Patient reported physical and mental health changes associated with a comprehensive cardiovascular risk reduction program for women with breast cancer receiving potentially cardiotoxic chemotherapy

Cardio-Oncology

Michael G. Fradley¹  R. Ashton Vautier²  Merna Armanious²  Mohammed Alomar²  Bernadette Shields²  Nhi Tran²  Roohi Ismail-Khan²  Theresa M. Beckie³  Kevin Kip⁴  Marcus W. Kilpatrick⁵  Amey Best⁵  Erika Bianco⁵ 

[1] Cardio-Oncology Center of Excellence, Division of Cardiology, Department of Medicine, University of Pennsylvania, 3400 Civic Center Blvd, 19104, Philadelphia, PA, USA;Cardio-Oncology Program, Moffitt Cancer Center, University of South Florida College of Medicine, Tampa, USA;College of Nursing, University of South Florida, Tampa, USA;Department of Clinical Analytics, Health Sciences Division, University of Pittsburgh, Pittsburgh, USA;Exercise Science Program, College of Arts and Sciences, University of South Florida, Tampa, USA;

关键词: Cardio-oncology;    Cardiotoxicity;    Breast cancer;    Cardiovascular;    Behavioral health;   

DOI  :  10.1186/s40959-021-00107-w

来源: Springer

【 摘 要 】

ObjectiveWomen with breast cancer (BCA) and cardiovascular disease (CVD) risk factors are at increased risk of developing cardiovascular complications when exposed to potentially cardiotoxic cancer therapy. The benefit of aggressive CVD risk factor modification to reduce adverse treatment-related psychologic and biologic effects is not well established.MethodsUsing a single group pre-test, post-test design, 33 women with BCA receiving anthracycline and/or trastuzumab therapy participated in a 6-month comprehensive CVD risk reduction program involving formal cardio-oncology evaluation along with regular motivational counseling for improved nutrition and physical activity. Study parameters were assessed at baseline and 6 months with paired t-tests used to evaluate changes after the intervention.ResultsThe mental component summary score assessed by SF-36V2 improved significantly after program completion (45.0 to 48.8, effect size 0.37, p = 0.017), however the physical component summary score declined (46.2 to 40.9, effect size − 0.53, p = 0.004). Despite this decline in perceived physical health, markers of health-related fitness and nutritional status were maintained or improved. Systolic and diastolic blood pressure also improved after the intervention (136.7 to 124.1 mmHg, p = 0.001 and 84.0 to 78.7 mmHg, p = 0.031, respectively). No significant change in resting heart rate, body mass index, lipids, hemoglobin A1C, or left ventricular ejection fraction was observed.ConclusionsPatient-reported mental health improved significantly in women with BCA enrolled in a comprehensive CVD risk reduction program despite exposure to potentially cardiotoxic therapies. This study provides preliminary data for future randomized controlled trials evaluating the effects CVD risk reduction program in high-risk breast cancer cohorts.

【 授权许可】

CC BY