Cohort study
Clinical and Prognostic Relevance of Cardiac Wasting in Patients With Advanced Cancer
- Prospective cohort study
Authors' conclusion
Low LV mass is associated with poor functional status and increased all-cause mortality in cancer.
Study context
- Population
- Patients with mostly advanced, active cancer without significant CVD or infection; controls of similar age and sex
- Participants
- 300 / 60 / 60
- Exposure
- Cancer patients vs healthy controls vs chronic HF patients
- Cancern = 300
- Healthy controln = 60reference
- Heart failuren = 60
Main finding
As reported in the abstract
LV mass (transthoracic echocardiography)
- Lower left ventricular (LV) mass in cancer than controls or HF
- P < 0.001
Observational data: associations, not effects.
Further findings
LV mass, cancer patients with cachexia
- LV mass lowest in cancer patients with cachexia
- 153 ± 42 g
- P < 0.001
Low LV mass and previous cardiotoxic anticancer therapy
- Low LV mass independent of previous cardiotoxic anticancer therapy
All-cause mortality, cancer patients · mean follow-up 16 months
- Deaths
- 149
- 1-year all-cause mortality
- 43% (95% CI: 37%-49%)
Change in LV mass on second echocardiogram (90 cancer patients) · 122 ± 71 days
- LV mass decline
- 9.3% ± 1.4%
- P < 0.001
Stroke volume and resting heart rate in cancer patients with cardiac wasting
- Stroke volume decreased
- P < 0.001
- Resting heart rate increased
- P = 0.001
LV mass as prognostic marker
- LV mass and LV mass adjusted for height squared independent prognostic markers
- P < 0.05
- Adjustment for body surface area masked the survival impact
Functional status and physical performance
- LV mass below prognostic cutpoints associated with reduced functional status and lower physical performance
Original publication
Clinical and Prognostic Relevance of Cardiac Wasting in Patients With Advanced Cancer. J Am Coll Cardiol. Published 25 April 2023. doi:10.1016/j.jacc.2023.02.039
Summarised from the published abstract; every number is checked against it