Childhood Exercise and Diastolic Function in Adult Hypertrophic Cardiomyopathy

Favorable left ventricular diastolic function in adults with hypertrophic cardiomyopathy (HCM) phenotype left ventricular hypertrophy (LVH+) and in adults with an HCM-causative genotype without LVH (G+ LVH-) has been associated with increased exercise training prior to adulthood, according to study findings published in the International Journal of Cardiology.

Researchers sought to investigate the associations between exercise prior to adulthood and diastolic function in adulthood among individuals with HCM or with an HCM-causative genetic variant. They conducted a cross-sectional retrospective study of clinical and echocardiographic data, as well as exercise history from childhood. The study included participants with HCM or an HCM-causative genotype enrolled from the Unit for Genetic Cardiac Diseases, Department of Cardiology, Oslo University Hospital, Rikshospitalet, Norway. Of the 260 individuals invited to the study, 187 answered an exercise history questionnaire. Among those participants, those with HCM phenotype were placed in the HCM LVH+ cohort, and those with genotype positive family without LVH were placed in the G+ LVH- cohort.

After adjusting for LVH and age at examination, exercise prior to adulthood (average 123 hours of exercise per year between ages 7 and 20 years) had a positive correlation with improved average diastolic tissue velocity (genotype+ LVH-, P=.0136; HCM LVH+,  P=.0115), E-wave deceleration time to 0 (genotype+ LVH-, P=.0403; HCM LVH+, P=.0116), and end-diastolic volume (genotype+ LVH-, P=.0002; HCM LVH+, P=.0019). The correlation appeared in both cohorts and there was no unfavorable correlation between increased exercise and diastolic measurements.

Study limitations include the cross-sectional and retrospective design and that there was no information available on exercise advice given at diagnosis or time of genetic testing. Also, the causality between exercise improving diastolic function or improved diastolic function encouraging increased exercise cannot be determined.

The study authors wrote, “More exercise training during childhood and adolescence was associated with favorable LV diastolic function in both HCM LVH+ and G+ LVH- groups, regardless of presence of hypertrophy at the time of examination.” They added that early-in-life exercise would reflect positively on heart function among individuals with HCM or an HCM-causative genotype in adulthood.

Reference

Andreassen K, Dejgaard LA, Lie Ø, et al. Exercise training during childhood and adolescence is associated with favorable diastolic function in hypertrophic cardiomyopathy. Int J Cardiol. Published online June 14, 2022. doi:10.1016/j.ijcard.2022.06.042