Influence of Cancer Severity and Functional Status of Cancer on Cardiac Parasympathetic Indicators

Abstract

Objective: To investigate the influence of cancer severity and functional status of cancer patients on cardiac parasympathetic indicators. Methods:A total of 267 patients with a fresh clinical diagnosis of solid malignant tumor not yet put on cancer therapy and 250 controls matched for age, sex of study subjects were included. Severity of cancer was defined based on the American Joint Committee on Cancer staging. Accordingly, study subjects were subdivided into early stage (Stage I and II combined) and advanced stage (Stage III and IV combined). In cancer patients, the Eastern Cooperative Oncology Group (ECOG) performance score and the Faces Pain Scale score (FPS) was noted. Two indicators of vagal function, expiratory:inspiratory ratio (E:I ratio) and root mean square of successive N-N interval difference (r-MSSD) were included. E:I ratio during deep breathing at six respiratory cycles/minute and r-MSSD at rest was obtained from 1 minute lead II electrocardiogram. Data were analyzed by applying suitable statistical tests. p≤0.05 was considered significant.Results: R-MSSD and E:I ratio was significantly reduced in the early and advanced stage of cancer compared to controls (p≤0.0001). r-MSSD and E:I ratio was significantly reduced in advanced stage compared to the early stage of cancer (p≤0.0001). r-MSSD and E:I ratio was significantly different in subgroups of stages of cancer and controls (p≤0.0001). In cancer patients, r-MSSD was negatively correlated with ECOG and FPS score (p≤0.0278, p≤0.0100). Conclusion:Severity of cancer affects vagal function. However, r-MSSD alone was associated with functional status (ECOG, FPS) of cancer patients.

Is pre-operative heart rate variability a prognostic indicator for overall survival and cancer recurrence in patients with primary colorectal cancer?

“…The same results were found in studies of Bijoor et al where RMSSD was found to be significantly lower in patients with early-and advanced stage cancer compared to a healthy control group [36,37]. When comparing patients with advanced stage cancer (TNM III and IV) to patients with an early stage of cancer (TNM I and II), RMSSD was found to be significantly lower in patients with advanced stages of cancer [36,37]. Thus, though experimental studies in animals show that vagal nerve functioning can causally slow tumorigenesis, the human data suggests that the malignant tumour causes vagal nerve dysfunction and therewith decreased HRV [38].…”

“…A study of De Couck et al showed that cancer patients in general have a significantly lower HRV than healthy people [7]. The same results were found in studies of Bijoor et al where RMSSD was found to be significantly lower in patients with early-and advanced stage cancer compared to a healthy control group [36,37]. When comparing patients with advanced stage cancer (TNM III and IV) to patients with an early stage of cancer (TNM I and II), RMSSD was found to be significantly lower in patients with advanced stages of cancer [36,37].…”

How to properly evaluate cardiac vagal tone in oncology studies: a state-of-the-art review

“… 102 All cancers 23.79±20.48 ms n 103 = 657; lung NSCLC 19.1±21.1 ms and prostate 32.34±40.25 ms, n 102 = 246; breast 19.8±8.5 ms (<18 months after surgery) and 15.0±6.0 ms (>18 months after surgery), n 95 = 30; leukemia 26±11 ms, n 137 = 36; ovarian cancer 11.5 ms (min = 1.70; max = 84.8), n 135 = 202. Always significantly lower values than in heathy people n 137 , 138 = 184. pNN50 3 AM 139 12±10 ms (n 68 = 543) No data.…”

Cancer classification using machine learning and HRV analysis: preliminary evidence from a pilot study

“…On the other hand, Strous et al 14 ⁠ suggested that the same cancer-related mechanisms accompanying the development and progression of a malignant tumour may cause vagal dysfunction and decreased HRV. Although the origin of the relationship between the vagus nerve and cancer is unclear, the lower HRV was unanimously reported in early and advanced cancer patients compared to healthy individuals 15 , 16 .…”