Importance: Formulating exercise recommendations for patients with hypertrophic cardiomyopathy is challenging because of concern about triggering ventricular arrhythmias and because a clinical benefit has not been previously established in this population. Objective: To determine whether moderate-intensity exercise training improves exercise capacity in adults with hypertrophic cardiomyopathy. Design, Setting, and Participants: A randomized clinical trial involving 136 patients with hypertrophic cardiomyopathy was conducted between April 2010 and October 2015 at 2 academic medical centers in the United States (University of Michigan Health System and Stanford University Medical Center). Date of last follow-up was November 2016. Interventions: Participants were randomly assigned to 16 weeks of moderate-intensity exercise training (n = 67) or usual activity (n = 69). Main Outcomes and Measures: The primary outcome measure was change in peak oxygen consumption from baseline to 16 weeks. Results: Among the 136 randomized participants (mean age, 50.4 [SD, 13.3] years; 42% women), 113 (83%) completed the study. At 16 weeks, the change in mean peak oxygen consumption was +1.35 (95% CI, 0.50 to 2.21) mL/kg/min among participants in the exercise training group and +0.08 (95% CI, -0.62 to 0.79) mL/kg/min among participants in the usual-activity group (between-group difference, 1.27 [95% CI, 0.17 to 2.37]; P = .02). There were no occurrences of sustained ventricular arrhythmia, sudden cardiac arrest, appropriate defibrillator shock, or death in either group. Conclusions and Relevance: In this preliminary study involving patients with hypertrophic cardiomyopathy, moderate-intensity exercise compared with usual activity resulted in a statistically significant but small increase in exercise capacity at 16 weeks. Further research is needed to understand the clinical importance of this finding in patients with hypertrophic cardiomyopathy, as well as the long-term safety of exercise at moderate and higher levels of intensity. Trial Registration: clinicaltrials.gov Identifier: NCT01127061.
RCT Entities:
Importance: Formulating exercise recommendations for patients with hypertrophic cardiomyopathy is challenging because of concern about triggering ventricular arrhythmias and because a clinical benefit has not been previously established in this population. Objective: To determine whether moderate-intensity exercise training improves exercise capacity in adults with hypertrophic cardiomyopathy. Design, Setting, and Participants: A randomized clinical trial involving 136 patients with hypertrophic cardiomyopathy was conducted between April 2010 and October 2015 at 2 academic medical centers in the United States (University of Michigan Health System and Stanford University Medical Center). Date of last follow-up was November 2016. Interventions: Participants were randomly assigned to 16 weeks of moderate-intensity exercise training (n = 67) or usual activity (n = 69). Main Outcomes and Measures: The primary outcome measure was change in peak oxygen consumption from baseline to 16 weeks. Results: Among the 136 randomized participants (mean age, 50.4 [SD, 13.3] years; 42% women), 113 (83%) completed the study. At 16 weeks, the change in mean peak oxygen consumption was +1.35 (95% CI, 0.50 to 2.21) mL/kg/min among participants in the exercise training group and +0.08 (95% CI, -0.62 to 0.79) mL/kg/min among participants in the usual-activity group (between-group difference, 1.27 [95% CI, 0.17 to 2.37]; P = .02). There were no occurrences of sustained ventricular arrhythmia, sudden cardiac arrest, appropriate defibrillator shock, or death in either group. Conclusions and Relevance: In this preliminary study involving patients with hypertrophic cardiomyopathy, moderate-intensity exercise compared with usual activity resulted in a statistically significant but small increase in exercise capacity at 16 weeks. Further research is needed to understand the clinical importance of this finding in patients with hypertrophic cardiomyopathy, as well as the long-term safety of exercise at moderate and higher levels of intensity. Trial Registration: clinicaltrials.gov Identifier: NCT01127061.
