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Diastolic Dysfunction Contributes to Impaired Cardiorespiratory Fitness in Patients with Lung Cancer and Reduced Lung Function Following Chest Radiation

  • CARDIAC DYSFUNCTION AFTER RADIOTHERAPY FOR LUNG CANCER
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Abstract

Cardiorespiratory fitness (CRF) is a robust and independent predictor of cardiovascular health and overall mortality. Patients with lung cancer often have chronic lung disease, contributing to impaired CRF. Radiation to the heart during lung cancer treatment may further reduce CRF. The determinants of CRF in this population are not well understood. We prospectively evaluated 12 patients with lung cancer without known cardiovascular disease with reduced lung function receiving curative intent thoracic radiotherapy to determine whether cardiac diastolic function, as assessed by Doppler echocardiography and N-terminal pro-brain natriuretic peptide (NTproBNP) levels, correlate with CRF measured by peak oxygen consumption (VO2). Doppler-derived measures of diastolic function and serum NTproBNP levels inversely correlated with peak VO2. In a multivariate regression model, NTproBNP was the strongest independent variable associated with peak VO2. These results suggest that diastolic dysfunction further contributes to reduced CRF in patients with lung cancer who have received radiotherapy.

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References

  1. Atkins KM, Rawal B, Chaunzwa TL, Lamba N, Bitterman DS, Williams CL, Kozono DE, Baldini EH, Chen AB, Nguyen PL, D’Amico AV, Nohria A, Hoffmann U, Aerts HJWL, Mak RH (2019) Cardiac radiation dose, cardiac disease, and mortality in patients with lung cancer. J Am Coll Cardiol 73(23):2976–2987. https://doi.org/10.1016/j.jacc.2019.03.500

    Article  PubMed  Google Scholar 

  2. Wang K, Eblan MJ, Deal AM, Lipner M, Zagar TM, Wang Y, Mavroidis P, Lee CB, Jensen BC, Rosenman JG, Socinski MA, Stinchcombe TE, Marks LB (2017) Cardiac toxicity after radiotherapy for stage III non-small-cell lung cancer: pooled analysis of dose-escalation trials delivering 70 to 90 Gy. J Clin Oncol 35(13):1387–1394. https://doi.org/10.1200/JCO.2016.70.0229

    Article  PubMed  PubMed Central  Google Scholar 

  3. Yeh ETH, Vejpongsa P (2015) Subclinical cardiotoxicity associated with cancer therapy: early detection and future directions. J Am Coll Cardiol 65(23):2523–2525. https://doi.org/10.1016/j.jacc.2015.04.012

    Article  PubMed  Google Scholar 

  4. Jones LW, Watson D, Herndon JE 2nd, Eves ND, Haithcock BE, Loewen G, Kohman L (2010) Peak oxygen consumption and long-term all-cause mortality in nonsmall cell lung cancer. Cancer 116(20):4825–4832. https://doi.org/10.1002/cncr.25396

    Article  PubMed  Google Scholar 

  5. Canada JM, Trankle CR, Carbone S, Buckley LF, de Chazal M, Billingsley H, Evans RK, Garten R, Van Tassell BW, Kadariya D, Mauro A, Toldo S, Mezzaroma E, Arena R, Hundley WG, Grizzard JD, Weiss E, Abbate A (2020) Determinants of cardiorespiratory fitness following thoracic radiotherapy in lung or breast cancer survivors. Am J Cardiol 125(6):988–996. https://doi.org/10.1016/j.amjcard.2019.12.019

    Article  CAS  PubMed  Google Scholar 

  6. Brunelli A, Kim AW, Berger KI, Addrizzo-Harris DJ (2013) Physiologic evaluation of the patient with lung cancer being considered for resectional surgery: Diagnosis and management of lung cancer, 3rd ed: American College of Chest Physicians evidence-based clinical practice guidelines. Chest 143(5 Suppl):e166S-e190S. https://doi.org/10.1378/chest.12-2395

    Article  CAS  PubMed  Google Scholar 

  7. Kang HS, Shin AY, Yeo CD, Kim JS, Kim YH, Kim JW, Lee SH (2018) A lower level of forced expiratory volume in one second predicts the poor prognosis of small cell lung cancer. J Thorac Dis 10(4):2179–2185. https://doi.org/10.21037/jtd.2018.03.121

    Article  PubMed  PubMed Central  Google Scholar 

  8. Hassel E, Stensvold D, Halvorsen T, Wisløff U, Langhammer A, Steinshamn S (2017) Lung function parameters improve prediction of VO2peak in an elderly population: the Generation 100 study. PLoS ONE 12(3):e0174058. https://doi.org/10.1371/journal.pone.0174058

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  9. Williams SG, Ng LL, O’Brien RJ, Taylor S, Wright DJ, Li YF, Tan LB (2005) Complementary roles of simple variables, NYHA and N-BNP, in indicating aerobic capacity and severity of heart failure. Int J Cardiol 102(2):279–286. https://doi.org/10.1016/j.ijcard.2004.05.054

