Clinical Sciences

Authors

J. Helgerud1,2,3, T. Karlsen1, W. Y. Kim4, K. L. Hydal1,5, A. Stylen1,6, H. Pedersen4, L. Brix4,9,

S. Ringgaard4, J. Kvrness7, J. Ho1,8

Aliations

Aliation addresses are listed at the end of the article

Key words
endurance training

coronary artery disease

high aerobic intensity

interval training
left ventricular ejection

fraction
4 4 min intervals

cardiovascular magnetic

resonance

Abstract

This study sought to study the eect of high

intensity aerobic interval endurance training on
peak stroke volume and maximal strength training on mechanical eciency in coronary artery
disease (CAD) patients. 8 CAD patients (age
61.4 3.7 years) trained 30 interval training sessions with 4 4 min intervals at 8595 % of peak
heart rate while 10 CAD patients (age 66.5 5.5
years) trained 24 sessions of maximal horizon-

Introduction

accepted after revision

August 26, 2010
Bibliography
DOI http://dx.doi.org/
10.1055/s-0030-1267180
Published online: 2010
Int J Sports Med
Georg Thieme
Verlag KG Stuttgart New York
ISSN 0172-4622
Correspondence
Prof. Jan Helgerud
Norwegian University of
Science and Technology
Department of Circulation and
Medical Imaging
N-7491 Trondheim
Norway
Tel.: + 47/918/218 92
Fax: + 47/728/283 72
Jan.Helgerud@ntnu.no

Endurance training has been recognized to

increase peak oxygen uptake (VO2peak) in cardiovascular disease patients (CAD) [7] while high
intensity aerobic interval training, employing
4 4 min (rest and recovery intervals), is a more
eective approach [10, 21, 25]. Elevating VO2peak
through endurance training is important as it
relates to cardiovascular disease, due to the association between poor cardiovascular fitness, a
sedentary lifestyle and mortality risk [16]. Similarly, low skeletal muscular strength is associated
with increased mortality [19], and skeletal muscle strength decreases with age and inactivity
[26].
Specific to the cardiac muscle itself, cardiovascular disease, aging and a sedentary lifestyle deteriorate cardiac function with left ventricular
stiness, decreased left ventricular compliance
and diminished diastolic performance [1, 20, 23].
Endurance training can improve peak stroke volume and left ventricular function in CAD patients
[5, 6], but it has previously been recognized that,
at least in healthy subjects, high intensity aerobic
interval training at 9095 % of maximal heart rate
is superior to less intense exercise in terms of
increasing maximal stroke volume [10]. This aerobic interval training-induced increase in stroke

tal leg press. In the interval training group peak

stroke volume increased significantly by 23 %
from 94.1 23.0 mL beat 1 to 115.8 22.4 mL
beat 1 (p < 0.05). Peak oxygen uptake increased
significantly by 17 % from 27.2 4.5 mL kg 1
min 1 to 31.8 5.0 mL kg 1 min 1 (p < 0.05) in
the same group. In contrast, there was no such
exercise training-induced change in peak stroke
volume or peak oxygen uptake in the maximal
strength training group, despite a 35 % improvement in sub maximal walking performance.

volume was not only associated with an increased

VO2max [10], but also a reversal of left ventricular
remodelling, improving left ventricular ejection
fraction in heart failure patients [25].
Specific to skeletal muscle itself, there is a minimum muscular strength required for the activities of daily life such as walking or stair climbing
and when lacking, may lead to disability [3]. Low
muscular strength is associated with reduced
mechanical eciency, the oxygen cost of generating a given work load [17], during endurance
activities. It has been documented that CAD
patients walk with mechanical ineciency,
which is likely a consequence of skeletal muscle
weakness [11]. Increased skeletal muscle strength
and the subsequent improvement in the mechanical eciency of a simple task such as walking
could shift the stress of daily activity from severe,
to tolerable and repeatable in such patients [14].
The beginning of an upward spiral in terms of
daily activity will likely yield an improvement in
endurance performance.
Peak oxygen pulse has been documented to
increase as a consequence of 4 4 aerobic interval training at 8595 % of peak heart rate in
healthy adults [22], however, to our knowledge,
there has not been a study that has revealed the
eect of such high intensity aerobic interval
training on peak stroke volume in CAD patients.

