Higher aortic pulse pressure and lower VO2peak were associated with longer TMT-A (ρ=0.55, ρ=-0.56; P=0.02) and TMT-B times (ρ=0.61, ρ=-0.60; P=0.01) in women post-chemotherapy for breast cancer.
Cross-Sectional (n=20)
Are vascular function and cardiorespiratory fitness associated with cognitive function in women treated with chemotherapy for early-stage breast cancer?
Higher arterial stiffness and lower cardiorespiratory fitness correlate with reduced cognitive function in breast cancer survivors post-chemotherapy.
Breast cancer is the most prevalent cancer in women, and chemotherapy is a cornerstone of treatment. One in three women who received chemotherapy for breast cancer may experience cognitive impairment, which adversely impacts quality of life. The mechanisms responsible for cognitive impairment are not fully understood, but evidence in healthy individuals and clinical populations indicates large elastic artery stiffness and low cardiorespiratory fitness are implicated. The purpose of this study was to investigate whether cognitive function is associated with vascular function and cardiorespiratory fitness in women who received chemotherapy for early-stage breast cancer. Twenty women (56±12 years, mean±SD) with stage I to III breast cancer participated in the study 6 to 18 months after completing chemotherapy. Cognitive function was assessed using the Montreal Cognitive Assessment (MoCA), a commonly used screening tool for cognitive impairment inclusive of brief tests of executive function, memory, visuospatial skills, and language. In addition, the Trail Making Test (TMT) was conducted to assess visual search and psychomotor speed skills (TMT-A) and set-shifting (TMT-B), and the Hopkins Verbal Learning Test-Revised (HVLT-R) was conducted to evaluate verbal learning and working memory. Central pulse pressure, arterial stiffness, and wave reflection were assessed by aortic pulse pressure, carotid-femoral pulse wave velocity (cfPWV), and augmentation index at heart rate 75 beats/min (AIx@75), respectively, using the SphygmoCor Xcel device (CONNEQT Health). Cardiorespiratory fitness was assessed using peak oxygen consumption (VO2peak) obtained via open circuit spirometry during a graded maximal exercise test. We found that higher aortic pulse pressure, indicating higher arterial stiffness, and lower VO2peak, indicating lower cardiorespiratory fitness, were associated with longer TMT-A time (ρ=0.55 and ρ=-0.56, P=0.02) and TMT-B time (ρ=0.61 and ρ=-0.60, P=0.01), indicating reduced visual search and psychomotor speed skills, and set-shifting. Higher cfPWV, indicating higher arterial stiffness, was related with longer TMT-B time (ρ=0.56, P=0.02), indicating reduced set-shifting. Higher AIx@75, indicating higher wave reflection, was related with longer TMT-A time (ρ=0.49, P=0.03), indicating reduced visual search and psychomotor speed skills. The MoCA score and HVLT-R total recall and learning scores were not significantly correlated with aortic pressure, cfPWV, AIx@75, and VO2peak (P>0.05). In conclusion, we have demonstrated that higher aortic pulse pressure, arterial stiffness, and wave reflection, and lower cardiorespiratory fitness are associated with worse cognitive function in women with early-stage breast cancer who received chemotherapy. Further investigation is warranted to confirm these relationships in a larger cohort and to examine the mechanisms that may be underlying these associations. This abstract was presented at the American Physiology Summit 2026 and is only available in HTML format. There is no downloadable file or PDF version. The Physiology editorial board was not involved in the peer review process.
Kim et al. (Fri,) conducted a cross-sectional in early-stage breast cancer (n=20). Higher aortic pulse pressure and lower VO2peak were associated with longer TMT-A (ρ=0.55, ρ=-0.56; P=0.02) and TMT-B times (ρ=0.61, ρ=-0.60; P=0.01) in women post-chemotherapy for breast cancer.