    Article  CAS  PubMed  Google Scholar 

  10. Sarullo FM, Gristina T, Brusca I, Milia S, Raimondi R, Sajeva M, La Chiusa SM, Serio G, Paterna S, Di Pasquale P, Castello A (2006) Effect of physical training on exercise capacity, gas exchange and N-terminal pro-brain natriuretic peptide levels in patients with chronic heart failure. Eur J Cardiovasc Prev Rehabil 13(5):812–817. https://doi.org/10.1097/01.hjr.0000238396.42718.61

    Article  Google Scholar 

  11. Otsuka T, Nojiri T, Minami S, Hosoda H, Kuroyama M, Hirata H, Nakanishi K, Yamamoto S, Komuta K, Kangawa K, Kijima T (2017) Evaluation of natriuretic peptide in non-small cell lung cancer patients treated with bevacizumab together with carboplatin-paclitaxel: a prospective study. Anticancer Res 37(7):3505–3512. https://doi.org/10.21873/anticanres.11718

    Article  CAS  PubMed  Google Scholar 

  12. Aujollet N, Meyer M, Cailliod R, Combier F, Coignet Y, Campard S, Facy O, Bernard A, Girard C (2010) High N-terminal pro-B-type natriuretic peptide: a biomarker of lung cancer? Clin Lung Cancer 11(5):341–345. https://doi.org/10.3816/CLC.2010.n.043

    Article  CAS  PubMed  Google Scholar 

  13. Omersa D, Cufer T, Marcun R, Lainscak M (2017) Echocardiography and cardiac biomarkers in patients with non-small cell lung cancer treated with platinum-based chemotherapy. Radiol Oncol 51(1):15–22. https://doi.org/10.1515/raon-2016-0037

    Article  CAS  PubMed  Google Scholar 

  14. Maeder MT, Brutsche MH, Christ A, Reichlin T, Staub D, Noveanu M, Breidthardt T, Potocki M, Mueller C (2009) Natriuretic peptides for the prediction of severely impaired peak VO2 in patients with lung disease. Respir Med 103(9):1337–1345. https://doi.org/10.1016/j.rmed.2009.03.015

    Article  PubMed  Google Scholar 

  15. Canada JM, Thomas GK, Trankle CR, Carbone S, Billingsley H, Van Tassell BW, Evans RK, Garten R, Weiss E, Abbate A (2020) Increased C-reactive protein is associated with the severity of thoracic radiotherapy-induced cardiomyopathy. Cardio-Oncology 6(1):2. https://doi.org/10.1186/s40959-020-0058-1

    Article  PubMed  PubMed Central  Google Scholar 

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Funding

This work was supported by a Virginia Commonwealth University Massey Cancer Center Pilot Project Grant [P30CA016059K]. This study was supported in part by a National Center for Clinical and Translational Research Clinical and Translational Science Award [UL1TR002649] to Virginia Commonwealth University (PI: Frederick Moeller, MD, USA).

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Authors and Affiliations

  1. Department of Internal Medicine, Virginia Commonwealth University, PO Box 980102, Richmond, VA, USA

    Georgia K. Thomas, Cory R. Trankle, Salvatore Carbone, Hayley Billingsley, Benjamin W. Van Tassell, Antonio Abbate & Justin M. Canada

  2. Department of Kinesiology & Health Sciences, College of Humanities & Sciences, Virginia Commonwealth University, Richmond, VA, USA

    Salvatore Carbone, Hayley Billingsley, Ronald K. Evans & Ryan Garten

  3. Department of Pharmacotherapy and Outcome Sciences, Virginia Commonwealth University, Richmond, VA, USA

    Benjamin W. Van Tassell

  4. Department of Radiation Oncology, VCU Massey Cancer Center, Virginia Commonwealth University, Richmond, VA, USA

    Elisabeth Weiss

  5. C. Kenneth and Dianne Wright Center for Clinical and Translational Research, Virginia Commonwealth University, Richmond, VA, USA

    Antonio Abbate

Authors
  1. Georgia K. Thomas
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  2. Cory R. Trankle
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  3. Salvatore Carbone
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  4. Hayley Billingsley
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  5. Benjamin W. Van Tassell
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  6. Ronald K. Evans
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  7. Ryan Garten
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  8. Elisabeth Weiss
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  9. Antonio Abbate
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  10. Justin M. Canada
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Corresponding author

Correspondence to Georgia K. Thomas.

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Conflict of interest

Dr. Weiss is supported by a grant from the National Institutes of Health [U01AI133595] to Virginia Commonwealth University. Dr. Carbone is supported by a Career Development Award [19CDA34660318] from the American Heart Association and by the Clinical and Translational Science Awards Program [UL1TR002649] from National Institutes of Health to Virginia Commonwealth University. Dr. Abbate is supported by a National Center for Clinical and Translational Research Clinical and Translational Science Award [UL1TR002649]. The other authors have nothing to disclose.

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Thomas, G.K., Trankle, C.R., Carbone, S. et al. Diastolic Dysfunction Contributes to Impaired Cardiorespiratory Fitness in Patients with Lung Cancer and Reduced Lung Function Following Chest Radiation. Lung 199, 403–407 (2021). https://doi.org/10.1007/s00408-021-00454-6

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  • DOI: https://doi.org/10.1007/s00408-021-00454-6

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