Applied Cachexia Research, Department of Cardiology, Charité Medical School, Campus Virchow-Klinikum, Berlin, Germany.
Department of Hematology and Oncology, Charité Medical School, Campus Virchow-Klinikum, Berlin, Germany.
J Am Coll Cardiol. 2014 Sep 30;64(13):1310-9. doi: 10.1016/j.jacc.2014.07.948.
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.
结直肠癌（CRC）患者常出现呼吸困难和疲劳。这些也是慢性心力衰竭（CHF）患者的常见症状。
我们假设 CRC 和 CHF 中存在相似的心血管紊乱模式。
我们前瞻性研究了 50 例 CRC 患者、51 例 CHF 患者和 51 例对照组。CRC 组分为接受化疗的患者（n=26）和未接受化疗的患者（n=24）两个亚组。我们评估了运动能力（肺量计检查）、心功能（超声心动图）、心率变异性（动态心电图）、身体成分（双能 X 线吸收法）和血液参数。
与对照组相比，CRC 患者的左心室射血分数（CRC 组 59.4%；对照组 62.5%）和峰值摄氧量（peak VO2）评估的运动表现（CRC 组 21.8ml/kg/min；对照组 28.0ml/kg/min）明显降低（均 p<0.02）。与对照组相比，CRC 患者的心率变异性标志物明显受损（均 p<0.008）。与对照组相比，CRC 组下肢瘦体重减少，内皮衍生 C 端末端内皮素-1 水平升高（均 p<0.02）。化疗患者和未化疗患者的心血管功能主要决定因素受损，尤其是运动能力、左心室射血分数、瘦体重和心率变异性（均 p<0.05 与对照组相比）。
CRC 患者的某些心血管功能受损。更重要的是，我们的发现独立于患者是否接受化疗。
