Effects of exercise training on cardiac toxicity markers in women with breast cancer undergoing chemotherapy with anthracyclines: a randomized controlled trial.

Autor:	Antunes P; Research Center in Sport Sciences, Health and Human Development (CIDESD), Sport Sciences Department, University of Beira Interior, Convento de Santo António, 6201-001 Covilhã, Portugal.; ONCOMOVE, AICSO - Associação de Investigação de Cuidados de Suporte em Oncologia (AICSO), Avenida João Paulo II, nº 911, loja 9, 4410-406 Vila Nova de Gaia, Portugal., Joaquim A; ONCOMOVE, AICSO - Associação de Investigação de Cuidados de Suporte em Oncologia (AICSO), Avenida João Paulo II, nº 911, loja 9, 4410-406 Vila Nova de Gaia, Portugal.; Department of Medical Oncology, Centro Hospitalar de Vila Nova de Gaia/Espinho, R. Conceição Fernandes S/N, 4434-502 Vila Nova de Gaia, Portugal., Sampaio F; Department of Cardiology, Centro Hospitalar de Vila Nova de Gaia/Espinho, R. Conceição Fernandes S/N, 4434-502 Vila Nova de Gaia, Portugal.; Cardiovascular Research & Development Center - UnIC@ RISE, Department of Surgery and Physiology, Faculty of Medicine of the University of Porto, Alameda Prof. Hernâni Monteiro, 4200-319 Porto, Portugal., Nunes C; Department of Mathematics and Center of Mathematics and Applications, University of Beira Interior, Avenida Marquês D'Avila e Bolama, 6200-001 Covilhã, Portugal., Ascensão A; Research Centre in Physical Activity, Health and Leisure Department of Sports Biology, Faculty of Sports, University of Porto, R. Dr. Plácido da Costa 91, 4200-450 Porto, Portugal., Vilela E; Department of Cardiology, Centro Hospitalar de Vila Nova de Gaia/Espinho, R. Conceição Fernandes S/N, 4434-502 Vila Nova de Gaia, Portugal., Teixeira M; Department of Cardiology, Centro Hospitalar de Vila Nova de Gaia/Espinho, R. Conceição Fernandes S/N, 4434-502 Vila Nova de Gaia, Portugal., Capela A; ONCOMOVE, AICSO - Associação de Investigação de Cuidados de Suporte em Oncologia (AICSO), Avenida João Paulo II, nº 911, loja 9, 4410-406 Vila Nova de Gaia, Portugal.; Department of Medical Oncology, Centro Hospitalar de Vila Nova de Gaia/Espinho, R. Conceição Fernandes S/N, 4434-502 Vila Nova de Gaia, Portugal., Amarelo A; ONCOMOVE, AICSO - Associação de Investigação de Cuidados de Suporte em Oncologia (AICSO), Avenida João Paulo II, nº 911, loja 9, 4410-406 Vila Nova de Gaia, Portugal.; Department of Medical Oncology, Centro Hospitalar de Vila Nova de Gaia/Espinho, R. Conceição Fernandes S/N, 4434-502 Vila Nova de Gaia, Portugal., Marques C; Department of Medical Oncology, Centro Hospitalar de Vila Nova de Gaia/Espinho, R. Conceição Fernandes S/N, 4434-502 Vila Nova de Gaia, Portugal., Viamonte S; ONCOMOVE, AICSO - Associação de Investigação de Cuidados de Suporte em Oncologia (AICSO), Avenida João Paulo II, nº 911, loja 9, 4410-406 Vila Nova de Gaia, Portugal.; Centro de Reabilitação do Norte, Centro Hospitalar de Vila Nova de Gaia/Espinho, R. Conceição Fernandes S/N, 4434-502 Vila Nova de Gaia, Portugal., Alves A; ONCOMOVE, AICSO - Associação de Investigação de Cuidados de Suporte em Oncologia (AICSO), Avenida João Paulo II, nº 911, loja 9, 4410-406 Vila Nova de Gaia, Portugal.; Research Center in Sport Sciences, Health and Human Development (CIDESD), Physical Education and Sport Sciences Department, University of Maia, Av. Carlos de Oliveira Campos, 4475-690 Maia, Portugal., Esteves D; Research Center in Sport Sciences, Health and Human Development (CIDESD), Sport Sciences Department, University of Beira Interior, Convento de Santo António, 6201-001 Covilhã, Portugal.
Jazyk:	angličtina
Zdroj:	European journal of preventive cardiology [Eur J Prev Cardiol] 2023 Jul 12; Vol. 30 (9), pp. 844-855.
DOI:	10.1093/eurjpc/zwad063
Abstrakt:	Aims: Exercise training has been suggested to prevent anthracycline-related cardiac dysfunction, but clinicalbased evidence is scarce. We investigated the effects of a supervised exercise training programme (SETP) on cardiac toxicity markers in women with breast cancer (BC) receiving anthracycline-containing chemotherapy. Methods and Results: Ninety-three women with early-stage breast cancer were randomly allocated to a supervised exercise training programme (SETP) plus usual care group (Exercise, n = 47) or usual care alone group (UC, n = 46). The SETP consisted of three sessions per week, combining aerobic and resistance training, conducted concurrently across the anthracycline-containing chemotherapy length. The primary endpoint was the change in left ventricular ejection fraction (LVEF) from baseline to the end of anthracycline cycles. Secondary endpoints included global longitudinal strain (GLS) and other conventional echocardiographic parameters, cardiorespiratory fitness (estimated peak VO2), circulating biomarkers (NT-proBNP, hs-TnT), and safety of the SETP. The study endpoints were also assessed 3 months after the end of anthracycline cycles. All patients were prescribed four cycles of doxorubicin plus cyclophosphamide (AC). No significant between-group differences in LVEF change were seen at the end of AC [mean difference: 0.7%; 95% confidence interval (CI): -0.8, 2.3; P = 0.349] and 3 months after AC (1.1%; 95% CI: -0.5, 2.6; P = 0.196). Compared to the usual care (UC) group, the estimated peak VO2 increased in the Exercise group at the end of AC (1.6 mL O2·kg-1·min-1; 95% CI: 0.06, 3.1; P = 0.041) and 3 months after AC (3.1 mL O2·kg-1·min-1; 95% CI: 1.4, 4.7; P < 0.001). No between-group differences were found in the remaining secondary endpoints. No serious adverse events were observed during SETP. Conclusion: Exercise training was safe during chemotherapy and significantly improved cardiorespiratory fitness. No significant effects were seen on cardiac toxicity markers (LVEF or GLS) as compared to the usual care. Trial Registration: Mama Move Gaia on treatment trial ISRCTN32617901. Competing Interests: Conflict of interest: None declared. (© The Author(s) 2023. Published by Oxford University Press on behalf of the European Society of Cardiology. All rights reserved. For permissions, please e-mail: journals.permissions@oup.com.)
Databáze:	MEDLINE
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