Abstract
Background: Childhood cancer survivors may have premature symptomatic cardiovascular and non-cardiovascular diseases that contribute to reduced capacity for physical activity. Studies of exercise capacity and identification of risk factors for reduced capacity in survivors are limited. Procedure: We assessed maximal myocardial oxygen consumption (VO2maxVO2max, a measure of exercise capacity) in survivors at least 4 years after cancer diagnosis and sibling controls. We evaluated associations between VO2max and age, sex, treatments, cardiac structure and function, biomarkers, endocrine function, and physical activity. Results: Of 72 survivors (mean age, 22 years; range, 8.0-40 years) and 32 siblings (mean age, 20.2 years; range, 8-46 years), about half were male. Mean time since diagnosis was 13.4 years (range, 4.5-31.6 years). In age- and sibling-pair adjusted analyses, VO2max was lower in survivors than siblings (males, 28.53 vs. 30.90ml/kg/minute, P=0.08; females, 19.81 vs. 23.40ml/kg/minute, P=0.03). In males, older age (P=0.01), higher percent body fat (P<0.001) and high or low left ventricular (LV) mass Z-scores (P=0.03) predicted lower VO2max. In females, older age (P<0.001), methotrexate exposure (P=0.01), and higher, but normal, LV load-dependent contractility (P=0.02) predicted lower VO2max. Conclusions: Fitness for most survivors and controls was poor and generally lower in survivors, particularly females. Older age, higher body fat, methotrexate exposure, and extremes of LV mass/function were associated with lower VO2max in survivors. Because physical activity can improve nutritional and cardiac conditions, survivors should be encouraged to exercise regularly with close monitoring.
| Original language | English |
|---|---|
| Pages (from-to) | 663-668 |
| Number of pages | 6 |
| Journal | Pediatric Blood and Cancer |
| Volume | 60 |
| Issue number | 4 |
| DOIs | |
| State | Published - Apr 1 2013 |
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Keywords
- Cancer survivor
- Cardiotoxicity
- Child
- Exercise capacity
- Fitness
ASJC Scopus subject areas
- Oncology
- Pediatrics, Perinatology, and Child Health
- Hematology
Cite this
Exercise capacity in long-term survivors of pediatric cancer : An analysis from the cardiac risk factors in childhood cancer survivors study. / Miller, Angela M.; Lopez-Mitnik, Gabriela; Somarriba, Gabriel; Lipsitz, Stuart R.; Hinkle, Andrea S.; Constine, Louis S.; Lipshultz, Steven E; Miller, Tracie L.
In: Pediatric Blood and Cancer, Vol. 60, No. 4, 01.04.2013, p. 663-668.Research output: Contribution to journal › Article
}
TY - JOUR
T1 - Exercise capacity in long-term survivors of pediatric cancer
T2 - An analysis from the cardiac risk factors in childhood cancer survivors study
AU - Miller, Angela M.
AU - Lopez-Mitnik, Gabriela
AU - Somarriba, Gabriel
AU - Lipsitz, Stuart R.
AU - Hinkle, Andrea S.
AU - Constine, Louis S.
AU - Lipshultz, Steven E
AU - Miller, Tracie L
PY - 2013/4/1
Y1 - 2013/4/1
N2 - Background: Childhood cancer survivors may have premature symptomatic cardiovascular and non-cardiovascular diseases that contribute to reduced capacity for physical activity. Studies of exercise capacity and identification of risk factors for reduced capacity in survivors are limited. Procedure: We assessed maximal myocardial oxygen consumption (VO2maxVO2max, a measure of exercise capacity) in survivors at least 4 years after cancer diagnosis and sibling controls. We evaluated associations between VO2max and age, sex, treatments, cardiac structure and function, biomarkers, endocrine function, and physical activity. Results: Of 72 survivors (mean age, 22 years; range, 8.0-40 years) and 32 siblings (mean age, 20.2 years; range, 8-46 years), about half were male. Mean time since diagnosis was 13.4 years (range, 4.5-31.6 years). In age- and sibling-pair adjusted analyses, VO2max was lower in survivors than siblings (males, 28.53 vs. 30.90ml/kg/minute, P=0.08; females, 19.81 vs. 23.40ml/kg/minute, P=0.03). In males, older age (P=0.01), higher percent body fat (P<0.001) and high or low left ventricular (LV) mass Z-scores (P=0.03) predicted lower VO2max. In females, older age (P<0.001), methotrexate exposure (P=0.01), and higher, but normal, LV load-dependent contractility (P=0.02) predicted lower VO2max. Conclusions: Fitness for most survivors and controls was poor and generally lower in survivors, particularly females. Older age, higher body fat, methotrexate exposure, and extremes of LV mass/function were associated with lower VO2max in survivors. Because physical activity can improve nutritional and cardiac conditions, survivors should be encouraged to exercise regularly with close monitoring.
AB - Background: Childhood cancer survivors may have premature symptomatic cardiovascular and non-cardiovascular diseases that contribute to reduced capacity for physical activity. Studies of exercise capacity and identification of risk factors for reduced capacity in survivors are limited. Procedure: We assessed maximal myocardial oxygen consumption (VO2maxVO2max, a measure of exercise capacity) in survivors at least 4 years after cancer diagnosis and sibling controls. We evaluated associations between VO2max and age, sex, treatments, cardiac structure and function, biomarkers, endocrine function, and physical activity. Results: Of 72 survivors (mean age, 22 years; range, 8.0-40 years) and 32 siblings (mean age, 20.2 years; range, 8-46 years), about half were male. Mean time since diagnosis was 13.4 years (range, 4.5-31.6 years). In age- and sibling-pair adjusted analyses, VO2max was lower in survivors than siblings (males, 28.53 vs. 30.90ml/kg/minute, P=0.08; females, 19.81 vs. 23.40ml/kg/minute, P=0.03). In males, older age (P=0.01), higher percent body fat (P<0.001) and high or low left ventricular (LV) mass Z-scores (P=0.03) predicted lower VO2max. In females, older age (P<0.001), methotrexate exposure (P=0.01), and higher, but normal, LV load-dependent contractility (P=0.02) predicted lower VO2max. Conclusions: Fitness for most survivors and controls was poor and generally lower in survivors, particularly females. Older age, higher body fat, methotrexate exposure, and extremes of LV mass/function were associated with lower VO2max in survivors. Because physical activity can improve nutritional and cardiac conditions, survivors should be encouraged to exercise regularly with close monitoring.
KW - Cancer survivor
KW - Cardiotoxicity
KW - Child
KW - Exercise capacity
KW - Fitness
UR - http://www.scopus.com/inward/record.url?scp=84873714954&partnerID=8YFLogxK
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U2 - 10.1002/pbc.24410
DO - 10.1002/pbc.24410
M3 - Article
VL - 60
SP - 663
EP - 668
JO - Pediatric Blood and Cancer
JF - Pediatric Blood and Cancer
SN - 1545-5009
IS - 4
ER -