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Exercise prescription in individuals with hypertrophic cardiomyopathy: what clinicians need to know.

Gati, S; Sharma, S (2022) Exercise prescription in individuals with hypertrophic cardiomyopathy: what clinicians need to know. Heart, 108 (24). pp. 1930-1937. ISSN 1468-201X https://doi.org/10.1136/heartjnl-2021-319861
SGUL Authors: Sharma, Sanjay

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Abstract

Hypertrophic cardiomyopathy (HCM) is the most frequently cited cause of exercise-related sudden cardiac death (SCD) in young individuals and has claimed the lives of some high-profile athletes. The circumstantial link between exercise and SCD from HCM has resulted in conservative exercise recommendations which focus on activities that should be avoided rather than the minimal amount of physical activity required to reap the multiple rewards of exercise. Consequently, most patients with HCM are confined to a sedentary lifestyle through fear of SCD, with accruing risk factors such as obesity and low cardiorespiratory fitness that confer a worse prognosis. Recent exercise programmes in asymptomatic and symptomatic individuals with HCM have shown that mild and moderate exercise is safe and accompanied by increased functional capacity and improved quality of life. Population studies also reveal that individuals with HCM in the higher quartiles of self-reported physical activity have lower total cardiovascular mortality compared with those in the lower quartiles. The impact of vigorous exercise on the natural history of HCM is unknown, although current experience suggests that affected adults with mild morphology and absence of high-risk factors may partake in such activity without adverse events. This review highlights the evidence base that has resulted in a paradigm shift in the approach to exercise in HCM and liberalised recent international exercise guidelines in HCM. Practical tips for prescribing exercise in symptomatic patients and relevant precautions are provided to aid clinicians when recommending exercise as part of the management plan for all patients with HCM.

Item Type: Article
Additional Information: © Author(s) (or their employer(s)) 2022. Reuse of this manuscript version (excluding any databases, tables, diagrams, photographs and other images or illustrative material included where a another copyright owner is identified) is permitted strictly pursuant to the terms of the Creative Commons Attribution-Non Commercial 4.0 International (CC-BY-NC 4.0) http://creativecommons.org/licenses/by-nc/4.0/
Keywords: cardiac rehabilitation, cardiomyopathy, hypertrophic, diagnostic imaging, Adult, Humans, Quality of Life, Cardiomyopathy, Hypertrophic, Death, Sudden, Cardiac, Exercise Therapy, Risk Factors, Prescriptions, Humans, Cardiomyopathy, Hypertrophic, Death, Sudden, Cardiac, Exercise Therapy, Risk Factors, Quality of Life, Adult, Prescriptions, 1102 Cardiorespiratory Medicine and Haematology, 1103 Clinical Sciences, Cardiovascular System & Hematology
SGUL Research Institute / Research Centre: Academic Structure > Molecular and Clinical Sciences Research Institute (MCS)
Journal or Publication Title: Heart
ISSN: 1468-201X
Language: eng
Dates:
DateEvent
24 November 2022Published
23 February 2022Published Online
1 February 2022Accepted
Publisher License: Creative Commons: Attribution-Noncommercial 4.0
PubMed ID: 35197306
Web of Science ID: WOS:000760931700001
Go to PubMed abstract
URI: https://openaccess.sgul.ac.uk/id/eprint/115361
Publisher's version: https://doi.org/10.1136/heartjnl-2021-319861

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