Evaluation of Exercise Tolerance in Cancer Patients With Cardiovascular Complications: A Japanese Single-Center...

Area of Science:

• Cardiology
• Oncology
• Pulmonology
• Exercise Physiology

Background:

• Cardio-oncology rehabilitation (CORE) is gaining importance, yet data on cardiopulmonary exercise testing (CPX) in Japanese cancer patients are limited.
• Understanding exercise capacity in this population is crucial for developing effective rehabilitation strategies.

Purpose of the Study:

• To evaluate cardiopulmonary exercise testing (CPX) parameters in Japanese cancer patients with concurrent cardiovascular conditions.
• To assess exercise tolerance and identify factors influencing it in this patient group.
• To inform the development of individualized cardio-oncology rehabilitation (CORE) protocols.

Main Methods:

• A retrospective review of 440 CPX examinations from 2018-2023 at Toranomon Hospital.
• Identified 37 tests from 28 cancer patients with cardiovascular problems, analyzing parameters like peak oxygen uptake (V̇O2), anaerobic threshold (AT), and ventilatory efficiency (V̇E/V̇CO2 slope).
• Patients were categorized based on the presence of cancer therapy-related cardiac dysfunction (CTRCD).

Main Results:

• Median peak V̇O2 was 14.7 mL/kg/min (63% predicted), with 43% below the prognostic threshold of 14 mL/kg/min.
• Reduced cardiorespiratory function was indicated by median AT of 10.9 mL/kg/min and V̇E/V̇CO2 slope of 30.7.
• No significant differences in CPX parameters were found between patients with and without CTRCD; exercise capacity changes did not consistently correlate with left ventricular ejection fraction in serial tests.

Conclusions:

• CPX in cancer patients with cardiovascular issues demonstrates exercise limitations extending beyond cardiac function.
• Findings highlight the necessity for personalized rehabilitation approaches within CORE programs.
• Further research is needed to optimize CORE strategies based on detailed exercise testing data.