Helgerud J et al. Interval and Strength Training in CAD Patients. Int J Sports Med

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Interval and Strength Training in CAD Patients

Clinical Sciences

Methods

Subjects
20 clinically diagnosed CAD patients were recruited from the St.
Olav University Hospital of Trondheim, and randomly allocated
to an aerobic interval training group (AIT) (n = 10) and a maximal
strength training group (MST) (n = 10). In the AIT group 3 patients
were diagnosed with previous myocardial infarction, 4 subjects
with percutaneous coronary intervention and 3 patients with
coronary artery bypass surgery. In the MST group 4 patients
were diagnosed with previous myocardial infarction, 3 subjects
with percutaneous coronary intervention and 4 patients with
coronary artery bypass surgery.
Inclusion criteria were stable CAD: Angina pectoris class IIII in
the Canadian Cardiovascular Society Classification (CCS),
Ischemia detected on exercise electrocardiogram, or angiographic documented CAD. Exclusion criterion were unstable
angina pectoris, myocardial infarction during the last month, PCI
during the last month, left ventricular ejection fraction less than
40 %, complex ventricular arrhythmias, and orthopaedic or neurological limitations to exercise. Patients remained on their
standard medication throughout the study and no changes were
reported. There was no dierence in the medication use between
the AIT and the MST group.
The study protocol was approved by the regional committees for
medical research ethics, and was accomplished according to the
declaration of Helsinki. All subjects gave written consent before
participating. The study has also been performed in accordance
with the ethical standards of the International Journal of Sports
Medicine [8]. Patients were supervised during training and no
discomfort or adverse events were reported. One patient in the
AIT group withdrew from the study while one subject in the
same group was excluded due to the inability to participate in
post testing.

Oxygen uptake
Sub maximal and peak oxygen uptake was measured before and
after the training interventions. After 10 min warm up consisting of treadmill walking at 35 km per hour and zero degree
inclination subjects walked at a sub maximal work load corresponding to 40 watts for 5 min. The treadmill speed was 35 km
per hour with appropriate inclination dependent upon the subjects body mass. To define the walking speed corresponding to
40 watts on the treadmill the following equation was used [11]:
V=

workload
3.6
[mb g] sin ()

V = velocity (km h 1)
workload = 40 Watt (Nm s 1)
g = gravitational constant (m s 2)
mb = body mass (kg)
= treadmill inclination (degrees)
Helgerud J et al. Interval and Strength Training in CAD Patients. Int J Sports Med

The work load was well below the lactate threshold, and steady
state VO2 values were achieved after 3 min of walking. Mechanical work eciency was assessed after 5 min of treadmill walking. The mean VO2 measured during the last minute of walking
was used to calculate the net eciency through the following
equation:

Net efficiency =

Work Performed (Kcal min 1)

