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癌症患者的心脏自主神经功能障碍:探究体育锻炼的作用。

Cardiac autonomic dysfunction in patients with cancer: exploring the role of physical exercise.

作者信息

Borsati Anita, Toniolo Linda, Ciurnelli Christian, Bettariga Francesco, Riva Silvia Teresa, Frada Paolo, Belluomini Lorenzo, Trestini Ilaria, Tregnago Daniela, Insolda Jessica, Sposito Marco, Schena Federico, Milella Michele, Newton Robert U, Pilotto Sara, Avancini Alice

机构信息

Biomedical, Clinical and Experimental Sciences, Department of Medicine, University of Verona, Verona, Italy.

Department of Neurosciences, Biomedicine and Movement, University of Verona, Verona, Italy.

出版信息

J Cancer Res Clin Oncol. 2025 Jun 28;151(6):197. doi: 10.1007/s00432-025-06234-6.

Abstract

PURPOSE

Cardiovascular diseases are a leading cause of non-cancer mortality among patients with cancer, with cardiac autonomic dysfunction identified as a significant predictor of future cardiovascular conditions. Despite the importance of autonomic dysfunction as a prognostic marker being well-established in healthy individuals and other chronic conditions, its role in patients with cancer remains underexplored. This narrative review aims to synthesize existing literature on the role of cardiac autonomic dysfunction in patients with cancer and explore the potential of physical exercise as a non-pharmacological intervention to modulate the autonomic nervous system positively.

METHODS

This review examines methods for assessing cardiac autonomic dysfunction, the factors contributing to its dysregulation, and the prognostic role of heart rate variability. It also analyzes current evidence on the effectiveness of various physical exercise modalities, including aerobic, resistance training, and mind-body interventions, in modulating autonomic function.

RESULTS

Patients with cancer are exposed to disease-related, lifestyle, and physiological factors that impair autonomic regulation. This dysfunction is associated with worse outcomes, such as increased mortality and disease progression. Preliminary evidence suggests that physical exercise, particularly a combination of aerobic and resistance training, as well as yoga, may improve heart rate variability and mitigate sympathovagal imbalance in patients.

CONCLUSION

While research on the effects of physical exercise on autonomic modulation in cancer patients is still limited, early findings show promise. Further studies are needed to fully understand the mechanisms through which exercise improves cardiac autonomic function and its long-term benefits in oncology, positioning this as a novel area of research.

摘要

目的

心血管疾病是癌症患者非癌症死亡的主要原因,心脏自主神经功能障碍被认为是未来心血管疾病的重要预测指标。尽管自主神经功能障碍作为一种预后标志物在健康个体和其他慢性病中的重要性已得到充分确立,但其在癌症患者中的作用仍未得到充分探索。本叙述性综述旨在综合现有关于心脏自主神经功能障碍在癌症患者中作用的文献,并探讨体育锻炼作为一种非药物干预手段对自主神经系统进行积极调节的潜力。

方法

本综述研究了评估心脏自主神经功能障碍的方法、导致其失调的因素以及心率变异性的预后作用。它还分析了当前关于各种体育锻炼方式(包括有氧运动、抗阻训练和身心干预)在调节自主神经功能方面有效性的证据。

结果

癌症患者面临与疾病相关、生活方式和生理等因素,这些因素会损害自主神经调节。这种功能障碍与更差的预后相关,如死亡率增加和疾病进展。初步证据表明,体育锻炼,特别是有氧运动和抗阻训练相结合,以及瑜伽,可能会改善患者的心率变异性并减轻交感迷走神经失衡。

结论

虽然关于体育锻炼对癌症患者自主神经调节影响的研究仍然有限,但早期研究结果显示出前景。需要进一步研究以充分了解运动改善心脏自主神经功能的机制及其在肿瘤学中的长期益处,将其定位为一个新的研究领域。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/73d0/12204876/b74467e7047b/432_2025_6234_Fig1_HTML.jpg

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