High Intensity Training in de Novo Heart Transplant Recipients in Scandinavia

Conditions

Heart Transplant Recipients, Physical Fitness

Brief summary

Compared to end-stage heart failure, a patient's situation is usually greatly improved after a heart transplant (HTx), but the exercise capacity remains sub-normal, also long-term, ranging from 50 to 70% in most studies. While effective rehabilitation, including regular exercise, is considered an effective tool of improving health related quality of life (HRQoL) and prognosis of cardiac patients in general, the knowledge about and the effect of different rehabilitation programs among HTx recipients is limited. Exercise training is considered one of the most central parts in rehabilitation, but the mode of exercise used in different studies varies considerably. It is documented that high intensity interval training (HIT) has superior effects compared to training with moderate intensity in cardiac and heart failure patients. In contrast, HTx recipients have a denervated heart, and HIT had been considered unphysiological. However, the investigators have recently demonstrated highly beneficial effects on exercise capacity, muscle strength, body composition, reduced progression of cardiac allograft vasculopathy and HRQoL among long-term HTx recipients. In the present study the investigators want to test the hypothesis that systematic aerobic exercise with high intensity improve exercise capacity also in newly transplanted recipients, and secondarily that it gives favourable effects on the heart, peripheral circulation and a better HRQoL.

Muzammil Rafique, Ole Geir Solberg, Lars Gullestad, Bjørn Bendz, Klaus Murbræch et al. (8 authors)

BMJ Open Sport & Exercise Medicine2023-07-013 citations

10.1136/bmjsem-2022-001331

High-intensity interval training and health-related quality of life in de novo heart transplant recipients - results from a randomized controlled trial.

Rolid K, Andreassen AK, Yardley M, Gude E, Bjørkelund E, Authen AR, Grov I, Pettersen KI, Dall CH, Karason K, Broch K, Gullestad L, Nytrøen K.

2020-08-1718 citations

10.1186/s12955-020-01536-4

Effect of high-intensity interval training in young heart transplant recipients: results from two randomized controlled trials

Kari Nytrøen, Katrine Rolid, Marianne Yardley, Lars Gullestad

BMC Sports Science Medicine and Rehabilitation2020-06-0310 citations

10.1186/s13102-020-00180-1

Long-term effects of high-intensity training vs moderate intensity training in heart transplant recipients: A 3-year follow-up study of the randomized-controlled HITTS study

Katrine Rolid, S Simonsen, Marianne Yardley, L Gullestad, Elisabeth Bjørkelund et al. (10 authors)

American Journal of Transplantation2020-06-0219 citations

10.1111/ajt.16087

Effect of High-Intensity Interval Training in De Novo Heart Transplant Recipients in Scandinavia

Kari Nytrøen, Katrine Rolid, S Simonsen, Marianne Yardley, L Gullestad et al. (14 authors)

Circulation2019-02-1884 citations

10.1161/circulationaha.118.036747

Interventions

BEHAVIORALHigh Intensity Interval Training

9 months of high intensity interval based aerobic exercise (3 times/week)

BEHAVIORALModerate Training

Study design

Allocation

RANDOMIZED

Intervention model

PARALLEL

Primary purpose

PREVENTION

Masking

SINGLE (Outcomes Assessor)

Eligibility

Sex/Gender

ALL

Age

18 Years to No maximum

Healthy volunteers

No

Inclusion criteria

* Clinically stable HTx recipients approximately 8-12 weeks after HTx. * Age \> 18 years, both sexes * Received immunosuppressive therapy as per local protocol. * Patient willing and capable of giving written informed consent for study participation and anticipated to be able to participate in the study for 9- 12 months.

Exclusion criteria

* Unstable condition or postoperative complications * Recent severe rejection episodes * Physical disabilities which prevent participation * Other diseases or disabilities that contradict/refrain from exercise.

Design outcomes

Primary

Measure	Time frame	Description
Effect of exercise on peak oxygen uptake	Baseline to one year	Change in ml/kg/min

Secondary

Measure	Time frame	Description
Effect of exercise on progression of coronary artery vasculopathy (CAV)	Baseline to one year	Change measured by intravascular ultrasound; change in maximum intimal thickness, total atheroma volume, percent atheroma volume and virtual histology.
Effect of exercise on chronotropic responses	Baseline to one year	Change in heart rate response, including changes in minimum and maximum heart rate and changes in chronotropic response index.
Effect of exercise on myocardial function	Baseline to one year	Change in echocardiographic parametres such as stroke volume, cardiac index and ejection fraction.
Effect of exercise on endothelial function	Baseline to one year	Change in endothelial function measured by flow mediated dilatation and EndoPat
Effect of exercise on muscle strength	Baseline to one year	Change measured in Newtonmeter and Joule
Effect of exercise on health related quality of life	Baseline to one year	Change measured on visual analogue scales and questionnaires
Effect of exercise on safety and tolerability	Baseline to 3 years follow-up	Measured by number of serious adverse effects related to the intervention
Long-term effects of exercise	Baseline to 3 years follow-up	Long-term effects will be measured by all outcomes listed above, including number of serious adverse effects.
Effect of exercise on biomarkers	Baseline to one year	Neuroendocrine, inflammatory and immunological biomarkers.

Countries

Denmark, Norway, Sweden

Outcome results

None listed