Effect of high-intensity interval training versus moderate intensity continuous training in heart failure patients on cardiorespiratory fitness and quality of life: a systematic review and meta-analysis.
Level 1 - systematic review of randomized trials
Systematic review and meta-analysis of comparative trials
PubMed 41581773 · doi:10.1016/j.rmed.2026.108662
What was done
Systematic review and meta-analysis following PRISMA guidelines comparing high-intensity interval training (HIIT) with moderate intensity continuous training (MICT) in patients with heart failure. Searches were conducted across PubMed, EMBASE, Web of Science, Cochrane Central, and PEDro up to April 2025. Outcomes assessed were peak oxygen uptake (VO2 peak) and health-related quality of life (HRQoL), with subanalyses based on isocaloric protocols and left ventricular ejection fraction (LVEF).
What was found
Eighteen studies were included. HIIT improved VO2 peak compared to MICT by 1.49 mL/kg/min (95% CI: 0.74 to 2.24; I2 = 61.2%; N = 682). However, subanalysis of isocaloric exercise protocols stratified by LVEF showed no statistically significant difference between HIIT and MICT. No statistically significant difference was observed between groups for HRQoL (no numerical values reported in abstract).
Why it matters
These findings suggest that the apparent cardiorespiratory fitness advantage of HIIT over MICT in heart failure may be driven by higher energy expenditure rather than the interval format itself, as the advantage disappears under isocaloric conditions.
Limits
The primary outcome meta-analysis showed moderate heterogeneity (I2 = 61.2%). The abstract does not provide numerical values or effect estimates for HRQoL, nor sample sizes and specific statistics for the isocaloric or LVEF subgroup analyses. Hard clinical endpoints like hospitalizations or mortality were not reported.
Cited by
- supports Most forms of heart failure respond positively to high-intensity exercise training.