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      Feasibility and impact of whole-body high-intensity interval training in patients with stable coronary artery disease: a randomised controlled trial

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          Abstract

          Exercise training reduces cardiovascular mortality and improves quality of life in CAD patients. We investigated the feasibility and impact of 12 weeks of low-volume high-intensity interval training (HIIT) in CAD-patients. Patients with stable CAD were randomized 1:1 to supervised HIIT or standard care. HIIT sessions were completed three times weekly for 12 weeks on a rowing ergometer. Before and after the 12-week intervention, patients completed a physiological evaluation of cardiorespiratory performance and quality of life questionnaires. Mixed model analysis was used to evaluate differences between and within groups. A total of 142 patients (67 ± 9 years, n HIIT = 64, n Standard care = 78) completed the trial. Training adherence was 97% (range 86–100%). Six patients dropped out because of non-fatal adverse events. Weekly training duration was 54 min with an average power output of 138 W. HIIT increased peak oxygen uptake by 2.5 mL/kg/min (95% CI 2.1–3.0), whereas no change was observed in standard care (0.2 mL/kg/min, 95% CI − 0.2–0.6, P < 0.001). In addition, HIIT improved markers of quality of life, including physical functioning, limitations due to physical illness, general health and vitality (P < 0.05). Twelve weeks of low-volume whole-body HIIT increased cardiorespiratory capacity and improved quality of life in patients with stable CAD compared to standard care. In addition, our study demonstrates that the applied vigorous training regime is feasible for this patient group.

          Clinical trial registration: www.clinicaltrials.gov. Identification number: NCT04268992.

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          2016 European Guidelines on cardiovascular disease prevention in clinical practice: The Sixth Joint Task Force of the European Society of Cardiology and Other Societies on Cardiovascular Disease Prevention in Clinical Practice (constituted by representatives of 10 societies and by invited experts)Developed with the special contribution of the European Association for Cardiovascular Prevention & Rehabilitation (EACPR).

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            Exercise as medicine - evidence for prescribing exercise as therapy in 26 different chronic diseases.

            This review provides the reader with the up-to-date evidence-based basis for prescribing exercise as medicine in the treatment of 26 different diseases: psychiatric diseases (depression, anxiety, stress, schizophrenia); neurological diseases (dementia, Parkinson's disease, multiple sclerosis); metabolic diseases (obesity, hyperlipidemia, metabolic syndrome, polycystic ovarian syndrome, type 2 diabetes, type 1 diabetes); cardiovascular diseases (hypertension, coronary heart disease, heart failure, cerebral apoplexy, and claudication intermittent); pulmonary diseases (chronic obstructive pulmonary disease, asthma, cystic fibrosis); musculo-skeletal disorders (osteoarthritis, osteoporosis, back pain, rheumatoid arthritis); and cancer. The effect of exercise therapy on disease pathogenesis and symptoms are given and the possible mechanisms of action are discussed. We have interpreted the scientific literature and for each disease, we provide the reader with our best advice regarding the optimal type and dose for prescription of exercise.
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              Cardiorespiratory fitness as a quantitative predictor of all-cause mortality and cardiovascular events in healthy men and women: a meta-analysis.

