Cardiovascular Function and Predictors of Exercise Capacity in Patients With Colorectal Cancer
Patients with colorectal cancer (CRC) often present with dyspnea and fatigue. These are also frequent symptoms in patients with chronic heart failure (CHF). We hypothesized that similar patterns of cardiovascular perturbations are present in CRC and CHF. We prospectively studied 50 patients with CRC...
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| Published in | Journal of the American College of Cardiology Vol. 64; no. 13; pp. 1310 - 1319 |
|---|---|
| Main Authors | , , , , , , , , , , , , |
| Format | Journal Article |
| Language | English |
| Published |
United States
Elsevier Inc
30.09.2014
Elsevier Limited |
| Subjects | |
| Online Access | Get full text |
| ISSN | 0735-1097 1558-3597 1558-3597 |
| DOI | 10.1016/j.jacc.2014.07.948 |
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| Abstract | Patients with colorectal cancer (CRC) often present with dyspnea and fatigue. These are also frequent symptoms in patients with chronic heart failure (CHF).
We hypothesized that similar patterns of cardiovascular perturbations are present in CRC and CHF.
We prospectively studied 50 patients with CRC, 51 patients with CHF, and 51 control subjects. The CRC group was divided into 2 subgroups: patients who underwent chemotherapy (n = 26) and chemotherapy-naive patients (n = 24). We assessed exercise capacity (spiroergometry), cardiac function (echocardiography), heart rate variability (Holter electrocardiography), body composition (dual-energy x-ray absorptiometry), and blood parameters.
Compared with the control arm, the left ventricular ejection fraction (CRC group 59.4%; control group 62.5%) and exercise performance as assessed by peak oxygen consumption (peak VO2) (CRC group 21.8 ml/kg/min; control group 28.0 ml/kg/min) were significantly reduced in CRC patients (both p < 0.02). Markers of heart rate variability were markedly impaired in CRC patients compared with control subjects (all p < 0.008). Compared with the control group, the CRC group also showed reduced lean mass in the legs and higher levels of the endothelium-derived C-terminal-pro-endothelin-1 (both p < 0.02). Major determinants of cardiovascular function were impaired in chemotherapy-treated patients and in the chemotherapy-naive patients, particularly with regard to exercise capacity, left ventricular ejection fraction, lean mass, and heart rate variability (all p < 0.05 vs. control subjects).
Some aspects of cardiovascular function are impaired in patients with CRC. More importantly, our findings were evident independently of whether patients were undergoing chemotherapy. |
|---|---|
| AbstractList | AbstractBackgroundPatients with colorectal cancer (CRC) often present with dyspnea and fatigue. These are also frequent symptoms in patients with chronic heart failure (CHF). ObjectivesWe hypothesized that similar patterns of cardiovascular perturbations are present in CRC and CHF. MethodsWe prospectively studied 50 patients with CRC, 51 patients with CHF, and 51 control subjects. The CRC group was divided into 2 subgroups: patients who underwent chemotherapy (n = 26) and chemotherapy-naive patients (n = 24). We assessed exercise capacity (spiroergometry), cardiac function (echocardiography), heart rate variability (Holter electrocardiography), body composition (dual-energy x-ray absorptiometry), and blood parameters. ResultsCompared with the control arm, the left ventricular ejection fraction (CRC group 59.4%; control group 62.5%) and exercise performance as assessed by peak oxygen consumption (peak VO 2) (CRC group 21.8 ml/kg/min; control group 28.0 ml/kg/min) were significantly reduced in CRC patients (both p < 0.02). Markers of heart rate variability were markedly impaired in CRC patients compared with control subjects (all p < 0.008). Compared with the control group, the CRC group also showed reduced lean mass in the legs and higher levels of the endothelium-derived C-terminal-pro-endothelin-1 (both p < 0.02). Major determinants of cardiovascular function were impaired in chemotherapy-treated patients and in the chemotherapy-naive patients, particularly with regard to exercise capacity, left ventricular ejection fraction, lean mass, and heart rate variability (all p < 0.05 vs. control subjects). ConclusionsSome aspects of cardiovascular function are impaired in patients with CRC. More importantly, our findings were evident independently of whether patients were undergoing chemotherapy. Patients with colorectal cancer (CRC) often present with dyspnea and fatigue. These are also frequent symptoms in patients with chronic heart failure (CHF). We hypothesized that similar patterns of cardiovascular perturbations are present in CRC and CHF. We prospectively studied 50 patients with CRC, 51 patients with CHF, and 51 control subjects. The