High-intensity Interval Versus Moderate-intensity Continuous Training in Heart Failure Rehabilitation: A Meta-analysis and Meta-regression.
Level 1 - systematic review of randomized trials
Systematic review and meta-analysis of randomized controlled trials
PubMed 41377639 · doi:10.17925/HI.2025.19.2.7
What was done
A systematic review and meta-analysis adhering to PRISMA guidelines and registered in PROSPERO (CRD42024602309) compared high-intensity interval training (HIIT) with moderate-intensity continuous training (MICT) in heart failure rehabilitation. Searches were conducted across 10 databases including PubMed, CENTRAL, Scopus, Web of Science, Embase, and others. Risk of bias was evaluated using the Cochrane RoB 2 tool, and meta-analyses were conducted in R.
What was found
Across 21 randomized controlled trials with overall low risk of bias, HIIT showed statistically significant benefits over MICT for left ventricular ejection fraction (MD = 2.69, 95% CI: 0.01 to 5.38, p = 0.0495), peak oxygen uptake (MD = 1.19, 95% CI: 0.43 to 1.95, p = 0.0021), and six-minute walk test distance (MD = 24.87, 95% CI: 11.19 to 37.75, p = 0.0002). There were non-significant differences for quality of life (MD = 1.11, 95% CI: -1.02 to 3.24, p = 0.31) and oxygen pulse (MD = 1.03, 95% CI: -0.18 to 2.24, p = 0.095).
Why it matters
This review indicates that HIIT may provide modest incremental improvements in functional capacity and cardiopulmonary fitness over standard moderate continuous exercise for heart failure patients during cardiac rehabilitation.
Limits
The abstract does not report the total participant count, patient phenotypes (such as preserved vs. reduced ejection fraction), training volume, adherence, or adverse events. The observed improvement in ejection fraction was borderline statistically significant, and the functional improvements did not translate to statistically significant gains in quality of life.
Cited by
- supports Most forms of heart failure respond positively to high-intensity exercise training.