title: Cardiovascular function and predictors of exercise capacity in patients with colorectal cancer.
abstract: BACKGROUND
  Patients with colorectal cancer (CRC) often present with dyspnea and fatigue. These are also frequent symptoms in patients with chronic heart failure (CHF).
  
  
  OBJECTIVE
  We hypothesized that similar patterns of cardiovascular perturbations are present in CRC and CHF.
  
  
  METHODS
  We prospectively studied 50 patients with CRC, 51 patients with CHF, and 51 control subjects. The CRC group was divided into 2 subgroups: patients who underwent chemotherapy (n = 26) and chemotherapy-naive patients (n = 24). We assessed exercise capacity (spiroergometry), cardiac function (echocardiography), heart rate variability (Holter electrocardiography), body composition (dual-energy x-ray absorptiometry), and blood parameters.
  
  
  RESULTS
  Compared with the control arm, the left ventricular ejection fraction (CRC group 59.4%; control group 62.5%) and exercise performance as assessed by peak oxygen consumption (peak VO2) (CRC group 21.8 ml/kg/min; control group 28.0 ml/kg/min) were significantly reduced in CRC patients (both p < 0.02). Markers of heart rate variability were markedly impaired in CRC patients compared with control subjects (all p < 0.008). Compared with the control group, the CRC group also showed reduced lean mass in the legs and higher levels of the endothelium-derived C-terminal-pro-endothelin-1 (both p < 0.02). Major determinants of cardiovascular function were impaired in chemotherapy-treated patients and in the chemotherapy-naive patients, particularly with regard to exercise capacity, left ventricular ejection fraction, lean mass, and heart rate variability (all p < 0.05 vs. control subjects).
  
  
  CONCLUSIONS
  Some aspects of cardiovascular function are impaired in patients with CRC. More importantly, our findings were evident independently of whether patients were undergoing chemotherapy.
authors.affiliation: Applied Cachexia Research, Department of Cardiology, Charité Medical School, Campus Virchow-Klinikum, Berlin, Germany.
authors.forename: Larissa
authors.initials: L
authors.lastname: Cramer
authors.affiliation: Department of Hematology and Oncology, Charité Medical School, Campus Virchow-Klinikum, Berlin, Germany.
authors.forename: Bert
authors.initials: B
authors.lastname: Hildebrandt
authors.affiliation: Applied Cachexia Research, Department of Cardiology, Charité Medical School, Campus Virchow-Klinikum, Berlin, Germany.
authors.forename: Thomas
authors.initials: T
authors.lastname: Kung
authors.affiliation: Applied Cachexia Research, Department of Cardiology, Charité Medical School, Campus Virchow-Klinikum, Berlin, Germany.
authors.forename: Kristin
authors.initials: K
authors.lastname: Wichmann
authors.affiliation: Department of Innovative Clinical Trials, University Medical Centre Göttingen, Göttingen, Germany; Department of Cardiology and Pneumology, University Medical Centre Göttingen, Göttingen, Germany.
authors.forename: Jochen
authors.initials: J
authors.lastname: Springer
authors.affiliation: Applied Cachexia Research, Department of Cardiology, Charité Medical School, Campus Virchow-Klinikum, Berlin, Germany; Center for Stroke Research CSB, Charité Medical School, Berlin, Germany.
authors.forename: Wolfram
authors.initials: W
authors.lastname: Doehner
authors.affiliation: Applied Cachexia Research, Department of Cardiology, Charité Medical School, Campus Virchow-Klinikum, Berlin, Germany.
authors.forename: Anja
authors.initials: A
authors.lastname: Sandek
authors.affiliation: Department of Innovative Clinical Trials, University Medical Centre Göttingen, Göttingen, Germany; 1st Department of Internal Medicine, Faculty Hospital, Bratislava, Slovak Republic.
authors.forename: Miroslava
authors.initials: M
authors.lastname: Valentova
authors.affiliation: Clinical Institute of Medical and Chemical Laboratory Diagnostics, Medical University of Graz, Graz, Austria.
authors.forename: Tatjana
authors.initials: T
authors.lastname: Stojakovic
authors.affiliation: Clinical Institute of Medical and Chemical Laboratory Diagnostics, Medical University of Graz, Graz, Austria.
authors.forename: Hubert
authors.initials: H
authors.lastname: Scharnagl
authors.affiliation: Department of Hematology and Oncology, Charité Medical School, Campus Virchow-Klinikum, Berlin, Germany.
authors.forename: Hanno
authors.initials: H
authors.lastname: Riess
authors.affiliation: Applied Cachexia Research, Department of Cardiology, Charité Medical School, Campus Virchow-Klinikum, Berlin, Germany; Department of Innovative Clinical Trials, University Medical Centre Göttingen, Göttingen, Germany.
authors.forename: Stefan D
authors.initials: SD
authors.lastname: Anker
authors.affiliation: Applied Cachexia Research, Department of Cardiology, Charité Medical School, Campus Virchow-Klinikum, Berlin, Germany; Department of Cardiology and Pneumology, University Medical Centre Göttingen, Göttingen, Germany. Electronic address: stephan.von.haehling@web.de.
authors.forename: Stephan
authors.initials: S
authors.lastname: von Haehling
mesh_terms: D015502:Absorptiometry, Photon; D000368:Aged; D000970:Antineoplastic Agents / Q000627:therapeutic use; D001823:Body Composition; D002319:Cardiovascular System / Q000503:physiopathology*; D015179:Colorectal Neoplasms / Q000503:physiopathology*; D004417:Dyspnea / Q000503:physiopathology; D004452:Echocardiography; D016552:Ergometry; D015444:Exercise; D017079:Exercise Tolerance / Q000502:physiology; D005221:Fatigue / Q000503:physiopathology; D005260:Female; D006333:Heart Failure / Q000503:physiopathology; D006339:Heart Rate; D006801:Humans; D008297:Male; D008875:Middle Aged; D010101:Oxygen Consumption; D011446:Prospective Studies; D016277:Ventricular Function, Left
chemical_list: D000970:Antineoplastic Agents
keywords: cardiovascular function; colorectal cancer; exercise capacity