Persistent impairment in cardiopulmonary fitness following breast cancer chemotherapy Foulkes, Stephen, Howden, Erin J, Bigaran, Ashley, Janssens, Kristel, Antill, Yoland, Loi, Sherene, Claus, Piet, Haykowsky, Mark J, Daly, Robin M, Fraser, Steven F and La Gerche, Andre 2019, Persistent impairment in cardiopulmonary fitness following breast cancer chemotherapy, Medicine and science in sports and exercise, pp. 1-43, doi: 10.1249/MSS.0000000000001970. Attached Files Name Description MIMEType Size Downloads Title Persistent impairment in cardiopulmonary fitness following breast cancer chemotherapy Author(s) Foulkes, Stephen Howden, Erin J Bigaran, Ashley Janssens, Kristel Antill, Yoland Loi, Sherene Claus, Piet Haykowsky, Mark J Daly, Robin M orcid.org/0000-0002-9897-1598 Fraser, Steven F orcid.org/0000-0003-0202-9619 La Gerche, Andre Journal name Medicine and science in sports and exercise Start page 1 End page 43 Total pages 43 Publisher Wolters Kluwer Place of publication Philadelphia, Pa. Publication date 2019-03-01 ISSN 1530-0315 Keyword(s) Cardiotoxicity Cardiac function Cardiopulmonary fitness Exercise training Summary PURPOSE: Anthracycline chemotherapy (AC) is associated with acute reductions in cardiopulmonary fitness (VO2peak). We sought to determine whether changes in VO2peak and cardiac function persisted at 12-months post-AC completion, and whether changes in cardiac function explain the heightened long-term heart failure risk. METHODS: Women with breast cancer scheduled for AC (n=28) who participated in a non-randomized trial of exercise training (ET; n=14) or usual care (UC; n=14) during AC completed a follow-up evaluation 12-months post-AC completion (16-months from baseline). At baseline, 4-months, and 16-months, participants underwent a resting echocardiogram (left ventricular ejection fraction, LVEF; global longitudinal strain, GLS), a blood sample (troponin; b-type natriuretic peptide), a cardiopulmonary exercise test, and cardiac MRI measures of stroke volume (SV), heart rate (HR) and cardiac output (Qc) at rest, and during intense exercise. RESULTS: Seventeen women (UC: n=8; ET: n=9) completed evaluation at baseline, 4-months and 16-months. At 4-months, AC was associated with 18% and 6% reductions in VO2peak in the UC and ET groups respectively, that persisted at 16-months (UC: -16%; ET: -7%), and was not attenuated by ET (interaction, P=0.10). Exercise Qc was lower at 16-months compared to baseline and 4-months (P<0.001), which was due to a blunted augmentation of SV during exercise (P=0.032; a 14% reduction in peak SV), with no changes in HR response. There was a small reduction in resting LVEF (baseline to 4-months) and GLS (between 4-months and 16-months), and an increase in troponin (baseline to 4-months), but only exercise Qc was associated with VO2peak (R=0.47, P<0.01). CONCLUSION: Marked reductions in VO2peak persisted 12-months following anthracycline-based chemotherapy, which was associated with impaired exercise cardiac function. CLINICAL TRIAL REGISTRATION: ACTRN12616001602415. Notes In press Language eng DOI 10.1249/MSS.0000000000001970 Field of Research 1106 Human Movement and Sports Sciences HERDC Research category C1 Refereed article in a scholarly journal Copyright notice ©2019, American College of Sports Medicine Persistent URL http://hdl.handle.net/10536/DRO/DU:30119358 Document type: Journal Article Collections: Faculty of Health School of Exercise and Nutrition Sciences Related Links Link Description Connect to published version Go to link with your DU access privileges     Unless expressly stated otherwise, the copyright for items in DRO is owned by the author, with all rights reserved. Versions Version Filter Type Fri, 08 Mar 2019, 09:25:53 EST Fri, 08 Mar 2019, 10:52:18 EST Fri, 08 Mar 2019, 11:01:28 EST Fri, 07 Jun 2019, 06:02:33 EST Wed, 19 Jun 2019, 13:57:52 EST Wed, 19 Jun 2019, 13:59:58 EST Wed, 19 Jun 2019, 14:00:35 EST Sat, 27 Jul 2019, 02:31:51 EST Sat, 03 Aug 2019, 02:30:53 EST Filtered Full Citation counts:   Cited 2 times in TR Web of Science Cited 2 times in Scopus Search Google Scholar Access Statistics: 167 Abstract Views, 2 File Downloads  -  Detailed Statistics Created: Fri, 08 Mar 2019, 09:25:53 EST

Every reasonable effort has been made to ensure that permission has been obtained for items included in DRO. If you believe that your rights have been infringed by this repository, please contact drosupport@deakin.edu.au.