Seo Jiwon, Choi Eui-Young, Rim Se-Joong
Division of Cardiology, Department of Internal Medicine, Gangnam Severance Hospital, Yonsei University College of Medicine, 06273 Seoul, Republic of Korea.
Rev Cardiovasc Med. 2023 Jun 6;24(6):166. doi: 10.31083/j.rcm2406166. eCollection 2023 Jun.
Traditionally, individuals with hypertrophic cardiomyopathy (HCM) have been advised not to participate in more than low-intensity exercises. HCM was originally described in the context of sudden death, and early literature from the registry showed that HCM was the most common cause of sudden cardiac death in young athletes. Therefore, there has long been a concern that exercise could trigger ventricular arrhythmia and sudden cardiac death. Although a few patients with HCM may progress along deteriorating disease pathways, many have no clinically significant symptoms or adverse events, no need for major treatment, and a normal life expectancy. Therefore, the routine restriction of any exercise intensity in this large group deprives them of the multiple benefits of exercise and may have detrimental effects on long-term clinical outcomes. However, it has been reported that light to moderate exercise is acceptable for many patients with HCM, and recent evidence suggests that vigorous exercise does not increase the risk of sudden death in this population. Thus, we reviewed previous literature regarding the effects of exercise in patients with HCM and provided cutting-edge information on the safety and concerns of exercise. In addition, based on our experience and previous research, we reviewed the conditions that should be met before starting exercise and the tests required to confirm them.
传统上，肥厚型心肌病（HCM）患者一直被建议不要参加强度超过低强度的运动。HCM最初是在猝死的背景下被描述的，登记处的早期文献表明，HCM是年轻运动员心脏性猝死最常见的原因。因此，长期以来人们一直担心运动可能引发室性心律失常和心脏性猝死。虽然少数HCM患者可能会沿着疾病恶化的路径发展，但许多患者没有临床显著症状或不良事件，无需进行重大治疗，且预期寿命正常。因此，对这一庞大群体的任何运动强度进行常规限制，会使他们无法获得运动的多重益处，并且可能对长期临床结果产生不利影响。然而，有报道称，许多HCM患者进行轻度至中度运动是可以接受的，最近的证据表明，剧烈运动并不会增加该人群猝死的风险。因此，我们回顾了以往关于运动对HCM患者影响的文献，并提供了关于运动安全性和相关问题的前沿信息。此外，根据我们的经验和以往的研究，我们回顾了开始运动前应满足的条件以及确认这些条件所需的检查。
