title: Exercise training improves cardiopulmonary and endothelial function in women with breast cancer: findings from the Diana-5 dietary intervention study.
abstract: To investigate whether exercise training (ET) improves cardiopulmonary and endothelial function in women with breast cancer (BC). Fifty-one female patients (aged between 39 and 72 years) with a history of primary invasive BC within the previous 5 years and enrolled in the Mediterranean diet-based DIANA (diet and androgens)-5 Trial were subdivided into 2 groups: an ET group (n = 25) followed a formal ET program of moderate intensity (3 session/week on a bicycle at 60-70 % VO2peak for 3 months, followed by one session/week until 1-year follow-up), while a control group (n = 26) did not perform any formal ET. At baseline and at 1-year follow-up, all patients underwent cardiopulmonary exercise stress test (CPET) and measurements of vascular endothelial function by peripheral artery tonometry (Reactive Hyperemia Index, RHI). There were no significant differences between the groups in baseline anthropometrical, BC characteristics, and metabolic profile. No differences in baseline CPET and RHI parameters were found. Peak oxygen consumption (VO2peak) significantly increased in ET group (from 12.4 ± 2.9 to 14.3 ± 3.3 mL/kg/min, p < 0.001) compared to the control group (from 12.8 ± 2.5 to 12.6 ± 2.8 mL/kg/min, p = 0.55; p < 0.001 between groups). Compared to the control group (from 2.0 ± 0.4 to 1.9 ± 0.4, p = 0.62), the ET group showed a significant improvement of RHI after 1 year (from 2.1 ± 0.7 to 2.5 ± 0.8, p < 0.001). Changes in VO2peak were correlated with changes in RHI (ΔVO2peak vs. ΔRHI: r = 0.47, p = 0.017). In BC survivors, ET program improves cardiopulmonary functional capacity and vascular endothelial function after 12 months. Whether these changes may favorably modulate some of the pathophysiological mechanisms implied in cancer evolution should be investigated.
authors.affiliation: Division of Internal Medicine and Cardiac Rehabilitation, Department of Translational Medical Sciences, University of Naples "Federico II", Via S. Pansini 5, 80131, Naples, NA, Italy. giallauria@libero.it.
authors.forename: Francesco
authors.initials: F
authors.lastname: Giallauria
authors.affiliation: Division of Internal Medicine and Cardiac Rehabilitation, Department of Translational Medical Sciences, University of Naples "Federico II", Via S. Pansini 5, 80131, Naples, NA, Italy.
authors.forename: Alessandra
authors.initials: A
authors.lastname: Vitelli
authors.affiliation: Division of Internal Medicine and Cardiac Rehabilitation, Department of Translational Medical Sciences, University of Naples "Federico II", Via S. Pansini 5, 80131, Naples, NA, Italy.
authors.forename: Luigi
authors.initials: L
authors.lastname: Maresca
authors.affiliation: Dipartimento di Medicina Clinica e Chirurgia, Federico II University, Naples, Italy.
authors.forename: Maria
authors.initials: M
authors.lastname: Santucci De Magistris
authors.affiliation: Medical Statistics Unit, Second University of Naples, Naples, Italy.
authors.forename: Paolo
authors.initials: P
authors.lastname: Chiodini
authors.affiliation: Dipartimento di Medicina Clinica e Chirurgia, Federico II University, Naples, Italy.
authors.forename: Amalia
authors.initials: A
authors.lastname: Mattiello
authors.affiliation: Dipartimento di Medicina Clinica e Chirurgia, Federico II University, Naples, Italy.
authors.forename: Marco
authors.initials: M
authors.lastname: Gentile
authors.affiliation: Division of Internal Medicine and Cardiac Rehabilitation, Department of Translational Medical Sciences, University of Naples "Federico II", Via S. Pansini 5, 80131, Naples, NA, Italy.
authors.forename: Maria
authors.initials: M
authors.lastname: Mancini
authors.affiliation: Division of Internal Medicine and Cardiac Rehabilitation, Department of Translational Medical Sciences, University of Naples "Federico II", Via S. Pansini 5, 80131, Naples, NA, Italy.
authors.forename: Alessandra
authors.initials: A
authors.lastname: Grieco
authors.affiliation: Division of Internal Medicine and Cardiac Rehabilitation, Department of Translational Medical Sciences, University of Naples "Federico II", Via S. Pansini 5, 80131, Naples, NA, Italy.
authors.forename: Angelo
authors.initials: A
authors.lastname: Russo
authors.affiliation: Division of Internal Medicine and Cardiac Rehabilitation, Department of Translational Medical Sciences, University of Naples "Federico II", Via S. Pansini 5, 80131, Naples, NA, Italy.
authors.forename: Rosa
authors.initials: R
authors.lastname: Lucci
authors.affiliation: Division of Internal Medicine and Cardiac Rehabilitation, Department of Translational Medical Sciences, University of Naples "Federico II", Via S. Pansini 5, 80131, Naples, NA, Italy.
authors.forename: Giorgio
authors.initials: G
authors.lastname: Torella
authors.affiliation: Department of Preventive and Predictive Medicine, National Cancer Institute, Milan, Italy.
authors.forename: Franco
authors.initials: F
authors.lastname: Berrino
authors.affiliation: Dipartimento di Medicina Clinica e Chirurgia, Federico II University, Naples, Italy.
authors.forename: Salvatore
authors.initials: S
authors.lastname: Panico
authors.affiliation: Division of Internal Medicine and Cardiac Rehabilitation, Department of Translational Medical Sciences, University of Naples "Federico II", Via S. Pansini 5, 80131, Naples, NA, Italy.
authors.forename: Carlo
authors.initials: C
authors.lastname: Vigorito
mesh_terms: D000328:Adult; D000368:Aged; D001943:Breast Neoplasms / Q000503:physiopathology* / Q000628:therapy*; D038441:Diet, Mediterranean; D004730:Endothelium, Vascular / Q000503:physiopathology*; D005080:Exercise Test; D005081:Exercise Therapy; D005260:Female; D006801:Humans; D008875:Middle Aged; D010101:Oxygen Consumption / Q000502:physiology*
keywords: Breast cancer; Cancer; Cardiopulmonary exercise testing; Endothelial function; Exercise training