Análise da modulação autonômica cardíaca associada ao estadiamento de câncer de mama

• Ano de defesa: 2018
• Autor(a) principal: Arab, Claudia [UNIFESP]
• Tipo de documento: Tese
• Tipo de acesso: Acesso aberto
• Idioma: por
• Instituição de defesa: Universidade Federal de São Paulo (UNIFESP)
• Palavras-chave em Português: Neoplasia; Breast neoplasia; Neoplasia staging; Autonomic nervous system; Vagus Nerve; Sympathetic nervous system; Neoplasias; Neoplasias da mama; Estadiamento de neoplasias; Sistema nervoso autônomo; Nervo vago; Sistema nervoso simpático
• Link de acesso: https://sucupira.capes.gov.br/sucupira/public/consultas/coleta/trabalhoConclusao/viewTrabalhoConclusao.jsf?popup=true&id_trabalho=6526951; https://repositorio.unifesp.br/handle/11600/52128

Aim: To analyze cardiac autonomic modulation in relation to breast cancer staging and associated factors. Methods: This crosssectional study included women (30–69 years old) with primary diagnosis of breast cancer and women with benign breast tumors at three public hospitals (Hospital São Paulo, Hospital Pérola Byington and Instituto do Câncer Doutor Arnaldo Vieira de Carvalho) in Sao Paulo (SP, Brazil). We evaluated cardiac modulation by heart rate variability and assessed factors of anxiety, depression (Hospital Anxiety and Depression Scale), physical activity (International Physical Activity Questionnarie – short form), and other relevant medical variables. Patients were divided into three groups based on TNM staging of cancer severity: earlystage cancer (n = 42), advancedstage cancer (n = 33), or benign breast tumors to serve as a control (n = 37). We analyzed heart rate variability in time and frequency domains. Oneway ANOVA and Kruskal–Wallis tests were used. Post hoc analyses (Bonferroni correction) followed statistical tests and the effect size was verified by etasquared indexes. Results: The advancedstage cancer group had lower vagal modulation than earlystage and benign groups; also, the advancestage group had lower overall heart rate variability when compared to benign conditions. Heart rate variability was influenced by age, menopausal status, and BMI. Conclusions: Cardiac autonomic modulation is inversely associated with breast cancer staging. Heart rate variability seems to be a promising, noninvasive tool for early diagnosis of autonomic dysfunction in breast cancer and detection of cardiovascular impairments at cancer diagnosis.