关键词: CMR, cardiovascular magnetic resonance CTRCD, cancer therapy–related cardiac dysfunction GEE, generalized estimating equation GLS, global longitudinal strain HER2, human epidermal growth factor receptor 2 LV, left ventricular MLHFQ, Minnesota Living With Heart Failure Questionnaire MVPA, moderate to vigorous physical activity PA, physical activity QoL, quality of life VAS, visual analogue scale Vo2peak, peak oxygen consumption anthracycline cardiorespiratory fitness echocardiography physical activity quality of life trastuzumab

来  源:   DOI:10.1016/j.jaccao.2022.06.006   PDF(Pubmed)

Abstract:
UNASSIGNED: Women treated for breast cancer are at risk for worsening health-related quality of life (QoL), cardiac function, and cardiorespiratory fitness.
UNASSIGNED: The aim of this study was to assess the associations of self-reported moderate to vigorous intensity physical activity (MVPA) during cancer treatment with concurrent measures of QoL and cardiac function and with post-treatment cardiorespiratory fitness in women with human epidermal growth factor receptor 2-positive breast cancer receiving sequential anthracyclines and trastuzumab.
UNASSIGNED: EMBRACE-MRI 1 (Evaluation of Myocardial Changes During Breast Adenocarcinoma Therapy to Detect Cardiotoxicity Earlier With MRI) study participants who completed questionnaires for MVPA (modified Godin Leisure Time Physical Activity Questionnaire) and QoL (EQ-5D-3L, Minnesota Living With Heart Failure Questionnaire) and cardiac imaging every 3 months during treatment and post-treatment cardiopulmonary exercise testing were included. Participants engaging in ≥90 minutes of MVPA each week were labeled \"active.\" Generalized estimation equations and linear regression analyses were used to assess concurrent and post-treatment associations with MVPA and activity status, respectively.
UNASSIGNED: Eighty-eight participants were included (mean age 51.4 ± 8.9 years). Mean MVPA minutes, QoL, and cardiac function (left ventricular ejection fraction, global longitudinal strain, E/A ratio, and E/e\' ratio) worsened by 6 months into trastuzumab therapy. Higher MVPA (per 30 minutes) during treatment was associated with better concurrent overall (β = -0.42) and physical (β = -0.24) Minnesota Living With Heart Failure Questionnaire scores, EQ-5D-3L index (β = 0.003), visual analogue scale score (β = 0.43), diastolic function (E/A ratio; β = 0.01), and global longitudinal strain (β = 0.04) at each time point (P ≤ 0.01 for all). Greater cumulative MVPA over the treatment period was associated with higher post-treatment cardiorespiratory fitness (peak oxygen consumption; β = 0.06 per 30 minutes; P < 0.001).
UNASSIGNED: Higher self-reported MVPA during treatment for human epidermal growth factor receptor 2-positive breast cancer was associated with better QoL and diastolic and systolic left ventricular function measures during treatment and better post-treatment cardiorespiratory fitness.
摘要:
未经证实:接受乳腺癌治疗的女性面临着健康相关生活质量(QoL)恶化的风险,心功能,和心肺健康。
UNASSIGNED:这项研究的目的是评估癌症治疗过程中自我报告的中等至剧烈强度体力活动(MVPA)与同时测量QoL和心脏功能以及治疗后的相关性。接受蒽环类药物和曲妥珠单抗的人表皮生长因子受体2阳性乳腺癌女性的心肺适应性。
UNASSIGNED:EMBRACE-MRI1(评估乳腺腺癌治疗期间的心肌变化以通过MRI早期检测心脏毒性)研究参与者完成了MVPA(改良的Godin休闲时间体育锻炼问卷)和QoL问卷(EQ-5D-3L,包括明尼苏达州心力衰竭生活问卷)和治疗期间每3个月的心脏成像以及治疗后的心肺运动测试。每周参加≥90分钟MVPA的参与者被标记为“活跃”。“使用广义估计方程和线性回归分析来评估与MVPA和活动状态的并发和治疗后关联,分别。
未经评估:88名参与者被纳入(平均年龄51.4±8.9岁)。平均MVPA分钟数,QoL,和心功能(左心室射血分数,全局纵向应变,E/A比,和E/e比值)在曲妥珠单抗治疗6个月后恶化。治疗期间更高的MVPA(每30分钟)与更好的并发总体(β=-0.42)和身体(β=-0.24)明尼苏达州心力衰竭生活问卷评分相关。EQ-5D-3L指数(β=0.003),视觉模拟评分(β=0.43),舒张功能(E/A比;β=0.01),和全局纵向应变(β=0.04)在每个时间点(所有P≤0.01)。治疗期间累积的MVPA增加与治疗后心肺适应性增加相关(峰值耗氧量;β=0.06/30分钟;P<0.001)。
UNASSIGNED:人表皮生长因子受体2阳性乳腺癌治疗期间自我报告的MVPA水平较高,与治疗期间的QoL、舒张和收缩左心室功能指标较好以及治疗后的心肺适应性较好相关。
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