Palma Mariana Romanholi, Vanderlei Luiz Carlos Marques, Ribeiro Fernanda Elisa, Mantovani Alessandra Madia, Christofaro Diego Giulliano Destro, Fregonesi Cristina Elena Prado Teles
Faculty of Science and Technology FCT/UNESP, Presidente Prudente, SP, Brazil.
Department of Physical Therapy and Graduate Program in Physical Therapy, Faculty of Science and Technology FCT/UNESP, Presidente Prudente, SP, Brazil.
Int J Cardiol. 2016 Dec 1;224:360-365. doi: 10.1016/j.ijcard.2016.09.053. Epub 2016 Sep 17.
BACKGROUND/OBJECTIVES: Breast cancer survivors present autonomic dysfunction when evaluated by their heart rate variability (HRV). The purpose of this study is to investigate the relationship between post-operative time and cardiac autonomic modulation in breast cancer survivors and compare these values to those of women without cancer.
This is a cross-sectional study consisting of 45 women from 35 to 70years old. These women were divided into two after breast cancer groups (BCG1 and BCG2) and a control group (CG). Group BCG1 consisted of women who had undergone breast cancer surgery within the last 18months and BCG2 those whose postoperative periods were more than 18months. The control group was formed by cancer-free women. HRV indices were used in the time and the frequency domain and geometric indexes.
The indices in millisecond, RMSSD (BCG1=19.83; BCG2=14.99; CG=31.46), SD1 (BCG1=14.03; BCG2=10.61; CG=22.27), SD2 (BCG1=39.17; BCG2=35.28; CG=61.16), SDNN (BCG1=29.58; BCG2=26.12; CG=46.36) and HF in milliseconds squared (BCG1=194.2; BCG2=91.07; CG=449.4) showed statistically significant reductions in the breast cancer groups compared to the CG (p≤0.0001). Lower SD1 index values were observed when comparing BCG2 to BCG1.
Breast cancer survivors regardless of their postoperative period exhibited a decrease in overall variability and both sympathetic and parasympathetic activity when compared to women without the disease. The group with the longer postoperative period manifested more pronounced autonomic modulation changes.
背景/目的：通过心率变异性（HRV）评估时，乳腺癌幸存者存在自主神经功能障碍。本研究的目的是调查乳腺癌幸存者术后时间与心脏自主神经调节之间的关系，并将这些值与无癌症女性的值进行比较。
这是一项横断面研究，由45名年龄在35至70岁之间的女性组成。这些女性被分为两个乳腺癌组（BCG1和BCG2）和一个对照组（CG）。BCG1组由在过去18个月内接受乳腺癌手术的女性组成，BCG2组由术后时间超过18个月的女性组成。对照组由无癌症女性组成。在时域和频域中使用HRV指标以及几何指标。
以毫秒为单位的指标，RMSSD（BCG1 = 19.83；BCG2 = 14.99；CG = 31.46）、SD1（BCG1 = 14.03；BCG2 = 10.61；CG = 22.27）、SD2（BCG1 = 39.17；BCG2 = 35.28；CG = 61.16）、SDNN（BCG1 = 29.58；BCG2 = 26.12；CG = 46.36）以及以毫秒平方为单位的HF（BCG1 = 194.2；BCG2 = 91.07；CG = 449.4）显示，与CG组相比，乳腺癌组有统计学意义的降低（p≤0.0001）。比较BCG2和BCG1时，观察到较低的SD1指标值。
与无疾病女性相比，无论术后时间长短，乳腺癌幸存者的总体变异性以及交感神经和副交感神经活动均降低。术后时间较长的组表现出更明显的自主神经调节变化。
