Cardiac mechanisms for low aerobic power in anthracycline treated, older, long-term breast cancer survivors

Rhys I Beaudry; Mark J Haykowsky; James P MacNamara; Wesley J Tucker; Roshni Rao; Barbara Haley; Satyam Sarma

doi:10.1186/s40959-022-00134-1

Cardiac mechanisms for low aerobic power in anthracycline treated, older, long-term breast cancer survivors

Cardiooncology. 2022 Apr 11;8(1):8. doi: 10.1186/s40959-022-00134-1.

Authors

Rhys I Beaudry¹, Mark J Haykowsky^{1

2}, James P MacNamara^{3

4}, Wesley J Tucker⁵, Roshni Rao⁶, Barbara Haley⁷, Satyam Sarma^{8

9}

Affiliations

¹ University of Texas at Arlington, Arlington, TX, USA.
² University of Alberta, Edmonton, Canada.
³ Institute for Exercise and Environmental Medicine, Texas Health Presbyterian Hospital, Dallas, TX, USA.
⁴ Department of Internal Medicine, University of Texas Southwestern Medical Center, Dallas, TX, USA.
⁵ Texas Woman's University, Houston, TX, USA.
⁶ Columbia University Irving Medical Center, New York Presbyterian, New York, NY, USA.
⁷ Department of Surgery, University of Texas Southwestern Medical Center, Dallas, TX, USA.
⁸ Institute for Exercise and Environmental Medicine, Texas Health Presbyterian Hospital, Dallas, TX, USA. satyamsarma2@texashealth.org.
⁹ Department of Internal Medicine, University of Texas Southwestern Medical Center, Dallas, TX, USA. satyamsarma2@texashealth.org.

Abstract

Breast cancer survivors have reduced peak aerobic capacity (VO_2peak) which may be related to latent or lingering chemotherapy induced cardiac damage. Nine, older (67 ± 3 years), long-term survivors (9.8 years) of anthracycline based chemotherapy and age- and sex-matched healthy controls were recruited and tested to determine whether: i) VO_2peak remains reduced in long-term survivorship; and ii) reductions in VO_2peak are due to cardiac dysfunction. VO_2peak was significantly reduced in breast cancer survivors relative to healthy controls (15.9 ± 2.0 vs 19.9 ± 3.1 ml/kg/min, p = 0.006), however the heart rate and stroke volume responses to exercise were normal (heart rate reserve; 88 ± 9 vs 85 ± 10 bpm, p = 0.62: stroke volume reserve; 13 ± 6 vs 13 ± 9 ml,p = 0.94). These findings indicate low-normal ventricular size in long-term breast cancer survivors, but normal reserve function.

Keywords: Aerobic capacity; Anthracycline; Breast cancer; Cardiac function; Exercise; VO2peak.