Effects of combined physical training on cardiac autonomic modulation in women with Breast Cancer undergoing chemotherapy

• Grant number: 23/01556-4
• Support Opportunities: Regular Research Grants
• Start date: July 01, 2023
• End date: January 31, 2026
• Field of knowledge: Health Sciences - Physical Education
• Agreement: CNPq
• Principal Investigator: Miguel Soares Conceição
• Grantee: Miguel Soares Conceição
• Host Institution: Universidade São Francisco (USF). Campus Bragança Paulista. Bragança Paulista , SP, Brazil
• Associated research grant: 21/01424-5 - Effects of combined physical training in women with Breast Cancer submitted to chemotherapy, AP.JP
• Associated scholarship(s): 23/10258-7 - Effects of combined physical training on cardiac autonomic modulation in women with breast cancer undergoing chemotherapy, BP.JD

Abstract

Breast cancer is the most identified neoplasm in women worldwide and the second leading cause of cancer mortality. Due to advances in treatment, mortality from breast cancer has been decreasing, increasing patient survival. However, new antineoplastic therapies increase susceptibility to cardiovascular disease, one of breast cancer survivors' leading causes of death. Changes in autonomic modulation are an early marker of morbidity and mortality related to cardiovascular diseases, with heart rate variability (HRV) being a non-invasive tool associated with changes in the autonomic nervous system. The same activation of the sympathetic nervous system may contribute to the onset and progression of cancer, but antineoplastic therapies have also been associated with autonomic changes. Physical training is considered a positive regulator of the autonomic nervous system in healthy patients. However, in cancer patients, the time course of autonomic dysfunction after exposure to antineoplastic therapies is still unclear. Likewise, little is known about the effects of a systematized combined training (CT) program on the autonomic modulation of patients with breast cancer. Objectives: To determine the effect of CT performed between breast cancer diagnosis and before starting treatment on cardiac autonomic modulation in women with breast cancer. Methods: 100 women with breast cancer with an indication for neoadjuvant chemotherapy will be allocated to one of the following groups: CT before chemotherapy (TC, n=50) or control group (GC, n=50). HRV assessments will be performed before and after each chemotherapy cycle and after three months. Body composition assessments by dual-energy X-ray absorptiometry (DXA); muscle strength through the one repetition maximum test (1-RM); and aerobic fitness through the direct test of maximum oxygen consumption (VO2max) will also be performed before and after the CT program. The participants will perform the CT as follows: 3 sets of 8-12 repetitions with 70% of 1-RM and one minute of rest between sets. After the strength training, the participants will perform aerobic training (AT) on the ergometric bicycle. The TA will consist of completing three sets of 3 minutes performed at an intensity between 50% of the load/power corresponding to the respiratory compensation point (pPCR) and MAP (delta50%) with an interval of 3 minutes of recovery between efforts performed in an active manner ( 80% of the pPCR). Expected Results: If the hypotheses of this project are confirmed, patients with breast cancer may be advised to undergo CT before starting treatment to avoid harmful changes in cardiac autonomic modulation and minimize the adverse effects caused by the treatment of breast cancer. (AU)