100
Energy used (Kcal min 1) REE (Kcal min 1)

REE = Resting energy expenditure

Work performed = 40 watt, 1 Watt = 0.01433 Kcal min 1
Resting energy expenditure was set to 3.5 mL kg 1 min 1. Both
VO2 and watts were converted to kilojoules to allow for calculation of percent mechanical eciency [11].
After completion of the sub maximal measurements the treadmill speed was increased to fast walking and the inclination was
increased by raising the inclination of the treadmill by 2 % every
minute until subjects reached exhaustion. Oxygen uptake was
measured continuously during the tests (V-max spectra, SensorMedics, USA), and the average of the 3 highest measurements
during 10 s determined VO2peak. Criteria for exhaustion were an
RQ value above 1.0 and a Borg scale value above 15. RQ was
above 1.0 in all patients and Borg scale values above 15 were
observed in 14 patients. In addition, the authors did a subjective
evaluation of the level of exhaustion through observations of
ventilation, walking action and facial expressions in patients at
the end stage of the test. Heart frequency was measured by a
heart rate monitor (Polar Sport, Finland) and 12 lead ECG readings were done during pre testing to evaluate the level of peak
exercise ischemia and assess the safety for exercise training (Vmax spectra, Cardiosoft, USA). A capillary blood sample taken
immediately after the tests, was analysed for lactate acid on an YSI
1 500 sport tester (YSI Incorporated, USA), and subjects reported
their level of perceived exhaustion by the Borg scale [2].

Stroke volume and cardiac output

Cardiac output (CO) and stroke volume were measured during
rest (standing) and during treadmill walking at 80 % of VO2peak
before and after the training periods. CO was measured through
a single breath gas technique, with a gas mixture containing
0.3 % carbon monoxide, 0.3 % acetylene, 0.3 % methane and 21 %
oxygen balanced with nitrogen. In the solution acetylene serves
as the soluble gas and methane the insoluble. Standing at rest
and while walking subjects completely exhaled ambient air,
inhaled the gas mixture, and completely exhaled again. Measurements of gas concentrations were carried out, and CO and HR
registered (V-max Spectra, SensorMedics, USA). The test method
has previously been validated and a coecient of variation of
7.6 % was found [4].
Maximal strength in the lower extremities was tested by one
repetition maximum (1RM) in a dynamic horizontal leg press
down to a knee joint angle of 90 using a horizontal leg press
machine (Technogym, Italy). Subjects were familiarized with the
lifting procedures before the start of the test. One repetition
maximum was obtained by repeating the leg press exercise with
increasing loads of 510 kilogram until the subjects were not
able to complete the lift. A total of 68 lifts were used to achieve
1RM and the highest weight lifted was recorded as 1RM. Maximal voluntary rate of force development (RFD) and peak force
during 90 dynamic leg press movement were assessed using a

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Additionally, although the importance of maintaining or improving skeletal muscle strength in CAD patients is clear, little is
known about the impact of maximal strength training on this
population. Therefore, the primary aim of the present study was
to examine the eect of high aerobic intensity interval training
on peak stroke volume and maximal strength training on
mechanical eciency in stable CAD patients.

Clinical Sciences

Quality of life
The MacNew Heart Disease Health-Related Quality of Life questionnaire was distributed to the patients for measurements of
quality of life before and after the training periods.

Cardiovascular magnetic resonance (CMR)

All patients in the AIT group underwent CMR examination before
and after the training period using a Philips Intera 1.5 T MR
whole body scanner (Phillips, Best, Netherlands), equipped with
a 5-element cardiac phased array coil and cardiac software package (R9.1.1).
Due to the long travelling distance and cost of travel only the AIT
group was investigated with CMR.
Lying during breath-hold, 2-chamber, 4-chamber and long-axis
views were acquired using a retrospectively electrocardiographically gated steady state free procession (SSFP) cine sequence. A
stack of 10-mm thick contiguous slices encompassing the left
ventricle from base to apex in the cardiac short-axis orientation
was acquired for volumetric measurements. Imaging parameters
included the following: 2.9/1.4 (repetition time ms/echo-time
ms), 160 160 matrix, 320 320 mm field of view, 2.0 2.0 mm
in-plane spatial resolution, half Fourier acquisition and 65degree flip angle. A total of 30 heart phases were acquired. End
diastolic volume (EDV), end systolic volume (ESV), left ventricular mass (LVM), stroke volume (SV), cardiac output (CO) and
ejection fraction (EF) were measured by semi automated segmentation of end-diastolic and end-systolic areas using dedicated software (Easyvision, Philips, Best, Netherlands).

Table 1 Physical characteristics of the subjects at inclusion.

