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William J. Gradishar, MD, FACP, FASCO
William J. Gradishar, MD, FACP, FASCO
Posted: Friday, November 10, 2023
Breast cancer treatments can impact cardiovascular function and may increase the chances of heart failure by threefold. An article published in JACC: Advances highlighted findings from a study investigating whether a multidisciplinary model of cardiac rehabilitation would reduce cardiotoxicity and improve cardiovascular risk in patients undergoing breast cancer treatment. Amy A. Kirkham, PhD, of the University of Alberta, Edmonton, Canada, and colleagues examined biomarkers of cardiotoxicity in patients undergoing treatment and found no difference in the primary outcome, left ventricular ejection fraction, between groups at 52 weeks. In addition, other markers of cardiotoxicity were similar between the groups.
“Cardiac rehabilitation…modeled care is recommended for patients with breast cancer to mitigate [the] risk of cardiotoxicity. However, the cardiovascular impact of cardiac rehabilitation–modeled interventions has not been studied,” stated Dr. Kirkham and colleagues.
A total of 74 women with early-stage breast cancer were included in this study. Patients were randomly assigned to cardiac rehabilitation intervention (n = 37) or usual care (n = 37). Those in the intervention group underwent guideline-directed management of cardiovascular risk factors, dietary counseling, and supervised exercise for 52 weeks. In addition, cardiac MRI, cardiopulmonary exercise testing, dual-energy x-ray absorptiometry, and serum biomarkers were acquired at baseline and then again at 52 weeks.
Findings revealed adverse cardiac and metabolic changes in all patients over the 52 weeks. They included reductions in left ventricular ejection fraction, left ventricular mass, high-density lipoprotein, lean body mass, and insulin-like growth factor-1, as well as increased triglycerides and whole-body and truncal fat mass (all P < .050). However, total cholesterol and low-density lipoprotein levels decreased in the intervention group at 52 weeks and were unchanged in the usual-care group.
Disclosure: For full disclosures of the study authors, visit coi.jacc.org.
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