Article

Recent data suggest that exercise training (ET) confers significant
symptomatic and functional improvements in patients with diastolic dysfunction,
and thus may be beneficial in patients with hypertrophic cardiomyopathy (HCM).
However, there are no data regarding the safety or efficacy of ET in HCM
patients. DESIGN: A prospective non-randomized intervention design was used.
METHODS: We enrolled 20 patients with symptomatic HCM, significantly limited in
everyday activity, into a supervised cardiac rehabilitation exercise program.
RESULTS: Patients were 62 +/- 13 years old, in New York Heart Association (NYHA)
functional class II (35%) or III (65%), had a mean interventricular septum
dimension of 17 +/- 5 mm and left ventricular ejection fraction (LVEF) of 53 +/-
15%. Left ventricular outflow gradient was present at rest in nine patients (mean
51 +/- 24 mm Hg) and six patients had an implantable defibrillator. Exercise
prescription was based on heart rate reserve (HRR) determined from a
symptom-limited graded exercise stress test. Exercise intensity was gradually
increased from 50% to 85% of the HRR over the training period. Patients completed
an average of 41 +/- 8 hours of aerobic ET. No adverse events or sustained
ventricular arrhythmias occurred during the training program. Functional
capacity, assessed by a graded exercise test, improved from 4.7 +/- 2.2 to 7.2
+/- 2.8 metabolic equivalents (METs) (p = 0.01). NYHA functional class improved
from baseline by >/= 1 grade in 10 patients (50%) and none experiencing
deterioration during follow-up. CONCLUSIONS: The present study suggests that
patients with HCM who remain symptomatic despite medical therapy may achieve
considerable functional improvement through a supervised ET program.
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Langue : ANGLAIS