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Hypertrophic Cardiomyopathy: Updates Through the Lens of Sports Cardiology

  • Lander, Bradley S.1
  • Phelan, Dermot M.2
  • Martinez, Matthew W.3, 4
  • Dineen, Elizabeth H.5
  • 1 Columbia University Irving Medical Center, New York, NY, 10032, USA , New York (United States)
  • 2 Sanger Heart & Vascular Institute, Atrium Health, Charlotte, NC, 28203, USA , Charlotte (United States)
  • 3 Atlantic Health, Morristown Medical Center, Morristown, NJ, 07960, USA , Morristown (United States)
  • 4 Sports Cardiology and Hypertrophic Cardiomyopathy, 111 S Madison Ave, Suite 300, Morristown, NJ, 07960, USA , Morristown (United States)
  • 5 University of California Irvine, 333 City Blvd W, Suite 400, Orange, CA, 92868, USA , Orange (United States)
Published Article
Current Treatment Options in Cardiovascular Medicine
Springer US
Publication Date
May 25, 2021
DOI: 10.1007/s11936-021-00934-1
Springer Nature


Purpose of reviewThis review will summarize the distinction between hypertrophic cardiomyopathy (HCM) and exercise-induced cardiac remodeling (EICR), describe treatments of particular relevance to athletes with HCM, and highlight the evolution of recommendations for exercise and competitive sport participation relevant to individuals with HCM.Recent findingsWhereas prior guidelines have excluded individuals with HCM from more than mild-intensity exercise, recent data show that moderate-intensity exercise improves functional capacity and indices of cardiac function and continuation of competitive sports may not be associated with worse outcomes. Moreover, recent studies of athletes with implantable cardioverter defibrillators (ICDs) demonstrated a safer profile than previously understood. In this context, the updated American Heart Association/American College of Cardiology (AHA/ACC) and European Society of Cardiology (ESC) HCM guidelines have increased focus on shared decision-making and liberalized restrictions on exercise and sport participation among individuals with HCM.SummaryNew data demonstrating the safety of exercise in individuals with HCM and in athletes with ICDs, in addition to a focus on shared decision-making, have led to the most updated guidelines easing restrictions on exercise and competitive athletics in this population. Further athlete-specific studies of HCM, especially in the context of emerging therapies such as mavacamten, are important to inform accurate risk stratification and eligibility recommendations.

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