervention studies lasted a minimum of 4 weeks, with 10 weeks being the longest intervention period, and included 2 to 4 HIIT sessions per week. Most of these studies combined HIIT sessions with continuous run(CR) sessions; 2 studies' subjects performed HIIT exclusively.Conclusion: HIIT-based running plans(2 to 3 HIIT sessions per week, combining HIIT and CR runs) show athletic performance improvements in endurance runners by improving maximal oxygen uptake and running economy along with muscular and metabolic adaptations. To maximize the adaptations to training, both HIIT and CR must be part of training programs for endurance runners.
文摘Increases in power output and maximal oxygen consumption(V_O2max)occur in response to sprint interval exercise(SIE),but common use of“all-out”intensities presents a barrier for many adults.Furthermore,lower-body SIE is not feasible for all adults.We compared physiological and perceptual responses to supramaximal,but“nonall-out”SIE between leg and arm cycling exercise.Twenty-four active adults(mean±SD age:[25±7]y;cycling VO_(2)max:[39±7]mL·kg^(-1)·min^(-1))performed incremental exercise using leg(LCE)and arm cycle ergometry(ACE)to determine VO_(2)max and maximal work capacity(Wmax).Subsequently,they performed four 20 s bouts of SIE at 130% Wmax on the LCE or ACE at cadence=120-130 rev/min,with 2 min recovery between intervals.Gas exchange data,heart rate(HR),blood lactate concentration(BLa),rating of perceived exertion(RPE),and affective valence were acquired.Data showed significantly lower(p<0.001)absolute mean([1.24±0.31]L·min^(-1) vs.[1.59±0.34]L·min^(-1);d=1.08)and peak VO_(2)([1.79±0.48]L·min^(-1) vs.[2.10±0.44]L·min^(-1);d=0.70)with ACE versus LCE.However,ACE elicited significantly higher(p<0.001)relative mean([62%±9%]VO_(2)max vs.[57%±7%]VO_(2)max,d=0.63)and peak VO_(2)([88%±10%]VO_(2)max vs.[75%±10%]VO_(2)max,d?1.33).Post-exercise BLa was significantly higher([7.0±1.7]mM vs.[5.7±1.5]mM,p=0.024,d?0.83)for LCE versus ACE.There was no significant effect of modality on RPE or affective valence(p>0.42),and lowest affective valence recorded(2.0±1.8)was considered“good to fairly good”.Data show that non“all-out”ACE elicits lower absolute but higher relative HR and VO_(2) compared to LCE.Less aversive perceptual responses could make this non-all-out modality feasible for inactive adults.
文摘Heart transplantation remains the gold standard in the treatment of end-stage heart failure(HF).Heart transplantation patients present lower exercise capacity due to cardiovascular and musculoskeletal alterations leading thus to poor quality of life and reduction in the ability of daily self-service.Impaired vascular function and diastolic dysfunction cause lower cardiac output while decreased skeletal muscle oxidative fibers,enzymes and capillarity cause arteriovenous oxygen difference,leading thus to decreased peak oxygen uptake in heart transplant recipients.Exercise training improves exercise capacity,cardiac and vascular endothelial function in heart transplant recipients.Pre-rehabilitation regular aerobic or combined exercise is beneficial for patients with end-stage HF awaiting heart transplantation in order to maintain a higher fitness level and reduce complications afterwards like intensive care unit acquired weakness or cardiac cachexia.All hospitalized patients after heart transplantation should be referred to early mobilization of skeletal muscles through kinesiotherapy of the upper and lower limbs and respiratory physiotherapy in order to prevent infections of the respiratory system prior to hospital discharge.Moreover,all heart transplant recipients after hospital discharge who have not already participated in an early cardiac rehabilitation program should be referred to a rehabilitation center by their health care provider.Although high intensity interval training seems to have more benefits than moderate intensity continuous training,especially in stable transplant patients,individualized training based on the abilities and needs of each patient still remains the most appropriate approach.Cardiac rehabilitation appears to be safe in heart transplant patients.However,long-term follow-up data is incomplete and,therefore,further high quality and adequately-powered studies are needed to demonstrate the long-term benefits of exercise training in this population.
文摘One of the most important prognostic factors in heart failure patients is physical capacity. Patients with very poor physical performance and otherwise eligible, may be listed as candidates for heart transplantation(HTx). After such surgery, life-long immunosuppression therapy is needed to prevent rejection of the new heart. The dark side of immunosuppression is the increased risk of infections, kidney failure, cancer and advanced atherosclerosis(cardiac allograft vasculopathy), with the two latter conditions as the main causes of later mortality. In a worldwide perspective, 50% of the HTx patients survive past 10 years. Poor aerobic capacity prior to graft deterioration is not only limited to the failing heart, but also caused by peripheral factors, such as limited function in the skeletal muscles and in the blood vessels walls. Exercise rehabilitation after HTx is of major importance in order to improve physical capacity and prognosis. Effects of high-intensity interval training(HIT) in HTx recipients is a growing field of research attracting worldwide focus and interest. Accumulating evidence has shown that HIT is safe and efficient in maintenance HTx recipients; with superior effects on physical capacity compared to conventional moderate exercise. This article generates further evidence to the field by summarizing results from a decade of research performed at our center supported by a broad, but not strict formal, literature review. In short, this article demonstrates a strong association between physical capacity measured after HTx and long-term survival. It describes the possible "HITeffect" with increased levels of inflammatory mediators of angiogenesis. It also describes long-term effects of HIT; showing a positive effect in development of anxiety symptoms despite that the improved physical capacity was not sustained, due to downregulation ofexercise and intensity. Finally, our results are linked to the ongoing HITTS study, which investigates safety and efficiency of HIT in de novo HTx recipients. Together with previous results, this study may have the potential to change existing guidelines and contribute to a better prognosis for the HTx population as a whole.
