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High-intensity interval training in cardiac rehabilitation: a multi-centre randomized controlled trial

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posted on 2023-03-13, 12:24 authored by Gordon McGregor, Richard Powell, Brian Begg, Stefan T. Birkett, Simon Nichols, Stuart Ennis, Scott McGuireScott McGuire, Jonathon Prosser, Olivier Fiassam,, Siew Wan Hee, Thomas Hamborg, Prithwish Banerjee, Ned Hartfiel, Joanna M. Charles, Rhiannon T. Edwards, Aimee DraneAimee Drane, Danish Ali, Faizel Osman, Hejie He, Tom Lachlan, Mark J. Haykowsky, Lee Ingle, Rob Shave


There is a lack of international consensus regarding the prescription of high-intensity interval training (HIIT) for people with coronary artery disease (CAD) attending cardiac rehabilitation (CR).


To assess the clinical effectiveness and safety of low-volume HIIT compared with moderate-intensity steady-state (MISS) exercise training for people with CAD.

Methods and results

We conducted a multi-centre RCT, recruiting 382 patients from 6 outpatient CR centres. Participants were randomized to twice-weekly HIIT (n = 187) or MISS (n = 195) for 8 weeks. HIIT consisted of 10 × 1 min intervals of vigorous exercise (>85% maximum capacity) interspersed with 1 min periods of recovery. MISS was 20–40 min of moderate-intensity continuous exercise (60–80% maximum capacity). The primary outcome was the change in cardiorespiratory fitness [peak oxygen uptake (VO2 peak)] at 8 week follow-up. Secondary outcomes included cardiovascular disease risk markers, cardiac structure and function, adverse events, and health-related quality of life. At 8 weeks, VO2  peak improved more with HIIT (2.37−1.min−1; SD, 3.11) compared with MISS (1.32−1.min−1; SD, 2.66). After adjusting for age, sex, and study site, the difference between arms was 1.04−1.min−1 (95% CI, 0.38 to 1.69; P = 0.002). Only one serious adverse event was possibly related to HIIT.


In stable CAD, low-volume HIIT improved cardiorespiratory fitness more than MISS by a clinically meaningful margin. Low-volume HIIT is a safe, well-tolerated, and clinically effective intervention that produces short-term improvement in cardiorespiratory fitness. It should be considered by all CR programmes as an adjunct or alternative to MISS.


Published in

European Journal of Preventive Cardiology


Oxford Academic


  • VoR (Version of Record)


McGregor, G., Powell, R., Begg, B., Birkett, S.T., Nichols, S., Ennis, S., McGuire, S., Prosser, J., Fiassam, O., Hee, S.W., Hamborg, T. et al (2023) 'High-intensity interval training in cardiac rehabilitation (HIIT or MISS UK): A multi-centre randomised controlled trial', European Journal of Preventive Cardiology, p.zwad039.

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Cardiff Met Affiliation

  • Cardiff School of Sport and Health Sciences

Cardiff Met Authors

Aimee Drane

Cardiff Met Research Centre/Group

  • Cardiovascular Physiology

Copyright Holder

  • © The Authors


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