scholarly journals Cardiac and skeletal muscle predictors of impaired cardiorespiratory fitness post-anthracycline chemotherapy for breast cancer

2021 ◽  
Vol 11 (1) ◽  
Author(s):  
Amy A. Kirkham ◽  
Mark J. Haykowsky ◽  
Rhys I. Beaudry ◽  
Justin G. Grenier ◽  
John R. Mackey ◽  
...  
Keyword(s):  
Breast Cancer ◽  
Cardiac Function ◽  
Breast Cancer Survivors ◽  
Fatty Infiltration ◽  
Thigh Muscle ◽  
Peak Exercise ◽  
Systolic Volume ◽  
End Systolic Volume ◽  
Oxygen Difference ◽  
Anthracycline Chemotherapy

AbstractThis study aimed to characterize peak exercise cardiac function and thigh muscle fatty infiltration and their relationships with VO2peak among anthracycline-treated breast cancer survivors (BCS). BCS who received anthracycline chemotherapy ~ 1 year earlier (n = 16) and matched controls (matched-CON, n = 16) were enrolled. Resting and peak exercise cardiac function, myocardial T1 mapping (marker of fibrosis), and thigh muscle fat infiltration were assessed by magnetic resonance imaging, and VO2peak by cycle test. Compared to matched-CON, BCS had lower peak SV (64 ± 9 vs 57 ± 10 mL/m2, p = 0.038), GLS (− 30.4 ± 2.2 vs − 28.0 ± 2.5%, p = 0.008), and arteriovenous oxygen difference (16.4 ± 3.6 vs 15.2 ± 3.9 mL/100 mL, p = 0.054). Mediation analysis showed: (1) greater myocardial T1 time (fibrosis) is inversely related to cardiac output and end-systolic volume exercise reserve; (2) greater thigh muscle fatty infiltration is inversely related to arteriovenous oxygen difference; both of which negatively influence VO2peak. Peak SV (R2 = 65%) and thigh muscle fat fraction (R2 = 68%) were similarly strong independent predictors of VO2peak in BCS and matched-CON combined. Post-anthracyclines, myocardial fibrosis is associated with impaired cardiac reserve, and thigh muscle fatty infiltration is associated with impaired oxygen extraction, which both contribute to VO2peak.

Use of the Frank-Starling mechanism during submaximal versus maximal upright exercise

1986 ◽  
Vol 251 (6) ◽  
pp. H1101-H1105 ◽  
Author(s):  
G. D. Plotnick ◽  
L. C. Becker ◽  
M. L. Fisher ◽  
G. Gerstenblith ◽  
D. G. Renlund ◽  
...  
Keyword(s):  
Stroke Volume ◽  
Blood Pool ◽  
Left Ventricular ◽  
Peak Exercise ◽  
Vigorous Exercise ◽  
Systolic Volume ◽  
Early Exercise ◽  
End Diastolic Volume ◽  
Blood Pool Scintigraphy ◽  
End Systolic Volume

To evaluate the extent to which the Frank-Starling mechanism is utilized during successive stages of vigorous upright exercise, absolute left ventricular end-diastolic volume and ejection fraction were determined by gated blood pool scintigraphy at rest and during multilevel maximal upright bicycle exercise in 30 normal males aged 26-50 yr, who were able to exercise to 125 W or greater. Left ventricular end-systolic volume, stroke volume, and cardiac output were calculated at rest and during each successive 3-min stage of exercise [25, 50, 75, 100, and 125–225 W (peak)]. During early exercise (25 W), end-diastolic and stroke volumes increased (+17 +/- 1 and +31 +/- 4%, respectively), with no change in end-systolic volume. With further exercise (50–75 W) end-diastolic volume remained unchanged as end-systolic volume decreased (-12 +/- 4 and -24 + 5%, respectively). At peak exercise end-diastolic volume decreased to resting level, stroke volume remained at a plateau, and end-systolic volume further decreased (-48 +/- 7%). Thus the Frank-Starling mechanism is used early in exercise, perhaps because of a delay in sympathetic mobilization, and does not appear to play a role in the later stages of vigorous exercise.

