Patients with coronary heart disease (CHD) generally have problems such as decreased cardiopulmonary endurance, cardiac autonomic dysfunction, and reduced quality of life. Cardiac rehabilitation is an effective means to improve the above outcomes, but traditional rehabilitation training has limitations such as insufficient exercise intensity and poor patient compliance. In recent years, low-volume high-intensity interval training (LV-HIIT) has attracted attention due to its time-saving and efficient advantages. At the same time, virtual reality (VR) technology enhances the immersion and fun of rehabilitation training. At present, there is still a lack of sufficient clinical basis for the clinical efficacy of LV-HIIT combined with VR in CHD patients. Whether it can synergistically improve cardiopulmonary function, cardiac autonomic nerve regulation, and metabolic inflammation indicators remains to be clarified.

Effects of LV-HIIT combined with VR on cardiac rehabilitation in patients with CHD.

Sixty patients with coronary heart disease admitted to Changzhou Dean Hospital from January 2025 to August 2025 were selected as the research subjects. They were divided into the resting group, the LV-HIIT, and the LV-HIIT combined with VR group (LV-HIIT+VR) using a random number table, with 20 cases in each group. All patients in each group received conventional drug treatment. The resting group underwent conventional rehabilitation training, the LV-HIIT group was given LV-HIIT training, and the LV-HIIT+VR group received VR in combination with LV-HIIT training. Each group intervened for a total of 12 weeks. Cardiopulmonary endurance [peak oxygen uptake (VO₂ peak), maximum metabolic equivalent (METmax), oxygen pulse (VO₂/HR)], heart rate variability [total standard deviation of RR intervals (SDNN), root mean square of successive differences between adjacent RR intervals (rMSSD), percentage of adjacent sinus RR intervals with differences exceeding 50 ms (pNN50)], echocardiogram [left ventricular ejection fraction (LVEF), left ventricular end-diastolic diameter (LVEDD)], ability to take care of daily life [evaluated using the modified Barthel index (mBI)], and laboratory indicators [triglycerides (TG), total cholesterol (TC), low-density lipoprotein cholesterol (LDL-C), high-density lipoprotein cholesterol (HDL-C), creatine kinase (CK), creatine kinase isoenzyme (CK-MB), high-sensitivity C-reactive protein (hs-CRP), interleukin 6 (IL-6)] were compared before and after the intervention in each group.

Five cases were lost to follow-up during the study. Finally, 19 cases were included in the resting group, 18 cases in the LV-HIIT group, and 18 cases in the LV-HIIT+VR group. After the intervention, VO₂ peak, METsmax, and VO₂/HR in the three groups increased compared with those before the intervention in each group, and the VE/VCO₂ slope decreased compared with that before the intervention in each group. Moreover, the LV-HIIT+VR group was better than the other two groups (P<0.05). After the intervention, SDNN, rMSSD, and pNN50 in the three groups were increased compared with those before the intervention in each group, and the LV-HIIT+VR group was better than the other two groups (P<0.05). After the intervention, LVEF and mBI of patients in the three groups were improved compared with those before the intervention in each group, and LVEDD was decreased compared with that before the intervention in each group. Moreover, the LV-HIIT+VR group was better than the other two groups (P<0.05). After the intervention, TG, TC, and LDL-C in the three groups were lower than those before the intervention in each group, and HDL-C was higher than that before the intervention in each group. Moreover, TG, TC, and LDL-C in the LV-HIIT+VR group were lower than those in the other two groups, and HDL-C was higher than that in the other two groups (P<0.05). After the intervention, the levels of CK, CK-MB, hs-CRP, and IL-6 in the three groups were lower than those before the intervention in each group, and the levels in the LV-HIIT+VR group were lower than those in the other two groups (P<0.05).

LV-HIIT combined with VR training can improve cardiopulmonary endurance in patients with coronary heart disease, regulate cardiac autonomic nervous function, improve quality of life, alleviate myocardial injury, and its mechanism may be related to regulating lipid metabolism and reducing the levels of inflammatory factors.