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Photobiomodulation Combined with Moderate or High-Intensity Interval Training on Oxygen Consumption and Exercise Tolerance in Patients with Heart Failure
ABC
Original Article

Photobiomodulation Combined with Moderate or High-Intensity Interval Training on Oxygen Consumption and Exercise Tolerance in Patients with Heart Failure

Diego Busin et al. Leandro Tolfo Franzoni Douglas Turella Olga Sergueevna Tairova … Anderson Donelli da Silveira Ricardo Stein Gabriel Lopes Amorim Pedro Dal Lago Ramiro Barcos Nunes

Abstract

Background

Aerobic training (AT), whether moderate or high intensity, is widely employed in cardiovascular rehabilitation. Photobiomodulation therapy (PBMT) has shown potential to enhance exercise performance in athletes; however, its effects in patients with heart failure (HF) remain uncertain.

Objective

To investigate whether the addition of PBMT to moderate- or high-intensity AT improves cardiopulmonary exercise performance in individuals with HF.

Methods

This nonrandomized clinical trial included 49 patients with HF (mean age 62.7 years; ejection fraction < 40%), allocated into 5 groups: i) moderate training alone, ii) moderate training + PBMT, iii) high-intensity training alone, iv) high-intensity training + PBMT, and iv) control group. All participants underwent a 10-week intervention. Cardiopulmonary exercise testing was used to assess VO2peak, ventilatory efficiency, and exercise tolerance. Statistical analysis was performed using Generalized Estimating Equations, with alpha set at 5% (p < 0.05).

Results

Significant improvements in speed and grade during the exercise test were observed in the training groups, particularly in the high-intensity training group. This group demonstrated a greater increase in oxygen consumption (mean difference: 1.80 ml.kg-1.min-1 ± 0.59 ml.kg-1.min-1; p = 0.002) and superior performance in time to exhaustion (speed: p = 0.05; grade: p < 0.01). Comparisons across groups revealed that PBMT did not provide any relevant additional effects when combined with training.

Conclusion

AT, especially at high intensity, enhances exercise performance in patients with HF. The addition of PBMT did not confer significant additional benefits in this study. Further trials using optimized PBMT protocols are warranted.

  • Endurance Training
  • Exercise Test
  • Insuficiência Cardíaca
  • Low-Level Light Therapy
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Creative Commons Attribution (CC BY) Creative Commons license
09/01/2026 DOI: 10.36660/abc.20250086i Views 1
Figure 1
ABCHF
Viewpoint

Ventricular Dysfunction and Heart Failure in Patients Undergoing Hematopoietic Stem Cell Transplant

Katia Regina Medeiros Luz et al. Beatriz da Silva Costa Cortizo Maria Claudia Rodrigues Moreira

It has been known for a long time that Cyclophosphamide (Cy) for conditioning regimens in hematopoietic stem cell transplant (HSCT) can induce cardiotoxicity. We have been learning in cardio-oncology that the best practice is to identify the risks of cardiotoxicity and, when possible, minimize them before the exposure. Several factors contribute to define cardiovascular toxicity risks including the type of transplant, age at transplant, hypertension, diabetes mellitus, dyslipidemia, and current smoking. Multiple uncontrolled preexisting cardiovascular conditions such as atrial fibrillation or atrial flutter, node sinus disease, ventricular arrhythmias, coronary artery disease, valve diseases and heart failure with reduced ejection fraction may also contribute to cardiotoxicity. So, it is important to know about the disease severity at the time of transplantation and probability of relapse, which may be correlated with increased exposure to other cardiotoxic chemotherapy drugs and radiotherapy before HSCT.

There are mainly two types of HSCT: (1) autologous transplantation, in which the patient receives his/her own progenitor cells, and the cardiotoxicity is mainly attributed to the direct toxic effects of the conditioning regimen; and (2) allogeneic transplantation in which the patient receives cells from another individual who may be fully or partially compatible. The allogeneic transplantation is known to have a higher risk of cardiotoxicity because in addition to the conditioning toxic effects, there are indirect effects of cytokines released in graft-versus-host disease and a possible direct cardiotoxicity through donor T-cell infiltration into the myocardium with subsequent inflammation leading to cardiac dysfunction. The HSCT has six stages as presented in : pre-transplant, conditioning phase (when the patient receives chemotherapy and often radiotherapy to eliminate the recipient’s bone marrow, infusion, aplasia, recovery and post-transplant stage. In pre-transplant, the cardio-oncologist must perform a comprehensive assessment of the risk factors for cardiotoxicity. Clinical history and physical examination, electrocardiogram, laboratory tests including T troponin and brain natriuretic peptide (BNP) (or N-terminal-proBNP NTproBNP), X-ray or, preferably, chest computed tomography, strain echocardiogram and spirometry test are essentials for a good evaluation. Rhythm and hemodynamic changes are described in the infusion stage, usually quick and benign as sinus tachycardia or bradycardia, hypotension or hypertension, but also serious ones as a total AV block. These changes seem to be caused by dimethyl sulfoxide, a cryoprotectant, but there is still not enough data to support this hypothesis. Many infectious complications may occur in the aplasia phase, such as myocarditis due to viral reactivation and sepsis-induced cardiomyopathy. The differential diagnosis between these conditions and cardiotoxicity can be challenging.

