Heart failure & cardiomyopathies
Exercise training in hypertrophic cardiomyopathy: a meta-analysis of randomised trials with trial sequential analysis
Pooled result · pVO₂Result — go to the resultMD 1.81 mL/kg/min 95% CI 1.01–2.61Authors' conclusion
In patients with mild, non-obstructive HCM, structured exercise appears safe and improves functional capacity and cardiometabolic parameters without adverse ventricular effects.
Study context
- Population
- Patients with hypertrophic cardiomyopathy (HCM), predominantly low-risk, non-obstructive, with mild functional limitation (mean left ventricular ejection fraction (LVEF) 66%)
- Participants
- 290 patients4 randomised controlled trials (RCTs)
- Comparison
- Structured exercise vs usual care
- Outcome
- Peak oxygen consumption (pVO₂)
Methodological detailsrandom-effects, trial sequential analysis
- Random-effects
- Trial sequential analysis
Pooled result
pVO₂
MD
1.81 mL/kg/min
95% CI 1.01–2.61
P < 0.01
Exercisevs Usual care
MD 1.81 mL/kg/min (95% CI 1.01–2.61); P < 0.01
As reported in the abstract
Further pooled results
| Outcome | MD (mm) (95% CI) | |
|---|---|---|
| LV wall thickness | −0.56 (−0.97 to −0.16) | |
| −1−0.500.5Difference, mm (linear scale) |
| Outcome | MD (kg/m²) (95% CI) | |
|---|---|---|
| BMI | −0.65 (−1.05 to −0.25) | |
| −1.5−1−0.500.5Difference, kg/m² (linear scale) |
LVEF, LV outflow gradients
- No significant changes in LVEF or LV outflow gradients
Safety
- No increase in arrhythmias, syncope, sudden cardiac death (SCD) or other adverse events
Original publication
Exercise training in hypertrophic cardiomyopathy: a meta-analysis of randomised trials with trial sequential analysis. Heart. Published 30 November 2025. doi:10.
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