Stage-related changes in functional capacity in Hodgkin’s disease: assessment by cardiopulmonary exercise testing before initiation of treatment

Page, Éric; Assouline, David; Durand, Christophe; O, Brun; Coeffic, D.; Fric, D.; Garnier, Claire; Leyronnas, Cécile; Alcalay, Véronique; Aguilaniu, B.

doi:10.1007/s00277-006-0174-5

Cited by 4 publications

(2 citation statements)

References 18 publications

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“…A cross-sectional study by Page et al assessed VO 2peak prior to beginning treatment and observed a significantly decreased VO 2peak among patients with advanced stages (IIB-IV) of disease (VO 2peak 21.4 ± 1.2 ml/kg/min, 65 ± 4% predicted) [46]. An association between fatigue and VO 2peak was also proposed in a prospective longitudinal study by Vermaete et al In this study, 17 NHL and 12 HL patients underwent serial assessments of physical activity (METs per day) with a portable accelerometer, VO 2peak with a maximal cycle ergometer test, and fatigue using a self-reported questionnaire before, during and after cancer treatment [47].…”

Section: • Valvular Heart Diseasementioning

confidence: 99%

Modulation of Cardiovascular Toxicity in Hodgkin Lymphoma: Potential Role and Mechanisms of Aerobic Training

Jones

2015

Future Cardiol.

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Hodgkin lymphoma (HL) outcomes have improved due to advances in cancer treatment. However, HL survivors remain at increased risk for cardiovascular (CV) morbidity and mortality related to the long-term cardiotoxicity of HL treatment, particularly anthracycline chemotherapy and mediastinal radiotherapy. The role of aerobic training for the prevention of CV disease in the general population has been well established. However the safety and efficacy of aerobic training on CV outcomes has not been well studied in HL survivors. The purpose of this paper is to provide an up-to-date summary of the treatment-related adverse CV effects in HL survivors, review the CV benefits of exercise and review the limited evidence on the potential CV benefit of aerobic training in HL survivors. Keywords• aerobic trainingHodgkin lymphoma (HL) is now a curable disease with a 5-year survival rate of 86%, and significant survival gains have been achieved through advances of multiagent chemotherapy and radiotherapy [1,2]. The specific treatment regimen for HL varies depending on the presenting stage and other prognostic factors, but anthracycline-based chemotherapy and radiotherapy have emerged as standard components of initial therapy for early stage HL [3]. Given the improved prognosis of HL survivors, the long-term consequences, particularly the cardiovascular (CV) late effects, of HL treatment are becoming an increasingly important aspect of long-term management of HL survivors.HL survivors are at markedly increased risk of cardiovascular disease (CVD) compared with the general population [4][5][6]. A robust series of studies indicate an increased risk of myocardial infarction, congestive heart failure and CVD-related mortality in HL survivors [7][8][9]. Of note, CVD is the leading nonmalignant cause of death among HL survivors, exceeded only by death related to HL or secondary malignancies [8]. The increased risk of CV events in HL survivors persists beyond 25 years from diagnosis, even when the background cardiac event rate in the general population starts to increase [10]. A major challenge in the management of HL patients is to develop strategies that minimize CV-related morbidity and mortality while maintaining the efficacy of anticancer regimens.Proposed strategies to minimize the CV events related to HL therapy include the use of modern irradiation techniques to reduce cardiac dose, omission of radiotherapy altogether, anthracycline dose reduction, use of liposomal anthracycline preparations and cardioprotective drugs such as iron chelators (e.g., dexrazoxane) [11][12][13][14]. There is concern, however, that some of the proposed strategies may diminish the anticancer efficacy of treatment [15,16]. In addition, these strategies have the potential to decrease, but not eliminate, the risk of CV toxicity related to HL treatment exposures.Physical activity is defined as any movement produced by skeletal muscles that results in energy expenditure, whereas exercise is defined as a regular regimen of physical activity performed for th...

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Section: • Valvular Heart Diseasementioning

confidence: 99%

Modulation of Cardiovascular Toxicity in Hodgkin Lymphoma: Potential Role and Mechanisms of Aerobic Training

Jones

2015

Future Cardiol.

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“…The patient underwent a sports medicine screening and performance testing with stress ECG, treadmill test (modified Bruce protocol) including spiroergometric assessment with lactate threshold. We measured a moderate to good VO 2 peak of 39ml×kg -1 ×min -1 incomparisontootherHodgkin'slymphomapatients matchingstadiumIIb [12].TheestimatedVO 2 maxwalkingintheBruce protocolwasalsomatchingat38.88ml×kg -1 ×min -1 [13].Theanaerobic thresholdlevelwasdeterminedatabloodlactatelevelof3.7mmol/lata pulseof126beats/min(bpm),andthemaximumpulseratewas168bpm.…”

Section: Case Reportmentioning

confidence: 99%