https://doi.org/10.1007/s00392-025-02625-4
1Universitätsklinikum Ulm Sektion für Sport- und Rehabilitaionsmedizin Ulm, Deutschland; 2Universitätsklinikum Ulm Klinik für Innere Medizin II Ulm, Deutschland; 3Universitätsklinikum Ulm Klinik für Diagnostische und Interventionelle Radiologie Ulm, Deutschland; 4Universitätsklinikum Ulm Klinik für Frauenheilkunde und Geburtshilfe Ulm, Deutschland; 5Herzplus Ulm Ulm, Deutschland
The incidence of breast cancer has increased from 900 000 to 2.3 million new annual cases over the last 25 years. The 5-year survival rate has markedly risen to over 90% worldwide due to significant therapeutic advancements. Longer survival in patients with breast cancer means more patients may experience long-term effects of their treatments, including cancer therapy-related cardiac dysfunction (CTRCD). To date, there is no established primary prevention to minimise CTRCD.
Purpose
The Cardiac Health in Breast Cancer (CHiB) study is a two-arm, single-center, randomised controlled trial investigating the impact of an exercise programme on cardiac changes and cardiac involvement in breast cancer patients undergoing cardiotoxic therapy.
Methods
Forty-eight females with breast cancer will be randomised to either a twelve-month intervention group (IG) or a control group (CG). The IG will receive a combination of supervised high-intensity interval training (HIT) and strength training (HIRT) for six months, while the CG will follow WHO guidelines for physical activity independently. All participants will undergo transthoracic echocardiography (TTE), cardiac magnetic resonance imaging (CMR) and a cardiopulmonary exercise test (CPET) at baseline (t1), after six months (t2) and after 12 months (t3). The primary endpoint is the occurrence of symptomatic or asymptomatic CTRCD at the time points of examination, detected by cardiac imaging, which may be mitigated by structural physical exercise. Secondary endpoints include assessments of mitochondrial dysfunction, cardiac inflammation (CMR), exercise capacity, average heart rate and heart rate variability (HRV), health-related quality of life, as well as the occurrence of fatigue, depression and anxiety.
Results
The study may provide evidence for the primary preventive effects of a structured exercise program in mitigating cardiac dysfunction associated with cardiotoxic breast cancer therapies.
Conclusions
CHiB is the first randomised clinical trial to investigate the effects of a structured exercise programme on the incidence of CTRCD in the treatment of breast cancer. Given the limited research on the effects of exercise on cardiac function in breast cancer patients, the clinical findings of this study could be pivotal for CTRCD research, potentially leading to the development of targeted exercise prescription guidelines during cardiotoxic cancer treatment.