SMARTEX-HF

Study of Myocardial Recovery After Exercise Training in Heart Failure

Paziente / Popolazione Intervento / Esposizione Confronto Esito

In 261 patients with heart failure and reduced ejection fraction, 12 weeks of supervised high-intensity interval training produced no greater reverse remodelling or gain in left ventricular end-diastolic diameter and peak oxygen uptake than moderate continuous training.

261

Disegno

Randomised controlled trial with three arms and 52-week follow-up

Esito

Change in left ventricular end-diastolic diameter at 12 weeks

Rilevanza

RisultatoNo difference between interval and moderate continuous training (p=0.45); peak VO₂ also equivalent (p=0.70). None of the gains persisted at 52 weeks. Half the interval arm trained below target and 80 % of the moderate arm above it.

Ellingsen Ø, Halle M, Conraads V, et al. Circulation. 2017;135(9):839-849. 10.1161/CIRCULATIONAHA.116.022924

Discussione e critica

As a dose comparison it is compromised by its own adherence data — the two arms converged, so the null may simply reflect failed separation. That failure is itself the finding: it demolished the small-trial claim that interval training is superior in heart failure and keeps moderate continuous training as the default.