[…]

  • Cardiotoxicidade
  • Insuficiência Cardíaca
  • Medula Óssea
  • Transplante
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18/12/2022 DOI: 10.36660/abchf.20220090
ABCHF
Viewpoint

Dobutamine vs Milrinone in Heart Failure with Preserved Ejection Fraction: How do We Choose?

Marcely Gimenes Bonatto

Heart failure (HF) occurs when the heart cannot pump sufficient blood to meet tissue needs and/or does so at the expense of high filling pressures, clinically manifesting itself through signs and symptoms of congestion and/or low cardiac output.

Decompensation is frequently observed in the condition’s natural history. Approximately 20% of HF exacerbations occur in low cardiac output syndrome, with cardiogenic shock being the most severe presentation. When there is evidence of poor organ perfusion, inotropes are fundamental pharmacological support, with dobutamine and milrinone being the most commonly used drugs.

[…]

  • Dobutamina
  • Insuficiência Cardíaca
  • Milrinona
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29/06/2022 DOI: 10.36660/abchf.20220031 Views 1
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ABCHF
Research Letter

New Drugs for Treatment of Heart Failure with Reduced Ejection Fraction: Vericiguat and Omecamtiv Mecarbil

Mucio Tavares de Oliveira Jr et al. Antonio Carlos Pereira Barretto Carlos Henrique Del Carlo Sergio Jallad Mariana Silveira de Alcantara Chaud

Omecamtiv mecarbil – myosin activator

During the 1980s and 1990s, several attempts at long-term treatment with inotropes in patients with systolic dysfunction almost always resulted in increased mortality or a neutral effect (oral milrinone, intravenous dobutamine infusion), with the exception of levosimendan, when used in intermittent infusions in patients with advanced heart failure, which did not interfere with prognosis and avoided worsening quality of life and readmissions.

Omecamtiv mecarbil is an inotropic agent whose mechanism of action differs from the others, having no relation to increased calcium influx or increased sensitivity to calcium by myocardial fibers. The drug increases cardiac contractility by selectively interacting with cardiac myosin, increasing the number of molecules available to bind to actin and produce greater kinetic energy at the beginning of systole, without increasing calcium and/or oxygen consumption. Omecamtiv mecarbil binds to a site that stabilizes the molecule, promoting a greater number of actin-myosin interactions, increasing the amount of energy generated with each ventricular systole.

[…]

  • Hospitalização
  • Insuficiência Cardíaca
  • Omecamtiv Mecarbil
  • Sobrevida
  • Vericiguat
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12/04/2022 DOI: 10.36660/abchf.20220009 Views 1

How to cite this article

EndNote RIS

Electronic Document Format (Vancouver)

Busin D, Franzoni LT, Turella D, Tairova OS, Silveira AD, Stein R, Amorim GL, et al. Photobiomodulation Combined with Moderate or High-Intensity Interval Training on Oxygen Consumption and Exercise Tolerance in Patients with Heart Failure. Arquivos Brasileiros de Cardiologia 2026;122(11):e20250086.

Electronic Document Format (ABNT)

Busin, Diego; Franzoni, Leandro Tolfo; Turella, Douglas; Tairova, Olga Sergueevna; Silveira, Anderson Donelli da; Stein, Ricardo; Amorim, Gabriel Lopes; Lago, Pedro Dal; Nunes, Ramiro Barcos. Photobiomodulation Combined with Moderate or High-Intensity Interval Training on Oxygen Consumption and Exercise Tolerance in Patients with Heart Failure. Arquivos Brasileiros de Cardiologia, v. 122, n. 11, e20250086, Jan. 2026.

Electronic Document Format (APA)

Busin, D., Franzoni, L. T., Turella, D., Tairova, O. S., Silveira, A. D. , Stein, R., Amorim, G. L., Lago, P. D., & Nunes, R. B. (2026). Photobiomodulation Combined with Moderate or High-Intensity Interval Training on Oxygen Consumption and Exercise Tolerance in Patients with Heart Failure. Arquivos Brasileiros de Cardiologia, 122(11), e20250086.

Electronic Document Format (ISO)

Busin, Diego and Franzoni, Leandro Tolfo and Turella, Douglas and Tairova, Olga Sergueevna and Silveira, Anderson Donelli da and Stein, Ricardo and Amorim, Gabriel Lopes and Lago, Pedro Dal and Nunes, Ramiro Barcos. Photobiomodulation Combined with Moderate or High-Intensity Interval Training on Oxygen Consumption and Exercise Tolerance in Patients with Heart Failure. Arquivos Brasileiros de Cardiologia [online]. 2026, vol. 122, n. 11, [cited 2026-10-14], e20250086. Available from: <https://journals.cardiol.br/en/article/photobiomodulation-combined-with-moderate-or-high-intensity-interval-training-on-oxygen-consumption-and-exercise-tolerance-in-patients-with-heart-failure/>. ISSN 0066-782X

EndNote RIS

Electronic Document Format (Vancouver)

Luz KRM, Cortizo BSC, Moreira MCR. Ventricular Dysfunction and Heart Failure in Patients Undergoing Hematopoietic Stem Cell Transplant. ABC: Heart Failure & Cardiomyopathy 2022;2(4):415-6.