CRC group was divided into 2 subgroups: patients who underwent chemotherapy (n = 26) and chemotherapy-naive patients (n = 24). We assessed exercise capacity (spiroergometry), cardiac function (echocardiography), heart rate variability (Holter electrocardiography), body composition (dual-energy x-ray absorptiometry), and blood parameters. Compared with the control arm, the left ventricular ejection fraction (CRC group 59.4%; control group 62.5%) and exercise performance as assessed by peak oxygen consumption (peak VO2) (CRC group 21.8 ml/kg/min; control group 28.0 ml/kg/min) were significantly reduced in CRC patients (both p < 0.02). Markers of heart rate variability were markedly impaired in CRC patients compared with control subjects (all p < 0.008). Compared with the control group, the CRC group also showed reduced lean mass in the legs and higher levels of the endothelium-derived C-terminal-pro-endothelin-1 (both p < 0.02). Major determinants of cardiovascular function were impaired in chemotherapy-treated patients and in the chemotherapy-naive patients, particularly with regard to exercise capacity, left ventricular ejection fraction, lean mass, and heart rate variability (all p < 0.05 vs. control subjects). Some aspects of cardiovascular function are impaired in patients with CRC. More importantly, our findings were evident independently of whether patients were undergoing chemotherapy. Patients with colorectal cancer (CRC) often present with dyspnea and fatigue. These are also frequent symptoms in patients with chronic heart failure (CHF).BACKGROUNDPatients with colorectal cancer (CRC) often present with dyspnea and fatigue. These are also frequent symptoms in patients with chronic heart failure (CHF).We hypothesized that similar patterns of cardiovascular perturbations are present in CRC and CHF.OBJECTIVESWe hypothesized that similar patterns of cardiovascular perturbations are present in CRC and CHF.We prospectively studied 50 patients with CRC, 51 patients with CHF, and 51 control subjects. The CRC group was divided into 2 subgroups: patients who underwent chemotherapy (n = 26) and chemotherapy-naive patients (n = 24). We assessed exercise capacity (spiroergometry), cardiac function (echocardiography), heart rate variability (Holter electrocardiography), body composition (dual-energy x-ray absorptiometry), and blood parameters.METHODSWe prospectively studied 50 patients with CRC, 51 patients with CHF, and 51 control subjects. The CRC group was divided into 2 subgroups: patients who underwent chemotherapy (n = 26) and chemotherapy-naive patients (n = 24). We assessed exercise capacity (spiroergometry), cardiac function (echocardiography), heart rate variability (Holter electrocardiography), body composition (dual-energy x-ray absorptiometry), and blood parameters.Compared with the control arm, the left ventricular ejection fraction (CRC group 59.4%; control group 62.5%) and exercise performance as assessed by peak oxygen consumption (peak VO2) (CRC group 21.8 ml/kg/min; control group 28.0 ml/kg/min) were significantly reduced in CRC patients (both p < 0.02). Markers of heart rate variability were markedly impaired in CRC patients compared with control subjects (all p < 0.008). Compared with the control group, the CRC group also showed reduced lean mass in the legs and higher levels of the endothelium-derived C-terminal-pro-endothelin-1 (both p < 0.02). Major determinants of cardiovascular function were impaired in chemotherapy-treated patients and in the chemotherapy-naive patients, particularly with regard to exercise capacity, left ventricular ejection fraction, lean mass, and heart rate variability (all p < 0.05 vs. control subjects).RESULTSCompared with the control arm, the left ventricular ejection fraction (CRC group 59.4%; control group 62.5%) and exercise performance as assessed by peak oxygen consumption (peak VO2) (CRC group 21.8 ml/kg/min; control group 28.0 ml/kg/min) were significantly reduced in CRC patients (both p < 0.02). Markers of heart rate variability were markedly impaired in CRC patients compared with control subjects (all p < 0.008). Compared with the control group, the CRC group also showed reduced lean mass in the legs and higher levels of the endothelium-derived C-terminal-pro-endothelin-1 (both p < 0.02). Major determinants of cardiovascular function were impaired in chemotherapy-treated patients and in the chemotherapy-naive patients, particularly with regard to exercise capacity, left ventricular ejection fraction, lean mass, and heart rate variability (all p < 0.05 vs. control subjects).Some aspects of cardiovascular function are impaired in patients with CRC. More importantly, our findings were evident independently of whether patients were undergoing chemotherapy.CONCLUSIONSSome aspects of cardiovascular function are impaired in patients with CRC. More