RESET-HCM
Randomised Exploratory Study of Exercise Training in Hypertrophic Cardiomyopathy
Patient / Population Intervention / Exposition Comparaison Critère de jugement
In 136 adults with hypertrophic cardiomyopathy, 16 weeks of moderate-intensity aerobic exercise training produced a small increase in peak oxygen consumption, with no ventricular arrhythmias, compared with usual activity.
N
136
Schéma
Randomised clinical trial over 16 weeks
Critère
Change in peak oxygen consumption at 16 weeks
Pertinence
3
RésultatBetween-group difference 1.27 mL/kg/min (95 % CI 0.17–2.37; p=0.02). No sustained ventricular arrhythmia, cardiac arrest, appropriate defibrillator shock or death in either group.
Saberi S, Wheeler M, Bragg-Gresham J, et al. JAMA. 2017;317(13):1349-1357. 10.1001/jama.2017.2503
Discussion et critique
Underpowered for safety by design — 136 patients over 16 weeks can only crudely exclude an arrhythmic hazard — and the gain in peak oxygen uptake is of borderline clinical importance. It is the sole randomised evidence in hypertrophic cardiomyopathy and overturned decades of blanket exercise restriction.