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Feasibility and Outcomes of an Exercise Intervention for Chemotherapy-Induced Heart Failure

Tsai, Edward, MPH; Mouhayar, Elie, MD; Lenihan, Daniel, MD; Song, Jaejoon, PhD; Durand, Jean-Bernard, MD; Fadol, Anecita, PhD; Massey, Mona, BSN; Harrison, Carol, MEd; Basen-Engquist, Karen, PhD, MPH

Journal of Cardiopulmonary Rehabilitation and Prevention: May 2019 - Volume 39 - Issue 3 - p 199–203
doi: 10.1097/HCR.0000000000000388
Exercise Physiology
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Purpose: Cancer treatment–related heart failure (HF) is an emerging health concern, as the number of survivors is increasing rapidly, and cardiac health issues are a leading cause of mortality in this population. While there is general evidence for the efficacy of exercise rehabilitation interventions, more research is needed on exercise rehabilitation interventions for patients specifically with treatment-induced HF and whether such interventions are safe and well-accepted. This study provides feasibility and health outcomes of a pilot exercise intervention for cancer survivors with chemotherapy-induced HF.

Methods: Twenty-five participants were randomized to a clinic-based exercise intervention or a wait-list control group or, alternatively, allowed to enroll in a home-based exercise intervention if they declined the randomized study. For purposes of analysis, both types of exercise programs were combined into a single intervention group. Repeated-measures analysis of variance was conducted to assess for significant time and treatment group main effects separately and time × treatment group interaction effects.

Results: Significant improvements in maximum oxygen uptake (

O2max) were observed in the intervention group. Intervention satisfaction and adherence were high for both clinic- and home-based interventions, with no reported serious adverse events. Enrollment was initially low for the clinic-based intervention, necessitating the addition of the home-based program as an intervention alternative.

Conclusions: Results suggest that exercise rehabilitation interventions are feasible in terms of safety, retention, and satisfaction and have the potential to improve

O2max. To maximize adherence and benefits while minimizing participant burden, an ideal intervention may incorporate elements of both clinic-based supervised exercise sessions and a home-based program.

General evidence for efficacy of exercise rehabilitation interventions exists, but more research is needed on intervention feasibility and efficacy for those with treatment-induced heart failure. This study demonstrates that an exercise program has the potential to improve O2max, along with being safe and well-accepted by this cancer survivor population.

Department of Health Promotion & Behavioral Sciences, The University of Texas School of Public Health, Houston (Mr Tsai); Department of Behavioral Science (Mr Tsai, Ms Harrison, and Dr Basen-Engquist), Department of Cardiology, Division of Internal Medicine (Drs Mouhayar and Durand), Department of Biostatistics (Dr Song), Department of Nursing (Dr Fadol), and Clinical Research Support Center (Ms Massey), The University of Texas MD Anderson Cancer Center, Houston; and Cardiovascular Division, Washington University School of Medicine in St Louis, St Louis, Missouri (Dr Lenihan).

Correspondence: Karen Basen-Engquist PhD, MPH, Center for Energy Balance in Cancer Prevention and Survivorship, The University of Texas MD Anderson Cancer Center, PO Box 301439, Unit 1330, Houston, TX 77230 (kbasenen@mdanderson.org).

The authors declare no conflicts of interest.

Clinical Trial Registration (https://clinicaltrials.gov) Unique identifier: NCT00633633

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