Long-term outcome of cardiac function in a population-based cohort of breast cancer survivors: A cross-sectional study

2017 ◽  
Vol 81 ◽  
pp. 56-65 ◽  
Author(s):  
Liselotte M. Boerman ◽  
Saskia W.M.C. Maass ◽  
Peter van der Meer ◽  
Jourik A. Gietema ◽  
John H. Maduro ◽  
...  
Keyword(s):  
Breast Cancer ◽  
Cardiac Function ◽  
Breast Cancer Survivors ◽  
Population Based ◽  
Cross Sectional Study ◽  
Sectional Study ◽  
Term Outcome ◽  
Cross Sectional ◽  
Long Term Outcome

Comparison of energy supplements during prolonged exercise for maintenance of cardiac function: carbohydrate only versus carbohydrate plus whey or casein hydrolysate

2016 ◽  
Vol 41 (6) ◽  
pp. 674-683 ◽  
Author(s):  
Tanja Oosthuyse ◽  
Aletta M.E. Millen
Keyword(s):  
Cardiac Function ◽  
Casein Hydrolysate ◽  
Left Ventricular ◽  
Doppler Imaging ◽  
Energy Deficit ◽  
Strenuous Exercise ◽  
Lv Function ◽  
Time Effects ◽  
Systolic Volume ◽  
End Systolic Volume

Cardiac function is often suppressed following prolonged strenuous exercise and this may occur partly because of an energy deficit. This study compared left ventricular (LV) function by 2-dimensional echocardiography and tissue Doppler imaging (TDI) before and after ∼2.5 h of cycling (2-h steady-state 60% peak aerobic power output plus 16 km time trial) in 8 male cyclists when they ingested either placebo, carbohydrate-only (CHO-only), carbohydrate-casein hydrolysate (CHO-casein), or carbohydrate-whey hydrolysate (CHO-whey). No treatment-by-time interactions occurred, but pre-to-postexercise time effects occurred selectively. Although diastolic function measured by pulsed-wave Doppler early-to-late (E/A) transmitral blood flow velocity was suppressed in all trials from pre- to postexercise (mean change post-pre exercise: −0.53 (95% CI −0.15 to −0.91)), TDI early-to-late (e′/a′) tissue velocity was significantly suppressed pre- to postexercise only with placebo, CHO-only, and CHO-whey (septal and lateral wall e′/a′ average change: −0.62 (95% CI −1.12 to −0.12); −0.69 (95% CI −1.19 to −0.20); and −0.79 (95% CI −1.28 to −0.29), respectively) but not with CHO-casein (−0.40 (95% CI −0.90 to 0.09)). LV contractility was, or tended to be, significantly reduced pre- to postexercise with placebo, CHO-only, and CHO-whey (systolic blood pressure/end systolic volume change, mm Hg·mL−1: −0.8 (95% CI −1.2 to −0.4), p = 0.0003; −0.5 (95% CI −0.9 to −0.02), p = 0.035; and −0.4 (95% CI −0.8 to 0.04), p = 0.086, respectively), but not with CHO-casein (−0.3 (95% CI −0.8 to 0.1), p = 0.22). However, ejection fraction (EF) and ventricular-arterial coupling were significantly reduced pre- to postexercise only with placebo (placebo change: EF, −4.6 (95% CI −8.4 to −0.7)%; stroke volume/end systolic volume, −0.3 (95% CI −0.6 to −0.04)). Despite no treatment-by-time interactions, pre-to-postexercise time effects observed with specific beverages may be meaningful for athletes. Tentatively, the order of beverages with least-to-most variables displaying a time effect indicating suppression of LV function following exercise was CHO-casein < CHO-only and CHO-whey < placebo, and calls for further verification.

Cardiac autonomic dysfunction in breast cancer survivors.

2017 ◽  
Vol 35 (15_suppl) ◽  
pp. 10057-10057 ◽  
Author(s):  
David Payne ◽  
Syed Mahmood ◽  
Ann H. Partridge ◽  
Anju Nohria ◽  
John Groarke
Keyword(s):  
Breast Cancer ◽  
Exercise Capacity ◽  
Autonomic Dysfunction ◽  
Breast Cancer Survivors ◽  
Prognostic Significance ◽  
Hazard Ratio ◽  
Adjusted Hazard Ratio ◽  
Peak Exercise ◽  
Cardiac Autonomic Dysfunction ◽  
All Cause Mortality

