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实时运动可减少化疗乳腺癌患者受损的心脏功能：一项随机对照试验。

Real-time exercise reduces impaired cardiac function in breast cancer patients undergoing chemotherapy: A randomized controlled trial.

机构信息

Department of Oncology, National Cheng Kung University Hospital, College of Medicine, National Cheng Kung University, Tainan, Taiwan.

Department of Physical Therapy, College of Medicine, National Cheng Kung University, Tainan, Taiwan; Institute of Allied Health Sciences, College of Medicine, National Cheng Kung University, Tainan, Taiwan.

出版信息

Ann Phys Rehabil Med. 2022 Mar;65(2):101485. doi: 10.1016/j.rehab.2021.101485. Epub 2021 Nov 18.

DOI:10.1016/j.rehab.2021.101485

PMID:33453417

Abstract

BACKGROUND

Previous studies have reported that chemotherapy results in substantial long-term risk of heart failure. Exercise ameliorates exercise responses and exercise tolerance in patients receiving chemotherapy. The cardioprotective effect of real-time exercise in breast cancer is still unclear.

OBJECTIVES

The aim of the present study was to determine the effect of real-time moderate-to-high-intensity exercise training in women with breast cancer undergoing chemotherapy and to follow up on parameters of cardiac function and exercise capacity at different times. We hypothesized that early moderate-to-high-intensity exercise training has beneficial effects on cardiac function in women with breast cancer undergoing chemotherapy.

METHODS

This was a randomized controlled study that included 32 women randomly allocated into the control or exercise group. Exercise began with the first cycle of chemotherapy, and the training program was maintained during chemotherapy with 2 to 3 sessions per week for 3 months. Patients were instructed to perform moderate-to-high-intensity training with aerobic and resistance training. Outcome measurements were echocardiography and cardiopulmonary exercise test. The primary outcome was the change in left ventricle ejection fraction (LVEF). The secondary outcome was peak oxygen consumption (peak VO).

RESULTS

The control group showed lower cardiac systolic function than the exercise group [mean (SD) LVEF 62% (2) and 70% (5), P<0.05], reduced cardiac diastolic function, and cardiac hypertrophy at 3, 6 and 12 months after chemotherapy. At 6 months after chemotherapy, the exercise group exhibited relatively higher exercise capacity than controls [mean (SD) VO 12.1 (2.2) and 13.6 (2.2) mL/kg/min, P<0.05]. The main effect size of the study based on echocardiography outcomes was 0.25 (95% confidence interval 0.23 to 0.27), a medium effect size.

CONCLUSIONS

Moderate-to-high-intensity exercise training in breast cancer patients undergoing chemotherapy may prevent impaired cardiac function.

CLINICAL TRIAL REGISTRATION

https://www.

CLINICALTRIALS

in.th (Identifier TCTR20190330002).

摘要

背景

先前的研究报告表明，化疗会导致心力衰竭的长期风险显著增加。运动可以改善接受化疗的患者的运动反应和运动耐力。实时运动对乳腺癌的心脏保护作用尚不清楚。

目的

本研究旨在确定在接受化疗的乳腺癌女性中进行实时中高强度运动训练的效果，并在不同时间随访心脏功能和运动能力的参数。我们假设早期进行中高强度运动训练对接受化疗的乳腺癌女性的心脏功能有益。

方法

这是一项随机对照研究，纳入 32 名女性随机分配至对照组或运动组。运动从化疗的第一个周期开始，并在化疗期间每周进行 2-3 次，持续 3 个月，保持训练计划。患者被指示进行有氧运动和抗阻训练的中高强度训练。结果测量为超声心动图和心肺运动试验。主要结局是左心室射血分数（LVEF）的变化。次要结局是峰值摄氧量（peak VO）。

结果

对照组在化疗后 3、6 和 12 个月表现出较低的心脏收缩功能（LVEF 分别为 62%（2）和 70%（5），P<0.05）、降低的心脏舒张功能和心脏肥大。在化疗后 6 个月，运动组的运动能力相对高于对照组（peak VO 分别为 12.1（2.2）和 13.6（2.2）mL/kg/min，P<0.05）。基于超声心动图结果的研究主要效应量为 0.25（95%置信区间 0.23 至 0.27），为中等效应量。