Differences in heart rate variability and body composition in breast cancer survivors and women without cancer

Abstract

The aim of this study was to explore cardiac autonomic changes assessed by linear and nonlinear indexes of heart rate variability (HRV) and body composition modifications in breast cancer survivors and cancer-free control women. Women who were breast cancer survivors (BCS, n = 27) and without cancer with similar characteristics (Control, n = 31) were recruited for this study. We calculated some relevant linear and nonlinear parameters of 5 min of RR interval time series such as mean RR interval (RRave), the corrected Poincaré index (cSD1/SD2), the sample entropy (SampEn), the long-term fractal scaling exponent (α2) and 2UV from symbolic dynamics. Additionally, we indirectly assessed body composition measures such as body weight, fat mass, visceral fat rating (VFR), normalized VRF (nVFR), muscle mass, metabolic age, and total body water. We found that diverse HRV indexes and only one body composition measure showed statistical differences (p < 0.05) between the BCS and Control groups. RRave: 729 (648–802) vs. 795 (713–852) ms; cSD2/SD1: 3.4 (2.7–5.0) vs. 2.9 (2.3–3.5); SampEn: 1.5 (1.3–1.8) vs. 1.7 (1.5–1.8); α2: 0.6 (0.3–0.6) vs. 0.5 (0.4–0.5); 2UV: 7.1 (4.3–11.5) vs. 10.8 (6.4–15.7) and nVFR 0.12 (0.11–0.13) vs. 0.10 (0.08–0.12) points/kg, respectively. The nVFR was strongly significantly correlated with several indexes of HRV only in the BCS group.Our findings suggest that BCS exhibit lower parasympathetic cardiac activity and changes in HRV patterns compared to Controls. A concomitant increase of visceral fat, among other factors, may contribute to cardiac autonomic disturbances and changes in HRV patterns in BCS.

Association of heartbeat complexity with survival in advanced non-small cell lung cancer patients

“… Bettermann et al (2001) showed that compared with breast cancer patients without metastasis, the heartbeat complexity (reflected by ApEn) of breast cancer patients with metastasis was clearly lower. Escutia-Reyes et al (2021) showed that nonlinear HRV parameters, such as the SampEn, were significantly different between a breast cancer survivor group and a cancer-free female control group. In our previous study exploring the correlation between short-term HRV and TNM staging in patients with breast cancer, the results showed that the nonlinear HRV parameters ApEn and SampEn, which characterize heartbeat complexity, were not significantly different between tumor stages ( Wu et al, 2021 ).…”

“…It is worth noting that most of the published studies use classical linear indexes (time domain or frequency domain) based on HRV analysis, reflecting the regulation of heart rate by sympathetic and parasympathetic nerves ( De Couck et al, 2018 ; Kloter et al, 2018 ). Previous studies have also preliminarily explored the relationship between several nonlinear HRV parameters and the prognostic information of patients with malignant tumors ( Bettermann et al, 2001 ; Shi et al, 2019 ; Escutia-Reyes et al, 2021 ; Wu et al, 2021 ). For example, Shi et al (2019) found that the increase in irregularity and the decrease in complexity of heartbeat time series are significantly correlated with higher carcinoembryonic antigen levels in patients with gastric cancer.…”

“…Previous studies have also shown that compared with healthy people, the heartbeat complexity of patients with atrial fibrillation ( Mohebbi and Ghassemian, 2011 ), coronary artery disease ( Acharya et al, 2014 ), or acute myocardial ischemia ( Peng and Sun, 2011 ) is significantly lower. Recently, some studies have been conducted to preliminarily examine the prognostic value of nonlinear HRV parameters in cancer ( Shi et al, 2019 ; Escutia-Reyes et al, 2021 ; Li et al, 2022 ). For example, Shi et al (2019) found that decreased heartbeat complexity was associated with higher carcinoembryonic antigen levels in gastric cancer patients.…”

Diagnostic role of heart rate variability in breast cancer and its relationship with peripheral serum carcinoembryonic antigen

“…Liang [ 37 ] applied HRV to the assessment of changes in cardiac autonomic function in breast cancer patients treated with postoperative chemotherapy, reflecting that HRV had a certain guiding significance for the evaluation of cardiac damage in patients. Daniel et al [ 38 ] found significant changes in HRV of breast cancer patients and lower parasympathetic cardiac activity compared to the controls, which may be related to the fact that the autonomic nervous system played an important role in the development and progression of cancer [ 39 ]. In conclusion, the analysis of heart rate variability in breast cancer patients suggested the presence of autonomic dysfunction and showed significant changes in HRV indicators, which speculated from this result that HRV is of great value for the diagnosis of breast cancer.…”

Tracking Cancer: Exploring Heart Rate Variability Patterns by Cancer Location and Progression

“…Over the past two decades, studies have consistently demonstrated that heart rate variability (HRV) effectively predicts and tracks certain cancer-related outcomes [ 11 , 12 , 13 ]. HRV reflects the interplay between the sympathetic and parasympathetic nervous systems (SNS and PNS, respectively [ 14 ]), the two branches of the autonomic nervous system (ANS).…”