Cardiac dysfunction in cancer survivors unmasked during exercise

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Author
Kearney, Maria
Gallop-Evans, Eve
Cockcroft, John R.
Stöhr, Eric J.
Lee, Eveline
Backx, Karianne
Haykowski, Mark
Yousef, Zaheer
Shave, Rob
Date
2016-12-30Acceptance date
2016-12-28
Type
Article
Publisher
Wiley
ISSN
0014-2972
Metadata
Show full item recordAbstract
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.
Journal/conference proceeding
European Journal of Clinical Investigation;
Citation
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).
Description
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
Sponsorship
Cardiff Metropolitan University (Grant ID: Cardiff Metropolian (Internal))
Collections
- Sport Research Groups [1088]
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