TOPLINE: 

A 12-week home-based high-intensity interval training (HIIT) program with online monitoring improved exercise capacity in adolescents and young adults with repaired tetralogy of Fallot (rToF) compared with usual care, a study reported. The regimen was safe, had no adverse cardiac effects, and may offer a practical alternative to traditional on-site supervised training. 

METHODOLOGY:

• Researchers conducted a randomized controlled trial between 2021 and 2024 at two Dutch medical centers to evaluate the effects of an online, home-based HIIT program on exercise capacity and cardiac size and function in adolescents and young adults with rToF.
• They enrolled 34 patients (median age, 16 years) with rToF who had undergone surgical correction before 2 years of age. Participants were randomly assigned to either a 12-week, home-based HIIT program or standard of care.
• The HIIT group completed three sessions per week (two jump-rope sessions and one body weight circuit with progressive overload), along with heart rate monitoring. Those in the standard of care group continued their usual lifestyle.
• The co-primary endpoints were changes in peak oxygen consumption and maximal workload. The secondary outcomes were changes in cardiac function and rhythm, evaluated using cardiac MRI, echocardiography, and ECG at baseline and 12 weeks and at 24 weeks when relevant.

TAKEAWAY:

• No serious adverse events were reported. The only minor adverse event was a training-related back strain in one participant, resulting in a 5-day pause.
• After 12 weeks, the HIIT group showed greater improvements in peak oxygen consumption than the standard-of-care group (between-group mean difference, 4.0 mL/kg/min; P = .003) and a greater maximal workload (mean difference, 17 W; P = .009).
• In the full exercise cohort that comprised patients initially assigned to HIIT and those who completed HIIT after the standard-of-care period, peak oxygen consumption increased by 2.4 mL/kg/min, maximal workload increased by 15 W, and oxygen pulse increased by 1.1 mL/beat.
• No changes in cardiac volumes, ejection fraction, or other parameters of cardiac structure and function were observed.

IN PRACTICE:

“Home-based HIIT was able to safely achieve improvements in exercise capacity that are consistent with, if not greater than, those reported for aerobic exercise programmes,” the authors wrote.

SOURCE:

The study was led by Wouter Jeroen van Genuchten of the Department of Pediatric Cardiology, Erasmus MC-Sophia in Rotterdam, Netherlands. It was published online on April 20 in Heart.

LIMITATIONS:

The study had a relatively small sample size of 34 patients, which limited statistical power to detect subtle differences in cardiac structure and function. Eight patients dropped out, particularly during the exercise period following the standard-of-care period. The strict inclusion criteria regarding age and residual lesions may have limited generalizability to older adults or patients with different hemodynamic profiles. 

DISCLOSURES:

No funding information was provided for this study. Two authors reported being supported by the Netherlands CardioVascular Research Initiative (supported by the Dutch Heart Foundation) and Hartekind. The authors reported having no relevant conflicts of interest.

This article was created using several editorial tools, including AI, as part of the process. Human editors reviewed this content before publication.