Moderate-Intensity Training Improves Exercise Capacity in Hypertrophic Cardiomyopathy

Preliminary trial finds moderate-intensity exercise does not increase adverse events in this patient population.

Moderate exercise training in patients with hypertrophic cardiomyopathy (HCM) improves their exercise capacity without inducing an increase in adverse events, according to a study.

The findings for the preliminary RESET-HCM trial were presented at the American College of Cardiology Annual Scientific Session in Washington, DC.

Included in the study were 136 patients randomized to either undergo moderate intensity exercise training for 16 weeks or receive usual care.

The exercise training consisted of a structured, home-based exercise program individually prescribed based on baseline heart rate reserve derived from baseline cardiopulmonary exercise test. The recommended modes were walking/jogging, swimming, cycling, and an elliptical machine.

The primary outcome measure was change in peak oxygen consumption from baseline to 16 weeks. At week 16, the change in mean peak oxygen consumption was +1.35 mL/kg/min among patients in the exercise training group and +0.08 mL/kg/min for those in the usual activity group.

No occurrences of sustained ventricular arrhythmia, sudden cardiac arrest, appropriate defibrillator shock, or death, were observed in either group.

Secondary outcomes for exercise versus usual activity were no changes in cardiac morphology, LV outflow tract gradients, or B-type natriuretic peptide; significant improvement in physical functioning scale of Short Form-36; significant reduction in premature ventricular contraction burden; nonsustained ventricular tachycardia (31.7% vs 23.1%, respectively); syncope of 0% vs 1.4%; and musculoskeletal injury (4.5% vs 4.3%).

“In this preliminary study involving patients with hypertrophic cardiomyopathy, moderate-intensity exercise compared with usual activity results in a statistically significant but small increase in exercise capacity at 16 weeks,” the authors wrote.

Overall, moderate-intensity exercise training in patients with HCM improves exercise capacity without an increase in adverse events, such as syncope. Furthermore, there were salutary effects on PVC burden and overall quality of life.

The authors noted that the findings are important because in clinical practice, patients with HCM are often discouraged from participating in physical activity

Although the study provides some reassurance to clinicians in caring for patients with HCM, a larger trial with a longer follow-up period for safety endpoints is needed.