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Nakamura, FY, Antunes, P, Nunes, C, Costa, JA, Esco, MR, and Travassos, B. Heart rate variability changes from traditional vs. ultra–short-term recordings in relation to preseason training load and performance in futsal players. J Strength Cond Res 34(10): 2974–2981, 2020—The aims of this study were to analyze heart rate variability (HRV) changes in futsal players during preseason training using both “criterion” (10-minute) and ultra-shortened (2-minute) measures, and to determine whether they were related to changes in the Yo-Yo Intermittent Recovery Test, level 1 (Yo-Yo IR1) performance and accumulated training load (TL). Eleven male competitive futsal players (age = 25.19 ± 4.70 years; body mass = 73.15 ± 11.70 kg; and height = 176.90 ± 5.01 cm) volunteered for the study. Data collection took place during the first to the fourth weeks of preseason training. Training load was monitored with session ratings of perceived exertion. The total distance (TD) covered during the Yo-Yo IR1 was recorded during week 1 and week 4. Heart rate variability was measured through the log-transformed root mean square of successive normal-to-normal interval differences using the ultra-short analysis, with its weekly mean (lnRMSSDM) and coefficient of variation (lnRMSSDCV) recorded, and by means of the criterion method (weeks 1 and 4). lnRMSSDM was likely higher at week 4 compared with week 1 using both criterion and ultra-short recordings. Moderate-to-large correlations were found between changes in the lnRMSSDM and lnRMSSDCV values and changes in TL and TD (r values ranged from −0.48 to 0.65). Changes in ultra-short HRV measures (i.e., increase in lnRMSSDM and decrease in lnRMSSDCV) during futsal preseason were associated with increased performance. The players who accumulated higher perceived TLs displayed smaller improvements in the Yo-Yo IR1 performance and HRV.

Background: Breast cancer (BrC) is the most frequent neoplasm in women. New biomarkers, including aberrant DNA methylation, may improve BrC management. Herein, we evaluated the detection and prognostic performance of seven genes’ promoter methylation (APC, BRCA1, CCND2, FOXA1, PSAT1, RASSF1A and SCGB3A1). Methods: Methylation levels were assessed in primary BrC tissues by quantitative methylation-specific polymerase chain reaction (QMSP) and in circulating cell-free DNA (ccfDNA) by multiplex QMSP from two independent cohorts of patients (Cohort #1, n = 137; and Cohort #2, n = 44). Receiver operating characteristic (ROC) curves were constructed, and log-rank test and Cox regression were performed to assess the prognostic value of genes’ methylation levels. Results: The gene-panel APC, FOXA1, RASSF1A, SCGB3A1 discriminated normal from cancerous tissue with high accuracy (95.55%). In multivariable analysis, high PSAT1-methylation levels [>percentile 75 (P75)] associated with longer disease-free survival, whereas higher FOXA1-methylation levels (>P75) associated with shorter disease-specific survival. The best performing panel in ccfDNA (APC, FOXA1 and RASSF1A) disclosed a sensitivity, specificity and accuracy over 70%. Conclusions: This approach enables BrC accurate diagnosis and prognostic stratification in tissue samples, and allows for early detection in liquid biopsies, thus suggesting a putative value for patient management.

Background Anthracyclines are chemotherapeutic agents frequently used in breast cancer (BC) treatment. Although it improves disease-free and overall survival, the use of anthracyclines is associated with a cumulative risk of cardiac toxicity. Preventive strategies to optimize cardiac health are needed and exercise is proposed as a potential non-pharmacological approach for counteracting anthracycline-related cardiotoxicity (ARC). Most of the data on the effects of exercise to reduce ACT are from animal studies, with only a few studies in a limited number of patients indicating beneficial effects. To better understand the effectiveness of exercise in the mitigation of ARC, clinical, real-world trials claim require a larger sample size and more accurate and valuable clinical biomarkers. In this study, we intend to include a large sample and investigate cardiac function through serial measures of biomarkers and imaging techniques. Methods This protocol describes a two-arm, prospective, randomized controlled trial that will explore the cardioprotective effect of a structured exercise program in women with BC undergoing anthracycline-containing chemotherapy (ACT). Ninety adult women with early BC and recommended to receive ACT will be randomly assigned (1:1) to an intervention group or a control group. Patients allocated to the intervention group will perform a supervised exercise program three times per week, consisting of a combination of aerobic and resistance training with progressive intensity and volume, during the time period they receive ACT. The control group will receive standard BC care. Primary outcomes related to cardiac (dys)function will be circulating N-terminal pro-brain natriuretic peptide (NT-proBNP) levels, resting left ventricular (LV) longitudinal strain, and resting LV ejection fraction. Secondary outcomes will include the assessment of resting blood pressure, resting heart rate (HR), resting HR variability (HRV), recovery HR, physical function outcomes, self-reported physical activity level, health-related quality of life, and fatigue. Data will be obtained at baseline (t 0 ), after the end of anthracycline-treatment (t 2 ), and 3 months after t2 (t 3 ). Additionally, NT-proBNP will be measured 1–24 h prior to each anthracycline-treatment cycle (t1). Discussion The implementation of the present study design, using novel clinical biomarkers, will determine the effect of structured exercise interventions at mitigating ARC, with the overall aim of finding means to further improve BC care. Trial registration ISRCTN, ISRCTN32617901 . Registered on 24 October 2018. Last updated on 11 January 2019. Electronic supplementary material The online version of this article (10.1186/s13063-019-3499-9) contains supplementary material, which is available to authorized users....

