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Strategy for Exercise Restriction in Hypertrophic Cardiomyopathy.
1Division of Cardiology, Severance Cardiovascular Hospital, Yonsei University College of Medicine, 50-1 Yonsei-ro, Seodaemun-gu, Seoul 03722, Republic of Korea.
Heart Failure Clinics
|October 13, 2025
Summary
Most hypertrophic cardiomyopathy (HCM) patients can safely exercise, improving cardiovascular health. Current guidelines support personalized physical activity (PA) plans based on individual risk assessment, moving away from universal exercise restrictions.
Area of Science:
- Cardiology
- Exercise Physiology
Background:
- Traditional guidelines for hypertrophic cardiomyopathy (HCM) often recommended universal exercise restriction.
- Emerging evidence challenges this restrictive approach, suggesting potential benefits of physical activity (PA).
Purpose of the Study:
- To review current evidence and guidelines on exercise in hypertrophic cardiomyopathy (HCM).
- To advocate for individualized exercise recommendations over blanket restrictions for HCM patients.
Main Methods:
- Review of recent scientific literature and contemporary clinical guidelines.
- Analysis of evidence regarding the safety and efficacy of physical activity (PA) in HCM.
- Proposal of a clinical framework for risk stratification and shared decision-making.
Main Results:
- Most patients with hypertrophic cardiomyopathy (HCM) can safely participate in physical activity (PA).
- Vigorous PA in low-risk HCM patients has been shown to improve functional capacity without increasing adverse events.
- Contemporary guidelines emphasize individualized exercise prescriptions.
Conclusions:
- The paradigm of universal exercise restriction in hypertrophic cardiomyopathy (HCM) is evolving.
- Personalized exercise plans, based on risk stratification and shared decision-making, are recommended for HCM patients.
- Physical activity (PA) can be safely integrated into the management of most HCM patients to improve outcomes.
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