Compared to end-stage heart failure, a patient's situation is usually greatly improved after a heart transplant (HTx), but the exercise capacity remains sub-normal, also long-term, ranging from 50 to 70% in most studies. While effective rehabilitation, including regular exercise, is considered an effective tool of improving health related quality of life (HRQoL) and prognosis of cardiac patients in general, the knowledge about and the effect of different rehabilitation programs among HTx recipients is limited. Exercise training is considered one of the most central parts in rehabilitation, but the mode of exercise used in different studies varies considerably. It is documented that high intensity interval training (HIT) has superior effects compared to training with moderate intensity in cardiac and heart failure patients. In contrast, HTx recipients have a denervated heart, and HIT had been considered unphysiological. However, the investigators have recently demonstrated highly beneficial effects on exercise capacity, muscle strength, body composition, reduced progression of cardiac allograft vasculopathy and HRQoL among long-term HTx recipients. In the present study the investigators want to test the hypothesis that systematic aerobic exercise with high intensity improve exercise capacity also in newly transplanted recipients, and secondarily that it gives favourable effects on the heart, peripheral circulation and a better HRQoL.
Study Type
INTERVENTIONAL
Allocation
RANDOMIZED
Purpose
PREVENTION
Masking
SINGLE
Enrollment
80
9 months of high intensity interval based aerobic exercise (3 times/week)
Copenhagen University Hospital
Copenhagen, Denmark
Oslo University Hospital Rikshospitalet
Oslo, Norway
Sahlgrenska University Hospital
Gothenburg, Sweden
Effect of exercise on peak oxygen uptake
Change in ml/kg/min
Time frame: Baseline to one year
Effect of exercise on muscle strength
Change measured in Newtonmeter and Joule
Time frame: Baseline to one year
Effect of exercise on progression of coronary artery vasculopathy (CAV)
Change measured by intravascular ultrasound; change in maximum intimal thickness, total atheroma volume, percent atheroma volume and virtual histology.
Time frame: Baseline to one year
Effect of exercise on chronotropic responses
Change in heart rate response, including changes in minimum and maximum heart rate and changes in chronotropic response index.
Time frame: Baseline to one year
Effect of exercise on myocardial function
Change in echocardiographic parametres such as stroke volume, cardiac index and ejection fraction.
Time frame: Baseline to one year
Effect of exercise on endothelial function
Change in endothelial function measured by flow mediated dilatation and EndoPat
Time frame: Baseline to one year
Effect of exercise on biomarkers
Neuroendocrine, inflammatory and immunological biomarkers.
Time frame: Baseline to one year
Effect of exercise on health related quality of life
Change measured on visual analogue scales and questionnaires
Time frame: Baseline to one year
Effect of exercise on safety and tolerability
Measured by number of serious adverse effects related to the intervention
Time frame: Baseline to 3 years follow-up
Long-term effects of exercise
Long-term effects will be measured by all outcomes listed above, including number of serious adverse effects.
Time frame: Baseline to 3 years follow-up
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