Cardiotoxicity of Doxorubicin Treatment and Physical Activity: A Systematic Review

Abstract

The present study investigated whether the practice of exercise has a protective effect against cardiac toxicity induced by doxorubicin (DOX). A systematic review of randomized clinical trials evaluating the role of exercise in the control or prevention of DOX-induced cardiotoxicity was performed in MEDLINE and LILACS databases. Studies that did not address the main subject of this review, did not mention physical exercise or DOX, studies that evaluated other types of anthracycline-induced toxicities only (muscle, hepatic and renal toxicity) or other effects of exercise on DOX toxicity (fatigue) were excluded. With respect to the variables related to aerobic exercise prescription, there was no direct relationship between the frequency of exercise and the results of the studies. Also, intensity of exercise was not decisive for preservation of cardiac function, although a more intense exercise was associated with improvements in the antioxidant system, which was not observed in studies on lower intensity exercises. No significant differences in exercise effects were observed when it was performed before, during or after the treatment. Therefore, aerobic exercise may exert a protective effect of cardiac functions when performed before, during or after treatment with DOX. However, the mechanisms of this effect are still unknown.

Cardioprotective Effect of Date Palm Against Doxorubicin-Induced Cardiotoxicity

“…In parallel with the increase in the number of confirmed cases of cancer, new modalities of treatment have increased cancer survival and possibilities of cure. However, the treatment may cause several adverse effects including treatment-related cardiotoxicity that may lead to poorer prognosis than cancer itself, and also affect treatment continuation [1,2].…”

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“…Cardiotoxicity studies showed that EO supplementation was able to prevent changes caused by doxorubicin, commonly used in chemotherapy [ 94 ]. The added EO diet improved fractional shortening of the left ventricle and increased the levels of enzymes associated with cardiac metabolism, such as β-hydroxyacyl-CoA dehydrogenase, phosphofructokinase, citrate synthase, complex II enzyme activities, and ATP synthase.…”

Exercício Aeróbio e Função Cardíaca de Murinos Expostos à Doxorrubicina: uma Metanálise

“…42,43 No entanto, os mecanismos desse efeito ainda não foram completamente elucidados. 44,45 Em uma revisão sobre os efeitos de exercício físico na resposta cardiovascular de pacientes com câncer de mama, Sturgeon et al 46 revelaram uma falta de estudos focados em cardiotoxicidade em humanos. Eles apontaram que, apesar de poucos estudos pré-clínicos indicarem uma diminuição na frequência cardíaca em repouso e na pressão arterial em pacientes que praticam exercício aeróbio durante e após a quimioterapia, esses parâmetros não são suficientes para indicar boa função cardíaca.…”