Department of Rehabilitation, Kanazawa University Hospital, Takaramachi 13-1, Kanazawa, Ishikawa, 920-8641, Japan.
School of Health Sciences, Kanazawa University, Kodatsuno 5-11-80, Kanazawa, Ishikawa, 920-0942, Japan.
Int J Clin Oncol. 2018 Dec;23(6):1173-1177. doi: 10.1007/s10147-018-1315-2. Epub 2018 Jul 5.
High-dose chemotherapy for remission induction can induce cardiac toxicity prior to hematopoietic stem cell transplantation (HSCT). However, the details of cardiac function in patients undergoing HSCT are unclear, particularly during exercise. The aim of present study was to evaluate cardiac output responses to exercise in patients after high-dose chemotherapy before HSCT compared with in age-matched healthy controls.
Twenty-nine patients before HSCT (age 44.6 ± 15.2 years) and 13 controls (45.8 ± 16.0 years) performed the 6-min walk test (6MWT). Cardiac output (CO), stroke volume (SV), heart rate (HR), and cardiac index (CI) were continuously measured during the 6MWT using the noninvasive thoracic impedance method.
No significant difference was observed in the six-minute walk distance (6MD) between the two groups. SV, CO, and CI both at rest and the end of the 6MWT in the patients were significantly lower, compared with the controls, but there was no significant difference in HR. In all subjects, the 6MD was positively correlated with SV, CO, CI, and HR after the 6MWT.
These findings suggest that cardiac output response to exercise indicates exercise intolerance, which may not be detected by 6MD in patients before HSCT.
高剂量化疗诱导缓解可在造血干细胞移植（HSCT）前引起心脏毒性。然而，接受 HSCT 的患者心脏功能的细节尚不清楚，尤其是在运动期间。本研究的目的是评估与年龄匹配的健康对照组相比，接受 HSCT 前高剂量化疗后患者的运动时心输出量反应。
29 例 HSCT 前患者（年龄 44.6±15.2 岁）和 13 例对照组（年龄 45.8±16.0 岁）进行了 6 分钟步行试验（6MWT）。使用非侵入性胸部阻抗法在 6MWT 期间连续测量心输出量（CO）、每搏量（SV）、心率（HR）和心指数（CI）。
两组的 6 分钟步行距离（6MD）无显著差异。与对照组相比，患者在静息和 6MWT 结束时的 SV、CO 和 CI 均明显降低，但 HR 无显著差异。在所有受试者中，6MD 与 6MWT 后 SV、CO、CI 和 HR 呈正相关。
这些发现表明，运动时心输出量反应表明运动耐量下降，而在接受 HSCT 前的患者中，6MD 可能无法检测到。
