Date Thesis Awarded
4-2024
Access Type
Honors Thesis -- Access Restricted On-Campus Only
Degree Name
Bachelors of Science (BS)
Department
Neuroscience
Advisor
Daniel Cristol & W. Gregory Hundley
Committee Members
Lizabeth Allison
Randolph Coleman
Abstract
Abstract
Background: Women treated for breast cancer (BC) with anthracyclines and other chemotherapeutic agents experience decreased exercise capacity, thereby increasing their risk of developing heart failure.We determined in women treated for BC and in comparators if baseline physical activity (PA) levels and muscle quality were associated with changes in submaximal exercise capacity.
Methods: This longitudinal cohort study included 128 female breast cancer survivors who underwent MRI of the paraspinal muscles and completed a six-minute walk distance (6MWD) test prior to and 3 months after initiating potentially cardiotoxic chemotherapy.The study also included 76 female comparators who underwent abdominal MRI and 6MWD at baseline and three months later. The participants were categorized as active or inactive based on self-reported Godin-Shephard Leisure-Time PA questionnaire scores, and MRIs were analyzed in a blinded read for intermuscular fat (IMF) indexed to skeletal muscle (SM) within the paraspinal muscles. Participants were grouped by baseline IMF:SM into groups above or below the median.
Associations were examined using analysis of covariance (ANCOVA) models.
Results: The majority of the participants were of white race. There were no significant differences in average age, race, or BMI between the cancer patients and the comparators (p=0.14, p=0.85, p=0.2). The BC survivors experienced declines in 6MWD over three months relative to the comparators (p=0.0045), with a difference of -25.1 meters compared to +9.8 meters, respectively, in their 6MWD. The group of comparators who were active with good muscle quality exhibited a 51.7 meter increase in 6MWD from baseline to three months. This was significantly greater than all of the changes in 6MWD in the cancer group, except for the cancer patients who were active with low intermuscular fat. This group walked 9.8 meters farther after three months of chemotherapy than they did at baseline. The rest of the cancer groups saw declines in 6MWD during this time frame. The changes in 6MWD were not influenced by race (p=0.079), age (p=0.55), hematocrit (p=0.11), serum creatinine (p=0.44), tobacco use (p=0.38), cardiovascular risk factors (p=0.22), or history of myocardial infarction (p=0.61).
Conclusion:In BC survivors receiving three months of potentially cardiotoxic chemotherapy, sufficient physical activity and low IMF:SM is associated with maintenance of submaximal exercise capacity, indicating decreased risk of heart failure. Insufficient physical activity and/or high IMF:SM is associated with decreased exercise capacity.
Recommended Citation
Daniel, Lauren, "Association of Intermuscular Fat and Physical Activity Levels on Exercise Capacity in Breast Cancer Survivors" (2024). Undergraduate Honors Theses. William & Mary. Paper 2229.
https://scholarworks.wm.edu/honorstheses/2229