Authors: Bernard J Gersh; Barry J Maron; Robert O Bonow; Joseph A Dearani; Michael A Fifer; Mark S Link; Srihari S Naidu; Rick A Nishimura; Steve R Ommen; Harry Rakowski; Christine E Seidman; Jeffrey A Towbin; James E Udelson; Clyde W Yancy Journal: Circulation Date: 2011-11-08 Impact factor: 29.690
Authors: Jacob Sattelmair; Jeremy Pertman; Eric L Ding; Harold W Kohl; William Haskell; I-Min Lee Journal: Circulation Date: 2011-08-01 Impact factor: 29.690
Authors: Paul Sorajja; Thomas Allison; Courtney Hayes; Rick A Nishimura; Carolyn S P Lam; Steve R Ommen Journal: Am J Cardiol Date: 2012-02-21 Impact factor: 2.778
Authors: Raymond H Chan; Barry J Maron; Iacopo Olivotto; Michael J Pencina; Gabriele Egidy Assenza; Tammy Haas; John R Lesser; Christiane Gruner; Andrew M Crean; Harry Rakowski; James E Udelson; Ethan Rowin; Massimo Lombardi; Franco Cecchi; Benedetta Tomberli; Paolo Spirito; Francesco Formisano; Elena Biagini; Claudio Rapezzi; Carlo Nicola De Cecco; Camillo Autore; E Francis Cook; Susie N Hong; C Michael Gibson; Warren J Manning; Evan Appelbaum; Martin S Maron Journal: Circulation Date: 2014-08-05 Impact factor: 29.690
Authors: Elizabeth Reineck; Brice Rolston; Jennifer L Bragg-Gresham; Lisa Salberg; Linda Baty; Suwen Kumar; Matthew T Wheeler; Euan Ashley; Sara Saberi; Sharlene M Day Journal: Am J Cardiol Date: 2013-01-19 Impact factor: 2.778
Authors: Barry J Maron; Bernard R Chaitman; Michael J Ackerman; Antonio Bayés de Luna; Domenico Corrado; Jane E Crosson; Barbara J Deal; David J Driscoll; N A Mark Estes; Claudio Gil S Araújo; David H Liang; Matthew J Mitten; Robert J Myerburg; Antonio Pelliccia; Paul D Thompson; Jeffrey A Towbin; Steven P Van Camp Journal: Circulation Date: 2004-06-08 Impact factor: 29.690
Authors: Carlo De Innocentiis; Fabrizio Ricci; Mohammed Y Khanji; Nay Aung; Claudio Tana; Elvira Verrengia; Steffen E Petersen; Sabina Gallina Journal: Sports Med Date: 2018-11 Impact factor: 11.136
Authors: Ankit B Shah; Mary Z Bechis; Marcel Brown; Jennifer Michaud Finch; Garrett Loomer; Erich Groezinger; Rory B Weiner; Meagan M Wasfy; Michael H Picard; Michael A Fifer; Gregory B Lewis; Aaron L Baggish Journal: J Physiol Date: 2019-01-09 Impact factor: 5.182
Authors: Rui Providencia; Carina Teixeira; Oliver R Segal; Augustus Ullstein; Kim Mueser; Pier D Lambiase Journal: Europace Date: 2018-08-01 Impact factor: 5.214
Authors: Carlo Fumagalli; Niccolò Maurizi; Sharlene M Day; Euan A Ashley; Michelle Michels; Steven D Colan; Daniel Jacoby; Niccolò Marchionni; Justin Vincent-Tompkins; Carolyn Y Ho; Iacopo Olivotto Journal: JAMA Cardiol Date: 2020-01-01 Impact factor: 14.676
Authors: Christopher M Kramer; John P DiMarco; Paul Kolm; Carolyn Y Ho; Milind Y Desai; Raymond Y Kwong; Sarahfaye F Dolman; Patrice Desvigne-Nickens; Nancy Geller; Dong-Yun Kim; Martin S Maron; Evan Appelbaum; Michael Jerosch-Herold; Matthias G Friedrich; Jeanette Schulz-Menger; Stefan K Piechnik; Masliza Mahmod; Daniel Jacoby; James White; Amedeo Chiribiri; Adam Helms; Lubna Choudhury; Michelle Michels; William Bradlow; Michael Salerno; Dana K Dawson; Jonathan W Weinsaft; Colin Berry; Sherif F Nagueh; Chiara Buccarelli-Ducci; Anjali Owens; Barbara Casadei; Hugh Watkins; William S Weintraub; Stefan Neubauer Journal: JACC Clin Electrophysiol Date: 2021-06-30