Background Exercise training has been suggested to prevent anthracycline-related cardiac dysfunction, but clinical-based evidence is scarce. Aim We investigated the effects of a supervised exercise training program (SETP) on cardiac toxicity markers in women with breast cancer receiving anthracycline-containing chemotherapy. Methods Ninety-three women with early-stage breast cancer were randomly allocated to a SETP plus usual care group (Exercise, n=47) or usual care alone group (UC, n=46). The SETP consisted of 3 sessions per week, combining aerobic and resistance training, conducted concurrently across the anthracycline-containing chemotherapy length. The primary endpoint was the change in left ventricular ejection fraction (LVEF) from baseline to the end of anthracycline cycles. Secondary endpoints included global longitudinal strain (GLS) and other conventional echocardiographic parameters, cardiorespiratory fitness (estimated peak VO2), circulating biomarkers (NT-proBNP, hs-TnT), and safety of the SETP. The study endpoints were also assessed 3 months after the end of anthracycline cycles. Results All patients were prescribed four cycles of doxorubicin plus cyclophosphamide (AC). No significant between-group differences in LVEF change were seen at the end of AC [mean difference: 0.7%; 95% confidence interval (CI): -0.8, 2.3; p=0.349] and 3 months after AC [1.1% (95% CI: -0.5, 2.6; p=0.196]. Compared to the UC group, the estimated peak VO2 increased in the exercise group at the end of AC (1.6 mL O2·kg−1·min−1; 95% CI: 0.06, 3.1; p=0.041) and 3 months after AC (3.1 mL O2·kg−1·min−1; 95% CI: 1.4, 4.7; p<0.001). No between-group differences were found in the remaining secondary endpoints. No serious adverse events were observed during SETP. Conclusion Exercise training was safe during chemotherapy and significantly improved cardiorespiratory fitness. No significant effects were seen on cardiac toxicity markers (LVEF or GLS) as compared to usual care.

BackgroundCardiotoxicity is a known complication and one of the most adverse effects from the use of conventional treatments such as anthracyclines and trastuzumab in breast cancer (BC) care. This phenomenon has been associated with the restriction of therapeutic options and the increase of cardiovascular complications, which may compromise the survival of patients. Implementation of preventive strategies is an important approach for the management of this issue. Physical exercise has been proposed as a non-pharmacological strategy to counteracting cardiotoxicity. The aim of this protocol is to describe the rationale and methods for a systematic review of published randomized controlled trials (RCTs) that have analysed the effects of physical exercise on outcomes of cardiac (dys)function in women with BC undergoing neoadjuvant or adjuvant treatment containing anthracyclines and/or trastuzumab.Methods and analysisThis is a protocol for a systematic review reported according to the PRISMA-P 2015 checklist. Randomized controlled trials (RCTs) will be included. The literature will be screened on MEDLINE, EMBASE, the Cochrane Central Register of Controlled Trials, ISI Web of Science and Scopus. The risk of bias of the included RCTs will be assessed using the Cochrane Collaboration’s tool. The primary outcomes will be systolic function (left ventricular ejection fraction), diastolic function (E/A’ ratio, deceleration time of early left ventricular filling, isovolumetric relaxation time, E/E’ septal and lateral ratio) and myocardial deformation imaging outcomes (strain and strain rate [measured in longitudinal, radial, or circumferential directions]). Secondary outcomes will be cardiac biomarkers (troponin I or T, high-sensitivity troponin I or T, brain natriuretic peptide, amino terminal of B-type natriuretic peptide). Data will be descriptively reported, and quantitative synthesis will also be considered if the included studies are sufficiently homogenous.DiscussionThis systematic review will help to understand the effectiveness of physical exercise on counteracting cardiotoxicity related to anticancer therapies in women with BC.Systematic review registrationPROSPERO CRD42018096060.

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BackgroundBreast cancer is the most common cancer worldwide, and despite remarkable progress in its treatment, the survivors’ quality of life is hampered by treatment-related side effects that impair psychosocial and physiological outcomes. Several studies have established the benefits of physical exercise in breast cancer survivors in recent years. Physical exercise reduces the impact of treatment-related adverse events to promote a better quality of life and functional outcomes.AimThis study aims to provide an overview of systematic reviews and meta-analyses on the effect of physical exercise on the health-related quality of life, cardiorespiratory fitness, muscle strength, and body composition of breast cancer survivors.MethodsPubMed and Cochrane databases were searched for systematic reviews and meta-analyses from January 2010 to October 2022. The main focus was ascertaining the effectiveness of physical exercise in breast cancer survivors undergoing curative treatment (surgery and/or radiotherapy and/or chemotherapy). Two reviewers independently screened the literature, extracted the data, and assessed the risk of bias in the included studies.ResultsA total of 101 studies were identified, and 12 were yielded for final analysis. The eligible studies included nine systematic reviews/meta-analyses, one meta-analysis/meta-regression, and two systematic reviews. The number of randomised clinical trials included in each review varied from 11 to 63, and the number of participants was from 214 to 5761. A positive and significant effect of different physical exercise interventions on health-related quality of life was reported in 83.3% (10 studies) of the eligible studies. Physical exercise also improved cardiorespiratory fitness (3 studies; 25%) and showed to be effective in reducing body weight (3 studies; 25%) and waist circumference (4 studies; 33.3%).ConclusionsOur results suggest that physical exercise is an effective strategy that positively affects breast cancer survivors’ quality of life, cardiorespiratory fitness, and body composition. Healthcare professionals should foster the adoption of physical exercise interventions to achieve better health outcomes following breast cancer treatments.Systematic review registrationhttps://inplasy.com/inplasy-2022-11-0053/, identifier INPLASY2022110053.