Abstract
Women with early‐stage breast cancer have reduced peak exercise oxygen uptake (peak VO2). The purpose of this study was to evaluate peak VO2 and right (RV) and left (LV) ventricular function prior to adjuvant chemotherapy. Twenty‐nine early‐stage breast cancer patients (mean age: 48 years) and 10 age‐matched healthy women were studied. Participants performed an upright cycle exercise test with expired gas analysis to measure peak VO2. RV and LV volumes and function were measured at rest, submaximal and peak supine cycle exercise using cardiac magnetic resonance imaging. Peak VO2 was significantly lower in breast cancer patients versus controls (1.7 ± 0.4 vs. 2.3 ± 0.5 L/min, P = 0.0013; 25 ± 6 vs. 35 ± 6 mL/kg/min, P = 0.00009). No significant difference was found between groups for peak upright exercise heart rate (174 ± 13 vs. 169 ± 16 bpm, P = 0.39). Rest, submaximal and peak exercise RV and LV end‐diastolic and end‐systolic volume index, stroke index, and cardiac index were significantly lower in breast cancer patients versus controls (P < 0.05 for all). No significant difference was found between groups for rest and exercise RV and LV ejection fraction. Despite preserved RV and LV ejection fraction, the decreased peak VO2 in early‐stage breast cancer patients prior to adjuvant chemotherapy is due in part to decreased peak cardiac index secondary to reductions in RV and LV end‐diastolic volumes.
Highlights
Breast cancer is the most frequently diagnosed malignancy among women and the second leading cause of cancer mortality in the United States (Siegel et al 2017)
Breast cancer patients have severely reduced exercise tolerance, measured objectively as decreased peak oxygen uptake, that is associated with decreased quality of life and survival
Peak exercise power output and VO2 were significantly lower in breast cancer patients compared to healthy controls (38 Æ 21% and 29 Æ 17% lower, respectively, Table 2)
Summary
Breast cancer is the most frequently diagnosed malignancy among women and the second leading cause of cancer mortality in the United States (Siegel et al 2017). Breast cancer patients have severely reduced exercise tolerance, measured objectively as decreased peak oxygen uptake (peak VO2), that is associated with decreased quality of life and survival Jones et al (2012) reported that peak VO2 was 27% lower in breast cancer survivors compared to age- and sex-matched sedentary predicted values. Physiological Reports published by Wiley Periodicals, Inc. on behalf of The Physiological Society and the American Physiological Society.
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