Exercise Training in Hypertrophic Cardiomyopathy: (SAFE-HCM)

Launched by ST GEORGE'S, UNIVERSITY OF LONDON · Jul 12, 2022

Keywords

ClinConnect Summary

A greater understanding of the pathogenic mechanisms underpinning HCM has translated to improved medical care and better survival of affected individuals. Historically these patients were considered to be at high risk of sudden cardiac death during exercise, therefore exercise recommendations were highly conservative and promoted a sedentary life style. There is emerging evidence which suggests that exercise in HCM has a favourable effect on cardiovascular remodelling and moderate exercise programmes have not raised any safety concerns. Furthermore, individuals with HCM have a similar burde...

Gender

ALL

Eligibility criteria

• Inclusion Criteria:
• • HCM\*
• • Age range (16-60 years)
• • All genders
• • All ethnicities
• • Symptomatic and/or asymptomatic HCM patients (NYHA functional class I-II) stable on medication over the preceding 3 months
• • Patients may have ICDs
• • Patients able to exercise
• • Patients able to commit to the full duration of the exercise programme
• • Patients able to lie flat
• Exclusion Criteria:
• • Competitive athletes (individuals who participate in team or individual sports that require systematic training to participate in regular competition against others)
• • Exercise induced syncope
• • Uncontrolled ventricular arrhythmias (arrhythmias which cause distracting/disabling symptoms or have caused or may cause incapacity)
• • NYHA class III-IV
• • Severe LV failure (ejection fraction \<35%)
• • Exercise limited by a non-cardiac (unrelated to HCM) cause
• • Surgical myectomy
• • Awaiting or recent device implantation (within the last 3 months if due to an arrhythmic events, 4 weeks for primary prevention)
• • Known coronary artery disease - defined as a coronary artery lesion of \>50% on coronary angiography or known coronary intervention
• • Renal failure (eGFR \<30ml/min, chronic kidney disease stage 4 and 5 or acute renal failure)
• • Patients with Friedrich's ataxia, Noonan syndrome, Anderson-Fabry disease and other disorders associated with cardiac hypertrophy
• • Pregnancy