              Epidemiological studies have indicated an inverse association between cardiorespiratory fitness (CRF) and coronary heart disease (CHD) or all-cause mortality in healthy participants. To define quantitative relationships between CRF and CHD events, cardiovascular disease (CVD) events, or all-cause mortality in healthy men and women. A systematic literature search was conducted for observational cohort studies using MEDLINE (1966 to December 31, 2008) and EMBASE (1980 to December 31, 2008). The Medical Subject Headings search terms used included exercise tolerance, exercise test, exercise/physiology, physical fitness, oxygen consumption, cardiovascular diseases, myocardial ischemia, mortality, mortalities, death, fatality, fatal, incidence, or morbidity. Studies reporting associations of baseline CRF with CHD events, CVD events, or all-cause mortality in healthy participants were included. Two authors independently extracted relevant data. CRF was estimated as maximal aerobic capacity (MAC) expressed in metabolic equivalent (MET) units. Participants were categorized as low CRF ( or = 10.9 METs). CHD and CVD were combined into 1 outcome (CHD/CVD). Risk ratios (RRs) for a 1-MET higher level of MAC and for participants with lower vs higher CRF were calculated with a random-effects model. Data were obtained from 33 eligible studies (all-cause mortality, 102 980 participants and 6910 cases; CHD/CVD, 84 323 participants and 4485 cases). Pooled RRs of all-cause mortality and CHD/CVD events per 1-MET higher level of MAC (corresponding to 1-km/h higher running/jogging speed) were 0.87 (95% confidence interval [CI], 0.84-0.90) and 0.85 (95% CI, 0.82-0.88), respectively. Compared with participants with high CRF, those with low CRF had an RR for all-cause mortality of 1.70 (95% CI, 1.51-1.92; P < .001) and for CHD/CVD events of 1.56 (95% CI, 1.39-1.75; P < .001), adjusting for heterogeneity of study design. Compared with participants with intermediate CRF, those with low CRF had an RR for all-cause mortality of 1.40 (95% CI, 1.32-1.48; P < .001) and for CHD/CVD events of 1.47 (95% CI, 1.35-1.61; P < .001), adjusting for heterogeneity of study design. Better CRF was associated with lower risk of all-cause mortality and CHD/CVD. Participants with a MAC of 7.9 METs or more had substantially lower rates of all-cause mortality and CHD/CVD events compared with those with a MAC of less 7.9 METs.
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                Author and article information

                Contributors
                magnim@setur.fo
                Journal
                Sci Rep
                Sci Rep
                Scientific Reports
                Nature Publishing Group UK (London )
                2045-2322
                14 October 2022
                14 October 2022
                2022
                : 12
                : 17295
                Affiliations
                [1 ]Department of Medicine, National Hospital of the Faroe Islands, Tórshavn, Faroe Islands
                [2 ]GRID grid.154185.c, ISNI 0000 0004 0512 597X, Department of Clinical Biochemistry, , Aarhus University Hospital, ; Aarhus, Denmark
                [3 ]GRID grid.154185.c, ISNI 0000 0004 0512 597X, Department of Cardiology, , Aarhus University Hospital, ; Aarhus, Denmark
                [4 ]GRID grid.7048.b, ISNI 0000 0001 1956 2722, Faculty of Health, , Aarhus University, ; Aarhus, Denmark
                [5 ]GRID grid.449708.6, ISNI 0000 0004 0608 1526, Faculty of Health, , University of the Faroe Islands, ; Tórshavn, Faroe Islands
                [6 ]GRID grid.5254.6, ISNI 0000 0001 0674 042X, Department of Nutrition, Exercise and Sports, , University of Copenhagen, ; Copenhagen, Denmark
                [7 ]GRID grid.10825.3e, ISNI 0000 0001 0728 0170, Department of Sports Science and Clinical Biomechanics, SDU Sport and Health Sciences Cluster (SHSC), , University of Southern Denmark, ; 5230 Odense M, Denmark
                Article
                21655
                10.1038/s41598-022-21655-w
                9568554
                36241898
                b01f2a20-6730-458f-9032-67e8fa6898e4
                © The Author(s) 2022

                Open Access This article is licensed under a Creative Commons Attribution 4.0 International License, which permits use, sharing, adaptation, distribution and reproduction in any medium or format, as long as you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons licence, and indicate if changes were made. The images or other third party material in this article are included in the article's Creative Commons licence, unless indicated otherwise in a credit line to the material. If material is not included in the article's Creative Commons licence and your intended use is not permitted by statutory regulation or exceeds the permitted use, you will need to obtain permission directly from the copyright holder. To view a copy of this licence, visit http://creativecommons.org/licenses/by/4.0/.

                History
                : 20 June 2022
                : 29 September 2022
                Funding
                Funded by: Research Council Faroe Islands
                Award ID: 3029
                Award Recipient :
                Funded by: The Betri Foundation
                Funded by: Aarhus University
                Categories
                Article
                Custom metadata
                © The Author(s) 2022

                Uncategorized
                cardiology,quality of life,randomized controlled trials,cardiovascular diseases
                Uncategorized
                cardiology, quality of life, randomized controlled trials, cardiovascular diseases

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