{
  "abstract": "Background Patients with hypertrophic cardiomyopathy (HCM) often reduce their physical activity due to concerns about sudden cardiac death. However, objective data on activity patterns in HCM, particularly in relation to clinical phenotype and quality of life (QoL), remain limited.Methods We assessed physical activity using 7-day accelerometry in 203 patients with HCM and 37 genotype-positive, phenotype-negative (G+/P−) individuals. Outcomes included daily step counts, time spent in moderate-to-vigorous physical activity (MVPA) and sedentariness. QoL was measured using the Kansas City Cardiomyopathy Questionnaire (KCCQ) and the EuroQoL 5-domain 5-level (EQ-5D-5L).Results HCM patients took fewer steps/day (5254 vs 6573), engaged in less MVPA (3.4% vs 4.5% of the day) and were more often sedentary (61% vs 35% spending >80% of the day sedentary) compared with G+/P− controls (all p<0.01). Symptomatic and obstructive HCM patients showed the lowest activity levels. Notably, asymptomatic obstructive HCM patients demonstrated reduced activity comparable to symptomatic individuals. Obesity and use of cardiac medications were also associated with lower activity. Step counts were positively associated with QoL scores: a 250 steps/day increment corresponded to a 2.15-point higher KCCQ score and a 1000 steps/day increment to a 0.05-point higher EQ-5D-5L score (both p<0.001), remaining significant after adjustment for age and sex. Most HCM patients (62%) recalled receiving exercise guidance, and many (59%) reported reducing their activity as a result.Conclusions Objectively measured physical activity was significantly lower in HCM patients compared with G+/P− individuals, particularly among those with symptoms, obstruction or obesity. Even modestly higher daily step counts were associated with better QoL, highlighting the relevance of individualised, phenotype-informed exercise counselling in HCM.",
  "authors": [
    {
      "affiliations": [
        "Department of Cardiology, Cardiovascular Institute, Thorax Center, Erasmus MC, Rotterdam, The Netherlands"
      ],
      "name": "Stephan A C Schoonvelde"
    },
    {
      "affiliations": [
        "Department of Cardiology, Cardiovascular Institute, Thorax Center, Erasmus MC, Rotterdam, The Netherlands",
        "Netherlands Heart Institute, Utrecht, The Netherlands"
      ],
      "name": "Peter-Paul Zwetsloot"
    },
    {
      "affiliations": [
        "Department of Cardiology, Cardiovascular Institute, Thorax Center, Erasmus MC, Rotterdam, The Netherlands",
        "Department of Radiology and Nuclear Medicine, Erasmus MC, Rotterdam, Netherlands"
      ],
      "name": "Alexander Hirsch"
    },
    {
      "affiliations": [
        "Department of Cardiology, Cardiovascular Institute, Thorax Center, Erasmus MC, Rotterdam, The Netherlands"
      ],
      "name": "Arend F L Schinkel"
    },
    {
      "affiliations": [
        "Department of Cardiology and Cardiovascular Research Institute Maastricht (CARIM), Maastricht University Medical Centre, Maastricht, The Netherlands"
      ],
      "name": "Christian Knackstedt"
    },
    {
      "affiliations": [
        "Department of Cardiology, Noordwest Ziekenhuisgroep, Alkmaar, The Netherlands"
      ],
      "name": "Tjeerd Germans"
    },
    {
      "affiliations": [
        "Department of Clinical Genetics, University Medical Center Rotterdam, Erasmus, The Netherlands"
      ],
      "name": "Marjon A van Slegtenhorst"
    },
    {
      "affiliations": [
        "Department of Clinical Genetics, University Medical Center Rotterdam, Erasmus, The Netherlands"
      ],
      "name": "Judith M A Verhagen"
    },
    {
      "affiliations": [
        "Department of Cardiology, Cardiovascular Institute, Thorax Center, Erasmus MC, Rotterdam, The Netherlands"
      ],
      "name": "Rudolf A de Boer"
    },
    {
      "affiliations": [
        "Department of Cardiology, Cardiovascular Institute, Thorax Center, Erasmus MC, Rotterdam, The Netherlands"
      ],
      "name": "Michelle Michels"
    }
  ],
  "title": "Accelerometry-defined physical activity and quality of life in hypertrophic cardiomyopathy",
  "uid": "e35b7a6c-9f3b-5e41-a0be-b81741c1ad5f"
}