Cardiovascular Research Unit and Exercise Physiology, Federal University of Juiz de Fora, Juiz de Fora, Brazil.
Laboratory of Exercise Sciences, Department of Physiology and Pharmacology, Fluminense Federal University, Niteroi, Brazil.
Support Care Cancer. 2021 Jul;29(7):3831-3838. doi: 10.1007/s00520-020-05911-1. Epub 2020 Nov 27.
Chemotherapy treatment can lead to cardiovascular toxicity and physical impairment prior to autologous hematopoietic stem cell transplantation (auto-HSCT). Cardiovascular adjustments during exercise and the exercise capacity remain unknown in patients prior to auto-HSCT. Thus, the hemodynamic responses during exercise and exercise capacity were evaluated using a novel effort test in patients prior to auto-HSCT.
Thirty patients prior to auto-HSCT (BMT group: 44.6 ± 14.1 years) and 23 control participants (CON group: 43.9 ± 16.6 years) performed the 6-Minute Step Test (6MST) to assess their exercise capacity and the hemodynamic responses during exercise. Systolic and diastolic blood pressure (SBP and DBP), heart rate (HR), and oxygen saturation (SpO) were measured during the test. Rate-pressure product (RPP) was calculated multiplying SBP by HR. The highest HR value recorded during the test was compared with the maximum HR predicted by age and was used as % of maximum HR (%HRmax).
The number of steps up and down performed by the BMT group was lower than CON (108.8 ± 25.3 vs. 127.5 ± 34.4 steps, P = 0.02). The BMT group showed a higher magnitude of increase in SBP and RPP during the 6MST when compared to CON (ΔSBP: 18.5 ± 11.45 vs. 8.30 ± 18.46 mmHg, P = 0.01; and ΔRPP: 8197.3 ± 3829.1 vs. 6170.9 ± 3568.9 mmHg beats min, P = 0.05). The BMT group exhibited higher SpO2 and HR values throughout the protocol (P < 0.05), reaching a higher %HRmax than CON group (76.9 ± 9.6 vs. 66.4 ± 8.9%, P < 0.01).
Patients with indication for auto-HSCT have exacerbated chronotropic and pressor responses during exercise and reduced exercise capacity in the 6MST.
在自体造血干细胞移植（auto-HSCT）前，化疗治疗可导致心血管毒性和身体损伤。在 auto-HSCT 前，患者运动时的心血管调节和运动能力尚不清楚。因此，本研究使用新型努力测试评估了 auto-HSCT 前患者的运动时血流动力学反应和运动能力。
30 例 auto-HSCT 患者（BMT 组：44.6±14.1 岁）和 23 名对照参与者（CON 组：43.9±16.6 岁）进行 6 分钟踏步测试（6MST）以评估运动能力和运动时的血流动力学反应。在测试过程中测量收缩压和舒张压（SBP 和 DBP）、心率（HR）和血氧饱和度（SpO）。乘积 SBP 乘以 HR 计算心率压力产物（RPP）。将测试中记录的最高 HR 值与年龄预测的最大 HR 进行比较，并用作最大 HR 的百分比（%HRmax）。
BMT 组上下台阶的次数少于 CON 组（108.8±25.3 步与 127.5±34.4 步，P=0.02）。与 CON 组相比，BMT 组在 6MST 期间 SBP 和 RPP 的增加幅度更大（ΔSBP：18.5±11.45 与 8.30±18.46 mmHg，P=0.01；和 ΔRPP：8197.3±3829.1 与 6170.9±3568.9 mmHg·beats·min，P=0.05）。BMT 组在整个方案中显示出更高的 SpO2 和 HR 值（P<0.05），达到比 CON 组更高的%HRmax（76.9±9.6 与 66.4±8.9%，P<0.01）。
有自体造血干细胞移植适应证的患者在运动时表现出更明显的变时性和加压反应，以及 6MST 中运动能力降低。
