JOURNAL OF SHANGHAI JIAOTONG UNIVERSITY (MEDICAL SCIENCE) ›› 2021, Vol. 41 ›› Issue (12): 1643-1648.doi: 10.3969/j.issn.1674-8115.2021.12.014

• Clinical research • Previous Articles    

Assessment of cardiopulmonary exercise capacity in early stage of patients with breast cancer undergoing neoadjuvant chemotherapy and related factors

Ye-zi CHAI(), Jun MA(), Wen-long JIANG, Qi-ming LIU, Qi-fan LU, Zheng-yu TAO, Meng JIANG(), Jun PU()   

  1. Department of Cardiology, Renji Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai 200127, China
  • Received:2021-08-04 Online:2021-12-28 Published:2022-01-28
  • Contact: Meng JIANG,Jun PU;;
  • Supported by:
    National Natural Science Foundation of China(81971570);Shanghai Shenkang Hospital Development Center Three-year Action Plan: Promoting Clinical Skills and Innovation in Municipal Hospital(SHDC2020CR2025B);Advanced Technology Leader of Shanghai Science and Technology Committee(21XD143210);Innovation Research Project of Shanghai Science and Technology Commission(20Y11910500);Shanghai Pudong Municipal Health Commission-Joint Research Project(PW2018D-03);Medical-Engineering Cross Research of Shanghai Jiao Tong University(YG2019ZDA13);Medical-Engineering Cross Research of University of Shanghai for Science and Technology(10-20-302-425);Shanghai Municipal Education Commission—Gaofeng Clinical Medicine Grant Support(20172014)

Abstract: Objective

·To assess the cardiopulmonary exercise capacity in patients with breast cancer after neoadjuvant chemotherapy in the early stage and explore possible factors leading to the reduced functional tolerance in those patients.


·Fifty-two consecutive patients suffering from breast cancer and receiving neoadjuvant chemotherapy were included and completed cardiopulmonary exercise testing (CPET), laboratory tests, electrocardiograph and echocardiography after 1 cycle of chemotherapy in the Department of Cardiology, Renji Hospital, Shanghai Jiao Tong University School of Medicine from September, 2020 to May, 2021. Fifty-two healthy age-, gender- and body mass index (BMI)-matched volunteers were enrolled and received CPET as the control group. The general conditions, hematological biomarkers, electrocardiogram and echocardiography of the subjects in the two groups were collected and recorded.


·Compared to the control group, the group of patients receiving neoadjuvant chemotherapy had reduced peak VO2 [(18.22±3.48) mL/(min·kg) vs (22.80±3.13) mL/(min·kg), P=0.000], anaerobic threshold [(12.09±2.35) mL/(min·kg) vs (14.93±2.60) mL/(min·kg), P=0.000] and oxygen pulse [(7.67±1.45) mL/beat vs (8.87±1.29) mL/beat), P=0.000]. On multivariable regression analysis, BMI was independently associated with peak VO2 (β=-0.528,P=0.047) of patients in the early stage of neoadjuvant chemotherapy.


·Decreased cardiopulmonary function could be detected in the early stage of neoadjuvant chemotherapy on patients with breast cancer via CPET. High BMI can be an independent predictor of the reduced peak VO2. Maintaining BMI at normal level by losing weight may help to improve patients' cardiopulmonary function and long-term cardiovascular prognosis.

Key words: breast cancer, neoadjuvant chemotherapy, cardiopulmonary exercise testing (CPET), peak VO2, body mass index (BMI)

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