One-year Aerobic Interval Training Improves Endothelial Dysfunction in Patients with Atrial Fibrillation: A Randomized Trial

Objective To evaluate the effects of one-year aerobic interval training on endothelial dysfunction in patients with atrial fibrillation.Methods Seventy-four patients with atrial fibrillation (53 men, 21 women; mean age 63 & PLUSMN;6 years old) were randomized into a 1-year continuous aerobic interval training (CT), 6-month detraining after 6 months of aerobic interval training (DT), or medical treatment only (MT) group. Aerobic interval training was performed 3 times a week for 1 year or 6 months, with an exercise intensity of 85-95% of the peak heart rate. The primary outcome was a change in biomarkers of endothelial dysfunction from baseline at six months or at the one-year follow-up.Results Six-month aerobic interval training reduced von Willebrand factor (CT: 103.7 & PLUSMN;30.7 IU/dL and DT: 106 & PLUSMN;31.2 IU/dL vs. MT: 145 & PLUSMN;47.7 IU/dL, p=0.044). Improvements were maintained with continuous aerobic interval training; however, the values increased again to the baseline levels upon detraining (CT: 84.3 & PLUSMN;39.1 IU/dL vs. DT: 122.2 & PLUSMN;27.5 IU/dL and MT: 135.9 & PLUSMN;50.4 IU/dL, p=0.002). Interleukin 1 beta levels decreased after 6 months of aerobic interval training (CT: 0.59 & PLUSMN;0.1 pg/mL and DT: 0.63 & PLUSMN;0.09 pg/mL vs. MT: 0.82 & PLUSMN; 0.28 pg/mL, p=0.031), and the improvement was maintained with continuous aerobic interval training and even after detraining (CT: 0.58 & PLUSMN;0.08 pg/mL and DT: 0.62 & PLUSMN;0.09 pg/mL vs. MT: 0.86 & PLUSMN;0.28 pg/mL, p=0.015).Conclusion One-year aerobic interval training improves endothelial dysfunction in patients with atrial fibrillation and is primarily associated with the reduction in circulating thrombogenic and pro-inflammatory factors. A definitive way to sustain these improvements is the long-term continuation of aerobic training.