High-intensity interval training reduces atheroma volume in patients with stable CAD following PCI: Study

The study, featured in the European Journal of Preventive Cardiology, suggests that HIIT counteracts the progression of atherosclerotic coronary disease and reduces atheroma volume in residual coronary atheromatous plaques following PCI (percutaneous coronary intervention).

Coronary atheroma volume is linked with coronary events risk in CAD (coronary artery disease). Exercise training is fundamental in primary and secondary CAD prevention, but the exercise's effect on coronary atheromatous plaques remains unknown. To fill this knowledge gap, Elisabeth Kleivhaug Vesterbekkmo, Clinic of Cardiology, St. Olavs University Hospital, Trondheim, Norway, and colleagues investigated the effect of six months of supervised high-intensity interval training on coronary plaque geometry using intravascular ultrasound in stable CAD patients following percutaneous coronary intervention.

The study included sixty patients; 30 were randomized to two weekly sessions of supervised HIIT at 85-95% of peak heart rate, and 30 followed current preventive guidelines (control group). Changes in percent atheroma volume and total atheroma volume (TAV) normalized for segment length (TAVnorm) were analyzed at a six-month follow-up (study endpoints).

The study revealed the following findings:

• The change in average PAV for matched coronary segments from baseline to follow-up showed a significant between-group difference (-1.4).
• There was a significant reduction in the HIIT group (-1.2) while not in the control group (0.2).
• TAVnorm was reduced (-9 mm3) after HIIT, with a significant between-group difference (-12.0 mm3).

"Among patients with stable coronary artery disease after PCI, HIIT is linked with regression of atheroma volume with implications for secondary preventive efforts," the authors concluded.

"The findings indicate that high-intensity interval training prevents atherosclerotic coronary disease progression and reduces atheroma volume in residual coronary atheromatous plaques following PCI," they conclude.

About High-intensity interval training

HIIT is a training protocol that alternates short periods of intense or fierce anaerobic exercise with short recovery periods until exhaustion. It comprises exercises performed in repeated quick bursts at maximum or near maximal efforts with low activity or periods of rest between bouts. It is differentiated from aerobic (cardiovascular) activity by very high-intensity level, number of spells, and interval duration because the body significantly involves anaerobic energy systems. Therefore, the method depends on "the anaerobic energy-releasing system almost maximally."

Reference:

Elisabeth Kleivhaug Vesterbekkmo, MD, Inger-Lise Aamot Aksetøy, PhD, Turid Follestad, PhD, Hans Olav Nilsen, Knut Hegbom, MD, Ulrik Wisløff, PhD, Rune Wiseth, MD, PhD, Erik Madssen, MD, PhD, High intensity interval training induces beneficial effects on coronary atheromatous plaques – a randomized trial, European Journal of Preventive Cardiology, 2022;, zwac309, https://doi.org/10.1093/eurjpc/zwac309