Study of Exercise Training in Hypertrophic Cardiomyopathy

Inclusion Criteria: * Age ≥ 18 years and ≤ 80. * Diagnosis of HCM, defined by the presence of unexplained left-ventricular hypertrophy \> 13 mm in any wall segment. * Agreement to be a participant in the study protocol and willing/able to return for follow-up. Exclusion Criteria: * History of exercise-induced syncope or arrhythmias (ventricular tachycardia or non-sustained ventricular tachycardia). * Medically refractory left ventricular outflow tract obstruction being evaluated for septal reduction therapy. * Less than 3 months post septal reduction therapy (surgery or catheter based intervention). * Hypotensive response to exercise (\> 20 mm Hg drop in systolic blood pressure from peak blood pressure to post exercise blood pressure). * Pregnancy. * Implantable Cardioverter-Defibrillator (ICD) placement in last 3 months or scheduled. * Left ventricular systolic dysfunction (left ventricular ejection fraction \< 55% by echocardiography). * Worsening clinical status in the last 3 months, advanced heart failure (New York Heart Association class IV symptoms) or angina (Canadian Cardiovascular Society class IV symptoms). * Life expectancy less than 12 months. * Inability to exercise due to orthopedic or other non-cardiovascular limitations. * Unwillingness to refrain from competitive sports, burst activity, or heavy isometric exercise for the duration of the study.