Heart Institute (InCor) do Hospital das Clínicas Faculdade de Medicina Universidade de São Paulo Brasil.
Cancer Institute of the State of São Paulo Hospital das Clínicas Faculdade de Medicina Universidade de São Paulo Brasil.
J Am Heart Assoc. 2021 Feb;10(5):e018076. doi: 10.1161/JAHA.120.018076. Epub 2021 Feb 23.
Background Patients treated for breast cancer have a high incidence of cardiovascular complications. In this study, we evaluated the impact of breast cancer on cardiac function and cardiomyocyte Ca-handling protein expression. We also investigated whether exercise training (ET) would prevent these potential alterations. Methods and Results Transgenic mice with spontaneous breast cancer (mouse mammary tumor virus-polyomavirus middle T antigen [MMTV-PyMT+], n=15) and littermate mice with no cancer (MMTV-PyMT-, n=14) were studied. For the ET analysis, MMTV-PyMT+ were divided into sedentary (n=10) and exercise-trained (n=12) groups. Cardiac function was evaluated by echocardiography with speckle-tracking imaging. Exercise tolerance test was conducted on a treadmill. Both studies were performed when the tumor became palpable and when it reached 1 cm. After euthanasia, Ca-handling protein expression (Western blot) was evaluated. Exercise capacity was reduced in MMTV-PyMT+ compared with MMTV-PyMT- (=0.031). Longitudinal strain ( <0.001) and strain rate (=0.030) were impaired. Cardiomyocyte phospholamban was increased (=0.011), whereas phospho-phospholamban and sodium/calcium exchanger were decreased (=0.038 and =0.017, respectively) in MMTV-PyMT+. No significant difference in sarcoplasmic or endoplasmic reticulum calcium 2 ATPase (SERCA2a) was found. SERCA2a/phospholamban ratio was reduced (=0.007). ET was not associated with increased exercise capacity. ET decreased left ventricular end-systolic diameter (=0.038) and end-diastolic volume (=0.026). Other morphological and functional cardiac parameters were not improved by ET in MMTV-PyMT+. ET did not improve cardiomyocyte Ca-handling protein expression. Conclusions Breast cancer is associated with decreased exercise capacity and subclinical left ventricular dysfunction in MMTV-PyMT+, which is at least partly associated with dysregulation of cardiomyocyte Ca handling. ET did not prevent or reverse these changes.
背景:接受乳腺癌治疗的患者心血管并发症发生率较高。本研究旨在评估乳腺癌对心脏功能和心肌细胞钙处理蛋白表达的影响。我们还研究了运动训练(ET)是否可以预防这些潜在的改变。
方法和结果:本研究纳入了 15 只自发性乳腺癌(鼠乳腺肿瘤病毒-多瘤病毒中 T 抗原[MMTV-PyMT+])转基因小鼠和 14 只无癌同窝对照小鼠(MMTV-PyMT-)。为了进行 ET 分析,将 MMTV-PyMT+分为久坐(n=10)和运动训练(n=12)组。通过斑点追踪成像技术进行超声心动图评估心功能。在肿瘤可触及和达到 1cm 时进行跑步机运动耐量测试。安乐死后,通过 Western blot 评估钙处理蛋白表达。与 MMTV-PyMT-相比,MMTV-PyMT+的运动能力降低(=0.031)。纵向应变( <0.001)和应变率(=0.030)受损。心肌肌浆网钙 ATP 酶(SERCA2a)没有明显差异。心肌磷蛋白和钠/钙交换体减少(=0.038 和 =0.017)。ET 并未增加运动能力。ET 降低左心室收缩末期直径(=0.038)和舒张末期容积(=0.026)。ET 并不能改善 MMTV-PyMT+的其他形态和功能心脏参数。ET 不能改善心肌细胞钙处理蛋白的表达。
结论:乳腺癌与 MMTV-PyMT+的运动能力下降和亚临床左心室功能障碍有关,这至少部分与心肌细胞钙处理的失调有关。ET 不能预防或逆转这些变化。
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