Endurance
training (n = 8)
men/women
age (years)
height (cm)
body mass (kg)
body mass index (kg/m2)
systolic blood pressure (mmHg)
diastolic blood pressure (mmHg)

6/2
61.4 3.7
175.4 9.3
80.2 13.2
26.1 2.9
135 20
84 8

Strength
training (n = 10)
10/0
66.5 5.5
177.8 7.4
83.6 9.9
26.5 3.1
131 16
80 12

Data is presented as mean and SD for each variable

angle corresponded to 90 . The subjects trained with a progressive work load starting at 8590 % of the individual 1RM, and all
training sessions were supervised by an exercise physiologist.
When the subjects were able to perform all sets and repetitions,
the load was increased by 2.5 kg. A 2 min rest period was
employed between each set of exercise. The training regime
lasted approximately 20 min per session.

Statistical analysis
All table values are expressed as mean standard deviation (SD)
while figure values are in percent change standard error of the
mean (SE). After data was tested for normal distribution, parametric tests were used to determine statistical significance.
Changes within groups were determined by repeated measure
ANOVA while dierences between the AIT and the MST groups
were calculated by using analysis of covariance (ANCOVA). Statistical analyses were performed using the software program
SPSS, version 14.0 (Statistical Package for Social Science, Chigago,
Illinois, USA). Post hoc testing was automatically done by SPSS. A
2-tailed p-value < 0.05 was accepted as statistically significant
for all tests.

Training intervention

Results

Subjects in the AIT group completed 30 interval sessions of

treadmill walking in the 8 weeks following initial testing. During
the initial 4 weeks 5 weekly sessions were undertaken, followed
by 3 weekly sessions over the next 4 weeks until a total of 30
interval training sessions were performed. Each training session
started with 5 min warm up, continuing with 4 times 4 min of
interval training, with 3 min active breaks inbetween each interval. The training intensity for the 2 last minutes of intervals was
set to 8595 % of HRpeak, and during active breaks subjects walked
at an intensity corresponding to 6070 % of HRpeak. To compensate for increased VO2peak capacity, treadmill speed and grade
were increased several times during the study, to make sure the
patients trained at 8595 % of their HRpeak at all times. Patients
performed a warm down by walking for 5 min after the interval
period. HR was recorded continuously during exercise and self
reported exercise stamina was reported by the Borg scale. All
training sessions were supervised by an exercise physiologist.
The MST group completed an 8 week strength training regime, 3
times per week, a total of 24 training sessions in our laboratory.
Each training session consisted of 5 min warm up of stationary
biking and 4 series with 4 repetitions in each series of horizontal
dynamic leg press. The exercise was performed with emphasis
on maximal mobilization of force in the concentric action and
subjects started the concentric movement when the knee joint

There were no significant dierences in physical characteristics

or peak metabolic data between the 2 training groups at inclu Table 1,
Table 2).
sion (
Peak stroke volume increased significantly by 23 % in the AIT
group, a change significantly greater than in the MST group
Fig. 1). Peak cardiac output
where no change was detected (
improved significantly from 12.1 3.1 L min 1 before to
15.6 3.7 L min 1 after training in the AIT group (p < 0.05). In
the MST group no change in peak cardiac output was detected
from before to after training (10.7 2.110.5 2.0 L min 1).
There was no significant dierence in peak cardiac output
between the 2 training groups before training, but after training
it was significantly higher in the AIT group (p < 0.05).
VO2peak was significantly improved by 17 % in the AIT group after
training, a significantly greater change compared to the MST
group (p < 0.05) where no change was detected from pre to post
Table 2). The AIT group significantly increased peak
training (
treadmill work load by 25 % from 163 29 to 203 22 watts from
before to after training. Peak work load at post test were significantly greater than in the MST group where work loads of
202 37 and 208 38 were recorded before and after training
(p < 0.05). The peak values for lactate and ventilation increased
significantly from before to after training in the MST group
Table 2), while the Borg scale score increased significantly
(
Helgerud J et al. Interval and Strength Training in CAD Patients. Int J Sports Med

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force platform (9286AA, Kistler, Switzerland). Data were collected at 2 000 Hz (Bioware v3.06b, Kistler, Switzerland). Subjects performed 2 repetitions of dynamic leg press focusing on
maximal force production with a standardized resistance of 40
kilogram (kg). Rate of force development was measured between
10 and 90 % of peak force in the concentric phase of the sub maximal leg press.

