Efficacy and safety of exercise for hypertrophic cardiomyopathy: a systematic review and meta-analysis

Abstract

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: < 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.