Pre-Exercise Participation Cardiovascular Screening in a Heterogeneous Cohort of Adult Cancer Patients. (24th July 2014)

• Record Type: Journal Article
• Authors: Kenjale, Aarti A.; Hornsby, Whitney E.; Crowgey, Theresa; Thomas, Samantha; Herndon, James E.; Khouri, Michel G.; Lane, Amy R.; Bishop, Caroline E.; Eves, Neil D.; Peppercorn, Jeffrey; Douglas, Pamela S.; Jones, Lee W.
• Is Part Of: Oncologist. Volume 19:Number 9(2014)
• Page Start: 999
• Page End: 1005
• Publication Date: 2014-07-24
• Subjects: Exercise tolerance testing -- Safety -- Pre-exercise clearance -- Cancer -- Oncology -- Adverse events; Oncology -- Periodicals; Tumors -- Periodicals; Cancérologie -- Périodiques; Tumeurs -- Périodiques; Oncology; Tumors; Neoplasms; Electronic journals; Periodicals; Periodicals; 616.994
• DOI: 10.1634/theoncologist.2014-0078
• Languages: English
• ISSNs: 1083-7159

Abstract

Abstract: Background: The purpose of this study was to investigate the extent of pre-exercise participation ("preparticipation") health screening in a heterogeneous cohort of adult cancer patients. Methods: Patients ( n = 413) with histologically confirmed solid or hematologic malignancy were categorized into preparticipation health screening risk stratification based on American College Sports Medicine (ACSM) recommendations. Risk of an exercise-related event was evaluated during a symptom-limited cardiopulmonary exercise test (CPET) with 12-lead electrocardiography (ECG). Results: Participant risk was categorized as low risk ( n = 59, 14%), moderate risk ( n = 217, 53%), and high risk ( n = 137, 33%). Mean peak oxygen consumption was 21.7 ± 6.7 mL/kg −1 per minute −1 or 19.5 ± 21.7% below age- and sex-predicted sedentary values. No major serious adverse events or fatal events were observed during CPET procedures. A total of 31 positive ECG tests were observed, for an event rate of 8%. ACSM risk stratification did not predict the risk of a positive test. Age, statin use, antiplatelet therapy use, cardiovascular disease, prior treatment with anthracycline or radiation therapy, and being sedentary were predictors of a positive test (all p < .10). Conclusion: The patient risk-stratification profile strongly suggests that the use of formalized preparticipation health screening is required in all oncology scenarios; however, risk of an exercise-induced event is low, suggesting that the use of exercise testing is not required for pre-exercise clearance in the majority of patients. Abstract : The purpose of this study was to investigate the extent of pre-exercise participation ("preparticipation") cardiovascular screening in a heterogeneous cohort of adult cancer patients. The patient risk-stratification profile strongly suggests that the use of formalized preparticipation cardiovascular screening is required in all oncology scenarios, but risk of an exercise-induced event is low, suggesting that the use of exercise testing is not required for pre-exercise clearance in the majority of patients.