Clinical Sciences

Endurance training (n = 8)
Before
oxygen uptake
L min 1
mL kg 1 min 1
heart rate (beat min 1)
ventilation (L min 1)
respiratory exchange ratio
lactate (mmol L 1)
Borg scale

After

2.20 0.54
27.2 4.5
163 21
89 17
1.13 0.05
4.5 1.0
15 2

2.59 0.64* #
31.8 5.0* #
162 17
97.0 23
1.17 0.06
6.3 1.6
17 1* #

Strength training (n = 10)

Before

After

2.43 0.49
28.9 4.2
143 20
88 13
1.15 0.07
5.0 1.9
16 2

Table 2 Peak data before and

after training.

2.48 0.53
29.6 5.2
143 19
94 10*
1.18 0.06
7.2 1.8*
17 1

Data is presented as mean and SD for each variable

180

AIT

120

160

MST

105

100
80

75
60
30

40

15

20

15
Pre
Training

Post
Training

Fig. 1 Peak stroke volume before and after training, in the aerobic
interval training (AIT)- and the maximal strength training group (MST).
* P < 0.05 changes within group before vs. after training, # P < 0.05
changes in the AIT group vs. the MST group.

Table 3 Measurements of resting cardiac function by MRI in the endurance

training group before and after the training intervention (n = 8).
Before
left ventricular end diastolic volume (mL)
left ventricular end systolic volume (mL)
stroke volume (ml beat 1)
cardiac output (L min 1)
heart rate (beat min 1)
left ventricular ejection fraction ( %)
left ventricular mass (g)

137.1 24.1
52.4 17.2
84.8 9.6
6.2 0.8
74.5 15.9
62.3 6.5
112.6 14.8

After
136.7 28.8
48.7 18.2
88.0 14.0
6.1 1.1
70.5 16.2
65.4 7.2
115.5 18.0

Data is presented as mean and SD for each variable

from before to after training in the AIT group with a larger

Table 2).
change than in the MST group (
In the AIT group, measurements of left ventricular function by
magnetic resonance imaging displayed a trend towards higher
resting left ventricular ejection fraction, from 62.3 6.5 % before
Table 3). A non-signifito 65.4 7.2 % after training (p = 0.06) (
cant trend towards decreased end systolic volume and heart
rate, as well as increased stroke volume was also found. Resting
left ventricular end diastolic volume, cardiac output, and left
ventricular mass were unchanged after training.
The MST group improved leg press strength significantly. Maximal leg strength improved from 138 24 kg before training to
Fig. 2), rate of force development
198 24 kg after training (
improved from 2 656 1 090 N s 1 before training to 4 905
1 254 N s 1 after training, and sub maximal walking eciency
improved from 18 4 % before training to 25 6 % after training
Helgerud J et al. Interval and Strength Training in CAD Patients. Int J Sports Med

*#

45

60

Post
Training

MST
AIT

90

120

Pre
Training

*#

1 RM

RFD

Mechanical efficiency

Fig. 2 Percent change in maximal leg strength (1RM), rate of force

development (RFD) and walking mechanical eciency from before to after
training in the maximal strength training group (MST) and the aerobic
interval training (AIT) group. * P < 0.05 changes within group before vs.
after training, # P < 0.05 changes in the MST group vs. the AIT group.

