edited by Dr. Niccolo Maurizi
Historically, patients with Hypertrophic Cardiomyopathy (HCM) have been advised to avoid exercise due to fears of cardiac complications, but recently, thanks to increasingly detailed and well-conducted studies, this myth seems to be crumbling. Here is some evidence that all of us, doctors and patients, really need to embrace and apply in our daily lives.
According to a study published in Journal of the American Heart Association from the group of researchers at the University of Siena led by Prof. Flavio D'Ascenzi, patients with HCM can safely benefit from personalized exercise plans up to moderate intensity.
Why Exercise is Important
Living with HCM can be challenging, and the condition has historically been associated with a risk of cardiac arrhythmias, especially during vigorous and competitive physical activity. As a result, many patients avoid exercise altogether, resulting in a sedentary lifestyle that negatively impacts overall fitness and cardiac health. This study seeks to understand how even moderate, personalized exercise can make a big difference. In fact, colleagues found that:
- Better health through activity:
Patients who engaged in moderate exercise, such as walking or cycling, showed significant improvements in heart and lung function compared to sedentary patients. These individuals had better oxygen utilization, greater respiratory efficiency, and overall fitness levels. - Safety first:
The good news? There were no serious heart rhythm disturbances, such as life-threatening arrhythmias, reported among those who followed the prescribed exercise program. - The risks of inactivity:
In contrast, sedentary patients experienced a decline in their physical fitness and cardiac health over time, highlighting the risks of avoiding physical activity altogether. - Personalized exercise plans:
The study emphasized the importance of tailoring exercise routines to each patient's unique health profile. Activities were set at moderate intensity—not overly strenuous—to ensure safety.
In other words, experts recommend that patients start with just a few sessions a week, gradually increasing activity. Using a heart rate monitor can help keep you within safe limits during exercise. This research marks a significant change in the management of patients with HCM. It shows that avoiding inactivity altogether is essential for cardiac health. Regular, supervised exercise not only improves quality of life, but carries minimal risk when done properly.
D'Ascenzi was not the only one to deal with this problem. In fact, a group of Danish doctors published in the prestigious journal Circulation a study that looked at how patients with hypertrophic obstructive cardiomyopathy responded to 12 weeks of exercise. Improved heart function: Patients who participated in the exercise program saw a reduction in left ventricular filling pressure during light exercise. This means the heart had to work less to pump blood, a significant improvement compared to those who remained inactive.
- Better physical shape: Those who exercised showed a significant increase in maximal oxygen consumption (assessed with Cardiorespiratory test) and overall cardiac performance. In contrast, the sedentary group showed no improvement and even observed a slight decline in physical fitness.
- Improvement of the quality of life: Exercise not only helped patients improve their physical capacity, but also improved their quality of life, especially with regard to physical limitations and general well-being. These benefits were not observed in those who did not exercise.
This study also confirms that a well-structured, moderate exercise program can safely improve cardiac function and overall fitness in patients with HCM. Regular physical activity strengthens the heart, improves daily performance, and increases quality of life, helping patients live better despite their condition.
In conclusion, for patients with HCM, staying active is no longer out of the question: it is an essential part of staying healthy. Always consult a cardiologist with expertise in Cardiomyopathies before starting a new exercise program, but the message is clear: moving is important!
I remind you that Prof. D'Ascenzi will be a guest in our January Webinar and we will talk about sports: come in large numbers to ask us all your curiosities or simply understand more!
References:
Cavigli L, Ragazzoni GL, Vannuccini F, Targetti M, Mandoli GE, Senesi G, Pastore MC, Focardi M, Cameli M, Valente S, Bonifazi M, Olivotto I, D'Ascenzi F. Cardiopulmonary Fitness and Personalized Exercise Prescription in Patients With Hypertrophic Cardiomyopathy. J Am Heart Assoc. 2024 Oct 15;13(20):e036593.
Gudmundsdottir H, Axelsson Raja A, Rossing K, Rasmusen H, Snoer M, Andersen LJ, Gottlieb R, Christensen AH, Bundgaard H, Gustafsson F, Thune JJ. Exercise Training in Patients With Hypertrophic Cardiomyopathy Without Left Ventricular Outflow Tract Obstruction: A Randomized Clinical Trial. Circulation. 2024 Nov 8. doi: 10.1161/CIRCULATIONAHA.124.070064
References:
Cavigli L, Ragazzoni GL, Vannuccini F, Targetti M, Mandoli GE, Senesi G, Pastore MC, Focardi M, Cameli M, Valente S, Bonifazi M, Olivotto I, D'Ascenzi F. Cardiopulmonary Fitness and Personalized Exercise Prescription in Patients With Hypertrophic Cardiomyopathy. J Am Heart Assoc. 2024 Oct 15;13(20):e036593.
Gudmundsdottir H, Axelsson Raja A, Rossing K, Rasmusen H, Snoer M, Andersen LJ, Gottlieb R, Christensen AH, Bundgaard H, Gustafsson F, Thune JJ. Exercise Training in Patients With Hypertrophic Cardiomyopathy Without Left Ventricular Outflow Tract Obstruction: A Randomized Clinical Trial. Circulation. 2024 Nov 8. doi: 10.1161/CIRCULATIONAHA.124.070064
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