Cardiopulmonary exercise performance of cancer survivors and patients with stable coronary artery disease with preserved ejection fraction compared to healthy controls

Figures & data

Figure 1. Flowchart of study inclusion, CPET (cardiopulmonary exercise testing). CVD: Cardiovascular disease. EF: Ejection fraction. Mean age is reported, standard deviation in parentheses. MACE: Major adverse cardiovascular event. P_max: maximal power achieved in cardiopulmonary exercise testing (CPET) [W]. VO_2peak: peak oxygen uptake at maximal effort [l]. OUES: Oxygen uptake efficiency slope.

Table 1. Cardiovascular risk factors in the three groups

	HFpEF	Cancer	Controls	p-values
Hypertension				<.001*
Medically controlled hypertension	63%	18%	13%
Diabetes				p = .004*
Medically controlled diabetes	17%	2%	2%
LDL cholesterol [mg/dl]				<.001*
<70	8%	44%	22%
100–150	47%	23%	28%
Smoking				p = .117
Non-Smokers	72%	74%	78%
>20 pack years	15%	5%	2%
BMI [kg/m2]				p = .008*
BMI<20	5%	18%	3%
BMI >30	20%	20%	15%
Weekly endurance traning hours				p = .56
<5 h/week	77%	70%	65%
>5 h/week	23%	30%	35%

Table 1. Cardiovascular risk factors across the three groups. Significance (<.05) was marked with an asterisk.

Figure 2. (a) Maximal power (P_max) [W] across the three groups. b() Relative VO_2peak [ml/kg/min] across the three groups.

Table 2. Blood pressure at rest and peak exercise across the three groups

	HFpEF	Cancer	Controls	p-values
RRsysRest [mmHg]	128.17 ± 14.87	123.31 ± 14.93	128.25 ± 14.67	p = .224
	CI:124.32–132.01	CI: 119.41–127.20	CI: 124.46–132.04
RRdiaRest [mmHg]	80.25 ± 8.66	80.25 ± 7.85	80.45 ± 8.3	p = .704
	CI: 78.01–82.49	CI: 78.21–82.30	CI: 79.22–81.67
RRsysPeak [mmHg]	193.75 ± 29.32	182.88 ± 28.48	200.17 ± 24.97	p = .005*
	CI: 186.18–201.32	CI: 175.46–190.30	CI: 193.72–206.62
RRdiaPeak [mmHg]	86.05 ± 14.41	84.75 ± 10.92	84.83 ± 9.52	p = .871
	CI: 82.33–89.77	CI: 81.10–87.89	CI: 82.37–87.29
ΔRRsys [mmHg]	67.58 ± 24.78	60.08 ± 21.41	71.25 ± 20.58	p = .018*
	CI: 61.18–73.98	CI: 54.51–65.66	CI: 65.93–76.57
ΔRRdia [mmHg]	5.17 ± 11.39	5.34 ± 9.69	4.00 ± 8.70	p = .873
	CI: 2.23–8.11	CI:2.81–7.86	CI: 1.75–6.25

Table2. Mean values of resting and peak systolic and diastolic blood pressures with standard deviations in the three groups. A 95% confidence interval (CI) is depicted as well as p-values. Significance (alpha<.05) is marked with an asterisk. RRsysRest: systolic pressure at rest; RRdiaRest: diastolic pressure at rest; RRsysPeak: systolic pressure at peak performance; RRdiaPeak: diastolic pressure at peak performance; ΔRRsys: Difference between systolic resting and peak pressure; ΔRRdia: difference between diastolic resting and peak pressure.

Figure 3. Graphical display of performance [W] at the first ventilatory threshold (VT), lactate threshold (LT), individual anaerobic threshold (IAT) and the ventilatory compensation point (VCP).

Table 3. Correlation between weekly endurance hours and maximal performance

	HFpEF	Cancer
Pmax [W]	p = .005; r = .361	p < .001; r = .443
VO2peak [l/min]	p = .032; r = .278	p < .001; r = .514
OUES	p = .015; r = .312	p > .001; r = 445

Table3. Correlations between weekly endurance hours and maximal performance (P_max), VO_2peak and oxygen uptake efficiency slope (OUES), alpha <.05.