{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,6,24]],"date-time":"2026-06-24T13:16:21Z","timestamp":1782306981953,"version":"3.54.5"},"reference-count":49,"publisher":"Oxford University Press (OUP)","issue":"2","license":[{"start":{"date-parts":[[2022,2,16]],"date-time":"2022-02-16T00:00:00Z","timestamp":1644969600000},"content-version":"vor","delay-in-days":15,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2022,3,4]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:sec><jats:title>Background<\/jats:title><jats:p>Physical activity may increase the risk of cardiotoxicity (myocardial ischemia, major arrhythmias) of 5-Fluorouracil, but this risk has never been investigated for its prodrug capecitabine.<\/jats:p><\/jats:sec><jats:sec><jats:title>Patients and Methods<\/jats:title><jats:p>One hundred and ninety-two consecutive patients undergoing capecitabine chemotherapy from December 1, 2010 through July 31, 2016 were prospectively evaluated. The baseline evaluation included electrocardiography (ECG) and echocardiography (2DE); a follow-up evaluation, including ECG and exercise stress testing (2DE in case of ECG abnormalities), was done after \u226510 days of treatment. Cardiotoxicity was suspected from ischemic ECG changes, new kinetic abnormalities at 2DE, Lown classification \u22652 ventricular arrhythmia, symptomatic arrhythmias, or positive stress test, and confirmed by a negative stress test after capecitabine washout.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>Cardiotoxicity was diagnosed in 32 patients (16.7%): six at rest and 26 during exercise. All 32 patients had ECG abnormalities: ST-segment changes (24 patients), negative T-waves (2) and\/or arrhythmias: ventricular arrhythmias (14 cases), supraventricular tachycardia (2), complete heart block (1). Eight patients had typical symptoms, 6 had atypical symptoms, 1 had syncope, 17 (53%) were asymptomatic. Cardiotoxicity was more common in patients with atypical symptoms during daily life (OR = 15.7) and in those on a therapeutic schedule of 5 days\/week (OR = 9.44).<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusion<\/jats:title><jats:p>Capecitabine cardiotoxicity is frequent, and often elicited by physical effort. Oncologists, cardiologists, and general practitioners should be aware of this risk. Active cardiotoxicity surveillance with ECG (and echocardiogram and\/or stress testing in suspected cases) during therapy is recommended.<\/jats:p><\/jats:sec><jats:sec><jats:title>Clinical Trials registration number<\/jats:title><jats:p>CRO-2010-17.<\/jats:p><\/jats:sec>","DOI":"10.1093\/oncolo\/oyab035","type":"journal-article","created":{"date-parts":[[2022,1,14]],"date-time":"2022-01-14T12:07:24Z","timestamp":1642162044000},"page":"e158-e167","source":"Crossref","is-referenced-by-count":21,"title":["Cardiotoxicity from Capecitabine Chemotherapy: Prospective Study of Incidence at Rest and During Physical Exercise"],"prefix":"10.1093","volume":"27","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-9709-4909","authenticated-orcid":false,"given":"Chiara","family":"Lestuzzi","sequence":"first","affiliation":[{"name":"Cardiology Department, ASFO: Azienda Sanitaria Friuli Occidentale, Cardiology and Cardio-Oncology Rehabilitation Service, Aviano (PN), 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Angelis","sequence":"additional","affiliation":[{"name":"Cardiology Department, University Hospital of Trieste, Trieste, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-7593-8138","authenticated-orcid":false,"given":"Sara","family":"Lonardi","sequence":"additional","affiliation":[{"name":"Medical Oncology Unit 1, Veneto Institute of Oncology IRCCS, Padua, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Roberto","family":"Innocente","sequence":"additional","affiliation":[{"name":"Radiation Oncology Department, Centro di Riferimento Oncologico di Aviano (CRO), IRCCS, Aviano (PN), Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Massimiliano","family":"Berretta","sequence":"additional","affiliation":[{"name":"Oncology Department, Centro di Riferimento Oncologico di Aviano (CRO), IR, Aviano (PN), 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