Key result
Six months of supervised exercise training significantly improved exercise capacity but did not exert any measurable effects on endothelial dysfunction (change in RHI p=0.323) compared to usual care in postmenopausal women with breast cancer on aromatase inhibitor therapy.
Why the study?
Aromatase inhibitor therapy reduces systemic estrogen levels, potentially causing endothelial dysfunction and cardiovascular disease, but whether exercise training improves endothelial dysfunction in this population was unknown.
Does supervised exercise training improve endothelial function in postmenopausal women with breast cancer under aromatase inhibitor therapy?
RCT (n=32)
1:1
Yes
Does supervised exercise training improve endothelial function in postmenopausal women with breast cancer under aromatase inhibitor therapy?
Absolute Event Rate: -0.1% vs 0.02%
p-value: p=0.323
In postmenopausal women with breast cancer on aromatase inhibitors, 6 months of supervised exercise training significantly improved exercise capacity but did not improve endothelial dysfunction.
Exercise training does not improve endothelial function in AI-treated postmenopausal breast cancer patients despite capacity gains; challenges vascular benefit assumptions and warrants alternative strategies.
BACKGROUND: Breast cancer is the leading non-cardiovascular cause of death in women. In endocrine receptor positive women, aromatase inhibitors (AI) are the therapy of choice despite the fact that a decrease in systemic estrogen levels may result in endothelial dysfunction and eventually in cardiovascular disease. In this study, we assessed whether exercise training (ET), which has repeatedly shown to lead to an improvement of endothelial dysfunction, will also exert this effect in postmenopausal women with AI treated breast cancer. METHODS: Thirty two postmenopausal women with AI treated breast cancer were randomized to an intervention group (ET; 6 months, supervised training plus 6 months without intervention) or control group of usual care (UC; 12 months without intervention plus initial exercise counseling). Endothelial function was assessed via Reactive Hyperemia Index (RHI) measured non-invasively with the EndoPAT-System at baseline, 6 and 12 months. RESULTS: After 6 months of supervised ET, changes in maximal exercise capacity were significantly greater in ET than in UC (∆W: 24.1 ± 11.5 vs. 1.1 ± 8.2 watts; p < 0.001). Even though 43.8% of all participants had endothelial dysfunction at baseline, there were no significant group differences in the changes of RHI between ET (∆RHI: -0.1 ± 1.04) and UC (0.02 ± 0.75; p = 0.323) after 6 months. CONCLUSION: Even though ET led to significantly greater improvement in exercise capacity in postmenopausal women with AI treated breast cancer than exercise counseling only, it did not exert any measurable effects on endothelial dysfunction.
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Mayr et al. (2022) conducted an RCT in Breast cancer under aromatase inhibitor therapy (n=32). Exercise training (high-intensity interval training and resistance training) vs. Usual care (initial exercise counseling) was evaluated on Change in Reactive Hyperemia Index (RHI) at 6 months (p=0.323). Six months of supervised exercise training significantly improved exercise capacity but did not exert any measurable effects on endothelial dysfunction (change in RHI p=0.323) compared to usual care in postmenopausal women with breast cancer on aromatase inhibitor therapy.
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