The effect of a cardiac rehabilitation program including moderate-intensity continuous exercise training and high-intensity interval exercise training on sarcopenia and myokines in patients with heart failure

Background Cardiac rehabilitation (CR) has been shown to be beneficial in preventing and treating sarcopenia in those with cardiovascular disease. The aim of the study is to compare the effects of high intensity intermittent aerobic training (HIIT) and moderate-intensity continuous aerobic training (MCT) on sarcopenia and myokines in heart failure (HF) patients.Methods In this prospective randomized controlled clinical trial, patients aged 18–75 years with stable HF were enrolled in HIIT or MCT exercise groups 3 days a week for a total of 6 weeks. Before and after treatment, patients were assessed with cardiopulmonary exercise test (CPET), 6-minute walk test (6MWT), modified Medical Research Council scale, short form-36, ultrasonographic thigh muscle thickness measurement, hand grip strength (HGS), chair stand test (CST), hospital anxiety depression scale. Serum myostatin and BDNF levels were also measured.Results In both HIIT and MCT groups, significant improvement was observed on post treatment 6MWT (p = 0.005, p = 0.002), mMRCS (p = 0.005, p = 0.014), quadriceps muscle thickness (p = 0.005, p = 0.001), HGS (p = 0.005, p = 0.001), CST (p = 0.005, p = 0.001) and VO2max (p = 0.022, p = 0.001) compared to before treatment. There was no statistical difference in treatment-related change between the two protocols. The post-treatment myostatin and BDNF levels did not change in both groups (both p > 0.05).Conclusions Both HIIT and MCT exercise training have similar positive effects on sarcopenia, quality of life and functional capacity in patients with HF while having an undetectable effect on biochemical analysis of myostatin and BDNF serum levels. Nonetheless, the absence of detectable changes in circulating myokines should be carefully considered.ClinicalTrials.gov Identifier: NCT07245459.