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Mitigating Cardiotoxicity: The Effects of Physical Activity on Echocardiographic Parameters and the Metabolome in Breast Cancer Patients Receiving Anthracycline Treatment

dc.contributor.authorKendall, Stephanie
dc.contributor.copyright-releaseNot Applicableen_US
dc.contributor.degreeMaster of Scienceen_US
dc.contributor.departmentSchool of Health & Human Performanceen_US
dc.contributor.ethics-approvalReceiveden_US
dc.contributor.external-examinerGerry Johnstonen_US
dc.contributor.graduate-coordinatorMelanie Keatsen_US
dc.contributor.manuscriptsNot Applicableen_US
dc.contributor.thesis-readerTobias Karakachen_US
dc.contributor.thesis-readerMelanie Keatsen_US
dc.contributor.thesis-supervisorDr. Scott Grandyen_US
dc.date.accessioned2023-07-28T18:48:47Z
dc.date.available2023-07-28T18:48:47Z
dc.date.defence2023-07-18
dc.date.issued2023-07-28
dc.description.abstractMetabolomic profiling is a novel technique to identify anthracycline-induced cardiotoxicity (CTX). Higher physical activity levels may mitigate this damage. Therefore, the primary objectives of this thesis were to determine the effects of anthracyclines on the metabolome, investigate the relationship between echocardiographic parameters and the metabolome, and assess the impact of physical activity levels on echocardiographic and metabolic changes. 17 adult females with stage I to III breast cancer scheduled to receive anthracyclines completed baseline and 24-week follow-up assessments. Assessments included an echocardiogram to measure left ventricular ejection fraction (LVEF) and global longitudinal strain (GLS), a questionnaire to assess physical activity levels, and a blood draw for the targeted metabolomic analysis. No significant changes in LVEF% (P = .08) or GLS% (P = .07) were identified. Lipids were the most frequently affected metabolite class.The altered metabolites were unrelated to changes in LVEF% (P = .40, R2 = 0.93) or GLS% (P = .34, R2 = 0.94). Baseline levels of physical activity were associated with changes in GLS% (P = .01) and phosphatidylcholine 16:0/16:0 (P = .02). Baseline physical activity levels were also associated with changes in 71% of assessed metabolites compared to follow-up physical activity levels. Follow-up reported physical activity levels impacted changes in urea relative intensity (P = .02). Anthracyclines altered metabolite levels, particularly in lipid-based metabolites. Physical activity levels, notably baseline, were associated with changes in metabolic parameters and GLS%. Changes in the metabolome were not predictive of echocardiographic parameters. Future longitudinal research should be conducted to identify metabolic biomarkers for CTX, and investigate the effect of physical activity, particularly before anthracycline treatment, on CTX development.en_US
dc.identifier.urihttp://hdl.handle.net/10222/82741
dc.language.isoenen_US
dc.subjectCardiotoxicityen_US
dc.subjectMetabolomicsen_US
dc.subjectPhysical Activityen_US
dc.subjectBreast Canceren_US
dc.subjectAnthracyclinesen_US
dc.subjectExerciseen_US
dc.subjectCardiooncologyen_US
dc.subjectMetabonomicsen_US
dc.titleMitigating Cardiotoxicity: The Effects of Physical Activity on Echocardiographic Parameters and the Metabolome in Breast Cancer Patients Receiving Anthracycline Treatmenten_US

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