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Exercise in hypertrophic cardiomyopathy: restrict or rethink.
Adaya Weissler Snir1,2, Kim A Connelly3,4,5, Jack M Goodman6,7
1Department of Medicine, University of Connecticut, Farmington, Connecticut.
Summary
Aerobic training in hypertrophic cardiomyopathy (HCM) may be protective, contrary to fears of worsening the condition or causing arrhythmias. Current data suggest a lower risk of sudden cardiac death (SCD) than previously believed, prompting a reevaluation of exercise restrictions.
Area of Science:
- Cardiology
- Exercise Physiology
- Genetics
Background:
- Hypertrophic cardiomyopathy (HCM) patients face concerns regarding exercise, including phenotype worsening and arrhythmia risk.
- Existing research on exercise's impact on HCM is limited, with some animal studies suggesting protective effects.
Discussion:
- This review critically evaluates the pathophysiology of HCM and exercise's effects on autonomic function, hemodynamics, and cardiac parameters.
- It examines the mechanisms potentially triggering exercise-induced arrhythmias and assesses the evidence for sudden cardiac death (SCD) risk in athletes with HCM.
Key Insights:
- The risk of SCD in HCM patients may be lower than previously assumed.
- Animal models indicate exercise could be protective against HCM progression.
- There is an ongoing debate regarding the necessity and extent of exercise restrictions for individuals with HCM.
Outlook:
- Future research should focus on personalized exercise prescriptions for HCM patients.
- Further investigation into the benefits of targeted exercise interventions is warranted.
- Revising current guidelines on sports participation for HCM individuals based on emerging evidence is crucial.
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