Physical cardiac rehabilitation effects on cardio-metabolic outcomes in the patients with hypertrophic cardiomyopathy: a systematic review.

Objectives: This systematic review aimed to review existing evidence to evaluate the effects of physical cardiac rehabilitation on cardio-pulmonary outcomes in the patients with hypertrophic cardiomyopathy (HCM).

Methods: We conducted a systematic search of the databases PubMed, Web of Science, Embase, Scopus, and Google Scholar. The initial search led to 1222 citations after removing duplicate results. We included only English-written studies published since 2013 (2013-2023). Ultimately, we retrieved five studies, involving 235 participants. We used the Cochrane Risk of Bias Tool for randomized trials (RoB2) and risk of bias in non-randomized studies of intervention (ROBINS-I) for evaluating the risk of bias in randomized and non-randomized studies, respectively.

Results: Results showed that four training programs improved participants' functional capacity by up to 46%. Improvements in weight, BMI, echocardiography, and remodeling parameters (left atrium volume index, premature ventricular contraction burden, pulmonary artery systolic pressure), exercise test results (minute ventilation/carbon dioxide production, peak workload, heart rate reserve, exercise duration, peak heart rate, peak systolic pressure, and blood pressure response to exercise normalization), and a decrease in N- Terminal Pro-Brain Natriuretic Peptide (NT-pro BNP) were reported in these studies. No major adverse events, including sustained tachyarrhythmia, implantable cardioverter-defibrillator discharge, and sudden cardiac death were reported.

Conclusion: Supervised exercise training is safe and helpful for patients diagnosed with HCM. It can improve exercise capacity and is considered an adjunctive therapeutic option.