Autonomic Dysfunction Among Adult Survivors of Childhood Cancer in the St. Jude Lifetime Cohort Study
Authors' conclusion
Survivors of childhood cancer manifest a higher prevalence of autonomic dysfunction associated with impaired cardiorespiratory fitness.
Study context
- Population
- Adult survivors of childhood cancer and community controls in SJLIFE (St Jude Lifetime Cohort Study)
- Participants
- 1,041 vs 286
- Exposure
- Childhood cancer survivors vs community controls
- Survivorsn = 1,041
- Controln = 286reference
- Outcome
- Prevalence of 4 measures of autonomic dysfunction (elevated resting heart rate, decreased heart rate reserve, decreased SBP response to exercise, delayed heart rate recovery)
Methodological detailsprospective
- Prospective
Main finding
As reported in the abstract
Prevalence of autonomic dysfunction measures
Elevated resting heart rate
Decreased heart rate reserve
Decreased SBP response to exercise
Delayed heart rate recovery
- Prevalence more than 2-fold higher among survivors for all four measures
- P < 0.001
Observational data: associations, not effects.
Further findings
Risk factors for ≥2 measures of autonomic dysfunction (survivors)
| Adjusted OR (95% CI) | P value | ||
|---|---|---|---|
| Carboplatin | 2.50 (1.42–4.40) | P = 0.001 | |
| Chest-directed radiation therapy | 2.06 (1.52–2.75) | P < 0.001 | |
| Cranial radiation | 1.49 (1.08–2.05) | P = 0.015 | |
| 0.20.5125Adjusted odds ratio (log scale) |
Impaired cardiorespiratory fitness (peak Vo2 < 80% predicted) with ≥2 measures of autonomic dysfunction (survivors)
| Adjusted OR (95% CI) | P value | ||
|---|---|---|---|
| ≥2 measures of autonomic dysfunction | 2.71 (1.82–4.02) | P < 0.001 | |
| 0.20.5125Adjusted odds ratio (log scale) |
Original publication
Autonomic Dysfunction Among Adult Survivors of Childhood Cancer in the St. Jude Lifetime Cohort Study. JACC CardioOncol. Published 8 October 2024. doi:10.
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