Wang Yutong, Song Xinyang, Xu Tao, Chen Yanwen, Guo Ying, Wang Fang
Cardiology Department, Beijing Hospital, National Center of Gerontology, Institute of Geriatric Medicine, Chinese Academy of Medical Sciences & Peking Union Medical College, Beijing, China.
Cardiology Department, Peking University Fifth School of Clinical Medicine, Beijing, China.
Front Cardiovasc Med. 2025 May 22;12:1569944. doi: 10.3389/fcvm.2025.1569944. eCollection 2025.
Cardiorespiratory fitness (CRF) has gained attention for its potential association with cardiovascular risks. This study aims to examine the association between CRF and adverse cardiovascular outcomes [atrial fibrillation (AF), heart failure (HF), cancer therapy-related cardiovascular toxicity (CTR-CVT)] in cancer patients and explore whether enhancing CRF could improve these outcomes.
The association between three key exposure factors of CRF-resting heart rate (RHR), maximum heart rate (HRmax), and maximal oxygen uptake (V̇O)-and the risk of adverse cardiovascular outcomes were assessed using Cox regression analysis.
RHR is significantly associated with an increased risk of adverse events (HF: HR = 1.013, 95% CI 1.008-1.019, < 0.001; CTR_CVT: HR = 1.006, 95% CI 1.004-1.008, < 0.001), except for AF (HR = 0.998, 95% CI 0.994-1.001, = 0.194). HRmax was associated with a lower risk of CTR_CVT events (HR = 0.995, 95% CI 0.993-0.998, < 0.001), but this was not the case for HF and AF (HF: HR = 1.000, 95% CI 0.992-1.009, = 0.962; AF: HR = 0.998, 95% CI 0.992-1.003, = 0.420). V̇O was negatively correlated with all adverse events, with HRs ranging from 0.957 to 0.958 ( < 0.05 for all). RHR showed a significant non-linear relationship with CTR_CVT (Pnon-linear < 0.0001), AF (Pnon-linear < 0.0001), and HF (Pnon-linear = 0.0057). Similarly, V̇O demonstrated a notable non-linear relationship with CTR_CVT (Pnon-linear = 0.0081) and AF (Pnon-linear = 0.0093). No non-linear relationship between HRmax and the outcomes was observed.
Cardiorespiratory fitness, as measured by V̇O, is consistently negatively correlated with all adverse cardiovascular outcomes, suggesting that higher fitness levels are protective. These findings highlight the potential role of CRF in predicting cardiovascular risks in cancer patients, underscoring the importance of monitoring and improving physical fitness to mitigate adverse outcomes.
心肺适能（CRF）因其与心血管风险的潜在关联而受到关注。本研究旨在探讨癌症患者中CRF与不良心血管结局[心房颤动（AF）、心力衰竭（HF）、癌症治疗相关心血管毒性（CTR-CVT）]之间的关联，并探讨增强CRF是否能改善这些结局。
使用Cox回归分析评估CRF的三个关键暴露因素——静息心率（RHR）、最大心率（HRmax）和最大摄氧量（V̇O）——与不良心血管结局风险之间的关联。
RHR与不良事件风险增加显著相关（HF：HR = 1.013，95%置信区间1.008 - 1.019，P < 0.001；CTR_CVT：HR = 1.006，95%置信区间1.004 - 1.008，P < 0.001），AF除外（HR = 0.998，95%置信区间0.994 - 1.001，P = 0.194）。HRmax与CTR_CVT事件风险较低相关（HR = 0.995，95%置信区间0.993 - 0.998，P < 0.001），但HF和AF并非如此（HF：HR = 1.000，95%置信区间0.992 - 1.009，P = 0.962；AF：HR = 0.998，95%置信区间0.992 - 1.003，P = 0.420）。V̇O与所有不良事件呈负相关，HR范围为0.957至0.958（所有P < 0.05）。RHR与CTR_CVT（P非线性 <
