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HRV-guided training vs traditional HIIT training in cardiac rehabilitation: a randomized controlled trial

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Abstract

High-intensity interval training is the gold standard for cardiac rehabilitation although current revascularization therapy focuses on the recovery of autonomic nervous system balance through heart rate variability (HRV). The main objective was to analyze the effect of HRV-guided training versus high-intensity interval training on cardiorespiratory fitness, heart rate variability, quality of life, and training volume at high intensity, as well as exercise adherence, safety, and feasibility in ischemic patients. This is an 8-week cluster randomized controlled trial with an HRV-based training group (HRV-G) and a traditional HIIT group (HIIT-G). Maximal oxygen consumption, heart rate, and blood pressure were measured during the Bruce protocol treadmill test. HRV was measured with the HRV4Training application, and quality of life with the MacNew QLMI. The repeated measures ANCOVA was used with the age and the baseline scores as covariables. Forty-six patients (mean age 55 ± 11.03 years) were randomized and assigned either to HRV-G (n = 23) or HIIT-G (n = 23). Both groups improved maximal oxygen consumption and METS (P > .05). However, the resting systolic blood pressure was lower in HRV-G (4.3 ± 1.2 mmHg, P = .05). In HRV-G, the resting diastolic, maximal diastolic, and systolic blood pressure decreased (5.4 ± 5.96 mmHg, P = .007; 11.4 ± 12.46 mmHg, P = .005; and 5 ± 5.98 mmHg, P = .013, respectively) whereas the recovery heart rate increased significantly (−21.5 ± 23.16 beats/min, P = .003). The LnrMSSDcv ([LnrMSSDSD/LnrMSSDMEAN] × 100) was lower in HRV-G (1.23 ± 0.91 mmHg, P = .03) while the training volume at high intensity was higher in HIIT-G (31.4 ± 29.2 min, P = .024). HRV-guided training presents a better cardioprotective effect than HIIT-G at a lower high-intensity training volume.

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Data availability

The data that support the findings of this study will openly available in the University of Almería repository through this link: https://repositorio.ual.es/submissions.

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Acknowledgements

We appreciate the involvement of the University Hospital Torrecardenas staff and Health Research Centre directives in this project.

Funding

This research was financially supported by the Health and Public Administration Research Center of the University of Almería. The human work group and the equipment were transferred by the University Hospital Torrecárdenas (Almería, Spain).

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Author notes

  1. María Carrasco-Poyatos and Rut López-Osca contributed equally to this work.

Authors and Affiliations

  1. Department of Education, Health and Public Administration Research Center, University of Almería, Carretera Sacramento s/n. 04120, La Cañada de San Urbano, Almería, Spain

    María Carrasco-Poyatos, Rut López-Osca & Antonio Granero-Gallegos

  2. Department of Physiotherapy, Physical Exercise and Human Performance Research Group, University of Murcia, Avda. Teniente Flomesta, 5, 30003, Murcia, Spain

    Ignacio Martínez-González-Moro

Authors
  1. María Carrasco-Poyatos
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  2. Rut López-Osca
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  3. Ignacio Martínez-González-Moro
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Contributions

Formal analysis — MCP, RLO; research — MCP, RLO, IMGM; methodology — MCP, AGG; project administration — MCP, AGG; supervision — MCP; writing the original draft — MCP, RLO; writing the review and editing — IMGM, AGG.

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Correspondence to María Carrasco-Poyatos.

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Key points

What is known about the topic?

- HIIT-guided training is safe and feasible in cardiac rehabilitation but standardized training programs provoke varying physiological responses among patients.

- HRV is a powerful health and mortality predictor post myocardial infarction as it is an indicator of the interaction between the autonomous nervous system and the cardiovascular system. It could be used as a tool for training individualization.

What does the study add?

- Both HRV-guided training and HIIT traditional training improved cardiorespiratory fitness (VO2max and METS) in cardiomyopathy patients, although HRV-guided training showed a more beneficial effect on blood pressure and heart rate parameters.

- The age was an interfering factor for HRV domains.

- Both training programs are safe and feasible for cardiac rehabilitation.

- Lower volumes of high-intensity training present a better cardioprotective effect than a standardized HIIT training program.

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Carrasco-Poyatos, M., López-Osca, R., Martínez-González-Moro, I. et al. HRV-guided training vs traditional HIIT training in cardiac rehabilitation: a randomized controlled trial. GeroScience 46, 2093–2106 (2024). https://doi.org/10.1007/s11357-023-00951-x

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