Skeletal muscle substrate oxidation was compared during moderate-intensity continuous exercise (MICE) and high-intensity intermittent exercise (HIIE) in patients with heart failure and reduced ejection fraction (HFREF). Eighteen patients (aged 60 ¡À 9 years; LVEF, 26 ¡À 7 % ) randomly performed MICE (22 minutes at 60 % of peak power) and HIIE (30 seconds at 100 % of peak power interspersed by 30 seconds' rest for 16 minutes). Carbohydrate and lipid oxidation calculated using the Frayn equation were 4.8- and 1.42-fold higher during MICE and 5-?and 1.22-fold higher during HIIE (P < 0.0001). HIIE and MICE can similarly and favourably increase carbohydrate and lipid oxidation in patients with HFREF.