Review Article--Exercise and Hypertrophic Cardiomyopathy: Risks, Benefits, and Safety - A Systematic Review and Meta-analysis.

Arif Albulushi, Qasim Al Abri, Ahmed Tawfek, Ahmed R Bagheri, Said Al-Hinai
Author Information
  1. Arif Albulushi: Department of Adult Cardiology, National Heart Center, The Royal Hospital, Muscat, Oman.
  2. Qasim Al Abri: Department of Cardiothoracic Surgery, National Heart Center, The Royal Hospital, Muscat, Oman.
  3. Ahmed Tawfek: Department of Adult Cardiology, National Heart Center, The Royal Hospital, Muscat, Oman.
  4. Ahmed R Bagheri: Department of Adult Cardiology, National Heart Center, The Royal Hospital, Muscat, Oman.
  5. Said Al-Hinai: Division of Cardiology, Diwan Medical Complex, Muscat, Oman.

Abstract

Hypertrophic Cardiomyopathy (HCM) is often associated with conservative exercise recommendations due to the risk of sudden cardiac death (SCD). However, emerging evidence suggests that tailored exercise programs may provide significant benefits to HCM patients. This systematic review and meta-analysis evaluated the impact of different types and intensities of exercise on clinical outcomes and quality of life in HCM patients, assessed the role of exercise in preventing disease progression and arrhythmias, and determined the safety and efficacy of structured exercise programs tailored to individual risk profiles. A comprehensive literature search was conducted using PubMed, Embase, Cochrane Library, and relevant cardiology journals. Studies included were those that evaluated exercise interventions in HCM patients and reported clinical outcomes, quality of life measures, and safety data. Data were extracted and pooled to determine the overall impact of exercise on HCM. Meta-analysis results showed that moderate-intensity exercise improved VO max by 3.5 mL/kg/min (95% CI 2.0-5.0, p < 0.001), reduced NYHA class by -0.5 (95% CI -0.7 to -0.3, p < 0.001), and enhanced quality of life measures across physical, emotional, and social domains (SMD +0.40, 95% CI 0.25-0.55, p < 0.001). No significant increase in arrhythmias (RR 0.95, 95% CI 0.75-1.20, p = 0.68) or mortality (RR 0.85, 95% CI 0.60-1.20, p = 0.35) was observed. Tailored exercise programs show promise in managing symptoms and preventing disease progression. This systematic review underscores the potential benefits of personalized exercise regimens for HCM patients. Further research is needed to establish standardized exercise protocols that optimize safety and efficacy.

Keywords

References

  1. Cardiol Rev. 2024 Aug 23;: [PMID: 39177404]
  2. Circulation. 2007 Feb 13;115(6):773-81 [PMID: 17261650]
  3. Trends Cardiovasc Med. 2025 Feb;35(2):126-134 [PMID: 39147002]
  4. Circulation. 2006 Jul 18;114(3):216-25 [PMID: 16831987]
  5. Hellenic J Cardiol. 2024 Nov-Dec;80:83-95 [PMID: 38977062]
  6. Prog Cardiovasc Dis. 2006 Mar-Apr;48(5):342-62 [PMID: 16627049]
  7. J Am Coll Cardiol. 2013 Oct 1;62(14):1252-1259 [PMID: 23623916]
  8. Am J Cardiol. 2013 Apr 1;111(7):1034-9 [PMID: 23340032]
  9. JAMA. 1999 Feb 17;281(7):650-5 [PMID: 10029128]
  10. Circ Heart Fail. 2024 Aug;17(8):e011663 [PMID: 39087355]
  11. JAMA. 2012 Aug 22;308(8):764-5 [PMID: 22820673]
  12. J Am Coll Cardiol. 2020 Jun 23;75(24):3033-3043 [PMID: 32553256]
  13. Int J Cardiol. 2024 Aug 1;408:132116 [PMID: 38703898]
  14. J Sci Med Sport. 2017 Apr;20(4):333-338 [PMID: 27707537]
  15. Circulation. 2020 Dec 22;142(25):e558-e631 [PMID: 33215931]
  16. BMJ. 2021 Mar 29;372:n71 [PMID: 33782057]
  17. J Am Coll Cardiol. 2008 Apr 8;51(14):1369-74 [PMID: 18387438]
  18. Eur Heart J. 2021 Jan 1;42(1):17-96 [PMID: 32860412]
  19. J Am Heart Assoc. 2024 Oct 15;13(20):e036593 [PMID: 39392151]
  20. Br J Sports Med. 2013 Jan;47(1):28-33 [PMID: 23193325]
  21. Eur Heart J. 2006 Aug;27(16):1933-41 [PMID: 16754630]
  22. J Clin Med. 2024 Apr 17;13(8): [PMID: 38673596]
  23. JAMA. 2017 Apr 4;317(13):1349-1357 [PMID: 28306757]
  24. Eur Heart J. 2014 Oct 14;35(39):2733-79 [PMID: 25173338]
  25. Am J Cardiol. 2016 Feb 1;117(3):434-5 [PMID: 26718233]
  26. Cardiovasc Res. 2001 May;50(2):399-408 [PMID: 11334844]
  27. JAMA. 2007 Jul 25;298(4):405-12 [PMID: 17652294]
  28. Circulation. 1999 Feb 23;99(7):963-72 [PMID: 10027821]
  29. Open Heart. 2016 Jul 20;3(2):e000484 [PMID: 27547438]
  30. Curr Probl Cardiol. 2024 Dec;49(12):102825 [PMID: 39222831]

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