Background: Patients with chronic diseases frequently adapt their lifestyles to their functional limitations. Functional capacity in Hypertrophic Cardiomyopathy (HCM) can be assessed by stress testing. We aim to review and analyze the available data from the literature on the value of Cardiopulmonary Exercise Test (CPET) in HCM. Objective measurements from CPET are used for evaluation of patient response to traditional and new developing therapeutic measurements. Methods: A systematic review of the literature was conducted in PubMed, Web of Science and Cochrane in Mar-20. The original search yielded 2628 results. One hundred and two full texts were read after the first screening, of which, 69 were included for qualitative synthesis. Relevant variables to be included in the review were set and 17 were selected, including comorbidities, body mass index (BMI), cardiac-related symptoms, echocardiographic variables, medications and outcomes. Results: Study sample consisted of 69 research articles, including 11,672 patients (48 ± 14 years old, 65.9%/34.1% men/women). Treadmill was the most common instrument employed (n = 37 studies), followed by upright cycle-ergometer (n = 16 studies). Mean maximal oxygen consumption (VO2max) was 22.3 ± 3.8 mL·kg⁻¹·min⁻¹. The highest average values were observed in supine and upright cycle-ergometer (25.3 ± 6.5 and 24.8 ± 9.1 mL·kg⁻¹·min⁻¹; respectively). Oxygen consumption in the anaerobic threshold (ATVO2) was reported in 18 publications. Left ventricular outflow tract gradient (LVOT) > 30 mmHg was present at baseline in 31.4% of cases. It increased to 49% during exercise. Proportion of abnormal blood pressure response (ABPRE) was higher in severe (>20 mm) vs. mild hypertrophy groups (17.9% vs. 13.6%, p < 0.001). Mean VO2max was not significantly different between severe vs. milder hypertrophy, or for obstructive vs. non-obstructive groups. Occurrence of arrhythmias during functional assessment was higher among younger adults (5.42% vs. 1.69% in older adults, p < 0.001). Twenty-three publications (9145 patients) evaluated the prognostic value of exercise capacity. There were 8.5% total deaths, 6.7% cardiovascular deaths, 3.0% sudden cardiac deaths (SCD), 1.2% heart failure death, 0.6% resuscitated cardiac arrests, 1.1% transplants, 2.6% implantable cardioverter defibrillator (ICD) therapies and 1.2 strokes (mean follow-up: 3.81 ± 2.77 years). VO2max, ATVO2, METs, % of age-gender predicted VO2max, % of age-gender predicted METs, ABPRE and ventricular arrhythmias were significantly associated with major outcomes individually. Mean VO2max was reduced in patients who reached the combined cardiovascular death outcome compared to those who survived (−6.20 mL·kg⁻¹·min⁻¹; CI 95%: −7.95, −4.46; p < 0.01). Conclusions: CPET is a valuable tool and can safely perform for assessment of physical functional capacity in patients with HCM. VO2max is the most common performance measurement evaluated in functional studies, showing higher values in those based on cycle-ergometer compared to treadmill. Subgroup analysis shows that exercise intolerance seems to be more related to age, medication and comorbidities than HCM phenotype itself. Lower VO2max is consistently seen in HCM patients at major cardiovascular risk.

Background/Objectives: Major cardiac surgery is associated with a high rate of postoperative complications, particularly in older and frail patients. Prehabilitation—defined as a preoperative intervention based on structured exercise—aims to enhance patients’ physiological and functional reserve before surgery. To evaluate the effectiveness of prehabilitation programs on functional capacity and postoperative complications in cardiac surgery and to propose a clinical exercise-based intervention model tailored to these patients. Methods: A systematic search was conducted in PubMed, Cochrane, PEDro, and LILACS (2005–2025). Randomized controlled trials investigating preoperative exercise interventions in adults undergoing cardiac surgery were included. Outcomes assessed included functional measures (6-Minute Walk Test [6MWT], Timed Up and Go test [TUG], maximal oxygen uptake [VO₂max], maximal inspiratory pressure [MIP]), frailty (Clinical Frailty Scale [CFS], Essential Frailty Toolset [EFT]), postoperative complications and quality of life. Results: Nine studies comprising a total of 873 patients were included. Prehabilitation significantly improved functional capacity (∆6MWT: +52.4 m; p < 0.001), reduced respiratory complications (pneumonia, atelectasis) and shortened hospital stay (−15.2 h; p < 0.001). The greatest benefits were observed in multimodal programs lasting ≥4 weeks. Conclusions: Exercise-based prehabilitation is an effective and safe strategy in patients awaiting cardiac surgery. Its systematic implementation should be considered as part of the perioperative pathway, reinforcing the role of exercise as a therapeutic tool in this clinical context.

