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Cardiac dysfunction in cancer survivors unmasked during exercise

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journal contribution
posted on 2022-12-19, 17:09 authored by Maria Kearney, Eve Gallop-Evans, John Cockcroft, Eric StohrEric Stohr, Eveline Lee, Karianne Backx, Mark Haykowsky, Zaheer Yousef, Rob Shave



The cardiac dysfunction associated with anthracycline-based chemotherapy cancer treatment can exist subclinically for decades before overt presentation. Stress echocardiography, the measurement of left ventricular (LV) deformation and arterial haemodynamic evaluation, has separately been used to identify subclinical cardiovascular (CV) dysfunction in several patient groups including those with hypertension and diabetes. The purpose of the present cross-sectional study was to determine whether the combination of these techniques could be used to improve the characterisation of subclinical CV dysfunction in long-term cancer survivors previously treated with anthracyclines.

Materials and methods

Thirteen long-term cancer survivors (36 ± 10 years) with prior anthracycline exposure (11 ± 8 years posttreatment) and 13 age-matched controls were recruited. Left ventricular structure, function and deformation were assessed using echocardiography. Augmentation index was used to quantify arterial haemodynamic load and was measured using applanation tonometry. Measurements were taken at rest and during two stages of low-intensity incremental cycling.


At rest, both groups had comparable global LV systolic, diastolic and arterial function (all P > 0·05); however, longitudinal deformation was significantly lower in cancer survivors (−18 ± 2 vs. −20 ± 2, P < 0·05). During exercise, this difference between groups persisted and further differences were uncovered with significantly lower apical circumferential deformation in the cancer survivors (−24 ± 5 vs. −29 ± 5, −29 ± 5 vs. 35 ± 8 for first and second stage of exercise respectively, both P < 0·05).


In contrast to resting echocardiography, the measurement of LV deformation at rest and during exercise provides a more comprehensive characterisation of subclinical LV dysfunction. Larger studies are required to determine the clinical relevance of these preliminary findings.


Published in

European Journal of Clinical Investigation




  • AM (Accepted Manuscript)


Kearney, M., Gallop-Evans, E., Cockcroft, J., Stohr, E., Lee, E., Backx, K., Haykowsky, M., Yousef, Z. and Shave, R. (2016) 'Cardiac dysfunction in cancer survivors unmasked during exercise' European Journal of Clinical Investigation

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Cardiff Met Affiliation

  • Cardiff School of Sport and Health Sciences

Cardiff Met Authors

John Cockcroft

Cardiff Met Research Centre/Group

  • Cardiovascular Physiology

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  • © The Publisher


  • en

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