Abstract 13296: Cardiovascular Determinants of Exercise Capacity in Patients With Cancer

Abstract

Introduction: Maintaining cancer patients′ exercise capacity and therefore patients′ self-determined life is of huge importance, but little is known about major determinants. We sought to identify determinants of exercise capacity in patients with a broad spectrum of cancer types, who were already receiving cancer treatment or about to commence such therapy. Methods: Exercise capacity was assessed in 253 consecutive patients mostly suffering from advanced cancer using the 6-minute walk test (6-MWT). All patients underwent echocardiography, physical examination, resting electrocardiogram (ECG), hand grip strength (HGS) measurement, and laboratory assessments. Results: Patients were divided into two groups according to the median distance in the 6-MWT (459 meters). Patients with lower exercise capacity were older, had significantly lower HGS and haemoglobin and higher values of high sensitive (hs) Troponin T and NT-proBNP (all p <0.05). Whilst the co-morbidity burden was significantly higher in this group, no differences were detected for sex, body mass index, tumour type, or cachexia (all p > 0.2). Using multivariable logistic regression, we found that the presence of anaemia (odds ratio (OR) 6.172, 95% confidence interval (CI) 1.401-27.201, p=0.016) as well as an increase in hs Troponin T (OR 3.077, 95% CI 1.202-5.301, p=0.019) remained independent predictors of impaired exercise capacity. Increasing HGS was associated with a reduced risk of a lower exercise capacity (OR 0.896, 95% CI 0.813 - 0.987, p=0.026). Conclusions: Screening patients for elevated hs troponin levels as well as reduced HGS may help to identify patients at risk of lower exercise capacity during cancer treatment.