(p < 0.01). Maximal leg strength and rate of force development

were unchanged in the AIT group from pre to post training, however walking mechanical eciency improved from 19 4 %
Fig. 2).
before training to 25 5 % after training (p < 0.05) (
Several scores for quality of life were significantly improved
from before to after training within each exercise group. In the
AIT group there was a 9 %, 13 %, and 10 % improvement for the
scores for total, physical and social quality of life detected by the
MacNew questionnaire (p < 0.05). In the MST group the social
score detected by the MacNew questioner improved by 8 %
(p < 0.05). There were no significant dierences between groups
in the change in quality of life measurements from before to
after training.

Discussion

The main finding in the present study was that 8 weeks of high
aerobic intensity interval training at 8595 % of HRpeak significantly improved peak stroke volume by 23 % in CAD patients.
Improved sub maximal endurance due to improved leg maximal
strength and rate of force development did not improve peak
stroke volume in CAD.
Endurance training is known to improve cardiac function [5, 6].
High aerobic intensity interval training (4 4 min) at 9095 % of
peak heart rate has been demonstrated to be more eective than
moderate continuous training at 70 % of peak heart rate for
improving cardiac function in heart failure patients [25]. To our
knowledge the present study is the first to document the eect

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*#

140

% Change

Stroke Volume (Ml * Beat1)

* P < 0.05 changes within group before vs. after training, # P < 0.05 changes in the ET group vs. the MST group

of 4 4 min of high aerobic intensity interval training on peak

stroke volume in CAD patients with a better cardiac function
(left ventricular ejection fraction ~ 62 %) than reported in heart
failure patients [25].
In the present study there was only a trend towards increased
myocardial contractility as observed by increased resting left
ventricular ejection fraction. This may serve as an explanation
for the observed improvement in peak stroke volume. However,
one could also argue that improving LVEF within the normal
range probably has little clinical relevance [9].
In the present study resting left ventricle diastolic volume and
mass were unchanged after aerobic interval training, and there
was a trend towards decreased left ventricular end systolic volume with a subsequent increase in stroke volume. Heart rate
decreased correspondingly, maintaining an unchanged cardiac
output during rest. Left ventricular MRI measurements were
done at rest, thereby the adaptation in the cardiovascular system
may not be as evident as during peak exercise. Possible explanations for increased peak stroke volume may be a result of
increased LVEDV eecting the Starlings law of the heart, calcium mediated changes in contractility or a adaptation in the
balance between the cardiac filling time and the volume of
venous return [9].
Despite improvements in sub maximal endurance measured as
improved walking mechanical eciency, peak stroke volume
remained unchanged after maximal strength training in the CAD
patients. Both the AIT and the MST groups increased walking
mechanical eciency after training indicating that dierent
mechanisms may explain the adaptation seen in walking eciency. Increased muscle strength has the potential of improving
the circulatory management of day to day activities [15], and
could thereby eect the afterload of the heart during exercise.
Decreased afterload could potentially increase the stroke volume by lowering the pressure resistance in the main arteries.
The safety of strength training in CAD patients has been debated,
particularly focusing on the eect of blood pressure on cardiac
function. At present, stable CAD patients are recommended to
do strength training as a supplement to endurance training [18].
Judged by the present study, maximal strength training in cardiovascular disease patients does not aect stroke volume negatively.
Improved endurance through sub maximal performance may
stimulate increased daily activity levels with the possible eect
of increasing VO2peak and cardiac function over time. In the
present study neither VO2peak nor peak stroke volume increased
despite increased sub maximal performance. The time span of
the training intervention (8 weeks) was probably too short for
the improvement in sub maximal endurance to translate into
increased daily activity resulting in a measurable level of VO2peak.
The present study documents that high aerobic intensity interval training is more eective in increasing peak stroke volume in
CAD patients than through improved sub maximal endurance
through strength training.
Contrary to earlier beliefs, cardiac stroke volume increases from
rest until maximal performance in elite athletes, while stroke
volume levels o at lower intensities in less endurance trained
individuals [27]. Based on results from previous studies the level
of interval intensity during training seems vital for the cardiovascular training response [10, 21].
In addition to documenting changes in stroke volume, the
present study confirms that high aerobic intensity interval training significantly improves VO2peak in CAD patients [12, 21].

