Association of cardiorespiratory fitness with risk of adverse cardiovascular outcomes in cancer patients: a cohort study.

IF 2.8 3区医学 Q2 CARDIAC & CARDIOVASCULAR SYSTEMS

Frontiers in Cardiovascular Medicine Pub Date : 2025-05-22 eCollection Date: 2025-01-01 DOI:10.3389/fcvm.2025.1569944

Yutong Wang, Xinyang Song, Tao Xu, Yanwen Chen, Ying Guo, Fang Wang

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引用次数: 0

Abstract

Background: Cardiorespiratory fitness (CRF) has gained attention for its potential association with cardiovascular risks. This study aims to examine the association between CRF and adverse cardiovascular outcomes [atrial fibrillation (AF), heart failure (HF), cancer therapy-related cardiovascular toxicity (CTR-CVT)] in cancer patients and explore whether enhancing CRF could improve these outcomes.

Methods: The association between three key exposure factors of CRF-resting heart rate (RHR), maximum heart rate (HRmax), and maximal oxygen uptake (V̇O_2max)-and the risk of adverse cardiovascular outcomes were assessed using Cox regression analysis.

Results: RHR is significantly associated with an increased risk of adverse events (HF: HR = 1.013, 95% CI 1.008-1.019, P < 0.001; CTR_CVT: HR = 1.006, 95% CI 1.004-1.008, P < 0.001), except for AF (HR = 0.998, 95% CI 0.994-1.001, P = 0.194). HRmax was associated with a lower risk of CTR_CVT events (HR = 0.995, 95% CI 0.993-0.998, P < 0.001), but this was not the case for HF and AF (HF: HR = 1.000, 95% CI 0.992-1.009, P = 0.962; AF: HR = 0.998, 95% CI 0.992-1.003, P = 0.420). V̇O_2max was negatively correlated with all adverse events, with HRs ranging from 0.957 to 0.958 (P < 0.05 for all). RHR showed a significant non-linear relationship with CTR_CVT (Pnon-linear < 0.0001), AF (Pnon-linear < 0.0001), and HF (Pnon-linear = 0.0057). Similarly, V̇O_2max demonstrated a notable non-linear relationship with CTR_CVT (Pnon-linear = 0.0081) and AF (Pnon-linear = 0.0093). No non-linear relationship between HRmax and the outcomes was observed.

Conclusion: Cardiorespiratory fitness, as measured by V̇O_2max, is consistently negatively correlated with all adverse cardiovascular outcomes, suggesting that higher fitness levels are protective. These findings highlight the potential role of CRF in predicting cardiovascular risks in cancer patients, underscoring the importance of monitoring and improving physical fitness to mitigate adverse outcomes.

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癌症患者心肺健康与心血管不良结局风险的关联：一项队列研究

背景：心肺适能（CRF）因其与心血管风险的潜在关联而受到关注。本研究旨在探讨CRF与癌症患者不良心血管结局[心房颤动（AF）、心力衰竭（HF）、癌症治疗相关心血管毒性（cr - cvt）]之间的关系，并探讨增强CRF是否可以改善这些结局。方法：采用Cox回归分析，评价crf的三个关键暴露因素——静息心率（RHR）、最大心率（HRmax）和最大摄氧量（V * O2max）与心血管不良结局风险的相关性。结果：RHR与不良事件风险增加显著相关（HF: HR = 1.013, 95% CI 1.008-1.019, P P P = 0.194）。HRmax与较低的CTR_CVT事件风险相关(HR = 0.995, 95% CI 0.993-0.998, P P = 0.962；Af: hr = 0.998, 95% ci 0.992-1.003, p = 0.420)。V * O2max与所有不良事件呈负相关，hr范围为0.957 ~ 0.958 （P * O2max与CTR_CVT （p非线性= 0.0081）、AF （p非线性= 0.0093）呈显著的非线性关系）。HRmax与结果之间无非线性关系。结论：以vo2max衡量的心肺适能与所有心血管不良结局始终呈负相关，表明较高的适能水平具有保护作用。这些发现强调了CRF在预测癌症患者心血管风险方面的潜在作用，强调了监测和改善身体健康以减轻不良后果的重要性。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Frontiers in Cardiovascular Medicine Medicine-Cardiology and Cardiovascular Medicine

CiteScore

3.80

自引率

11.10%

发文量

3529

审稿时长

14 weeks

期刊介绍： Frontiers? Which frontiers? Where exactly are the frontiers of cardiovascular medicine? And who should be defining these frontiers? At Frontiers in Cardiovascular Medicine we believe it is worth being curious to foresee and explore beyond the current frontiers. In other words, we would like, through the articles published by our community journal Frontiers in Cardiovascular Medicine, to anticipate the future of cardiovascular medicine, and thus better prevent cardiovascular disorders and improve therapeutic options and outcomes of our patients.