Objective Current guidelines recommend precautionary disqualification from competitive sports in patients with hypertrophic cardiomyopathy (HCM). We assessed the incidence of cardiovascular events in a cohort of patients with HCM engaged in long-term exercise programmes and competitive sport. Methods We reviewed data on 88 consecutive athletes diagnosed with HCM, from 1997 to 2017; 92% male, 98% Caucasian, median age 31 (IQR: 19–44) years. All participated in regular exercise programmes and competitive sport at study entry. We performed follow-up evaluation after 7±5 (1–21) years. 61 (69%) of the athletes had substantially reduced or stopped exercise and sport (ie, HCM-detrained), and 27 had continued with regular training and sport competitions (HCM-trained). At baseline evaluation, both groups were similar for age, gender balance, symptoms, ECG abnormalities, extent of left ventricular hypertrophy, arrhythmias and risk profile for sudden cardiac death/arrest. Results During the follow-up period, two participants suffered sudden cardiac arrest or death (0.3% per year) both outside of sport participation. In addition, 19 (22%) reported symptoms (syncope in 3, palpitations in 10, chest pain in 4 and dyspnoea in 2). The Kaplan-Meier analyses of freedom from combined sudden cardiac arrest/death and symptoms (log-rank test p=0.264) showed no differences between HCM-trained and detrained patients. Conclusion In this adult cohort of low-risk HCM athletes, voluntary decision to pursue in participation in competitive sport events was not associated with increased risk for major cardiac events or clinical worsening compared with decision to reduce or withdraw from exercise programmes and sport. Similar results may not be seen in younger or racially diverse athlete populations, or in patients with more severe HCM phenotypes.

中文翻译：

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肥厚型心肌病成年运动员的临床结果：一项为期 7 年的随访研究

目的 目前的指南建议预防性取消肥厚型心肌病 (HCM) 患者的竞技运动资格。我们评估了一组从事长期锻炼计划和竞技运动的 HCM 患者的心血管事件发生率。方法 我们回顾了 1997 年至 2017 年 88 名连续诊断为 HCM 的运动员的数据；92% 男性，98% 白人，中位年龄 31 (IQR: 19–44) 岁。所有人在入学时都参加了定期锻炼计划和竞技运动。我们在 7±5 (1-21) 年后进行了随访评估。61 (69%) 名运动员大幅减少或停止运动和运动（即，HCM 未训练），27 名继续进行常规训练和体育比赛（HCM 训练）。在基线评估中，两组在年龄、性别平衡、症状、心电图异常、左心室肥厚的程度、心律失常和心脏猝死/骤停的风险概况。结果 在随访期间，两名参与者在运动之外发生了心脏骤停或死亡（每年 0.3%）。此外，19 人（22%）报告了症状（晕厥 3 人，心悸 10 人，胸痛 4 人，呼吸困难 2 人）。Kaplan-Meier 对心脏骤停/死亡和症状组合的自由度分析（对数秩检验 p=0.264）显示受过 HCM 培训的患者和未受过培训的患者之间没有差异。结论 在这个成人低风险 HCM 运动员队列中，与减少或退出锻炼计划和运动的决定相比，自愿决定参加竞技体育赛事与主要心脏事件或临床恶化的风险增加无关。