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Exercise Participation and Rehabilitation in Cardiomyopathies: An Updated Review

Domitilla Russo1, Cristina Gambardella2, Maurizio Volterrani3

  • 1Department of Cardiology, Santo Spirito Hospital, 00193 Rome, Italy.

Journal of Clinical Medicine
|December 30, 2025
PubMed

Insights

Individualized exercise and cardiac rehabilitation can improve outcomes for patients with cardiomyopathies (HCM, DCM, ACM). Guidelines now support supervised physical activity and reassessment for sports participation in selected individuals.

Area of Science:

  • Cardiology
  • Sports Medicine
  • Genetics

Background:

  • Cardiomyopathies (HCM, DCM, ACM) pose challenges for exercise and rehabilitation.
  • Historically, physical activity was restricted due to risks of arrhythmias and sudden cardiac death.

Purpose of the Study:

  • To review current evidence on exercise, sports participation, and rehabilitation for HCM, DCM, and ACM.
  • To inform international guideline recommendations and highlight personalized approaches.

Main Methods:

  • Systematic review of current evidence.
  • Analysis of international guideline recommendations.
  • Focus on shared decision-making and risk stratification.

Main Results:

  • Individualized exercise programs can enhance functional capacity and quality of life.
  • Current guidelines support supervised physical activity and reassessment for competitive sports in selected patients.
  • Addresses emerging scenarios like ICDs and genotype-positive/phenotype-negative individuals.

Conclusions:

  • Personalized exercise and rehabilitation are crucial for managing cardiomyopathies.
  • Shared decision-making, considering specific cardiomyopathy type and risk, is essential.
  • Guidelines increasingly support carefully managed sports participation.

Keywords:
arrhythmogenic cardiomyopathycardiac rehabilitationcardiomyopathydilated cardiomyopathyexercisehypertrophic cardiomyopathysudden cardiac death

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