importantly, our findings were evident independently of whether patients were undergoing chemotherapy. Background Patients with colorectal cancer (CRC) often present with dyspnea and fatigue. These are also frequent symptoms in patients with chronic heart failure (CHF). Objectives We hypothesized that similar patterns of cardiovascular perturbations are present in CRC and CHF. Methods We prospectively studied 50 patients with CRC, 51 patients with CHF, and 51 control subjects. The CRC group was divided into 2 subgroups: patients who underwent chemotherapy (n = 26) and chemotherapy-naive patients (n = 24). We assessed exercise capacity (spiroergometry), cardiac function (echocardiography), heart rate variability (Holter electrocardiography), body composition (dual-energy x-ray absorptiometry), and blood parameters. Results Compared with the control arm, the left ventricular ejection fraction (CRC group 59.4%; control group 62.5%) and exercise performance as assessed by peak oxygen consumption (peak VO2) (CRC group 21.8 ml/kg/min; control group 28.0 ml/kg/min) were significantly reduced in CRC patients (both p < 0.02). Markers of heart rate variability were markedly impaired in CRC patients compared with control subjects (all p < 0.008). Compared with the control group, the CRC group also showed reduced lean mass in the legs and higher levels of the endothelium-derived C-terminal-pro-endothelin-1 (both p < 0.02). Major determinants of cardiovascular function were impaired in chemotherapy-treated patients and in the chemotherapy-naive patients, particularly with regard to exercise capacity, left ventricular ejection fraction, lean mass, and heart rate variability (all p < 0.05 vs. control subjects). Conclusions Some aspects of cardiovascular function are impaired in patients with CRC. More importantly, our findings were evident independently of whether patients were undergoing chemotherapy. Patients with colorectal cancer (CRC) often present with dyspnea and fatigue. These are also frequent symptoms in patients with chronic heart failure (CHF). We hypothesized that similar patterns of cardiovascular perturbations are present in CRC and CHF. We prospectively studied 50 patients with CRC, 51 patients with CHF, and 51 control subjects. The CRC group was divided into 2 subgroups: patients who underwent chemotherapy (n = 26) and chemotherapy-naive patients (n = 24). We assessed exercise capacity (spiroergometry), cardiac function (echocardiography), heart rate variability (Holter electrocardiography), body composition (dual-energy x-ray absorptiometry), and blood parameters. Compared with the control arm, the left ventricular ejection fraction (CRC group 59.4%; control group 62.5%) and exercise performance as assessed by peak oxygen consumption (peak VO2) (CRC group 21.8 ml/kg/min; control group 28.0 ml/kg/min) were significantly reduced in CRC patients (both p < 0.02). Markers of heart rate variability were markedly impaired in CRC patients compared with control subjects (all p < 0.008). Compared with the control group, the CRC group also showed reduced lean mass in the legs and higher levels of the endothelium-derived C-terminal-pro-endothelin-1 (both p < 0.02). Major determinants of cardiovascular function were impaired in chemotherapy-treated patients and in the chemotherapy-naive patients, particularly with regard to exercise capacity, left ventricular ejection fraction, lean mass, and heart rate variability (all p < 0.05 vs. control subjects). Some aspects of cardiovascular function are impaired in patients with CRC. More importantly, our findings were evident independently of whether patients were undergoing chemotherapy. |
| Author | Springer, Jochen Hildebrandt, Bert Stojakovic, Tatjana Scharnagl, Hubert Valentova, Miroslava Anker, Stefan D. Riess, Hanno Cramer, Larissa Sandek, Anja Kung, Thomas von Haehling, Stephan Wichmann, Kristin Doehner, Wolfram |
| Author_xml | – sequence: 1 givenname: Larissa surname: Cramer fullname: Cramer, Larissa organization: Applied Cachexia Research, Department of Cardiology, Charité Medical School, Campus Virchow-Klinikum, Berlin, Germany – sequence: 2 givenname: Bert surname: Hildebrandt fullname: Hildebrandt, Bert organization: Department of Hematology and Oncology, Charité Medical School, Campus Virchow-Klinikum, Berlin, Germany – sequence: 3 givenname: Thomas surname: Kung fullname: Kung, Thomas organization: Applied Cachexia Research, Department of Cardiology, Charité Medical School, Campus Virchow-Klinikum, Berlin, Germany – sequence: 4 givenname: Kristin surname: Wichmann fullname: Wichmann, Kristin organization: Applied Cachexia Research, Department of Cardiology, Charité Medical School, Campus Virchow-Klinikum, Berlin, Germany – sequence: 5 givenname: Jochen surname: Springer fullname: Springer, Jochen organization: Department of Innovative Clinical Trials, University