Electronic Document Format (ABNT)

Luz, Katia Regina Medeiros; Cortizo, Beatriz da Silva Costa; Moreira, Maria Claudia Rodrigues. Ventricular Dysfunction and Heart Failure in Patients Undergoing Hematopoietic Stem Cell Transplant. ABC: Heart Failure & Cardiomyopathy, v. 2, n. 4, p. 415-416, Dec. 2022.

Electronic Document Format (APA)

Luz, K. R. M., Cortizo, B. S. C., & Moreira, M. C. R. (2022). Ventricular Dysfunction and Heart Failure in Patients Undergoing Hematopoietic Stem Cell Transplant. ABC: Heart Failure & Cardiomyopathy, 2(4), 415-416.

Electronic Document Format (ISO)

Luz, Katia Regina Medeiros and Cortizo, Beatriz da Silva Costa and Moreira, Maria Claudia Rodrigues. Ventricular Dysfunction and Heart Failure in Patients Undergoing Hematopoietic Stem Cell Transplant. ABC: Heart Failure & Cardiomyopathy [online]. 2022, vol. 2, n. 4, [cited 2026-10-14], pp. 415-416. Available from: <https://journals.cardiol.br/en/article/ventricular-dysfunction-and-heart-failure-in-patients-undergoing-hematopoietic-stem-cell-transplant/>

EndNote RIS

Electronic Document Format (Vancouver)

Bonatto MG. Dobutamine vs Milrinone in Heart Failure with Preserved Ejection Fraction: How do We Choose?. ABC: Heart Failure & Cardiomyopathy 2022;2(2):198-200.

Electronic Document Format (ABNT)

Bonatto, Marcely Gimenes. Dobutamine vs Milrinone in Heart Failure with Preserved Ejection Fraction: How do We Choose?. ABC: Heart Failure & Cardiomyopathy, v. 2, n. 2, p. 198-200, Jun. 2022.

Electronic Document Format (APA)

Bonatto, M. G. (2022). Dobutamine vs Milrinone in Heart Failure with Preserved Ejection Fraction: How do We Choose?. ABC: Heart Failure & Cardiomyopathy, 2(2), 198-200.

Electronic Document Format (ISO)

Bonatto, Marcely Gimenes. Dobutamine vs Milrinone in Heart Failure with Preserved Ejection Fraction: How do We Choose?. ABC: Heart Failure & Cardiomyopathy [online]. 2022, vol. 2, n. 2, [cited 2026-10-14], pp. 198-200. Available from: <https://journals.cardiol.br/en/article/dobutamine-vs-milrinone-in-heart-failure-with-preserved-ejection-fraction-how-do-we-choose/>

EndNote RIS

Electronic Document Format (Vancouver)

Oliveira Jr MT, Barretto ACP, Carlo HD, Jallad S, Chaud MSA. New Drugs for Treatment of Heart Failure with Reduced Ejection Fraction: Vericiguat and Omecamtiv Mecarbil. ABC Heart Fail Cardiomyop 2022;2(1):50-4.

Electronic Document Format (ABNT)

Oliveira Jr, Mucio Tavares de; Barretto, Antonio Carlos Pereira; Carlo, s Henrique Del; Jallad, Sergio; Chaud, Mariana Silveira de Alcantara. New Drugs for Treatment of Heart Failure with Reduced Ejection Fraction: Vericiguat and Omecamtiv Mecarbil. ABC Heart Fail Cardiomyop, v. 2, n. 1, p. 50-54, Apr. 2022.

Electronic Document Format (APA)

Oliveira Jr, M. T. , Barretto, A. C. P., Carlo, H. D., Jallad, S., & Chaud, M. S. A. (2022). New Drugs for Treatment of Heart Failure with Reduced Ejection Fraction: Vericiguat and Omecamtiv Mecarbil. ABC Heart Fail Cardiomyop, 2(1), 50-54.

Electronic Document Format (ISO)

Oliveira Jr, Mucio Tavares de and Barretto, Antonio Carlos Pereira and Carlo, s Henrique Del and Jallad, Sergio and Chaud, Mariana Silveira de Alcantara. New Drugs for Treatment of Heart Failure with Reduced Ejection Fraction: Vericiguat and Omecamtiv Mecarbil. ABC Heart Fail Cardiomyop [online]. 2022, vol. 2, n. 1, [cited 2026-10-14], pp. 50-54. Available from: <https://journals.cardiol.br/en/article/new-drugs-for-treatment-of-heart-failure-with-reduced-ejection-fraction-vericiguat-and-omecamtiv-mecarbil/>

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