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Exercise in Inherited Cardiomyopathies: Optimizing the Dose-Response Curve
Eleanor E Rye1,2,3, Amy M Mitchell4,5, Celine F Santiago1,6
1Victor Chang Cardiac Research Institute, Darlinghurst, New South Wales, Australia (E.R., A.L.G., D.F., C.F.S.).
Circulation Research
|July 3, 2025
Summary
For inherited cardiomyopathies, exercise recommendations must be personalized. Moderate-to-high exercise may be safe and beneficial for many patients, despite risks of arrhythmias.
Area of Science:
- Cardiology
- Exercise Physiology
- Genetics
Background:
- Exercise is crucial for cardiovascular health but poses risks for inherited cardiomyopathies.
- Exercise avoidance impacts cardiometabolic health, while excessive exercise may increase arrhythmia risk.
- Optimal exercise thresholds are complex and individualized, especially in inherited cardiomyopathies.
Purpose of the Study:
- To review the impact of exercise on myocardial function and arrhythmias in hypertrophic, arrhythmogenic, and dilated cardiomyopathies.
- To highlight disease-specific and genotype-specific risk factors influencing exercise tolerance.
- To explore the potential for personalized exercise strategies in cardiomyopathy management.
Main Methods:
- Review of human cohort studies and animal models.
- Analysis of factors influencing exercise response: frequency, intensity, duration, cardiomyopathy type, and genotype.
- Identification of disease-specific and genotype-specific risk factors.
Main Results:
- Exercise impact varies based on cardiomyopathy type, genotype, and individual traits.
- Emerging evidence suggests moderate-to-high exercise may be safe and beneficial for many patients.
- Understanding of specific risk factors remains incomplete.
Conclusions:
- Personalized exercise strategies are essential for inherited cardiomyopathies.
- Moderate-to-high exercise may offer cardioprotective benefits for many patients.
- Further research is needed to fully elucidate exercise impacts and refine personalized recommendations.
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