Autonomic Dysfunction Among Adult Survivors of Childhood Cancer in the St. Jude Lifetime Cohort Study.
Publication/Presentation Date
10-1-2024
Abstract
BACKGROUND: The burden and functional significance of autonomic dysfunction among survivors of childhood cancer is unknown.
OBJECTIVES: We evaluated the prevalence, risk factors, and functional relevance of autonomic dysfunction in survivors.
METHODS: We conducted a cross-sectional prospective evaluation of 1,041 adult survivors of childhood cancer treated with anthracyclines (31.1%), chest-directed radiation (13.5%), both (19.5%), or neither (35.9%), and 286 community control subjects enrolled in the SJLIFE (St Jude Lifetime Cohort Study). Four measures of autonomic dysfunction were evaluated: elevated resting heart rate, decreased heart rate reserve, decreased systolic blood pressure response to exercise, and delayed heart rate recovery. Logistic regression tested associations with impaired cardiorespiratory fitness (peak Vo
RESULTS: Survivors (50.7% female) were 9.0 ± 5.8 years at cancer diagnosis and 35.5 ± 8.9 years at evaluation. Prevalence (survivors vs control subjects) of elevated resting heart rate (17.9% vs 7.0%), decreased heart rate reserve (21.7% vs 9.1%), decreased systolic blood pressure response to exercise (25.3% vs 12.6%), and delayed heart rate recovery (24.3% vs 10.6%) was more than 2-fold higher among survivors (
CONCLUSIONS: Survivors of childhood cancer manifest a higher prevalence of autonomic dysfunction associated with impaired cardiorespiratory fitness.
Volume
6
Issue
5
First Page
775
Last Page
787
ISSN
2666-0873
Published In/Presented At
Groarke, J. D., Ness, K. K., Dhaduk, R., Plana, J. C., Durand, J. B., Luepker, R. V., Joshi, V. M., Ehrhardt, M., Mulrooney, D. A., Dixon, S. B., Nohria, A., Green, D. M., Howell, R. M., Srivastava, D. K., Jefferies, J. L., Robison, L. L., Hudson, M. M., & Armstrong, G. T. (2024). Autonomic Dysfunction Among Adult Survivors of Childhood Cancer in the St. Jude Lifetime Cohort Study. JACC. CardioOncology, 6(5), 775–787. https://doi.org/10.1016/j.jaccao.2024.08.005
Disciplines
Business Administration, Management, and Operations | Health and Medical Administration | Management Sciences and Quantitative Methods
PubMedID
39479326
Department(s)
Administration and Leadership
Document Type
Article