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Objective:  We aimed to determine the cardiorespiratory responses during, and adaptations to, high-intensity interval training (HIIT) prescribed using ratings of perceived exertion (RPE) in patients after myocardial infarction (MI) during early outpatient cardiac rehabilitation (CR).   Methods:  We prospectively recruited 29 MI patients after percutaneous coronary intervention who began CR within 2 weeks after hospital discharge. Eleven patients (seven men; four women; age: 61 ± 11 yrs) who completed ≥24 supervised HIIT sessions with metabolic gas exchange measured during HIIT once weekly for 8 weeks and performed pre- and post- CR cardiopulmonary exercise tests were included in the study. Each HIIT session consisted of 5–8 high-intensity intervals [HIIs, 1-min RPE 14–17 (Borg 6–20 scale)] and low-intensity intervals (LIIs, 4-min RPE &amp;lt; 12). Metabolic gas exchange, heart rate (HR), and blood pressure during HIIT were measured.   Results:  The mean oxygen uptake (V  ˙   O2 ) during HIIs across 88 sessions of HIITs [91 (14)% ofV  ˙   O2peak , median (interquartile range, IQR)] was significantly higher than the lower limit of targetV  ˙   O2  zone (75% ofV  ˙   O2peak ) recommended for the HII ( p  &amp;lt; 0.001). Exercise intensity during RPE-prescribed HIITs, determined as %V  ˙   O2peak , was highly repeatable with intra-class correlations of 0.95 (95% CI 0.86– 0.99,  p  &amp;lt; 0.001). For cardiorespiratory adaptations from the first to the last session of HIIT, treadmill speed, treadmill grade, treadmill power,V  ˙   O2HII , %V  ˙   O2peak , and V E  during HIIs were increased (all  p  &amp;lt; 0.05), while no difference was found for HR, %HR peak  and systolic blood pressure (all  p  &amp;gt; 0.05).V  ˙   O2peak  increased by an average of 9% from pre-CR to post-CR. No adverse events occurred.   Conclusion:  Our results demonstrate that HIIT can be effectively prescribed using RPE in MI patients during early outpatient CR. Participation in RPE-prescribed HIIT increases exercise workload andV  ˙   O2  during exercise training without increased perception of effort or excessive increases in heart rate or blood pressure.

frontiers in cardiovascular medicine

Cardiorespiratory Responses During High-Intensity Interval Training Prescribed by Rating of Perceived Exertion in Patients After Myocardial Infarction Enrolled in Early Outpatient Cardiac Rehabilitation