Institute for Exercise and Environmental Medicine, Texas Health Presbyterian Hospital, Dallas, Texas; Department of Internal Medicine, University of Texas Southwestern Medical Center, Dallas, Texas.
Department of Internal Medicine, University of Texas Southwestern Medical Center, Dallas, Texas.
J Am Coll Cardiol. 2018 Sep 4;72(10):1157-1165. doi: 10.1016/j.jacc.2018.06.054.
Current guidelines recommend that patients with hypertrophic cardiomyopathy (HCM) not partake in high-intensity exercise due to the increased risk of sudden cardiac death. But individuals with genetic cardiomyopathies are not immune from cardiometabolic diseases, and inactivity is common in patients with HCM, likely due to fear of exercise-induced adverse events. The RESET-HCM trial (Study of Exercise Training in Hypertrophic Cardiomyopathy) illustrated that although moderate-intensity exercise may be safe in this population, the increase in cardiorespiratory fitness achieved with this training paradigm is modest. High-intensity exercise is an efficacious stimulus for increasing cardiorespiratory fitness in chronic disease populations. Such increases in fitness are associated with substantial reductions in cardiovascular mortality and may outweigh the theoretical risks associated with exercise in patients with HCM. The goal of this review is to examine the evidence supporting the safety and efficacy of different intensities of exercise training in HCM, and consider novel strategies to improve fitness.
目前的指南建议肥厚型心肌病（HCM）患者不要进行高强度运动，因为这会增加心源性猝死的风险。但是，遗传性心肌病患者也不能幸免心血管代谢疾病，HCM 患者普遍不活动，这可能是由于担心运动引起的不良事件。RESET-HCM 试验（肥厚型心肌病运动训练研究）表明，尽管中等强度的运动在这一人群中可能是安全的，但这种训练模式所带来的心肺适应度的增加是适度的。高强度运动是增加慢性疾病患者心肺适应度的有效刺激。这种适应度的提高与心血管死亡率的显著降低有关，可能超过 HCM 患者运动相关的理论风险。本综述的目的是检查支持 HCM 中不同强度运动训练的安全性和有效性的证据，并考虑提高适应度的新策略。
