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“Summary of: Wisloff U et al (2007) Superior cardiovascular effect of aerobic interval training versus moderate continuous training in heart failure patients: a randomized study. Circulation 115: 3086–3094. [Prepared by Kylie Hill, CAP Editor.] Question: Is aerobic interval training (AIT) more effective than moderate continuous training

(MCT) at enhancing aerobic fitness and myocardial remodelling in patients with stable heart failure? Design: Randomised controlled trial in which participants were allocated to AIT, MCT, or a control group. Setting: Hospital in Trondheim, Norway. Participants: Adults with stable heart failure post myocardial infarction Stem Cells inhibitor with left ventricular ejection fraction (EF) < 40% on optimal medical management. Exclusion criteria comprised: unstable angina pectoris, uncompensated heart failure, myocardial infarction within four weeks, complex ventricular arrhythmias, no use of Đ-blockers and ACE inhibitors or, any other limitation to exercise. Randomisation of 27 patients allocated nine to each group. Interventions:

The AIT and MCT groups completed two supervised exercise training sessions and one home training session each week for 12 weeks. Those in AIT completed uphill treadmill walking that comprised a warm-up and cool down interspersed with 4 × 4 minute exercise intervals completed at 90–95% of peak heart rate. Intervals were separated by three minutes of walking at 50–70% of find more peak heart rate (total exercise time = 38 minutes). The MCT participants walked continuously for 47 minutes at 70–75% of peak heart rate. Weekly home

training comprised outdoor hill walking. The control group completed 47 minutes of supervised treadmill walking at 70% of peak heart rate once every three weeks. Outcome measures: The primary outcomes related to exercise capacity (eg, peak rate of oxygen uptake; VO2peak); secondary outcomes comprised measures of echocardiography and endothelial function. Results: Outcomes were available from 26 participants. The VO2peak achieved on completion of training was greater in the AIT group compared with about the MCT group (mean difference 4.1; 95% CI 2.4 to 5.8 ml/kg/min) and the control group (5.8, 95% CI 3.8 to 7.8 ml/kg/min). Compared with the other groups, AIT also conferred greater gains in measures of systolic and diastolic function and endothelial function. Conclusion: In adults with stable heart failure, AIT conferred greater gains than MCT in improving aerobic capacity and measures reflecting left ventricular and endothelial function. [Mean difference and 95% CIs calculated by the CAP Editor] A key objective of clinical exercise prescription is optimising physiological adaptations without placing the patient at risk of exercise-induced events.