Abstract
Purpose: Surgery and adjuvant therapy improved prognosis of breast cancer survivors. This improvement risks being offset by potential late-occurring cardiovascular toxicity of oncologic treatment and increased cardiometabolic risk profile associated with lifestyle changes. We address the hypothesis that in breast cancer survivors, multiple functional alterations might define a phenotype, characterized by vagal impairment, diminished aerobic fitness, increased metabolic risk, and reduced wellbeing. Methods: We studied 171 sedentary asymptomatic women (106 cancer survivor—65 controls) of similar age (53 ± 8.6; 51 ± 8.1 years). Autonomic regulation was evaluated by autoregressive spectral analysis of R wave to R wave (RR) interval and systolic arterial pressure variability. Aerobic fitness was directly assessed by cardiopulmonary exercise test. Body mass index (BMI) and waist circumference served as proxies of metabolism. Fatigue and stress-related symptoms were evaluated with validated questionnaire. Results: Patients showed significantly smaller total RR variance (1644 ± 2363 vs 2302 ± 1561 msec2), smaller absolute power of low frequency (LF) (386 ± 745 vs 810 ± 1300 msec2) and high frequency (HF) (485 ± 1202 vs 582 ± 555 msec2) of RR interval variability and smaller spontaneous baroreflex sensitivity (15.0 ± 8.9 vs 21.9 ± 10 msec/mmHg), suggesting vagal impairment. VO2 peak and O2 pulse were lower in cancer survivors than in controls. Fatigue and stress-related somatic symptoms scores were higher, as was BMI and waist circumference. Conclusion: Breast cancer survivors show multiple dysfunctions: vagal impairment, lower aerobic fitness, signs of altered metabolism, and higher perception of fatigue. Implications for Cancer Survivors: We propose that the concept of clinical phenotype, which may accommodate multiple functional disturbances, might be useful in long-term personalized prevention programs for breast cancer survivors.
| Original language | English |
|---|---|
| Pages (from-to) | 699-706 |
| Number of pages | 8 |
| Journal | Journal of Cancer Survivorship |
| Volume | 9 |
| Issue number | 4 |
| DOIs | |
| Publication status | Published - Apr 22 2015 |
Fingerprint
Keywords
- Autonomic nervous system
- Baroreflex sensitivity
- Cardiometabolic risk
- Cardiorespiratory fitness
- Lifestyle
- Secondary prevention
ASJC Scopus subject areas
- Oncology
- Oncology(nursing)
Cite this
Evidence of altered autonomic cardiac regulation in breast cancer survivors. / Vigo, Chiara; Gatzemeier, Wolfgang; Sala, Roberto; Malacarne, Mara; Santoro, Armando; Pagani, Massimo; Lucini, Daniela.
In: Journal of Cancer Survivorship, Vol. 9, No. 4, 22.04.2015, p. 699-706.Research output: Contribution to journal › Article
}
TY - JOUR
T1 - Evidence of altered autonomic cardiac regulation in breast cancer survivors
AU - Vigo, Chiara
AU - Gatzemeier, Wolfgang
AU - Sala, Roberto
AU - Malacarne, Mara
AU - Santoro, Armando
AU - Pagani, Massimo
AU - Lucini, Daniela
PY - 2015/4/22
Y1 - 2015/4/22
N2 - Purpose: Surgery and adjuvant therapy improved prognosis of breast cancer survivors. This improvement risks being offset by potential late-occurring cardiovascular toxicity of oncologic treatment and increased cardiometabolic risk profile associated with lifestyle changes. We address the hypothesis that in breast cancer survivors, multiple functional alterations might define a phenotype, characterized by vagal impairment, diminished aerobic fitness, increased metabolic risk, and reduced wellbeing. Methods: We studied 171 sedentary asymptomatic women (106 cancer survivor—65 controls) of similar age (53 ± 8.6; 51 ± 8.1 years). Autonomic regulation was evaluated by autoregressive spectral analysis of R wave to R wave (RR) interval and systolic arterial pressure variability. Aerobic fitness was directly assessed by cardiopulmonary exercise test. Body mass index (BMI) and waist circumference served as proxies of metabolism. Fatigue and stress-related symptoms were evaluated with validated questionnaire. Results: Patients showed significantly smaller total RR variance (1644 ± 2363 vs 2302 ± 1561 msec2), smaller absolute power of low frequency (LF) (386 ± 745 vs 810 ± 1300 msec2) and high frequency (HF) (485 ± 1202 vs 582 ± 555 msec2) of RR interval variability and smaller spontaneous baroreflex sensitivity (15.0 ± 8.9 vs 21.9 ± 10 msec/mmHg), suggesting vagal impairment. VO2 peak and O2 pulse were lower in cancer survivors than in controls. Fatigue and stress-related somatic symptoms scores were higher, as was BMI and waist circumference. Conclusion: Breast cancer survivors show multiple dysfunctions: vagal impairment, lower aerobic fitness, signs of altered metabolism, and higher perception of fatigue. Implications for Cancer Survivors: We propose that the concept of clinical phenotype, which may accommodate multiple functional disturbances, might be useful in long-term personalized prevention programs for breast cancer survivors.
AB - Purpose: Surgery and adjuvant therapy improved prognosis of breast cancer survivors. This improvement risks being offset by potential late-occurring cardiovascular toxicity of oncologic treatment and increased cardiometabolic risk profile associated with lifestyle changes. We address the hypothesis that in breast cancer survivors, multiple functional alterations might define a phenotype, characterized by vagal impairment, diminished aerobic fitness, increased metabolic risk, and reduced wellbeing. Methods: We studied 171 sedentary asymptomatic women (106 cancer survivor—65 controls) of similar age (53 ± 8.6; 51 ± 8.1 years). Autonomic regulation was evaluated by autoregressive spectral analysis of R wave to R wave (RR) interval and systolic arterial pressure variability. Aerobic fitness was directly assessed by cardiopulmonary exercise test. Body mass index (BMI) and waist circumference served as proxies of metabolism. Fatigue and stress-related symptoms were evaluated with validated questionnaire. Results: Patients showed significantly smaller total RR variance (1644 ± 2363 vs 2302 ± 1561 msec2), smaller absolute power of low frequency (LF) (386 ± 745 vs 810 ± 1300 msec2) and high frequency (HF) (485 ± 1202 vs 582 ± 555 msec2) of RR interval variability and smaller spontaneous baroreflex sensitivity (15.0 ± 8.9 vs 21.9 ± 10 msec/mmHg), suggesting vagal impairment. VO2 peak and O2 pulse were lower in cancer survivors than in controls. Fatigue and stress-related somatic symptoms scores were higher, as was BMI and waist circumference. Conclusion: Breast cancer survivors show multiple dysfunctions: vagal impairment, lower aerobic fitness, signs of altered metabolism, and higher perception of fatigue. Implications for Cancer Survivors: We propose that the concept of clinical phenotype, which may accommodate multiple functional disturbances, might be useful in long-term personalized prevention programs for breast cancer survivors.
KW - Autonomic nervous system
KW - Baroreflex sensitivity
KW - Cardiometabolic risk
KW - Cardiorespiratory fitness
KW - Lifestyle
KW - Secondary prevention
UR - http://www.scopus.com/inward/record.url?scp=84946492031&partnerID=8YFLogxK
UR - http://www.scopus.com/inward/citedby.url?scp=84946492031&partnerID=8YFLogxK
U2 - 10.1007/s11764-015-0445-z
DO - 10.1007/s11764-015-0445-z
M3 - Article
C2 - 25899303
AN - SCOPUS:84946492031
VL - 9
SP - 699
EP - 706
JO - Journal of Cancer Survivorship
JF - Journal of Cancer Survivorship
SN - 1932-2259
IS - 4
ER -