Response by Ellingsen et al to Letters Regarding Article, “High-Intensity Interval Training in Patients With Heart Failure With Reduced Ejection Fraction”
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These letters focus on 3 potentially important factors for training effects in the SMARTEX trial (The SMARTEX Heart Failure Study): (1) adequate load increase, (2) control of exercise intensity, and (3) inherent patient characteristics. In addition, adherence to exercise seems crucial for long-term outcomes after a supervised program.
Iellamo and Volterrani rightly point out that the success of an aerobic training program depends on regularly adapting load to individual improvement in exercise capacity. Adjustments are typically based on a combination of time and intensity of the training, which can be performed at different levels of technical complexity, from teaching participants to exercise according to the Borg scale of perceived exertion, to following sophisticated measures based on oxygen uptake, external mechanical load, heart rate, and lactate measurements. SMARTEX1 applied a simple procedure from a previous study by …