Medical Centre Göttingen, Göttingen, Germany – sequence: 6 givenname: Wolfram surname: Doehner fullname: Doehner, Wolfram organization: Applied Cachexia Research, Department of Cardiology, Charité Medical School, Campus Virchow-Klinikum, Berlin, Germany – sequence: 7 givenname: Anja surname: Sandek fullname: Sandek, Anja organization: Applied Cachexia Research, Department of Cardiology, Charité Medical School, Campus Virchow-Klinikum, Berlin, Germany – sequence: 8 givenname: Miroslava surname: Valentova fullname: Valentova, Miroslava organization: Department of Innovative Clinical Trials, University Medical Centre Göttingen, Göttingen, Germany – sequence: 9 givenname: Tatjana surname: Stojakovic fullname: Stojakovic, Tatjana organization: Clinical Institute of Medical and Chemical Laboratory Diagnostics, Medical University of Graz, Graz, Austria – sequence: 10 givenname: Hubert surname: Scharnagl fullname: Scharnagl, Hubert organization: Clinical Institute of Medical and Chemical Laboratory Diagnostics, Medical University of Graz, Graz, Austria – sequence: 11 givenname: Hanno surname: Riess fullname: Riess, Hanno organization: Department of Hematology and Oncology, Charité Medical School, Campus Virchow-Klinikum, Berlin, Germany – sequence: 12 givenname: Stefan D. surname: Anker fullname: Anker, Stefan D. organization: Applied Cachexia Research, Department of Cardiology, Charité Medical School, Campus Virchow-Klinikum, Berlin, Germany – sequence: 13 givenname: Stephan surname: von Haehling fullname: von Haehling, Stephan email: stephan.von.haehling@web.de organization: Applied Cachexia Research, Department of Cardiology, Charité Medical School, Campus Virchow-Klinikum, Berlin, Germany |
| BackLink | https://www.ncbi.nlm.nih.gov/pubmed/25257631$$D View this record in MEDLINE/PubMed |
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| Copyright | 2014 American College of Cardiology Foundation American College of Cardiology Foundation Copyright © 2014 American College of Cardiology Foundation. Published by Elsevier Inc. All rights reserved. Copyright Elsevier Limited Sep 30, 2014 |
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| Keywords | CHF LVM VE/VCO2 LVEF LVESV HRV VLF SDNN index MR-proANP VO2 cardiovascular function LVEDV hsTnT SDANN colorectal cancer MR-proADM CT-proET FVC CRC VCO2/VO2 SDNN exercise capacity hsCRP FEV1 LF HF 5-FU forced vital capacity high-sensitivity troponin T chronic heart failure high-sensitivity C-reactive protein VCO 2/VO 2 low frequency left ventricular ejection fraction SD of 5-min mean RR intervals left ventricular end-diastolic volume heart rate variability oxygen consumption respiratory exchange ratio forced expiratory volume in 1 second C-terminal pro-endothelin left ventricular end-systolic volume VO 2 FEV 1 VE/VCO 2 SD of all normal RR intervals mean of the SD of normal RR intervals every 5 min left ventricular mass ratio of minute ventilation and carbon dioxide output mid-regional pro-adrenomedulin mid-regional pro-atrial natriuretic peptide very low frequency high frequency 5-fluorouracil |
| Language | English |
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| Snippet | Patients with colorectal cancer (CRC) often present with dyspnea and fatigue. These are also frequent symptoms in patients with chronic heart failure (CHF).
We... AbstractBackgroundPatients with colorectal cancer (CRC) often present with dyspnea and fatigue. These are also frequent symptoms in patients with chronic heart... Patients with colorectal cancer (CRC) often present with dyspnea and fatigue. These are also frequent symptoms in patients with chronic heart failure (CHF). We... Background Patients with colorectal cancer (CRC) often present with dyspnea and fatigue. These are also frequent symptoms in patients with chronic heart... Patients with colorectal cancer (CRC) often present with dyspnea and fatigue. These are also frequent symptoms in patients with chronic heart failure... |
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| SubjectTerms | Absorptiometry, Photon Age Aged Antineoplastic Agents - therapeutic use Biomarkers Body Composition Cancer therapies Cardiology Cardiovascular cardiovascular function Cardiovascular System - physiopathology Chemotherapy Colorectal cancer Colorectal Neoplasms - physiopathology Confidence intervals Drug therapy Dyspnea - physiopathology Echocardiography Efficiency Ergometry Exercise exercise capacity Exercise Tolerance - physiology Fatigue - physiopathology Female Fitness equipment Heart Heart Failure - physiopathology Heart Rate Humans Male Middle Aged Mortality Oxygen Consumption Prospective Studies Quality of life Regression analysis Ventricular Function, Left |
| Title | Cardiovascular Function and Predictors of Exercise Capacity in Patients With Colorectal Cancer |
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