Exercise Intolerance in Non-obstructive Hypertrophic Cardiomyopathy

This study investigates whether a structured exercise training program can safely improve exercise tolerance in patients with non-obstructive hypertrophic cardiomyopathy (HCM) — a genetic heart condition where the heart muscle becomes abnormally thick, limiting its ability to fill with blood. Patients with HCM are often told to avoid vigorous exercise out of fear of triggering dangerous arrhythmias, but many experts now believe that moderate, supervised exercise may actually be beneficial rather than harmful. Eligible participants are adults aged 18 to 80 with confirmed non-obstructive HCM (without significant outflow tract blockage) and a preserved ejection fraction, who have access to exercise equipment and can use a smartphone to complete surveys. Key exclusions include a history of exercise-induced fainting or dangerous arrhythmias, recent ICD implantation, clinical decompensation in the past 3 months, and inability to exercise. Participants are randomized to an exercise program or standard care and followed for 24 weeks. Exercise intolerance is one of the most limiting symptoms of HCM, preventing patients from working, socializing, and enjoying a normal life. If this study demonstrates that exercise is safe and effective, it could overturn decades of overly conservative advice and give HCM patients a powerful, non-pharmacological tool to improve their fitness, symptoms, and mental health.