The Comparison of High-Intensity Interval Training Versus Moderate-Intensity Continuous Training after Coronary Artery Bypass Graft: A Systematic Review of Recent Studies

Currently, no international consensus on cardiac rehabilitation exists, leading to great variability in the intensity recommendations for training programs for cardiac patients, including those undergoing coronary artery bypass graft surgery (CABG). While some countries prefer the high-intensity interval training (HIIT) method to improve cardiorespiratory fitness, other countries opt for moderate-intensity continuous training (MICT). The aim of this systematic review was to compare the effects of HIIT and MICT on aerobic fitness and quality of life (QoL) in patients undergoing CABG with the intention of providing support for a consensus on exercise therapy. Methods: A systematic review of randomized controlled trials (RCTs) was conducted using the online publication databases PubMed, the Cochrane Library and the Bibliotheque nationale du Luxembourg (BnL) covering the last ten years to July 2022. Relevant identified studies respecting the inclusion/exclusion criteria were selected, screened and extracted by four reviewers. Furthermore, the methodological quality of the clinical trials was assessed using the PEDro scale, which was reinforced using the Cochrane Risk of Bias Tool for Randomized Trials (RoB2) for the evaluation of the risk of bias to provide more detail in the evaluation. The certainty of the evidence analysis was established using different levels of evidence in accordance with the Grading of Recommendations, Assessment, Development and Evaluation (GRADE) framework. Results: A total of 379 patients from five RCTs diagnosed with coronary artery disease, including patients undergoing CABG, performed aerobic exercise over different time periods and were assessed based on peakVO2, VO(2)max and QoL. Overall, both training methods provided improvements in cardiorespiratory fitness and quality of life, with greater changes in HIIT groups. Conclusion: Both trainings methods provide improvements in cardiorespiratory fitness and QoL, with greater increases from HIIT. The moderate quality of evidence supports the use of HIIT and MICT to improve cardiorespiratory fitness and QoL.