Exercise in patients with hypertrophic cardiomyopathy: A review of current evidence, national guideline recommendations and a proposal for a new direction to fitness.
J Sci Med Sport
; 20(4): 333-338, 2017 Apr.
Article
em En
| MEDLINE
| ID: mdl-27707537
ABSTRACT
Hypertrophic cardiomyopathy is a common genetic disorder with a prevalence of 1500 in the general population. Amongst a varied spectrum of clinical presentations, the most feared complication of this cardiac disorder is sudden cardiac death. Although only a minority of patients with hypertrophic cardiomyopathy who suffer sudden cardiac death or resuscitated cardiac arrest do so during exercise, strenuous physical activity is regarded as an important trigger for these tragic outcomes. Furthermore, during exercise, patients with hypertrophic cardiomyopathy may develop augmentation of left ventricular outflow tract obstruction, myocardial ischemia, diastolic dysfunction and/or inappropriate vasodilation in non-exercising vascular beds. This in turn may lead to exertional dyspnea, chest pain or syncope. Accordingly, patients with hypertrophic cardiomyopathy are disqualified from competitive sports and in many cases are recommended to avoid strenuous physical activity of any kind. Nevertheless, avoidance of physical activity comes with a price. The positive effects of regular exercise have been extensively reported to convey a wide range of benefits including reduced cardiovascular events, weight reduction and improved wellbeing. Therefore, finding the right exercise level that will offer some of the benefits of physical activity without increasing the risk of sudden cardiac death is of utmost importance. In this review, we discuss the current evidence for and against exercise in this patient population and review national guideline recommendations. We also propose alternative fitness strategies including a novel fitness program implemented by our hypertrophic cardiomyopathy center which may be of particular usefulness for hypertrophic cardiomyopathy patients.
Palavras-chave
Texto completo:
1
Coleções:
01-internacional
Base de dados:
MEDLINE
Assunto principal:
Cardiomiopatia Hipertrófica
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Exercício Físico
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Morte Súbita Cardíaca
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Guias como Assunto
Tipo de estudo:
Etiology_studies
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Guideline
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Risk_factors_studies
Limite:
Humans
Idioma:
En
Revista:
J Sci Med Sport
Assunto da revista:
MEDICINA ESPORTIVA
Ano de publicação:
2017
Tipo de documento:
Article
País de afiliação:
Canadá
País de publicação:
AU
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AUSTRALIA
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AUSTRÁLIA