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dc.contributor.authorKirkham, Amy
dc.contributor.authorShave, Rob
dc.contributor.authorBland, Kelcey
dc.contributor.authorBovard, Josh
dc.contributor.authorEves, Neil
dc.contributor.authorGelmon, Karen
dc.contributor.authorVirani, Sean
dc.contributor.authorStöhr, Eric J.
dc.contributor.authorWarburton, Darren
dc.contributor.authorCampbell, Kristin
dc.date.accessioned2017-08-23T14:16:50Z
dc.date.available2017-08-23T14:16:50Z
dc.date.issued2017-07-14
dc.identifier.citationKirkham, A. A., Shave, R. E., Bland, K. A., Bovard, J. M., Eves, N. D., Gelmon, K. A., McKenzie, D.C., Virani, S.A., Stöhr, E.J., Warburton, D.E.R. and Campbell, K. L. (2017) 'Protective effects of acute exercise prior to doxorubicin on cardiac function of breast cancer patients: A proof-of-concept RCT' International Journal of Cardiology (in press)en_US
dc.identifier.issn0167-5273
dc.identifier.issn1874-1754 (ESSN)
dc.identifier.urihttp://hdl.handle.net/10369/8756
dc.descriptionThis article was published in International Journal of Cardiology on 14 July 2017 (online), available at http://dx.doi.org/10.1016/j.ijcard.2017.07.037en_US
dc.description.abstractBackground: Preclinical studies have reported that a single treadmill session performed 24 h prior to doxorubicin provides cardio-protection. We aimed to characterize the acute change in cardiac function following an initial doxorubicin treatment in humans and determine whether an exercise session performed 24 h prior to treatment changes this response. Methods: Breast cancer patients were randomized to either 30 minutes of vigorous-intensity exercise 24 h prior to the first doxorubicin treatment (n=13), or no vigorous exercise for 72 h prior to treatment (control, n=11). Echocardiographically-derived left ventricular volumes, longitudinal strain, twist, E/A ratio, and circulating NT-proBNP, a marker of later cardiotoxicity, were measured before and 24-48 h after the treatment. Results: Following treatment in the control group, NT-proBNP, end-diastolic and stroke volumes, cardiac output, E/A ratio, strain, diastolic strain rate, twist, and untwist velocity significantly increased (all p≤0.01). Whereas systemic vascular resistance (p<0.01) decreased, and ejection fraction (p=0.02) and systolic strain rate (p<0.01) increased in the exercise group only. Relative to control, the exercise group had a significantly lower NT-proBNP (p<0.01) and a 46% risk reduction of exceeding the cut-point used to exclude acute heart failure. Conclusion: The first doxorubicin treatment is associated with acutely increased NT-proBNP, echocardiographic parameters of myocardial relaxation, left ventricular volume overload, and changes in longitudinal strain and twist opposite in direction to documented longer-term changes. An exercise session performed 24 h prior to treatment attenuated NT-proBNP release and increased systolic function. Future investigations should verify these findings in a larger cohort and across multiple courses of doxorubicin.en_US
dc.language.isoenen_US
dc.publisherElsevieren_US
dc.relation.ispartofseriesInternational Journal of Cardiology;
dc.subjectdoxorubicinen_US
dc.subjectbreast canceren_US
dc.subjectcardiotoxicityen_US
dc.subjectexerciseen_US
dc.subjectlongitudinal strainen_US
dc.subjectNT-proBNPen_US
dc.titleProtective effects of acute exercise prior to doxorubicin on cardiac function of breast cancer patients: A proof-of-concept RCTen_US
dc.typeArticleen_US
dc.identifier.doihttp://dx.doi.org/10.1016/j.ijcard.2017.07.037
dcterms.dateAccepted2017-07-12
rioxxterms.funderCardiff Metropolitan Universityen_US
rioxxterms.identifier.projectCardiff Metropolian (Internal)en_US
rioxxterms.versionAMen_US
rioxxterms.licenseref.urihttps://creativecommons.org/licenses/by-nc-nd/4.0/en_US
rioxxterms.licenseref.startdate2017-08-23
rioxxterms.freetoread.startdate2018-07-14
rioxxterms.funder.project37baf166-7129-4cd4-b6a1-507454d1372een_US


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