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IntroductionHigh-intensity interval training (HIIT) is an emerging method of cardiac rehabilitation, which is more and more popular in recent years. Research into the effect of HIIT on peak oxygen uptake (VO2 peak) and myocardial fibrosis among patients with myocardial infarction (MI) is lacking. Here, we describe the rationale along with the protocol for a clinical trial to test the following hypotheses: (1) compared with the control group, VO2 peak will be increased in both the moderate-intensity continuous training (MICT) and HIIT groups and (2) compared with the control group, myocardial fibrosis due to MI will be improved by HIIT and MICT.Methods and AnalysisThis is a single-center, randomized controlled clinical trial. In total, 180 patients with MI are to be recruited for this study. VO2 peak will be tested by cardiopulmonary exercise testing (CPET) and myocardial fibrosis will be evaluated by cardiac MR. A variety of blood and psychometric tests and also the peripheral arterial tonometry, reactive hyperemia index for microvascular endothelial function, and microvascular blockage or digital vasomotor response are included.Ethics and DisseminationThe ethics committee of the Guangdong Provincial People's Hospital has authorized this mechanistic clinical research. Peer-reviewed articles and conference presentations will be used to disseminate the findings.Trial Registration NumberNCT04863677.

Purpose: Little is known about the interindividual variability in fat mass (FM) loss in response to high-intensity interval training (HIIT) and moderate continuous training (MCT) in individuals with type 2 diabetes mellitus (T2DM). Moreover, the impact on health-related outcomes in those who fail to reduce FM is still unclear. The aims of this investigation were (1) to assess if the individuals with T2DM who FM differed across MCT, HIIT, and control groups over a 1-year intervention and (2) to assess the changes on glycemic control and vascular function in the exercising patients who failed to lose FM.Methods: Adults with T2DM were randomized into a 1-year intervention involving a control group (n=22), MCT with resistance training (RT; n=21), and HIIT with RT (n=19). FM was assessed using dual-energy X-ray absorptiometry and a change in total body FM above the typical error was used to categorize FM responders. Glycemic control and vascular stiffness and structure were assessed. A chi-square test and generalized estimating equations were used to model the outcomes.Results: Both MCT (n=10) and HIIT (n=10) had a similar proportion of individuals who were categorized as high responders for FM, with the percent change in FM on average −5.0±9.6% for the MCT and −6.0±12.1% for the HIIT, which differed from the control group (0.2±7.6%) after a 1-year intervention (p0.05).Conclusion: Our results suggest that the number of FM responders did not differ between the MCT or HIIT, compared to the control, following a 1-year exercise intervention in individuals with T2DM. However, low responders to FM may still derive reductions in arterial stiffness and structure.Clinical Trial Registration: Comparing Moderate and High-intensity Interval Training Protocols on Biomarkers in Type 2 Diabetes Patients (D2FIT study) – number: NCT03144505 (https://clinicaltrials.gov/ct2/show/NCT03144505).

Purpose : Little is known about the interindividual variability in fat mass (FM) loss in response to high-intensity interval training (HIIT) and moderate continuous training (MCT) in individuals with type 2 diabetes mellitus (T2DM). Moreover, the impact on health-related outcomes in those who fail to reduce FM is still unclear. The aims of this investigation were (1) to assess if the individuals with T2DM who FM differed across MCT, HIIT, and control groups over a 1-year intervention and (2) to assess the changes on glycemic control and vascular function in the exercising patients who failed to lose FM. Methods : Adults with T2DM were randomized into a 1-year intervention involving a control group (n =22), MCT with resistance training (RT; n =21), and HIIT with RT (n =19). FM was assessed using dual-energy X-ray absorptiometry and a change in total body FM above the typical error was used to categorize FM responders. Glycemic control and vascular stiffness and structure were assessed. A chi-square test and generalized estimating equations were used to model the outcomes. Results : Both MCT (n =10) and HIIT (n =10) had a similar proportion of individuals who were categorized as high responders for FM, with the percent change in FM on average −5.0±9.6% for the MCT and −6.0±12.1% for the HIIT, which differed from the control group (0.2±7.6%) after a 1-year intervention (p <0.05). A time-by-group interaction for carotid artery intima-media thickness (cIMT) (p for interaction=0.042) and lower-limb pulse wave velocity (LL PWV; p for interaction=0.010) between those categorized as low FM responders and the control group. However, an interaction was observed between the high responders for FM loss and controls for both brachial and carotid hemodynamic indices, as well as in cIMT, carotid distensibility coefficient, carotid beta index, and LL PWV (p for interactions <0.05). No interactions were found for glycaemic indices (p for interaction >0.05). Conclusion : Our results suggest that the number of FM responders did not differ between the MCT or HIIT, compared to the control, following a 1-year exercise intervention in individuals with T2DM. However, low responders to FM may still derive reductions in arterial stiffness and structure. Clinical Trial Registration : Comparing Moderate and High-intensity Interval Training Protocols on Biomarkers in Type 2 Diabetes Patients (D2FIT study) – number: NCT03144505 (https://clinicaltrials.gov/ct2/show/NCT03144505). [ABSTRACT FROM AUTHOR]