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Background
Cardiac allograft vasculopathy (CAV) is a progressive form of atherosclerosis occurring in heart transplant (HTx) recipients, leading to increased morbidity and mortality. Given the atheroprotective effect of exercise on traditional atherosclerosis, we hypothesized that high-intensity interval training (HIIT) would reduce the progression of CAV among HTx recipients.
Methods
Forty-three cardiac allograft recipients (mean ¡À SD age 51 ¡À 16 years; 67 % men; time post-HTx 4.0 ¡À 2.2 years), all clinically stable and >18 years old, were randomized to either a HIIT group or control group (standard care) for 1 year. The effect of training on CAV progression was assessed by intravascular ultrasound (IVUS).
Results
IVUS analysis revealed a significantly smaller mean increase [95 % CI] in atheroma volume (PAV) of 0.9 % [95 % CI -;0.3 % to 1.9 % ] in the HIIT group as compared with the control group, 2.5 % [1.6 % to 3.5 % ] (p = 0.021). Similarly, the mean increase in total atheroma volume (TAV) was 0.3 [0.0 to 0.6] mm3/mm in the HIT group vs 1.1 [0.6 to 1.7] mm3/mm in the control group (p = 0.020), and mean increase in maximal intimal thickness (MIT) was 0.02?0.01 to 0.04] mm in the HIIT group vs 0.05 [0.03 to 0.08] mm in the control group (p = 0.054). Qualitative plaque progression (virtual histology parameters) and inflammatory activity (biomarkers) were similar between the 2 groups during the study period.
Conclusions
HIIT among maintenance HTx recipients resulted in a significantly impaired rate of CAV progression. Future larger studies should address whether exercise rehabilitation strategies should be included in CAV management protocols.
