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Body fat as a predictor of impaired cardiorespiratory fitness in breast cancer patients treated with anthracyclines
Session:
SESSÃO DE COMUNICAÇÕES ORAIS 10 – DOENÇA CARDIOVASCULAR EM DOENTES ONCOLÓGICOS E ANTICOAGULAÇÃO
Speaker:
Luísa Pinheiro
Congress:
CPC 2025
Topic:
K. Cardiovascular Disease In Special Populations
Theme:
30. Cardiovascular Disease in Special Populations
Subtheme:
30.6 Cardio-Oncology
Session Type:
Comunicações Orais
FP Number:
---
Authors:
Luísa Pinheiro; Margarida de Castro; Mariana Tinoco; Emídio Mata; Bárbara Lage Garcia; Tamara Pereira; Mário Lourenço; Filipa Castro; Alexandre Teixeira; Gonçalo Torres; Olga Azevedo; António Lourenço
Abstract
<p style="text-align:justify"><span style="font-size:14px"><span style="font-family:Aptos,sans-serif"><strong>Introduction: </strong>Cardiorespiratory fitness (CRF), <span style="color:black">indicated by peak oxygen consumption (Vo2peak), is a strong predictor of quality of life, heart failure (HF) and mortality in cancer patients. Anthracycline chemotherapy (AC) is known to reduce CRF, independently from left ventricular ejection fraction (LVEF) and global longitudinal strain (GLS). </span>Non-cardiac mechanisms underlying this decline in CRF remain however unclear. Body composition, which can be affected by cancer/cancer treatment-induced metabolic changes, may influence physical activity and clinical outcomes. Therefore, assessing body composition may provide valuable insights into the factors contributing to impaired CRF in breast cancer (BC) patients treated with AC.</span></span></p> <p style="text-align:justify"><span style="font-size:14px"><span style="font-family:Aptos,sans-serif"><strong>Purpose: </strong>To evaluate the impact of AC in body composition of BC patients and to assess whether body composition these changes after AC are associated with impaired CRF.</span></span></p> <p style="text-align:justify"><span style="font-size:14px"><span style="font-family:Aptos,sans-serif"><strong>Methods</strong>: A prospective study was conducted in women diagnosed with BC undergoing AC. Participants were assessed at two time points: before AC and twelve months post-AC. During each visit, cardiopulmonary exercise testing (CPET) was performed to measure CRF, and body composition was analysed using Bioelectric impedance analysis (BIA). Functional disability (FD) was defined as a Vo2peak ≤ 18.0 mL/kg/min.</span></span></p> <p style="text-align:justify"><span style="font-size:14px"><span style="font-family:Aptos,sans-serif"><strong>Results: </strong>A total of 32 women were included in the study. FD increased significantly over time, from 9% prior to AC to 44% one month after AC and 53% six months post-AC. Before AC, patients with FD, had a significantly higher body mass index (BMI) (35.3 ± 1.0 vs. 26.2 ± 3.2 kg/m², p<0.001), as well as higher body fat (39.5 ± 5.6 vs. 23.4 ± 6.3 kg, p<0.001) and visceral fat levels (18.3 ± 2.1 vs. 10.4 ± 3.7, p=0.001). Twelve months after AC, patients with FD also exhibited higher body fat and visceral fat levels (27.9 ± 9.1 vs. 21.9 ± 5.5 kg, p=0.034; 14.2 ± 6.2 vs. 9.4 ± 3.6, p=0.013). A significant association was found between body fat and Vo2peak, with body fat being independently associated to lower Vo2peak (each unit increase in body fat was associated with a decrease of -0.146 in Vo2peak, p=0.004).</span></span></p> <p style="text-align:justify"><span style="font-size:14px"><span style="font-family:Aptos,sans-serif"><strong>Conclusion:</strong> This study underscores the multifactorial nature of impaired CRF in BC patients undergoing AC. Body fat is independently and inversely associated with Vo2peak, highlighting the importance of non-cardiac factors, such as body composition, when evaluating CRF in this population. Further research is needed to better understand the impact of body composition on the overall health and physical performance of BC patients treated with AC.</span></span></p>
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