High-Intensity Interval Exercise in Chronic Heart Failure: Protocol Optimization

Background: There are little data on the optimization of high-intensity aerobic interval exercise (HIIE) protocols in patients with chronic heart failure (CHF). Therefore, we compared acute cardiopulmonary responses to 4 different HIIE protocols to identify the optimal one. Methods and Results: Twenty men with stable systolic CHF performed 4 different randomly ordered single HIIE sessions with measurement of gas exchange. For all protocols (A, B, C, and D) exercise intensity was set at 100% of peak power output (PPO). Interval duration was 30 seconds (A and B) or 90 seconds (C and D), and recovery was passive (A and C) or active (50% of PPO in B and D). Time spent above 85% of VO2peak and time above the ventilatory threshold were similar across all 4 HIIE protocols. Total exercise time was significantly longer in protocols with passive recovery intervals (A: 1,651 +/- 347 s; C: 1,574 +/- 382 s) compared with protocols with active recovery intervals (B: 986 +/- 542 s; D: 961 +/- 556 s). All protocols appeared to be safe, with exercise tolerance being superior during protocol A. Conclusion: Among the 4 HIIE protocols tested, protocol A with short intervals and passive recovery appeared to be superior. (J Cardiac Fail 2012;18:126-133)