During the last decades, the practice of sport and hypertrophic cardiomyopathy (HCM) were considered as incompatible, since evidence was not sufficient to gauge the risk associated to repeat and/or vigorous exercise across the spectrum of HCM. Additionally, it was acknowledged thatrisk stratification tools developed for HCM were not derived from athlete cohorts. Recent epidemiological studies focused on HCM both in the general population and in athletes, however, have de-emphasized the contribution of this condition to the risk of sport-associated sudden death, supporting the possibility of allowing the practice of some sports, even at professional level, for certain low-risk HCM categories. We hereby analyze the complex interaction of vigorous and continuative exercise with HCM, revising the available evidence for sports eligibility in HCM, the challenges and limitations of shared decision-making, as well as the potential harms and benefits of a highly personalised exercise schedule in subjects diagnosed with this complex disease.

在过去的几十年里，运动和肥厚性心肌病 (HCM) 的实践被认为是不相容的，因为证据不足以衡量与 HCM 范围内重复和/或剧烈运动相关的风险。此外，人们承认为 HCM 开发的风险分层工具并非来自运动员队列。然而，最近针对普通人群和运动员的 HCM 的流行病学研究不再强调这种情况对运动相关猝死风险的影响，支持允许进行某些运动的可能性，即使是在职业运动中级别，适用于某些低风险 HCM 类别。我们在此分析了剧烈和持续运动与 HCM 之间的复杂相互作用，修改了 HCM 中运动资格的现有证据，