{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,11,7]],"date-time":"2026-11-07T03:44:12Z","timestamp":1794023052245,"version":"4.8.0"},"reference-count":36,"publisher":"Oxford University Press (OUP)","issue":"3","license":[{"start":{"date-parts":[[2018,10,30]],"date-time":"2018-10-30T00:00:00Z","timestamp":1540857600000},"content-version":"tdm","delay-in-days":0,"URL":"http:\/\/journals.sagepub.com\/page\/policies\/text-and-data-mining-license"}],"content-domain":{"domain":["journals.sagepub.com"],"crossmark-restriction":true},"short-container-title":["Eur J Prev Cardiolog"],"published-print":{"date-parts":[[2019,2]]},"abstract":"<jats:sec><jats:title>Background<\/jats:title><jats:p> Anthracycline chemotherapy may be associated with decreased cardiac function and functional capacity measured as the peak oxygen uptake during exercise ([Formula: see text] peak). We sought to determine (a) whether a structured exercise training program would attenuate reductions in [Formula: see text] peak and (b) whether exercise cardiac imaging is a more sensitive marker of cardiac injury than the current standard of care resting left ventricular ejection fraction (LVEF). <\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p> Twenty-eight patients with early stage breast cancer undergoing anthracycline chemotherapy were able to choose between exercise training (mean\u2009\u00b1\u2009SD age 47\u2009\u00b1\u20099 years, n\u2009=\u200914) or usual care (mean\u2009\u00b1\u2009SD age 53\u2009\u00b1\u20099 years, n\u2009=\u200914). Measurements performed before and after anthracycline chemotherapy included cardiopulmonary exercise testing to determine [Formula: see text] peak and functional disability ([Formula: see text] peak\u2009&lt;\u200918\u2009ml\/min\/kg), resting echocardiography (LVEF and global longitudinal strain), cardiac biomarkers (troponin and B-type natriuretic peptide) and exercise cardiac magnetic resonance imaging to determine stroke volume and peak cardiac output. The exercise training group completed 2\u2009\u00d7\u200960 minute supervised exercise sessions per week. <\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p> Decreases in [Formula: see text] peak during chemotherapy were attenuated with exercise training (15 vs. 4% reduction, P\u2009=\u20090.010) and fewer participants in the exercise training group met the functional disability criteria after anthracycline chemotherapy compared with those in the usual care group (7 vs. 50%, P\u2009=\u20090.01). Compared with the baseline, the peak exercise heart rate was higher and the stroke volume was lower after chemotherapy ( P\u2009=\u20090.003 and P\u2009=\u20090.06, respectively). There was a reduction in resting LVEF (from 63\u2009\u00b1\u20095 to 60\u2009\u00b1\u20095%, P\u2009=\u20090.002) and an increase in troponin (from 2.9\u2009\u00b1\u20091.3 to 28.5\u2009\u00b1\u200922.4\u2009ng\/mL, P\u2009&lt;\u20090.0001), but no difference was observed between the usual care and exercise training group. The baseline peak cardiac output was the strongest predictor of functional capacity after anthracycline chemotherapy in a model containing age and resting cardiac function (LVEF and global longitudinal strain). <\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusions<\/jats:title><jats:p> The peak exercise cardiac output can identify patients at risk of chemotherapy-induced functional disability, whereas current clinical standards are unhelpful. Functional disability can be prevented with exercise training. <\/jats:p><\/jats:sec>","DOI":"10.1177\/2047487318811181","type":"journal-article","created":{"date-parts":[[2018,10,30]],"date-time":"2018-10-30T17:35:12Z","timestamp":1540920912000},"page":"305-315","update-policy":"https:\/\/doi.org\/10.1177\/sage-journals-update-policy","source":"Crossref","is-referenced-by-count":142,"title":["Exercise as a diagnostic and therapeutic tool for the prevention of cardiovascular dysfunction in breast cancer patients"],"prefix":"10.1093","volume":"26","author":[{"given":"Erin J","family":"Howden","sequence":"first","affiliation":[{"name":"Department of Sports Cardiology, Baker Heart and Diabetes Institute, Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ashley","family":"Bigaran","sequence":"additional","affiliation":[{"name":"Department of Sports Cardiology, Baker Heart and Diabetes Institute, Australia"},{"name":"Exercise and Nutrition Research Program, Mary MacKillop Institute for Health Research, Australian Catholic University, Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Rhys","family":"Beaudry","sequence":"additional","affiliation":[{"name":"Integrated Cardiovascular Exercise Physiology and Rehabilitation Laboratory, College of Nursing & Health Innovation, University of Texas Arlington, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Steve","family":"Fraser","sequence":"additional","affiliation":[{"name":"Institute for Physical Activity and Nutrition, Deakin University, Australia"},{"name":"School of Exercise and Nutrition Sciences, Deakin University, Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Steve","family":"Selig","sequence":"additional","affiliation":[{"name":"School of Exercise and Nutrition Sciences, Deakin University, Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Steve","family":"Foulkes","sequence":"additional","affiliation":[{"name":"Department of Sports Cardiology, Baker Heart and Diabetes Institute, Australia"},{"name":"Institute for Physical Activity and Nutrition, Deakin University, Australia"},{"name":"School of Exercise and Nutrition Sciences, Deakin University, Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yoland","family":"Antill","sequence":"additional","affiliation":[{"name":"Oncology Care Victoria, Cabrini Health, Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Sophie","family":"Nightingale","sequence":"additional","affiliation":[{"name":"Surgical Oncology Department, Peter MacCallum Cancer Centre, Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Sherene","family":"Loi","sequence":"additional","affiliation":[{"name":"Translational Breast Cancer Genomics Laboratory, Peter MacCallum Cancer Centre, Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Mark J","family":"Haykowsky","sequence":"additional","affiliation":[{"name":"Department of Sports Cardiology, Baker Heart and Diabetes Institute, Australia"},{"name":"Integrated Cardiovascular Exercise Physiology and Rehabilitation Laboratory, College of Nursing & Health Innovation, University of Texas Arlington, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Andr\u00e9","family":"La Gerche","sequence":"additional","affiliation":[{"name":"Department of Sports Cardiology, Baker Heart and Diabetes Institute, Australia"},{"name":"Cardiology Department, St Vincent's Hospital Melbourne, Melbourne VIC, 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