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HIgh intensity training for heart transplants

The research for using high intensity training to build strength and VO2 capacity in heart transplant people was written about in the Journal of Transplantation.  This is the link to that article:

http://onlinelibrary.wiley.com/doi/10.1111/j.1600-6143.2012.04221.x/full

I corresponded with the author a couple of times. This is a copy of my email to her and her reply:

Dr. Nytroen:
My name is John Braden. I had a heart transplant at Duke University on November 2, 2009. I was and am a fairly serious runner. I run about 50 miles a week at a slow pace. I am very interested in your study about high intensity intervals raising VO2 levels and reducing the incidence of CAV. My VO2 is about 23 and regardless of how much I run, it does not seem to go up. Running is about the same now, 4 years after my transplant, as it was 6 months after. I'd like to ask you some questions about the exercise your test subjects did.
1) Why did you choose 4 minute exercise intervals?

WE DO 4 MINUTE INTERVALS BECAUSE RESEARCH IN BOTH ATHLETES AND NON-ATHLETES (EVEN CAD PATIENTS) HAVE SHOWN THAT IT TAKES UP TO TWO MINUTES OF HIGH INTENSITY EXERCISE (85-95% OF HR MAX) TO GET THE STROKE VOLUME UP TO ITS MAXIMUM) AND ALSO- THE TIME SPENT WITH THE STROKEVOLUME "ON TOP" CORRELATES WITH INCREASED EXERCISE CAPACITY (VO2 PEAK)

This seems a little long to me. When I have tried similar workouts, I run very hard for about a minute and do about 10 repeats.

TRY AT LEAST TO KEEP THE INTERVAL FOR 2 MINUTES AND GRADUALLY INCREASE (MAKE SURE YOU DO NOT EXCEED 95% OF YOUR MAXIMUM HR!!)

OUR EXPERIENCE IS THAT IF THE PATIENTS WALK UPHILL OR RUN TOO HARD (I.E. HR>95% OF MAX) THEY ARE NOT ABLE TO LAST FOR 4 MINUTES
2) In other tests of this nature, not related to transplants, the rest interval is longer than the exercise interval. Yours was 4 minutes exercise/3 minutes rest.
OUR PRINCIPLE IS THAT THE ACTIVE REST PERIOD SHOULD LAST 75% OF THE PREVIOUS TOUGH INTERVAL (THIS I SSUFFICIENT TIME TO BURN MOST OF THE ACUUMULATING LACTATE, AND ALSO NOT TOO LONG IN ORDER FOR THE HR NOT TO GET TOO LOW - THIS IS ESPECIALLY IMPORTANT IN HTX PATIENTS WITH ONLY PARTIAL REINNERVATION. THIS IS DONE WITH SUCCESS IN A LARGE NUMBER OF STUDIES IN OUR COUNTRY (BOTH HEALTHY AND CORONARY PATIENTS AND PATIENTS WITH HEART FAILURE)
3) I generally run twice a day (3 or 4 miles at a time). Can I just substitute the high intensity work for one of those runs 3 times per week?
YOU RUN A LOT!! AND I WOULD SUGGEST YOU SLOW DOWN A BIT. TRY 3 INTERVAL SESSIONS (ACCORDING TO OUR MODEL) PER WEEK AND DO NOT RUN LONG-DISTANCE THE SAME DAY. IF YOU ABSOLUTELY HAVE TO RUN MORE, DO ANOTHER 2 DAYS OF RUNNING (OR OTHER PHYSICAL ACTIVITY) BUT KEEP AT LEAST 2 DAYS "RUN-FREE"
ALTHOUGH THERE ARE A FEW NON-RESPONDERS TO EXCERCISE OUT THERE, THERE ARE A LARGER POSSIBILTY THAT YOU MIGHT SUFFER FROM "OVERTRAINING" , AND THAT A TOTALLY DIFFERENT TRAINING REGIMEN (NOT 7 DAYS A WEEK!!)  WILL GET YOUR VO2 PEAK UP
 
GOOD LUCK!
 
BEST REGARDS, KARI NYTRØEN

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Replies

  • Fascinating! Thank you John for sharing.

    Keep on Running!!

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