EPICH- Exercise Prescription In Cardiomyopathies and Heart Transplant

Introduction: Most patients with hypertrophic cardiomyopathy (HCM) are restricted to competitive sports due to early evidence that exercise increases their risk of sudden cardiac death and malignant arrhythmias. As a result, they become inactive and experience the negative consequences of a sedentary lifestyle. Hence, the need arises to strike the right balance between these two extremes through personalized exercise prescription. The aims of this study were: 1) to assess the characteristics of HCM patients who practised regular aerobic physical activity compared to HCM sedentary patients; 2) to perform a personalized moderate-intensity exercise prescription and evaluate its effects. Methods: HCM patients were evaluated through clinical evaluation, ECG, ambulatory ECG monitoring, echocardiography, and CPET. In selected patients, a personalized moderate-intensity exercise prescription was performed. Subsequently, patients were reevaluated with the same investigations. Results: Physically active HCM patients demonstrated better cardiopulmonary functional capacity than sedentary patients (p≤0.0001), without significant differences regarding ventricular arrhythmias (p=0.43); moderate intensity exercise prescription led to improved cardiopulmonary fitness without occurrence of adverse events. The sedentary subjects showed a greater BMI, a higher prevalence of obesity (p=0.07), and a deterioration of their cardiopulmonary fitness due to the maintenance of a sedentary lifestyle. Conclusions: A sedentary lifestyle led to a deterioration of cardiopulmonary functional capacity and fitness. The tailored moderate-intensity personalized exercise prescription appears to be a feasible approach in carefully selected HCM patients to counterbalance the negative effects of sedentary behaviour without significant major events.