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Exercise Training in Hypertrophic Cardiomyopathy: A Systematic Review, Meta-analysis, and Meta-regression.
Adrián Bayonas-Ruiz1,2, Juan R Gimeno-Blanes3,4,5, Francisca M Muñoz-Franco6
1Department of Physiology, Faculty of Medicine, Edificio LAIB/Departamental, Campus de Excelencia Internacional de Ámbito Regional (CEIR) Campus Mare Nostrum (CMN), Campus CC Salud-El Palmar, 30120, Murcia, Spain.
Sports Medicine - Open
|July 15, 2026
Summary
Structured exercise training improves functional capacity and exercise tolerance in patients with hypertrophic cardiomyopathy (HCM). This meta-analysis found significant improvements in peak oxygen uptake and exercise time, with no reported adverse events.
Area of Science:
- Cardiology
- Exercise Physiology
- Sports Medicine
Background:
- Recent research suggests structured exercise may benefit patients with hypertrophic cardiomyopathy (HCM).
- However, a comprehensive synthesis of exercise intervention effects in HCM is lacking.
Purpose of the Study:
- To evaluate the impact of exercise training on bodyweight, functional capacity, echocardiography, blood pressure, heart rate (HR), double product, and NT-proBNP in HCM patients.
- To synthesize evidence from randomized controlled trials (RCTs) and non-randomized studies on exercise interventions in HCM.
Main Methods:
- Systematic review and random-effects meta-analysis of RCTs and non-randomized studies.
- Included adult patients (≥18 years) with obstructive and non-obstructive HCM undergoing endurance and concurrent training.
- Extracted data from PubMed, Web of Science, and Cochrane; assessed risk of bias using ROBINS-I V2.
Main Results:
- Training significantly increased peak oxygen uptake (pVO2), predicted pVO2, exercise time, peak HR, and HR reserve (HRR).
- Body mass index and resting HR significantly decreased.
- No significant changes were observed in other echocardiographic parameters, blood pressure, or NT-proBNP.
Conclusions:
- Individualized exercise interventions improve functional capacity, exercise tolerance, cardiac adaptability, and chronotropic competence in low-to-moderate risk HCM patients.
- Further research is needed on the effects of beta-blockers on HRR and training adaptations.
- Results should be interpreted cautiously due to study heterogeneity and limited generalizability.
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