10057 Background: Cardiac autonomic dysfunction (AD) has been associated with increased cardiovascular (CV) and all-cause mortality in several diseases. We evaluated the prevalence, functional and prognostic significance of cardiac AD in a cohort of breast cancer (BC) survivors referred for exercise treadmill testing (ETT). Methods: Cardiac AD was defined as the presence of both an elevated resting heart rate (HR ≥ 80 beats per minute) and abnormal HR recovery (HRR ≤ 12 beats per minute if active cool down, or ≤ 18 beats per minute if passive recovery) at 1 minute after peak exercise. Presence of cardiac AD, exercise capacity, and all-cause mortality were assessed in 448 women (age 62.6±10.0 years), 8.7 [range 4.5, 14.3] years from BC diagnosis, compared to 448 cancer-free, age- and sex-matched controls, all of whom were clinically referred for ETT. Results: Elevated resting HR (23.7% vs. 17.0%, p = 0.013), abnormal HRR (25.9% vs. 20.3%, p = 0.048), and cardiac AD (8.0% vs. 4.2%, p = 0.025) were more prevalent in BC survivors than controls. BC survivors with cardiac AD had reduced exercise capacity compared to those without AD (Table). Among controls, cardiac AD was not associated with decreased exercise capacity. Among BC survivors (age-adjusted hazard ratio 1.90 (95% CI 0.78-4.62) and controls (age-adjusted hazard ratio 4.09 (95% CI 0.49-34.18), cardiac AD was not associated with increased all-cause mortality. Conclusions: Among patients referred for ETT, BC survivors have an increased prevalence of cardiac AD relative to controls. Cardiac AD is associated with decreased exercise capacity, but not increased all-cause mortality, in BC survivors. Available strategies to modulate cardiac AD may improve functional capacity in BC survivors. Table: Impact of markers of cardiac AD on exercise capacity. [Table: see text]

Possibility for Application of 99mTc-Methoxyisobutylisonitrile in Assessing the Efficiency of Chemotherapy Cardiotoxicity Prevention

2015 ◽  
Vol 1084 ◽  
pp. 426-429
Author(s):  
Vladimir Chernov ◽  
Tatiana Kravchuk ◽  
Roman Zelchan ◽  
Dmitriy Podoplekin ◽  
Victor Goldberg
Keyword(s):  
Breast Cancer ◽  
Left Ventricular ◽  
Left Ventricular Ejection ◽  
Control Group ◽  
Breast Cancer Patients ◽  
Ventricular Ejection Fraction ◽  
Systolic Volume ◽  
End Systolic Volume ◽  
Prophylactic Use ◽  
Chemotherapy Cardiotoxicity

The main focus of the paper is to estimate the possibility of trimethylhydrasine propionate application to prevent an acute doxorubicin-induced cardiotoxicity in breast cancer patients. The study included women with breast cancer. Main group were injected intravenously trimethylhydrasine propionate prior to chemotherapy. For the cancer treatment of these patients doxorubicin was used. All patients were examined by GATE SPECT before starting chemotherapy and 1 hour after the first administration of doxorubicin. After doxorubicin administration in the control group there was a decrease in left ventricular ejection fraction (LVEF), and an increase in left ventricular end-systolic volume. After administration of doxorubicin 40% of patients had a significant reduction in LVEF. Prophylactic use of trimethylhydrasine propionate allows reducing acute doxorubicin-induced cardiotoxicity incidences by 22.5%.

Measurement of Left Ventricular Function During Arm Ergometry Using the VESTTM Nuclear Probe

1994 ◽  
Vol 19 (4) ◽  
pp. 462-471
Author(s):  
Len S. Goodman ◽  
Jack M. Goodman ◽  
Linda Yang ◽  
Joanna Sloninko ◽  
Terry Hsia ◽  
...  
Keyword(s):  
Ejection Fraction ◽  
Left Ventricular ◽  
Peak Exercise ◽  
Lv Function ◽  
Trained Subjects ◽  
Arm Exercise ◽  
Systolic Volume ◽  
End Systolic Volume ◽  
Lv Ejection Fraction ◽  
Rest And Exercise

A chest-mounted left ventricular (LV) nuclear probe (VEST™) for use during arm and leg ergometry is presented, with a discussion of the validity and reproducibility of LV function measures at rest and exercise. During both arm and leg ergometry in trained subjects, transient changes in LV function/volumes were observed. LV ejection fraction and relative end-systolic and end-diastolic volumes were 25 to 30% less with the arms versus the legs, agreeing with data from other studies using conventional techniques. At peak exercise with both limbs, LV ejection fraction and relative LV end-systolic volume increased, followed by immediate postexercise normalization. The effect was greatest with the arms and reflects the effect of high intramuscular and arterial pressures generated during arm cranking, leading to increased LV afterloading. The VESTTM permits rapid and noninvasive assessment of LV function during arm exercise, avoiding the limitations of other techniques. Key words: arm exercise, radionuclide, chest-mounted probe

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