Determinants of exercise intolerance in breast cancer patients prior to anthracycline chemotherapy

Women with early‐stage breast cancer have reduced peak exercise oxygen uptake (peak V O2). The purpose of this study was to evaluate peak V O2 and right (RV ) and left (LV ) ventricular function prior to adjuvant chemotherapy. Twenty‐nine early‐stage breast cancer patients (mean age: 48 years) and 10 age‐matched healthy women were studied. Participants performed an upright cycle exercise test with expired gas analysis to measure peak V O2. RV and LV volumes and function were measured at rest, submaximal and peak supine cycle exercise using cardiac magnetic resonance imaging. Peak V O2 was significantly lower in breast cancer patients versus controls (1.7 ± 0.4 vs. 2.3 ± 0.5 L/min, P = 0.0013; 25 ± 6 vs. 35 ± 6 mL/kg/min, P = 0.00009). No significant difference was found between groups for peak upright exercise heart rate (174 ± 13 vs. 169 ± 16 bpm, P = 0.39). Rest, submaximal and peak exercise RV and LV end‐diastolic and end‐systolic volume index, stroke index, and cardiac index were significantly lower in breast cancer patients versus controls (P < 0.05 for all). No significant difference was found between groups for rest and exercise RV and LV ejection fraction. Despite preserved RV and LV ejection fraction, the decreased peak V O2 in early‐stage breast cancer patients prior to adjuvant chemotherapy is due in part to decreased peak cardiac index secondary to reductions in RV and LV end‐diastolic volumes

Cardiac mechanisms for low aerobic power in anthracycline treated, older, long-term breast cancer survivors

Breast cancer survivors have reduced peak aerobic capacity (VO2peak) which may be related to latent or lingering chemotherapy induced cardiac damage. Nine, older (67 ± 3 years), long-term survivors (9.8 years) of anthracycline based chemotherapy and age- and sex-matched healthy controls were recruited and tested to determine whether: i) VO2peak remains reduced in long-term survivorship; and ii) reductions in VO2peak are due to cardiac dysfunction. VO2peak was significantly reduced in breast cancer survivors relative to healthy controls (15.9 ± 2.0 vs 19.9 ± 3.1 ml/kg/min, p = 0.006), however the heart rate and stroke volume responses to exercise were normal (heart rate reserve; 88 ± 9 vs 85 ± 10 bpm, p = 0.62: stroke volume reserve; 13 ± 6 vs 13 ± 9 ml,p = 0.94). These findings indicate low-normal ventricular size in long-term breast cancer survivors, but normal reserve function

Exercise attenuates cardiotoxicity of anthracycline chemotherapy measured by global longitudinal strain [Letter]

[Extract] Anthracycline-based chemotherapy (AC) is a common treatment for patients with breast cancer and has been associated with a dramatic improvement in breast cancer survivorship. Among patients with early-stage breast cancer, cardiovascular diseases represent the most common cause of mortality, and there is a growing emphasis on strategies for minimizing the toxic effects of breast cancer treatments on the cardiovascular system (1)

Exercise attenuates cardiotoxicity of anthracycline chemotherapy measured by global longitudinal strain [Letter]

[Extract] Anthracycline-based chemotherapy (AC) is a common treatment for patients with breast cancer and has been associated with a dramatic improvement in breast cancer survivorship. Among patients with early-stage breast cancer, cardiovascular diseases represent the most common cause of mortality, and there is a growing emphasis on strategies for minimizing the toxic effects of breast cancer treatments on the cardiovascular system (1)

Determinants of exercise intolerance in breast cancerpatients prior to anthracycline chemotherapy

Women with early-stage breast cancer have reduced peak exercise oxygenuptake (peakVO2). The purpose of this study was to evaluate peakVO2andright (RV) and left (LV) ventricular function prior to adjuvant chemotherapy.Twenty-nine early-stage breast cancer patients (mean age: 48 years) and 10age-matched healthy women were studied. Participants performed an uprightcycle exercise test with expired gas analysis to measure peakVO2. RV and LVvolumes and function were measured at rest, submaximal and peak supinecycle exercise using cardiac magnetic resonance imaging. PeakVO2was signif-icantly lower in breast cancer patients versus controls (1.7 0.4 vs.2.3 0.5 L/min,P=0.0013; 25 6 vs. 35 6 mL/kg/min,P=0.00009).No significant difference was found between groups for peak upright exerciseheart rate (174 13 vs. 169 16 bpm,P=0.39). Rest, submaximal andpeak exercise RV and LV end-diastolic and end-systolic volume index, strokeindex, and cardiac index were significantly lower in breast cancer patients ver-sus controls (P<0.05 for all). No significant difference was found betweengroups for rest and exercise RV and LV ejection fraction. Despite preservedRV and LV ejection fraction, the decreased peakVO2in early-stage breastcancer patients prior to adjuvant chemotherapy is due in part to decreased peak cardiac index secondary to reductions in RV and LV end-diastolic volumes.status: publishe