Key result
Exercise improves peak VO2 and reduces all-cause mortality in patients with HCM.
Why the study?
Patients with HCM are generally restricted from exercising, leaving its effects on cardiorespiratory fitness, cardiac structure, cardiac function, and safety unclear.
Does exercise improve cardiorespiratory fitness, cardiac structure, and clinical safety in patients with hypertrophic cardiomyopathy?
Meta-Analysis (n=9,702)
Does exercise improve cardiorespiratory fitness, cardiac structure, and clinical safety in patients with hypertrophic cardiomyopathy?
Mean Difference: 1.78 (95% CI 0.98–2.59)
p-value: p=< 0.01
Structured exercise interventions in patients with hypertrophic cardiomyopathy are safe, improve cardiorespiratory fitness and quality of life, and may reduce mortality, challenging historical restrictions on exercise in this population.
Exercise safely boosts fitness in HCM; reinforces guideline support with largest pooled analysis to date.
Background Patients with hypertrophic cardiomyopathy (HCM) are generally restricted from exercising. We aimed to investigate the effects of exercise on cardiorespiratory fitness, cardiac structure, cardiac function, and clinical safety for patients with HCM.Methods We performed a systematic review and meta-analysis by searching PubMed, Web of Science, Scopus, Embase, and CENTRAL up to April 2025. Dichotomous outcomes were pooled using risk ratios (RRs), while continuous outcomes were pooled using mean differences (MDs) or standardized mean differences (SMDs), all with 95% confidence intervals (CIs), using R version 4.3.1.Results With the inclusion of seven studies—three randomized controlled trials and four observational studies—our cohort comprised 9702 patients. Compared to the control group, exercise was significantly associated with increased cardiorespiratory fitness (peak oxygen consumption [peak VO2] (mL∙kg−1∙min−1) (MD: 1.78; 95% CI [0.98, 2.59]; P < 0.01) and VO2 at an anaerobic threshold (mL∙kg−1∙min−1) (MD: 1.27; 95% CI [0.34, 2.20]; P < 0.01), reduced body mass index (kg/m2) (MD: −0.67; 95% CI [−1.17, −0.18]; P < 0.01), reduced left ventricular wall thickness (mm) measured by echocardiography (MD: −0.56; 95% CI [−1.01, −0.11]; P = 0.01), increased quality of life physical factor (SMD: 0.66; 95% CI [0.34, 0.97]; P < 0.01), and decreased incidence of all-cause mortality (RR: 0.71; 95% CI [0.60, 0.85]; P < 0.01).Conclusion This study suggests that structured exercise interventions are safe and associated with improvements in cardiorespiratory fitness, left ventricular wall thickness, body mass index, and quality of life physical factor in patients with HCM, without increasing the risk of arrhythmias. Although a lower mortality rate was observed, this finding was mainly driven by observational studies and should therefore be interpreted with caution. Larger randomized controlled trials are needed to confirm these findings.
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Amin et al. (2026) conducted a meta-analysis in hypertrophic cardiomyopathy (n=9,702). structured exercise interventions vs. control group was evaluated on cardiorespiratory fitness (peak oxygen consumption [peak VO2]) (MD 1.78, 95% CI 0.98, 2.59, p=< 0.01). Exercise significantly increased peak oxygen consumption (MD 1.78; 95% CI 0.98-2.59; P<0.01) and decreased all-cause mortality in patients with hypertrophic cardiomyopathy.
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