Vigorous exercise in patients with hypertrophic cardiomyopathy

Area of Science:

• Cardiology
• Exercise Physiology
• Genetics

Background:

• Investigating the impact of vigorous exercise on cardiac structure and function in hypertrophic cardiomyopathy (HCM).
• Examining differences between genotype-positive, phenotype-negative (Genotype+ LVH-) and phenotype-positive (HCM LVH+) individuals.

Purpose of the Study:

• To determine if a history of vigorous exercise is associated with changes in left ventricular morphology, function, and ventricular arrhythmias (VAs).
• To compare these associations in Genotype+ LVH- and HCM LVH+ subjects.

Main Methods:

• Cross-sectional study of 187 subjects (121 HCM LVH+, 66 Genotype+ LVH-).
• Assessed physical activity history via questionnaire, defining vigorous exercise (≥6 METs) and athletes (≥4h/week for ≥6 years).
• Utilized echocardiography and Holter monitoring to assess cardiac structure, function, and VAs.

Main Results:

• Lifetime vigorous exercise correlated with larger left ventricular end-diastolic volume in both groups (p<0.001).
• Vigorous exercise correlated with increased left ventricular mass in Genotype+ LVH- (p=0.03) but not HCM LVH+ (p=0.53).
• HCM LVH+ athletes showed improved diastolic function (lower E/e', higher e') compared to non-athletes.

Conclusions:

• Increased lifetime vigorous exercise is associated with larger left ventricular volumes in HCM.
• Exercise correlated with left ventricular mass only in Genotype+ LVH- and improved diastolic function in HCM LVH+.
• Vigorous exercise was not associated with an increased risk of VAs in either group.