Contemporary review of exercise in heart transplant recipients.

Heart transplantation (HTx) is a therapeutic option for a selected group of patients with end-stage heart failure. Although secondary prevention including exercise therapy is recommended in the management of patients following HTx, little information is available on their metabolic and physiological consequences in HTx. Therefore, we aimed to conduct a contemporary review the effectiveness of exercise therapy on functional capacity, cardiovascular health and health-related quality of life for adult HTx patients. We searched the database MEDLINE for articles published between January 2015 and October 2020 and were able to include 6 studies involving 202 patients. Larger improvements in exercise capacity were seen after high-intensity interval training and in patients with evidence of cardiac reinnervation. Clinically relevant reductions were observed for daytime and 24 h ambulatory blood pressure after exercise training and following a single bout of aerobic exercise. Finally, limited data suggest that quality of life is higher in HTx patients following high-intensity training. In summary, the available evidence shows the potential for exercise as a vital treatment in patients following HTx. Yet, the scant data calls for more well-designed and adequately powered studies to support its effectiveness and to unravel optimal exercise characteristics, which would allow for more effective and person-tailored exercise prescription.

High-Intensity Interval Versus Moderate-Intensity Continuous Training in Individuals With Parkinson's Disease: Hemodynamic and Functional Adaptation.

PURPOSE: To investigate the effect of high-intensity interval training (HIIT) versus moderate-intensity continuous exercise training (MICE) on hemodynamic and functional variables in individuals with Parkinson's disease. METHODS: Twenty participants (13 men) were randomly assigned to a thrice-weekly HIIT (n = 12) or MICE (n = 8) for 12 weeks. Hemodynamic (resting heart rate and blood pressure, carotid femoral pulse wave velocity, endothelial reactivity, and heart rate variability) and functional variables (5-time sit-to-stand, timed up and go, and 6-min walking tests) assessed before and after training. RESULTS: Demographic, hemodynamic and functional variables were similar between groups at baseline. Endothelial reactivity tended to increase after HIIT, but not after MICE, resulting in improved level (∼8%, P < .01) of this variable in HIIT versus MICE during follow-up. Six-minute walking test improved after HIIT (10.4 ± 3.8%, P < .05), but did not change after MICE. Sit to stand improved similarly after HIIT (27.2 ± 6.1%, P < .05) and MICE (21.5 ± 5.4%, P < .05). No significant changes were found after HIIT or MICE in any other variable assessed. CONCLUSION: These results suggest that exercise intensity may influence training-induced adaptation on endothelial reactivity and aerobic capacity in individuals with Parkinson's disease.