Background: Exercise training in patients with HCM has evidenced benefits on functional capacity, cardiac function, and a reversion of adverse cardiac remodeling. The objective of this study was to assess the effect of a concurrent resistance and cardiorespiratory training program on functional capacity, biochemical parameters, and echocardiographic variables in a pilot group. Methods: Two HCM patients were evaluated before and after 12 weeks of individualized concurrent training with two sessions/week. Pre- and post-training data were compared for each patient. Evaluations included a cardiopulmonary exercise test (CPET), body composition, echocardiography, electrocardiography, and blood analysis. Results: Training promoted an increase in functional capacity (+4 mL·kg⁻¹·min⁻¹), ventilatory thresholds, and other CPET-derived variables associated with a better prognosis and long-term survival. Muscular mass was augmented (0.8 and 1.2 kg), along with a mean increase of 62% in upper and lower body strength. Echocardiographic features demonstrated the maintenance of cardiac function with signs of positive left ventricular remodeling and an improvement in diastolic function. Blood analyses, including cardiac troponins and NT-proBNP, displayed uneven changes in each patient, but the values fell into normal ranges in both cases. Conclusions: The available data suggest a positive effect of concurrent resistance and cardiorespiratory training on patients’ functional capacity and cardiac function that may improve their functional class, quality of life, and long-term prognosis. The replication of this protocol in a larger cohort of patients is warranted to confirm these preliminary results.

Ocaña-García, Á, Herrero-Atiénzar, JM, López-Gullón, JM, Bonacasa, B, and Bayonas-Ruiz, A. A velocity-based approach to variable resistance training in the bench press: repetitions to failure and level of effort. J Strength Cond Res 40(3): 272–282, 2026—This study analyzed the use of elastic bands in the bench press exercise within a velocity-based training approach to explore its application in variable resistance training (VRT) in regard to the level of effort methodology. Therefore, we aimed to (a) investigate the intersubject and intrasubject variability in the number of repetitions to failure ( n RM) across 3 one-repetition maximum percentages (%1RM) and 2 load configurations using elastic bands: 25% (B25) and 50% (B50) of the load from bands; (b) examine the relationship between the number of repetitions completed and velocity loss reached; (c) assess the mean propulsive velocity associated to each %1RM and elastic bands contribution; and (d) study the influence of the subject's strength level on these parameters. After determining the individual 1RM, 26 subjects with low ( n = 9), medium ( n = 9), and high ( n = 8) relative strength levels completed 2 rounds of n RM tests against their 60, 70, and 80% 1RM with B25 and B50 configurations in the bench press. Number of repetitions to failure increased with band contribution (B50 > B25, p < 0.01) and showed moderate intersubject variability (coefficients of variation = 16%) and very low intrasubject ( SEM ≤ 1.4 repetitions) variability for all the strength levels, %1RM, and band contributions analyzed. A very high correlation ( R ² = 0.910–0.935) between the number of repetitions completed and the percentage of velocity loss reached (from 5 to 65%) was found. These findings support the use of the level of effort as a reliable and practical tool for programming VRT.

This study analyzed the effect of elastic bands on the sticking region (SR) in the bench press within a velocity-based training approach. We sought to: (a) investigate the characteristics of the SR in sets to failure with three loads (60%, 70%, 80% 1RM) and three configurations using different contributions of elastic band tension to total resistance: 0%, 25%, and 50% (B0, B25, B50); (b) study the kinematic characteristics of the pre-sticking, sticking, and post-sticking regions; (c) analyze the differences regarding loads and bands contribution; and (d) study intersubject and intrasubject variability across loads and configurations. After determining the individual 1RM, 25 subjects completed 2 rounds of sets to failure against their 60, 70, and 80% 1RM with B0, B25, and B50 in the bench press. Elastic bands resulted in (p < 0.05 all) lower repetition times and increased SR duration across all loads. The SR occurred at a higher point of the range of motion with elastic bands. The first peak velocity increased with bands contribution (p < 0.05), while no differences were observed in the minimum and second peak velocities. It was concluded that adding elastic bands in the load configuration in the bench press alters barbell kinematics and SR characteristics.