Post-Graduate Program in Health Sciences: Cardiology, Institute of Cardiology of Rio Grande do Sul/University Foundation of Cardiology, Av. Princesa Isabel, 370, Porto Alegre, Rio Grande do Sul, CEP 90620-001, Brazil.
Sci Rep. 2021 Mar 18;11(1):6330. doi: 10.1038/s41598-021-83877-8.
Doxorubicin (DOX)-induced cardiotoxicity in chemotherapy is a major treatment drawback. Clinical trials on the cardioprotective effects of exercise in cancer patients have not yet been published. Thus, we conducted a systematic review and meta-analysis of preclinical studies for to assess the efficacy of exercise training on DOX-induced cardiomyopathy. We included studies with animal models of DOX-induced cardiomyopathy and exercise training from PubMed, Web of Sciences and Scopus databases. The outcome was the mean difference (MD) in fractional shortening (FS, %) assessed by echocardiography between sedentary and trained DOX-treated animals. Trained DOX-treated animals improved 7.40% (95% CI 5.75-9.05, p < 0.001) in FS vs. sedentary animals. Subgroup analyses revealed a superior effect of exercise training execution prior to DOX exposure (MD = 8.20, 95% CI 6.27-10.13, p = 0.010). The assessment of cardiac function up to 10 days after DOX exposure and completion of exercise protocol was also associated with superior effect size in FS (MD = 7.89, 95% CI 6.11-9.67, p = 0.020) vs. an echocardiography after over 4 weeks. Modality and duration of exercise, gender and cumulative DOX dose did were not individually associated with changes on FS. Exercise training is a cardioprotective approach in rodent models of DOX-induced cardiomyopathy. Exercise prior to DOX exposure exerts greater effect sizes on FS preservation.
多柔比星（DOX）诱导的化疗性心脏毒性是主要的治疗障碍。关于运动对癌症患者的心脏保护作用的临床试验尚未公布。因此，我们对评估运动训练对 DOX 诱导的心肌病的疗效的临床前研究进行了系统评价和荟萃分析。我们纳入了来自 PubMed、Web of Sciences 和 Scopus 数据库的 DOX 诱导的心肌病动物模型和运动训练的研究。结果是超声心动图评估的静息和训练 DOX 处理动物之间的短轴缩短率（FS，%）的平均差异（MD）。与静息动物相比，接受训练的 DOX 处理动物的 FS 改善了 7.40%（95%CI 5.75-9.05，p<0.001）。亚组分析显示，在 DOX 暴露前进行运动训练的效果更好（MD=8.20，95%CI 6.27-10.13，p=0.010）。在 DOX 暴露后 10 天内和完成运动方案时评估心脏功能也与 FS 的更大效应大小相关（MD=7.89，95%CI 6.11-9.67，p=0.020）vs. 超过 4 周后的超声心动图。运动的方式和持续时间、性别和累积 DOX 剂量与 FS 变化均无单独关联。运动训练是 DOX 诱导的心肌病的啮齿动物模型中的一种心脏保护方法。在 DOX 暴露前进行运动训练对 FS 的保护作用更大。
