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

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 VO₂ 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.