Abstract 16945: Is Exercise Intensity Associated with Clinical or Echocardiographic Outcomes in Hypertrophic Cardiomyopathy?
Background: Guidelines recommend against high intensity athletic activity in hypertrophic cardiomyopathy (HCM). However, the impact of exercise on outcomes or disease progression has not been previously investigated.
Methods: HCM patients with ICDs (N=210) from a single referral center with outcomes collected over mean FU of 4.4 ± 4.1 years participated in a telephone survey regarding their lifetime athletic participation. Cumulative yearly hours engaging in sports >1A intensity (Bethesda guidelines defined) were quantified and averaged over age (“Sports-hours”). Associations of “sports-hours” with outcomes of death/transplant (TX), appropriate ICD shock, and changes in echo parameters between the earliest and latest available echos (mean 8.5 ± 5.2 years apart) were analyzed.
Results: Patients’ mean age was 50 ± 14 years, 62% were male, and 17 were NYHA class 3/4. Four died, 7 underwent Tx and 55 received an ICD shock (20 appropriate; 35 inappropriate) during FU. 183 pts had participated in sports > 1A intensity, 114 at competitive levels, with 29 (14%) currently participating. Mean “sports-hours” was 76 ± 122. Reported reasons for stopping sports included: non-HCM related (N=63); HCM-related symptoms, (n=36) physician recommendation,(n=8) and ICD placement (n=4).
“Sports-hours” were not associated with death/TX, ICD shock, or NYHA 3/ 4 in bivariate analysis or multivariate controlling for age, fractional shortening (FS), or NYHA 3/4 (for other outcomes) Pts currently participating in sports > 1A were not more likely to experience an appropriate shock, 7% vs 9%, p NS. Those in the top quartile of “sports-hours” (>92 hours/year) showed no difference in change in max wall thickness, left atrial size or LV diastolic diameter but showed less increase in LV systolic diameter (0.52 vs 0.88mm/year, p < 0.05) and less decrease in FS (0.54% vs 1.2% per year) than those exercising less. Following adjustment for age, NYHA 3/4 and death/TX in FU, the association of more extensive exercise participation with less deterioration of cardiac function (FS) remained significant.
Conclusions: More extensive sports participation was not associated with adverse clinical outcome or echo progression in HCM. Prospective studies are needed.
Author Disclosures: E.C. DePasquale: Consultant/Advisory Board; Modest; XdX. C. O’Mahony: None. V. Amin: None. P.M. Elliott: None. W.J. McKenna: None. R. Lampert: Research Grant; Significant; Medtronic, Boston Scientific, St. Jude.
- © 2014 by American Heart Association, Inc.