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Real-time exercise reduces impaired cardiac function in breast cancer patients undergoing chemotherapy: a randomized controlled trial - 13/01/21

Doi : 10.1016/j.rehab.2021.101485 
Wei-Pang Chung, MD 1, #, Hsin-Lun Yang, PT MS 2, 3, #, Ya-Ting Hsu, MD 4, Ching-Hsia Hung, PT PhD 2, 3, Ping-Yen Liu, MD PhD 5, 6, Yen-Wen Liu, MD PhD 5, 6, Shih-Hung Chan, MD PhD 6, Kun-Ling Tsai, PT PhD 2, 3,
1 Department of Oncology, National Cheng Kung University Hospital, College of Medicine, National Cheng Kung University, Tainan, Taiwan 
2 Department of Physical Therapy, College of Medicine, National Cheng Kung University, Tainan, Taiwan 
3 Institute of Allied Health Sciences, College of Medicine, National Cheng Kung University, Tainan, Taiwan 
4 Division of Hematology, Department of Internal Medicine, National Cheng Kung University Hospital, College of Medicine, National Cheng Kung University, Tainan, Taiwan 
5 Institute of Clinical Medicine, College of Medicine, National Cheng Kung University, Tainan, Taiwan 
6 Division of Cardiology, Internal Medicine, College of Medicine, National Cheng Kung University Hospital, Tainan, Taiwan 

Corresponding author: Department of Physical Therapy, College of Medicine, National Cheng Kung University, Tainan, TaiwanDepartment of Physical Therapy, College of Medicine, National Cheng Kung UniversityTainanTaiwan
Sous presse. Manuscrit accepté. Disponible en ligne depuis le Wednesday 13 January 2021

Highlights

Exercise prevented early phase chemotherapy-impaired cardiac function.
Early exercise in breast cancer patients undergoing chemotherapy could prevent left atrial enlargement.
Early exercise in breast cancer patients undergoing chemotherapy does not affect valvular dysfunction.

Le texte complet de cet article est disponible en PDF.

Abstract

Background: Previous studies have reported that chemotherapy results in substantial long-term risk of heart failure. Exercise ameliorates exercise responses and exercise tolerance in patients receiving chemotherapy. The cardioprotective effect of real-time exercise in breast cancer is still unclear.

Objectives: The aim of the present study was to determine the effect of real-time moderate-to-high–intensity exercise training in women with breast cancer undergoing chemotherapy and to follow up on parameters of cardiac function and exercise capacity at different times. We hypothesized that early moderate-to-high–intensity exercise training has beneficial effects on cardiac function in women with breast cancer undergoing chemotherapy.

Methods: This was a randomized controlled study that included 32 women randomly allocated into the control or exercise group. Exercise began with the first cycle of chemotherapy, and the training program was maintained during chemotherapy with 2 to 3 sessions per week for 3 months. Patients were instructed to perform moderate-to-high–intensity training with aerobic and resistance training. Outcome measurements were echocardiography and cardiopulmonary exercise test. The primary outcome was the change in left ventricle ejection fraction (LVEF). The secondary outcome was peak oxygen consumption (peak VO2).

Results: The control group showed lower cardiac systolic function than the exercise group [mean (SD) LVEF 62% (2) and 70% (5), p < 0.05], reduced cardiac diastolic function, and cardiac hypertrophy at 3, 6 and 12 months after chemotherapy. At 6 months after chemotherapy, the exercise group exhibited relatively higher exercise capacity than controls [mean (SD) VO2 12.1 (2.2) and 13.6 (2.2) mL/kg/min, p < 0.05]. The main effect size of the study based on echocardiography outcomes was 0.25 (95% confidence interval 0.23 to 0.27), a medium effect size.

Conclusions: Moderate-to-high–intensity exercise training in breast cancer patients undergoing chemotherapy may prevent impaired cardiac function.

Le texte complet de cet article est disponible en PDF.

Keywords : Breast cancer, exercise capacity, chemotherapy, cardiac function



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