The improvement in VO2peak in the CAD patients in the AIT

group was at the same absolute level as previously reported in
healthy young men [10]. High aerobic intensity interval training
improves maximal stroke volume in healthy young men as well
[10]. In the present study high aerobic intensity interval training
improved peak stroke volume by 21 ml/stroke, compared to
~1415 ml/stroke in healthy young men [10]. Despite lower initial stroke volume and the presence of ischemic heart disease,
CAD patients demonstrated approximately the same absolute
myocardial response to high aerobic intensity interval training
as healthy young men, and more importantly they are able to
carry out the high aerobic intensity training despite their documented heart disease.
In the present study, the increase in stroke volume is parallel to
the increase in VO2peak with improvement in the magnitude of
23 % in peak stroke volume and 17 % in VO2peak. The same pattern
is reported by Helgerud et al. [10] in healthy young men where
peak stroke volume increased by 10 % and VO2max by 7.2 % after
high intensity aerobic interval training. CAD patients are thereby
able to carry out high aerobic intensity interval training with the
same quality as healthy young men, achieving equal absolute
training responses and relatively better scores due to lower fitness levels before training. The dierences of the peak metabolic
data before and after training in the AIT group could have been
influenced by a higher degree of exhaustion after training. This
is indicated by a significant higher score on the Borg scale after
Table 2). On the other hand no physiological paramtraining (
eter measured; heart rate, ventilation, RER or lactate, changed
significantly from before to after training.
Stroke volume deterioration as observed with aging and heart
disease may reflect increasing levels of inactivity at least before
ischemia disrupts peak myocardial function. Heart patients were
previously restricted from strength training due to the fear of a
harmful eect on the myocardium. Today, studies on the eect of
strength training on the myocardium have provided evidence of it
being safe with no negative eect on myocardial contractility or
enhanced myocardial deterioration [13]. The lack of response in
VO2peak and peak stroke volume in the strength training group
supports the importance of performing high intensity endurance
training for gaining cardiovascular training adaptations. Improving sub maximal endurance did not aect peak stroke volume.
Quality of life improved in both the aerobic interval training
group and the strength training group indicating that shorter
time periods of training may improve quality of life in CAD
patients. This is an important aspect of training since better
quality of life is associated with less self reported disability in
heart patients [24]. The improvement in the social score in the
strength training group may reflect the social aspect of supervised training during the training period.
The weakness of the present study is the low number of participants included, however the low number of patients did allow
for high quality supervision during training. Also due to the long
travelling distance and cost of travel only the AIT group was
investigated with cardiac MRI.

Conclusion

High aerobic intensity interval training significantly improves peak

stroke volume and VO2peak in CAD patients. Improved sub maximal
endurance after maximal strength training does not improve peak
stroke volume or peak oxygen uptake in CAD patients.
Helgerud J et al. Interval and Strength Training in CAD Patients. Int J Sports Med

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Clinical Sciences

Aliations
1
Department of Circulation and Medical Imaging, Faculty of Medicine,
Norwegian University of Science and Technology, Norway
2
Hokksund Medical Rehabilitation Centre, Norway
3
Telemark University College, Department of Sports and Outdoor Life
Studies, B
4
MR Research Centre, Aarhus University Hospital, Skejby, Denmark
5
Volda University College, Department of Physical education, Faculty of Art
and Physical education, Volda, Norway
6
Department of Cardiology, St. Olavs University Hospital, Norway
7
Philips Healthcare Nordic, Norway
8
Department of Physical Medicine and Rehabilitation, St. Olavs University
Hospital, Norway
9
Department of Clinical Engineering, Region Midtjylland, c/o Aarhus
University Hospital, Skejby, Denmark

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