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アントラサイクリンによる機能障害と心臓機能障害の予防のための運動: BREXIT 研究
Stephen J Foulkes1,2,3, Erin J Howden4,3, Mark J Haykowsky2
1Sports Cardiology (S.J.F., K.J., A.M.M., L.W., B.T.C., A.L., L.B., I.W., A.L.G.), Baker Heart and Diabetes Institute, Melbourne, VIC, Australia.
Circulation
|November 7, 2022
まとめ
アントラサイクリンベースの化学療法を受けた乳がん患者における運動トレーニング (ExT) は機能障害を予防することはなく,心肺機能と心臓の準備を改善した. ExTの遵守は機能低下を防ぐための鍵でした.
科学分野:
- 腫瘍学
- 心臓病科
- 運動 生理学
背景:
- アントラサイクリンベースの化学療法 (AC) は,乳がんの生存者における機能的制限と心臓機能不全のリスクを高めます.
- 早期の乳がん患者には,これらのリスクを軽減するための介入が必要です.
研究 の 目的:
- 12ヶ月の運動訓練 (ExT) がAC治療を受けている乳がん患者の機能障害を軽減できるかどうかを判断する.
- 心臓呼吸能力 (VO2ピーク) と心臓機能障害の予防に対するExTの影響を評価する.
主な方法:
- 早期乳がん患者104人を対象とした12ヶ月のランダム化比較試験.
- 参加者はランダムにExT (エアロビックおよびレジスタンス) または通常治療 (UC) に割り当てられました.
- 機能的測定には,心肺運動検査,心筋MRI,心声検査,生化学検査 (トロポニン,BNP) が含まれていた.
主要な成果:
- ExTは4ヶ月で機能障害が減ったが,12ヶ月では減らなかった.
- プロトコル分析により,ExTは12ヶ月後に機能障害を予防した (UCでは0%対20%,P=0. 005).
- ExTはVO2ピークを3. 5mL·kg-1·min-1で改善し,心臓の出力量,脳卒中の量,そしてエジェクション分数の準備を向上させました. 化学療法後のトロポニンの増加はExTで少ない.
結論:
- 12ヶ月のExTは機能不全を緩和しなかったが,ACを受けた乳がん患者の心肺機能と心臓の準備を有意に改善した.
- 機能障害を予防するには ExTの遵守が不可欠です.
- ExTは,化学療法を受けている乳がん患者にとって,心血管に重大な利点をもたらします.
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