Cardiac Structure and Function in Men with Prostate Cancer Receiving Androgen-Deprivation Therapy and the Effects of Recreational Small-Sided Football Training:A Randomized Controlled Trial

Purpose: Androgen deprivation therapy (ADT) is a cornerstone in prostate cancer (PCa) management that prolongs PCa-free and overall survival, but effects of ADT on human cardiac function have not been investigated. We used echocardiography to examine cardiac structure and function in patients with prostate cancer receiving ADT and to determine whether an exercise intervention can elicit cardiac adaptations in these subjects. Methods: Forty-three patients with prostate cancer receiving ADT were randomized to 12 weeks football training (ST group;n = 20) or usual care (control [CO] group;n = 23). Cardiac function was assessed at baseline and after 12 weeks by comprehensive echocardiography. Peak oxygen consumption, blood pressure and peripheral microvascular function was also measured. Results: At baseline, no considerable echocardiographic abnormalities were observed. In the ST group, increases in left ventricular diastolic function variables including E/A ratio (P = 0.03), E’ (P = 0.016), E’TDIcolor (P = 0.040) and in left atrial diameter (P = 0.001) were observed after 12 weeks. In addition, diastolic blood pressure (P = 0.027) and resting heart rate (P 0.001) were reduced after ST. In the CO group, no significant changes were observed in the examined variables after 12 weeks. Despite within group changes in the ST group, no significant differences were observed after 12 weeks between groups in echocardiographic variables, peak oxygen consumption, blood pressure and peripheral microvascular function. Conclusion: In men with prostate cancer receiving ADT, echocardiography showed no abnormalities in cardiac structure and function. Twelve weeks of ST failed to elicit significant cardiovascular adaptations and ADT may blunt cardiovascular adaptations to short-term exercise training.

A Modified Treatment Failure Classification System with Complete and Exhaustive Accounting of Any Adverse Events Related to the Previous Percutaneous Coronary Intervention

Objectives: To determine the clinical outcome related to treatment failure of the percutaneous coronary intervention (PCI) itself. Background: When considering the addition of PCI to the medical treatment of angina, it is necessary to know the balance between the benefit and the risk of the PCI itself, but the latter remains unknown. The usual outcome measures are imprecise because they contain events unrelated to the previous PCI and because some events clearly caused by PCI treatment failures are omitted. Methods: In total, 2098 unselected patients were randomized to receive either sirolimus-(n = 1065) or paclitaxel-(n = 1033) eluting coronary stents and followed for five years in the SORT OUT II. Any death, cardiac death, myocardial infarction (MI), stent thrombosis and documented stenosis was classified and combined to a “patient oriented clinical outcome” (POCO), the classical “major adverse cardiac events” (MACE) and the new “PCI-treatment oriented clinical outcome” (TOCO). Results: POCO occurred in 746 patients (35.6%), MACE in 467 patients (22.3%) and TOCO in 293 patients (14.0%), thus TOCO amounted to 39% of the POCO and to 63% of the MACE. Conclusion: By introduction of the present PCI treatment failure classification system, the clinical outcome of PCI-treatment itself may be credulously estimated by the rate of TOCO and eventually PCI is substantially better than what might be perceived from the classically used POCO and MACE rates.