Whether patients with cardiomyopathies can exercise or not and what is the right dose in terms of intensity and frequency has always been a debated topic in cardiology and even today there are few indications in this regard. There are many elements to take into account in order to formulate a correct exercise prescription.
First of all, the patient: his/her awareness of pathology, years since diagnosis, sports he/she practiced, volume of training he/she carried out.
Then the pathology: phenotype, genetic mutations, history of cardiac arrest, presence of an ICD, risk of arrhythmic events.
At the end, sports/exercise: it is important to distinguish between competitive sport and physical exercise and to consider that there are different training modalities and different possible intensities whose determination often requires more parameters than just heart rate.
All these aspects are integral part of our ‘Julian Ross ‘ Second Half’ program that includes medical and psychological assessment, two moments of counselling, a period of supervised training and, finally, the return to physical activity with modalities and intensities compatible with the pathology.
Our current series includes 45 patients with cardiomyopathies (39 men and 7 women, 19 hypertrophic cardiomyopathies mean age 44 years ± 17, 22 arrhythmogenic cardiomyopathies mean age 35 years ± 18 and 4 dilated cardiomyopathies mean age 19 years ± 4). We offered these patients a personalized exercise prescription after performing a complete risk stratification and a cardiopulmonary exercise stress test.
All patients were prescribed aerobic and resistance training with intensities depending on the pathology, the ventricles involved, evidence of exertional obstruction, exertional arrhythmic burden, specific mutations etc.
Both during supervised training sessions at our gym and the average follow-up of 18 months, we didn ‘t recorded any cardiovascular major events. None of the patient who followed our indications showed a worsening of the pathology in terms of arrhythmic burden and ventricular involvement, while there was an increase in VO2 max.
Conclusions: our case series demonstrate, even though in a short follow-up period, that aerobic and resistance training prescribed in a personalized way does not lead to a worsening of the disease and to adverse outcomes in an average follow-up of 18 months.