Cardiopulmonary exercise performance of cancer survivors and patients with stable coronary artery disease with preserved ejection fraction compared to healthy controls

Abstract

Purpose: Cardiorespiratory fitness (CRF) is a predictor of lower mortality in patients with coronary artery disease (CAD) and cancer patients. Whether cancer survivors with preserved ejection fraction (EF) have a higher fitness level than patients with stable CAD and heart failure with preserved EF (HFpEF) is unknown. Methods: We enrolled 61 cancer survivors with an EF >50% (mean age 56.9 years ± 12.4), 60 patients with HFpEF and stable CAD (mean age 58.9 years ±8.1) and 60 healthy control subjects (mean age 61.2 years±9.9) to perform cardiopulmonary exercise testing (CPET) in our outpatient sports medical centre. Results: Maximal power [W] was inferior in cancer survivors (mean: 141.52W ± 67.43; CI: 124.26–158.79 W) than in HFpEF patients (mean: 157.90W ± 58.31; CI: 142.84W-172.96W) and healthy controls (mean: 196.58 W ± 79.37; CI: 176.08–217.09W). Performance at the individual anaerobic threshold (IAT; p = .033) and ventilatory compensation point (VCP, p = .003) were worse in the cancer and HFpEF groups than in the controls. Conclusion: CRF is significantly inferior in stable CAD patients with preserved EF and in cancer patients than in matched controls. There is a trend that cancer survivors even perform worse than HFpEF patients. Regular follow-up of CRF in these two groups is crucial for early detection of health deterioration in these seemingly stable patients.

Keywords

• cardiopulmonary exercise testing
• cancer survivors
• stable cardiovascular disease
• exercise response
• vo2peak