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CARDIOVASCULAR RESPONSES TO ACUTE EXERCISE IN ANTHRACYCLINE TREATED CANCER SURVIVORS AND HEALTHY CONTROLS

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abstract
Cancer survivors often experience exercise intolerance well after the completion of adjuvant chemotherapy. Although cardiotoxicity is a known consequence of anthracycline-based chemotherapy, its relationship to exercise intolerance has not been elucidated. PURPOSE: the objective of this study was to compare cardiovascular responses, at rest and peak exercise, in anthracycline treated cancer survivors (ATS) and age-matched healthy controls (CON) to examine potential mechanisms of exercise intolerance. METHODS: Ten ATS, four males and six females, that were > 12 months post-anthracycline-treatment or are currently receiving treatment, were assessed. Ten age and gender matched CON participants were recruited as a comparison group. Each participant had a resting cardiac MRI (CMR) and then performed a maximal exercise test on a treadmill to obtain peak oxygen consumption (VO2 peak) and heart rate (HR). Immediately (<30 sec) following the exercise test, the participant was redirected into the scanner for repeat CMR measures. All cardiac volumes were indexed for body surface area. RESULTS: Although not statistically significant, but clinically meaningful, VO2 peak was 23% lower in the ATS compared to the CON group (25.8 ± 7.9 ml/kg/min vs. 33.5 ± 10.7 ml/kg/min) despite no significant differences between the two groups on any other cardiovascular or hemodynamic measure in response to exercise. CONCLUSION: Although not statistically significant, the ATS group had a higher heart rate and a lower stroke volume at lower levels of work. Data from this small study suggests that both “central” cardiovascular responses as well as “peripheral” factors related to the A-VO2 difference contribute to the reduced exercise capacity observed in the ATS group. Further studies are warranted to elucidate the specific mechanisms responsible for these findings and to investigate potential interventions to improve the exercise capacity in ATS patients.
subject
Anthracycline
cardiac magnetic resonance imaging
Cardio-oncology
cardiopulmonary exercise testing
contributor
Larson, Ashley (author)
Brubaker, Peter H (committee chair)
Hundley, Greg (committee member)
Mihalko, Shannon (committee member)
Jordan, Jennifer (committee member)
date
2017-06-15T08:35:58Z (accessioned)
2017 (issued)
degree
Health and Exercise Science (discipline)
2022-06-01 (liftdate)
embargo
2022-06-01 (terms)
identifier
http://hdl.handle.net/10339/82202 (uri)
language
en (iso)
publisher
Wake Forest University
title
CARDIOVASCULAR RESPONSES TO ACUTE EXERCISE IN ANTHRACYCLINE TREATED CANCER SURVIVORS AND HEALTHY CONTROLS
type
Thesis

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