Role Of Cardiac Reserve As A Tool To Unmask Cardiotoxicity Following Anthracycline Therapy And Whether Exercise Training Can Attenuate Cardiotoxicity.

556Background: Anthracycline-based chemotherapy (AC) is associated with an increased risk of cardiac damage and long-term heart failure. However, diagnosis of cardiac damage is infrequent, while long-term heart failure risk is substantial. Thus, we sought to evaluate whether exercise cardiac reserve may be a more sensitive marker of cardiac toxicity than standard measures of cardiac function and if exercise training maintained cardiac function and exercise capacity during AC. Methods: 28 BC patients undergoing AC were recruited into a non-randomised trial and allocated to exercise training (ET) (46.7±9.0 yrs, n = 14) or usual care (UC; 53.2±8.9 years, n = 14), respectively. Tests including echocardiography (left ventricular ejection fraction [LVEF] and global longitudinal strain [GLS]), cardiopulmonary exercise test (peak oxygen uptake, VO2peak), and exercise cardiac magnetic resonance imaging (exCMR, cardiac reserve) were performed prior to and after completion of AC. The ET group completed a twice weekl...