Cardio-oncology & otherCross-sectional study
Autonomic Dysfunction Among Adult Survivors of Childhood Cancer in the St. Jude Lifetime Cohort Study
- Cross-sectional study
- prospective
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)
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
| Outcome | adjusted OR (95% CI) | P value | |
|---|---|---|---|
| Risk factors for ≥2 measures of autonomic dysfunction (survivors) — Carboplatin vs Control | 2.50 (1.42–4.40) | P = 0.001 | |
| Risk factors for ≥2 measures of autonomic dysfunction (survivors) — Chest-directed radiation therapy vs Control | 2.06 (1.52–2.75) | P < 0.001 | |
| Risk factors for ≥2 measures of autonomic dysfunction (survivors) — Cranial radiation vs Control | 1.49 (1.08–2.05) | P = 0.015 | |
| Impaired cardiorespiratory fitness (peak Vo2 < 80% predicted) with ≥2 measures of autonomic dysfunction (survivors) | 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:10.1016/j.jaccao.2024.08.005
Summarised from the published abstract; every number is checked against it