{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,4]],"date-time":"2026-08-04T04:10:08Z","timestamp":1785816608113,"version":"3.56.0"},"reference-count":29,"publisher":"Ovid Technologies (Wolters Kluwer Health)","issue":"8","content-domain":{"domain":["www.ahajournals.org"],"crossmark-restriction":true},"short-container-title":["JAHA"],"published-print":{"date-parts":[[2026,4,21]]},"abstract":"<jats:sec xml:lang=\"en\">\n                    <jats:title>Background<\/jats:title>\n                    <jats:p xml:lang=\"en\">The RoMa classification, based on peak heart rate and oxygen pulse derived from cardiopulmonary exercise testing, was recently proposed to stratify patients with hypertrophic cardiomyopathy by physiological reserve during exercise. We aimed to externally validate RoMa in an independent multicenter cohort with hypertrophic cardiomyopathy and assess its association with long\u2010term clinical outcomes.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec xml:lang=\"en\">\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p xml:lang=\"en\">In this retrospective multicenter cohort study patients with hypertrophic cardiomyopathy, undergoing cardiopulmonary exercise testing, were consecutively enrolled. Patients were enrolled regardless of left ventricular outflow tract obstruction and were na\u00efve to disease\u2010specific therapy (eg, mavacamten). Patients were categorized into RoMa I to IV based on percentage of predicted heart rate and oxygen pulse. The primary end point was a composite of all\u2010cause and cardiovascular death, sudden cardiac death, or aborted sudden cardiac death, heart failure\u2013related hospitalization, stroke, systemic embolism, surgical myectomy, and heart transplantation.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec xml:lang=\"en\">\n                    <jats:title>Results<\/jats:title>\n                    <jats:p xml:lang=\"en\">\n                      The study included 292 patients (age 51 [36\u201363] years, 70% male sex, 30% with obstructive left ventricular outflow tract). Functional capacity declined hierarchically across RoMa groups (peak oxygen uptake 29.2 to 17.9 mL\/kg\/min;\n                      <jats:italic toggle=\"no\">P<\/jats:italic>\n                      \u2010trend &lt;0.001). During follow\u2010up (\u22486\u2009years), 68 composite events occurred. Kaplan\u2013Meier analysis showed significant differences in event\u2010free survival across groups (log\u2010rank\n                      <jats:italic toggle=\"no\">P<\/jats:italic>\n                      =0.019). In multivariable analysis, RoMa II to IV compared with RoMa I were independently associated with higher hazard ratios (HRs) for the composite outcome (HRs, 3.89\u20135.37; all\n                      <jats:italic toggle=\"no\">P<\/jats:italic>\n                      &lt;0.05), whereas genotype, LVEF &lt;50%, male sex, and left ventricular outflow tract obstruction were not predictive.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec xml:lang=\"en\">\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p xml:lang=\"en\">The RoMa classification independently predicts long\u2010term, clinically relevant outcomes in hypertrophic cardiomyopathy regardless of left ventricular outflow tract obstruction and may provide a novel approach to risk stratification.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1161\/jaha.125.046438","type":"journal-article","created":{"date-parts":[[2026,4,9]],"date-time":"2026-04-09T09:46:20Z","timestamp":1775727980000},"update-policy":"https:\/\/doi.org\/10.1161\/crossmarkpolicy","source":"Crossref","is-referenced-by-count":2,"title":["RoMa: A Cardiopulmonary Exercise Testing Based Risk Tool in Hypertrophic Cardiomyopathy"],"prefix":"10.1161","volume":"15","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-3405-5715","authenticated-orcid":false,"given":"Robin","family":"Willixhofer","sequence":"first","affiliation":[{"name":"Centro Cardiologico Monzino, IRCCS","place":["Milan, Italy"]},{"name":"University of Milan","place":["Milan, Italy"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-9985-7407","authenticated-orcid":false,"given":"Massimo","family":"Mapelli","sequence":"additional","affiliation":[{"name":"Centro Cardiologico Monzino, IRCCS","place":["Milan, 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Bristol Myers Squibb announces results from ODYSSEY\u2010HCM trial evaluating Camzyos\u2122 (mavacamten) in patients with symptomatic non\u2010obstructive hypertrophic cardiomyopathy: Bristol Myers Squibb. 2025 Accessed April 5 2025. https:\/\/news.bms.com\/news\/details\/2025\/Bristol\u2010Myers\u2010Squibb\u2010Provides\u2010Update\u2010on\u2010Phase\u20103\u2010ODYSSEY\u2010HCM\u2010Trial\/default.aspx."},{"key":"e_1_3_2_28_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.amjcard.2020.06.023"},{"key":"e_1_3_2_29_2","doi-asserted-by":"publisher","DOI":"10.1002\/ejhf.2737"},{"key":"e_1_3_2_30_2","doi-asserted-by":"publisher","DOI":"10.1136\/openhrt-2024-002876"}],"container-title":["Journal of the American Heart Association"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/www.ahajournals.org\/doi\/full\/10.1161\/JAHA.125.046438","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,5,9]],"date-time":"2026-05-09T15:26:33Z","timestamp":1778340393000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.ahajournals.org\/doi\/10.1161\/JAHA.125.046438"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2026,4,21]]},"references-count":29,"journal-issue":{"issue":"8","published-print":{"date-parts":[[2026,4,21]]}},"alternative-id":["10.1161\/JAHA.125.046438"],"URL":"https:\/\/doi.org\/10.1161\/jaha.125.046438","relation":{},"ISSN":["2047-9980"],"issn-type":[{"value":"2047-9980","type":"electronic"}],"subject":[],"published":{"date-parts":[[2026,4,21]]},"assertion":[{"value":"2025-09-09","order":0,"name":"received","label":"Received","group":{"name":"publication_history","label":"Publication History"}},{"value":"2026-01-28","order":2,"name":"accepted","label":"Accepted","group":{"name":"publication_history","label":"Publication History"}},{"value":"2026-04-09","order":3,"name":"published","label":"Published","group":{"name":"publication_history","label":"Publication History"}}],"article-number":"e046438"}}