Protective effects of acute exercise prior to doxorubicin on cardiac function of breast cancer patients

A proof-of-concept RCT

verfasst von

A. A. Kirkham, R. E. Shave, K. A. Bland, J. M. Bovard, N. D. Eves, K. A. Gelmon, D. C. McKenzie, S. A. Virani, E. J. Stöhr, D. E.R. Warburton, K. L. Campbell

Abstract

Background 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 min 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.

Organisationseinheit(en)

Sport und Gesundheit

Externe Organisation(en)

University of British Columbia
Cardiff Metropolitan University

Typ

Artikel

Journal

International Journal of Cardiology

Band

245

Seiten

263-270

Anzahl der Seiten

8

ISSN

0167-5273

Publikationsdatum

15.10.2017

Publikationsstatus

Veröffentlicht

Peer-reviewed

Ja

ASJC Scopus Sachgebiete

Kardiologie und kardiovaskuläre Medizin

Ziele für nachhaltige Entwicklung

SDG 3 – Gute Gesundheit und Wohlergehen

Elektronische Version(en)

http://hdl.handle.net/10369/8756 (Zugang: Offen)
https://doi.org/10.1016/j.ijcard.2017.07.037 (Zugang: Geschlossen)