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August 20, 2026European Heart Journal OpenOpen Access

Genotype Status and Arrhythmic Risk in Sport Participants with Hypertrophic Cardiomyopathy

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Why the study?

The impact of genotype on arrhythmic risk in sports-active hypertrophic cardiomyopathy patients remains unclear.

Does genotype-positive status increase arrhythmic risk in sports-active patients with hypertrophic cardiomyopathy compared to genotype-negative status?

Comparison

Genotype-positive vs genotype-negative athletes with HCM

Design

Retrospective cohort study

Follow-up

6.3 years [3.0-12.6]

Key result

In sports-active hypertrophic cardiomyopathy patients, genotype-positive status showed similar rates of ventricular arrhythmias compared to genotype-negative status (20.7% vs 23.3%, p=0.807).

Authors

FMFrédéric MyonMDMathilde DelatourNBNathalie Béhar

Discussion

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Overview

Genotype may not stratify arrhythmic risk in sports-active HCM; leaves open need for prospective validation before guiding decisions.

Key Points

  • To compare arrhythmic and cardiovascular outcomes between genotype-positive (G+) and genotype-negative (G-) sport-active patients with hypertrophic cardiomyopathy (HCM).
  • Retrospectively analyzed 59 sports-active HCM patients (median age 40.0 years; 67.8% competitive athletes; median sports practice 6.0 hours/week) followed for a median of 6.3 years.
  • Identified pathogenic or likely pathogenic variants in 29 participants (49.2%), predominantly in MYBPC3 (44.8%), MYH7 (24.1%), and TNNT2 (17.2%).
  • Assessed primary endpoints (sudden cardiac death/arrest, appropriate ICD therapy, SVT/NSVT) and secondary composite cardiovascular outcomes (ventricular arrhythmias, atrial fibrillation, ischemic stroke, heart failure hospitalization).
  • Ventricular arrhythmias occurred in 20.7% of G+ and 23.3% of G- patients (p=0.807), with 84.6% consisting of isolated non-sustained ventricular tachycardia.
  • Composite secondary cardiovascular outcomes occurred in 31.0% of G+ versus 33.3% of G- participants (p=0.850), while median 5-year sudden cardiac death risk scores were 1.87% versus 1.54% (p=0.048).

Study Design

Type

Cohort (n=59)

Structured PICO

Does genotype-positive status increase arrhythmic risk in sports-active patients with hypertrophic cardiomyopathy compared to genotype-negative status?

P
Population
59 sports-active patients with hypertrophic cardiomyopathy, followed for a median of 6.3 years.
E
Exposure
Genotype-positive (G+) status (carrying a likely pathogenic or pathogenic variant)
C
Comparator
Genotype-negative (G-) status
O
Outcome
Sudden cardiac death/arrest (SCD/SCA), appropriate implantable cardiovert-defibrillator (ICD) therapy, sustained/non-sustained ventricular tachycardia (SVT/NSVT)composite

Main Result

Absolute Event Rate: 20.7% vs 23.3%

p-value: p=0.807

In sports-active patients with hypertrophic cardiomyopathy, genotype status did not significantly impact the rate of ventricular arrhythmic or cardiovascular events over a 6.3-year follow-up.

Cite This Study

Myon et al. (2026) conducted a cohort in Hypertrophic cardiomyopathy (n=59). Genotype-positive status vs. Genotype-negative status was evaluated on Sudden cardiac death/arrest, appropriate ICD therapy, sustained/non-sustained ventricular tachycardia (p=0.807). In sports-active hypertrophic cardiomyopathy patients, genotype-positive status showed similar rates of ventricular arrhythmias compared to genotype-negative status (20.7% vs 23.3%, p=0.807).

synapsesocial.com/papers/6a86b5978a91293e6a1ccf6ehttps://doi.org/10.1093/ehjopen/oeag127
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