Cardiac dysfunction in cancer survivors unmasked by exercise
Cockcroft, John R.
Stöhr, Eric J.
MetadataShow full item record
Introduction: The cardiac dysfunction associated with anthracycline-based chemotherapy cancer treatment can exist sub-clinically for decades before overt presentation. Stress echocardiography, the measurement of left ventricular (LV) deformation and arterial haemodynamic evaluation have separately been used to identify sub-clinical cardiovascular (CV) dysfunction in several patient groups including those with hypertension and diabetes. The purpose of the present cross-sectional study was to determine whether the combination of these techniques could be used to improve the characterisation of sub-clinical CV dysfunction in long-term cancer survivors previously treated with anthracyclines. Materials and methods: Thirteen long-term cancer survivors (36±10 years) with prior anthracycline exposure (11±8 years post-treatment) and 13 age-matched controls were recruited. Left ventricular structure, function and deformation were assessed using echocardiography. Augmentation index was used to quantify arterial haemodynamic load and was measured using applanation tonometry. Measurements were taken at rest and during two stages of low-intensity incremental cycling.Results: At rest, both groups had comparable global LV systolic, diastolic and arterial function (all P>0.05), however longitudinal deformation was significantly lower in cancer survivors (-18±2 v -20±2, P<0.05). During exercise this difference between groups persisted and further differences were uncovered with significantly lower apical circumferential deformation in the cancer survivors (-24±5 v -29±5, -29±5 v 35±8 for first and second stage of exercise respectively, both P<0.05). Conclusion: In contrast to resting echocardiography the measurement of LV deformation at rest and during exercise provides a more comprehensive characterisation of sub-clinical LV dysfunction. Larger studies are required to determine the clinical relevance of these preliminary findings.
European Journal of Clinical Investigation;
Kearney, M., Gallop-Evans, E., Cockcroft, J., Stohr, E., Lee, E., Backx, K., Haykowsky, M., Yousef, Z. and Shave, R. (2016) 'Cardiac dysfunction in cancer survivors unmasked during exercise' European Journal of Clinical Investigation (online).
This article was published in European Journal of Clinical Investigation on 30 December 2016 (online), available at http://dx.doi.org/10.1111/eci.12720
Cardiff Metropolitan University (Grant ID: Cardiff Metropolian (Internal))
- Sport Research Groups 
Showing items related by title, author, subject and abstract.
UNDERSTANDING THE BENEFITS OF, AND PERCEPTIONS OF PHYSICAL ACTIVITY FOR THE BREAST CANCER PATIENT AND SURVIVOR IN ORDER TO PROMOTE INCREASED PARTICIPATION Hardiman, Annabelle (2013-02)Participation in physical activity appears to have many physiological and psychological benefits for patients and survivors of breast cancer. Whilst this is the case, breast cancer diagnosis has an inhibitory effect on ...
Impaired myocardial function does not explain reduced left ventricular filling and stroke volume at rest or during exercise at high altitude Stembridge, Mike; Ainslie, Philip; Hughes, Michael G.; Stöhr, Eric J.; Cotter, James D.; Tymko, Michael M.; Day, Trevor A.; Bakker, Akke; Shave, Rob (American Physiological Society, 2015-11-15)Impaired myocardial systolic contraction and diastolic relaxation have been suggested as possible mechanisms contributing to the decreased stroke volume (SV) observed at high altitude (HA). To determine whether intrinsic ...
The effect of an aerobic exercise bout 24 h prior to each doxorubicin treatment for breast cancer on markers of cardiotoxicity and treatment symptoms: a RCT Kirkham, A.A.; Eves, N.D.; Shave, Rob; Bland, K.A.; Bovard, J.; Gelmon, K.A.; Virani, S.A.; McKenzie, D.C.; Stöhr, Eric J.; Waburton, D.E.; Campbell, K.L. (Springer, 2017-11-06)Purpose = In rodents, a single exercise bout performed 24 h prior to a single doxorubicin treatment provides cardio-protection. This study investigated whether performing this intervention prior to every doxorubicin ...