The Association Between Visceral Fat and Left Ventricular Performance in Pre- and Post-Menopausal Age Stage I-IV Cancer Patients that Receive Anthracycline-based Chemotherapy
Date Thesis Awarded
Honors Thesis -- Access Restricted On-Campus Only
Bachelors of Science (BS)
W. Gregory Hundley
Adjuvant and neo-adjuvant anthracycline based therapeutic regimens reduce breast and other cancer treatment-related mortality; however, this form of treatment may adversely impact heart function and promote heart failure. For example, post-menopausal breast cancer survivors that receive anthracycline-based chemotherapy are more likely to die from cardiovascular disease (CVD) than of their cancer. Upon a woman’s transition into menopause, there is a shift in fat storage from subcutaneous (SQ) to intraperitoneal (IP) fat, which may play a role in the increased cardiotoxicity among post-menopausal women. The goal of this study was to determine whether there is a difference in left ventricular (LV) function between pre- and post-menopausal age women with cancer that receive anthracycline-based chemotherapy, and then investigate whether this difference correlates with distributional differences in body fat. We assessed body fat distribution and LV function in 51 women with breast, lymphoma, or sarcoma cancer before and three months after initiating anthracycline-based chemotherapy. Analyses included two-sample t-tests and regressions, both of which were conducted using Microsoft Excel. After accounting for CVD co-morbidities, which could be confounding variables, the change in LV ejection fraction (or LVEF, a widely used measure of LV function) was inversely correlated with IP fat volume (r = 0.5, p = 0.048) and the ratio of intraperitoneal to subcutaneous fat (IP:SQ; r = 0.5, p = 0.03). These relationships were prominent in pre-menopausal age women (r = 0.5, p = 0.098; r = 0.6, p = 0.037, respectively). In conclusion, among women receiving anthracycline-based chemotherapy without hypertension, diabetes, coronary artery disease, or smoking, greater IP fat volume and IP:SQ fat ratios were associated with cancer treatment associated declines in LVEF. This finding was most prominent in pre- as opposed to post-menopausal age women.
Mabudian, Leila, "The Association Between Visceral Fat and Left Ventricular Performance in Pre- and Post-Menopausal Age Stage I-IV Cancer Patients that Receive Anthracycline-based Chemotherapy" (2021). Undergraduate Honors Theses. William & Mary. Paper 1643.
On-Campus Access Only
My submission includes the signed coversheet on the 1st page.