Table 1.

Studies summary of the effects of physical cardiac rehabilitation programs on patients with hypertrophic cardiomyopathy

Author, Year	Study Design	Country	Participants (size, gender, age)	Rehabilitation programs details	Intervention duration/frequency	Reported Results
Robert Klempfner et al. [2015]	Single-arm prospective non-randomized clinical trial	Israel	20 patients, 70% male, 62 ± 13 years	Each session commenced with a 10-minute warm-up phase at 40-50% of the heart rate reserve (HRR), followed by aerobic exercise (treadmill, arm ergometer and upright cycle exercise), concluding with a prolonged 15 minutes of cool-down (total duration: 60 minutes). The beginning exercise intensity aimed for 50-60% of the HRR, progressively escalated to 65-85% of HRR. On average, they were engaged in 41 ± 8 hours of aerobic exercise.	24 weeks, Twice a week	An enhancement in functional capacity (METs) from 4.7 ± 2.2 to 7.2 ± 2.8 (P<0.01), representing a 46% increase was noted, alongside an improvement of ≥1 in NYHA functional class in 50% of participants, with no deterioration reported in any patient. Heart rate reserve and exercise duration rose from 38 ± 19 to 45 ± 20 bpm, representing a 19% enhancement, and from 6.24 ± 2.48 to 8.13 ± 2. 29 minutes respectively (all P<0.05). No significant adverse effects were reported.
Sara Saberi et al. [2017]	Randomized clinical trial	USA	136 patients, 58% male, 50.4 ± 13.3 years	In the exercise group, sessions commenced at 60% of each individual’s heart rate reserve and progressively escalated to a perceived effort range of 11-14 on the Borg scale (moderate intensity). Exercise modalities included cycling, walk-jog programs, and elliptical training. Each session endured 20-60 minutes. The control group maintained their regular daily activity.	16 weeks, 4-7 sessions a week	The peak oxygen consumption (VO2 peak) exhibited a 6% absolute increase in the exercise group vs to the regular activity group (between-group difference: +1.29 mL/kg/min; P=.02). Also, the SF-36v2 physical functioning scale shown substantial increase in the exercise group (difference, +8.2 points [95% CI, 2.6 to 13.7 points]). Additionally the exercise group exhibited a significant reduction in PVC burden (difference: -0.91 [95% CI, -1.76 to -0.05] PVC/h). No major adverse events were reported. One patient exhibited exercise-induced non-sustained ventricular tachycardia (NSVT).
Idan Hecht et al. [2017]	Observational study	Israel	107 patients (14 participants with HCM	The cardiac rehabilitation program included cardiac-related advice, dietary counseling, lifestyle modification, and a personalized exercise plan. The details of the exercise plans were not provided.	16-28 weeks, Twice a week	93% of patients with HCM (13 out of 14) had a normalized blood pressure response to exercise following the rehabilitation program; a rate significantly beyond that of participants without HCM (93% vs 62%, P: 0.03). No major adverse events were reported in the HCM cohort.
			Without exact information)
Yishay Wasserstrum et al. [2019]	Observational study	Israel	45 patients, 58 ± 13 years, 69% male	Each training session comprised a 15-minute warm-up period, followed by 45 minutes of exercise on a treadmill, a stair machine, and a bicycle, aimed at 60-70% of the heart rate reserve, often between 90 and 95 bpm, or a perceived exertion level of 13 Borg scale.	18 weeks, Twice a week	An enhancement in exercise capacity (METS, 5.3 ± 2.5 to 6.7 ± 2.5; P=0.01), peak heart rate (110 ± 23 to 120 ± 23 beats/min; P=0.05), and peak systolic blood pressure (144 ± 24.4 to 152 ± 30.0 mmHg; P=0.05) was observed. Additionally, 44% indicated enhancement in everyday functioning, subjective well-being, or physical activity levels. Only one patient experienced non-sustained ventricular tachycardia during exercise, with no other major adverse events.
Giuseppe Limongelli et al. [2021]	Observational study	Italy	20 patients, 45.3 ± 12.1 years, 65% male	During the first 6 months, engage in a minimum of 30 minutes of light physical activity on most days (4 to 5) of the week including walking briskly (<3 METS). Over the subsequent 18 months, each session included 20 minutes of cycling (60-80% of VO2 max), succeeded by resistance training, and concluded with body movements (3<METs<6).	96 weeks, 3 sessions a week	An increase in VO2 max (16.9 ± 4.6 vs 17.7 ± 4.4 mL/kg/min), peak workload (101.9 ± 30.2 vs 111.5 ± 26.0 watts), and a decrease in weight, BMI, left atrium volume index (44.9 ± 10.1 vs 42.7 ± 10.1 mL/m2), and PASP (34.8 ± 9.4 vs 32.0 ± 7.7 mmHg), VE/VCO2 slope (30.5 ± 3.6 vs 30.5 ± 3.6), NT-proBNP (468.8 ± 269.5 vs 418.1 ± 290.9), LVEF (57.7 ± 9.6 vs 50.6 ± 8.3), and maximal wall thickness (21.0 ± 6.1 vs 20.5 ± 6.2) were observed; (all P<0.05). Four individuals developed incidental atrial fibrillation, whereas five patients experienced non-sustained ventricular tachycardia.
				-All patients adhered to a Mediterranean diet.

PASP: pulmonary artery systolic pressure, VE/VCO2: minute ventilation/carbon dioxide production, VO2max: maximal oxygen uptake, AF: atrial fibrillation, NSVT: non-sustained ventricular tachycardia, PVC: premature ventricular contraction, METs: metabolic equivalence tasks, NT-pro-BNP: N- Terminal Pro-Brain Natriuretic Peptide, NYHA: New York Heart Association, LVEF: left ventricle ejection fraction.