Determinants of Cardiorespiratory Fitness Following Thoracic Radiotherapy in Lung or Breast Cancer Survivors

Research output: Contribution to journalArticle

Authors

  • Justin M. Canada
  • Cory R. Trankle
  • Salvatore Carbone
  • Leo F. Buckley
  • Medina de Chazal
  • Hayley Billingsley
  • Ronald K. Evans
  • Ryan Garten
  • Benjamin W. Van Tassell
  • Dinesh Kadariya
  • Adolfo Mauro
  • Stefano Toldo
  • Eleonora Mezzaroma
  • Ross Arena
  • William G. Hundley
  • John D. Grizzard
  • Elisabeth Weiss
  • Antonio Abbate

External Institution(s)

  • Virginia Commonwealth University
  • University of Illinois at Chicago

Details

Original languageEnglish (US)
Pages (from-to)988-996
Number of pages9
JournalAmerican Journal of Cardiology
Volume125
Issue number6
StatusPublished - Mar 15 2020
Peer-reviewedYes

Abstract

We measured peak oxygen consumption (VO2) in previous recipients of thoracic radiotherapy and assessed the determinants of cardiorespiratory fitness with an emphasis on cardiac and pulmonary function. Cancer survivors who have received thoracic radiotherapy with incidental cardiac involvement often experience impaired cardiorespiratory fitness, as measured by reduced peak VO2, a marker of impaired cardiovascular reserve. We enrolled 25 subjects 1.8 (0.1 to 8.2) years following completion of thoracic radiotherapy with significant heart exposure (at least 10% of heart volume receiving at least 5 Gray). All subjects underwent cardiopulmonary exercise testing, Doppler echocardiography, and circulating biomarkers assessment. The cohort included 16 Caucasians (64%), 15 women (60%) with a median age of 63 (59 to 66) years. The peak VO2 was 16.8 (13.5 to 21.9) ml·kg−1·min−1 or moderately reduced at 62% (50% to 93%) of predicted. The mean cardiac radiation dose was 5.4 (3.7 to 14.7) Gray, and it significantly correlated inversely with peak VO2 (R = −0.445, p = 0.02). Multivariate regression analysis revealed the diastolic functional reserve index and the N-terminal pro-brain natriuretic peptide (NTproBNP) serum levels were independent predictors of peak VO2 (ß = +0.813, p <0.01 and ß = −0.414, p = 0.04, respectively). In conclusion, patients who had received thoracic radiation display a dose-dependent relation between the cardiac radiation dose received and the impairment in peak VO2, the reduction in diastolic functional reserve index, and elevation of NTproBNP.

Citation formats

APA

Canada, J. M., Trankle, C. R., Carbone, S., Buckley, L. F., Chazal, M. D., Billingsley, H., ... Abbate, A. (2020). Determinants of Cardiorespiratory Fitness Following Thoracic Radiotherapy in Lung or Breast Cancer Survivors. American Journal of Cardiology, 125(6), 988-996. https://doi.org/10.1016/j.amjcard.2019.12.019

Harvard

Canada, JM, Trankle, CR, Carbone, S, Buckley, LF, Chazal, MD, Billingsley, H, Evans, RK, Garten, R, Van Tassell, BW, Kadariya, D, Mauro, A, Toldo, S, Mezzaroma, E, Arena, R, Hundley, WG, Grizzard, JD, Weiss, E & Abbate, A 2020, 'Determinants of Cardiorespiratory Fitness Following Thoracic Radiotherapy in Lung or Breast Cancer Survivors', American Journal of Cardiology, vol. 125, no. 6, pp. 988-996. https://doi.org/10.1016/j.amjcard.2019.12.019