Exercise Training and Cardiac Remodeling in Hypertrophic Cardiomyopathy: A Systematic Review and Meta-Analysis.
Level 2 - randomized trial
Systematic review and meta-analysis of both randomized trials and observational cohort studies
PubMed 42080244 · doi:10.1097/HPC.0000000000000428
What was done
Authors conducted a systematic review and meta-analysis following PRISMA 2020 guidelines examining randomized and observational studies of individuals aged ≥12 years with confirmed hypertrophic cardiomyopathy (HCM) participating in structured exercise or habitual physical activity. Comparators included usual care, lower-intensity exercise, or sedentary controls. Outcomes evaluated via random-effects models included cardiac remodeling parameters (wall thickness, chamber volumes, LVOT gradient, diastolic function), LVEF, BNP, peak VO2, BMI, and major adverse clinical events.
What was found
Across 11 included studies comprising 1,457 participants, exercise was not associated with adverse changes in wall thickness, chamber volumes, LVEF, LVOT gradient, diastolic indices, BNP, or BMI; no specific numerical effect sizes, confidence intervals, or p-values were reported in the abstract. Changes in peak VO2 were heterogeneous. No study reported excess adverse clinical events, such as sudden cardiac death, ventricular arrhythmias, syncope, or appropriate ICD discharge.
Why it matters
This review challenges historical practices of strict exercise restriction in patients with HCM, suggesting that structured and habitual physical activity is generally safe and supporting individualized exercise counseling.
Limits
The abstract provides no exact numerical values, point estimates, or confidence intervals. The inclusion of observational studies alongside randomized trials introduces risk of selection bias and confounding. Details on exercise intensity thresholds and long-term adverse event follow-up were not reported in the abstract.
Cited by
- supports Recent evidence indicates that patients with hypertrophic cardiomyopathy can safely train, and animal data suggests that exercise training at a young age may prevent the full expression of the disease.