Hypertrophic cardiomyopathy: changing the paradigm of exercise prescription and competitive sport participation.

However, emerging evidence has challenged this paradigm.

然而，新兴的证据已经挑战了这一范式。

Observational studies and randomized trials demonstrate improvements in functional capacity, quality of life, and overall cardiovascular and psychological health with tailored exercise in HCM populations -including competitive sports in low-risk individuals-in the absence of safety signals.

观察性研究和随机试验表明，针对HCM人群（包括低风险个体的竞技运动）进行的定制化运动可以改善功能能力、生活质量以及整体的心血管和心理健康，且未出现安全信号。

Low-risk individuals are defined by the lack of well-established adverse features such as a high European Society of Cardiology HCM SCD risk score, exercise-induced syncope, severe left ventricular outflow tract obstruction and ventricular arrhythmias.

低风险个体被定义为缺乏欧洲心脏病学会HCM SCD风险评分高、运动诱发的晕厥、严重的左心室流出道阻塞和室性心律失常等明确的不良特征。

The concept that this low-risk subset can safely engage in competitive sports is becoming widely accepted internationally, although local differences exist in terms of regulations and clinical approaches.

这一低风险人群可以安全参与竞技运动的概念正在国际上广泛接受，尽管在法规和临床方法上存在地区差异。

For individuals who do not meet low-risk criteria, evidence is more limited.

对于不符合低风险标准的个体，证据则更为有限。

Nevertheless, participation in competitive sports may still be considered on an individual basis, after appropriate risk mitigation strategies (including treatment of obstruction and ICD implantation when indicated).

然而，在适当的风险缓解策略（包括治疗阻塞和在指示时植入ICD）后，仍可根据个人情况考虑参与竞技运动。

A contemporary approach to HCM should be based on individualized, goal-oriented exercise prescription, supported by multidisciplinary counselling and shared decision-making, recognizing the importance of aligning medical recommendations with individual safety, values, goals, and quality of life.

对HCM的现代治疗方法应基于个体化的、目标导向的运动处方，得到多学科咨询和共同决策的支持，认识到将医疗建议与个人安全、价值观、目标和生活质量相一致的重要性。

In this review, we critically appraise the emerging evidence surrounding vigorous exercise and competitive sports in HCM and explore how novel data are reshaping clinical practice and international guidelines, setting the stage for a paradigm in the field.

在这篇综述中，我们批判性地评估了关于肥厚型心肌病（HCM）中剧烈运动和竞技体育的新兴证据，并探讨了新数据如何重塑临床实践和国际指南，为该领域的范式转变奠定了基础。