• Sara Saberi, Matthew Wheeler, Jennifer Bragg-Gresham, Whitney Hornsby, Prachi P Agarwal, Anil Attili, Maryann Concannon, Annika M Dries, Yael Shmargad, Heidi Salisbury, Suwen Kumar, Jonathan J Herrera, Jonathan Myers, Adam S Helms, Euan A Ashley, and Sharlene M Day.
• University of Michigan School of Medicine, Ann Arbor.
• JAMA. 2017 Apr 4; 317 (13): 1349-1357.

ImportanceFormulating exercise recommendations for patients with hypertrophic cardiomyopathy is challenging because of concern about triggering ventricular arrhythmias and because a clinical benefit has not been previously established in this population.ObjectiveTo determine whether moderate-intensity exercise training improves exercise capacity in adults with hypertrophic cardiomyopathy.Design, Setting, And ParticipantsA randomized clinical trial involving 136 patients with hypertrophic cardiomyopathy was conducted between April 2010 and October 2015 at 2 academic medical centers in the United States (University of Michigan Health System and Stanford University Medical Center). Date of last follow-up was November 2016.InterventionsParticipants were randomly assigned to 16 weeks of moderate-intensity exercise training (n = 67) or usual activity (n = 69).Main Outcomes And MeasuresThe primary outcome measure was change in peak oxygen consumption from baseline to 16 weeks.ResultsAmong the 136 randomized participants (mean age, 50.4 [SD, 13.3] years; 42% women), 113 (83%) completed the study. At 16 weeks, the change in mean peak oxygen consumption was +1.35 (95% CI, 0.50 to 2.21) mL/kg/min among participants in the exercise training group and +0.08 (95% CI, -0.62 to 0.79) mL/kg/min among participants in the usual-activity group (between-group difference, 1.27 [95% CI, 0.17 to 2.37]; P = .02). There were no occurrences of sustained ventricular arrhythmia, sudden cardiac arrest, appropriate defibrillator shock, or death in either group.Conclusions And RelevanceIn this preliminary study involving patients with hypertrophic cardiomyopathy, moderate-intensity exercise compared with usual activity resulted in a statistically significant but small increase in exercise capacity at 16 weeks. Further research is needed to understand the clinical importance of this finding in patients with hypertrophic cardiomyopathy, as well as the long-term safety of exercise at moderate and higher levels of intensity.Trial Registrationclinicaltrials.gov Identifier: NCT01127061.

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