Does sport participation worsen the clinical course of hypertrophic cardiomyopathy

Hypertrophic cardiomyopathy (HCM) is a heterogeneous disease with respect to its clinical expression and natural history, with sudden cardiac death (SCD) representing the most devastating complication in young people, including athletes. At present, guidelines recommend precautionary disqualification from competitive sports in individuals with HCM, regardless of the absence of major risks for SCD. However, the impact of sport participation on the clinical outcome of HCM has been poorly investigated. To address this question, we assessed the clinical course of a selected cohort of patients with HCM, in relation with their continued or dismissed participation in exercise training and sport competition. This study shows that over a period of 9-year follow-up, even low-risk athletes with HCM may incur symptoms (2.2% per year) and cardiac arrest (0.3% per year) but suggests that the incidence of event/symptoms is largely independent from continuation or interruption of regular exercise and sport programs.