Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
Randomized Controlled Trial
. 2023 Mar 1;43(2):129-134.
doi: 10.1097/HCR.0000000000000719. Epub 2022 Aug 4.

Cardiac Rehabilitation Improves Fitness in Patients With Subclinical Markers of Cardiotoxicity While Receiving Chemotherapy: A RANDOMIZED CONTROLLED STUDY

Dennis J Kerrigan  1 , Madhulata Reddy, Eleanor M Walker, Bernard Cook, James McCord, Randa Loutfi, Matthew A Saval, Jodi Baxter, Clinton A Brawner, Steven J Keteyian
Affiliations
Randomized Controlled Trial

Cardiac Rehabilitation Improves Fitness in Patients With Subclinical Markers of Cardiotoxicity While Receiving Chemotherapy: A RANDOMIZED CONTROLLED STUDY

Dennis J Kerrigan et al. J Cardiopulm Rehabil Prev. .

Abstract

Purpose: Heart failure (HF) due to cardiotoxicity is a leading non-cancer-related cause of morbidity and mortality in cancer survivors. Cardiac rehabilitation (CR) improves cardiorespiratory fitness (CRF) and reduces morbidity and mortality in patients with HF, but little is known about its effects on cardiotoxicity in the cancer population. The objective of this study was to determine whether participation in CR improves CRF in patients undergoing treatment with either doxorubicin or trastuzumab who exhibit markers of subclinical cardiotoxicity.

Methods: Female patients with cancer (n = 28: breast, n = 1: leiomyosarcoma) and evidence of subclinical cardiotoxicity (ie, >10% relative decrease in global longitudinal strain or a cardiac troponin of >40 ng·L -1 ) were randomized to 10 wk of CR or usual care. Exercise consisted of 3 d/wk of interval training at 60-90% of heart rate reserve.

Results: Cardiorespiratory fitness, as measured by peak oxygen uptake (V˙ o2peak ), improved in the CR group (16.9 + 5.0 to 18.5 + 6.0 mL∙kg -1 ∙min -1 ) while it decreased in the usual care group (17.9 + 3.9 to 16.9 + 4.0 mL∙kg -1 ∙min -1 ) ( P = .009). No changes were observed between groups with respect to high-sensitivity troponin or global longitudinal strain.

Conclusion: This study suggests that the use of CR may be a viable option to attenuate the reduction in CRF that occurs in patients undergoing cardiotoxic chemotherapy. The long-term effects of exercise on chemotherapy-induced HF warrant further investigation.

Trial registration: ClinicalTrials.gov NCT02796365.

PubMed Disclaimer

Conflict of interest statement

Dr James McCord has received consultant payments from Beckman, Roche, and Siemens, and has research grants as well with those three companies along with Abbott. None of the other authors have conflicts of interest to disclose. All authors have read and approved the article.

References

    1. Miller KD, Siegel RL, Lin CC, et al. Cancer treatment and survivorship statistics, 2016. CA Cancer J Clin. 2016;66(4):271–289.
    1. Thavendiranathan P, Poulin F, Lim KD, Plana JC, Woo A, Marwick TH. Use of myocardial strain imaging by echocardiography for the early detection of cardiotoxicity in patients during and after cancer chemotherapy: a systematic review. J Am Coll Cardiol. 2014;63(25, pt A):2751–2768.
    1. Curigliano G, Cardinale D, Dent S, et al. Cardiotoxicity of anticancer treatments: epidemiology, detection, and management. CA Cancer J Clin. 2016;66(4):309–325.
    1. Yu AF, Moskowitz CS, Lee Chuy K, et al. Cardiotoxicity surveillance and risk of heart failure during HER2 targeted therapy. JACC CardioOncol. 2020;2(2):166–175.
    1. Zamorano JL, Lancellotti P, Rodriguez Muñoz D, et al. 2016 ESC Position Paper on cancer treatments and cardiovascular toxicity developed under the auspices of the ESC Committee for Practice Guidelines: The Task Force for cancer treatments and cardiovascular toxicity of the European Society of Cardiology (ESC). Eur Heart J. 2016;37(36):2768–2801.

Publication types

Associated data