Incidence and Time on Onset of Cardiovascular Risk Factors and Cardiovascular Disease in Adult Survivors of Adolescent and Young Adult Cancer and Association with Exercise

青少年和青年癌症成年幸存者心血管危险因素和心血管疾病的发病率和时间以及与运动的关系

• 批准号: 10678157
• 负责人: Becky Leigh Hoover
• 金额: $ 4.06万
• 依托单位: UNIV OF NORTH CAROLINA CHAPEL HILL
• 依托单位国家: 美国
• 财政年份: 2023
• 资助国家: 美国
• 起止时间: 2023-05-15 至 2025-05-14
• 项目状态: 未结题
• 来源: https://reporter.nih.gov/project-details/10678157
• 关键词: 20 year old; Address; Adolescent; Adolescent and Young Adult; Adult; Aftercare; Age; Alkylating Agents; Anthracycline; Award; Canada; Cancer Survivor; Cancer Survivorship; Cardiac; Cardiotoxicity; Cardiovascular Diseases; Cardiovascular system; Cessation of life; Chest; Child; Childhood Cancer Survivor Study; Childhood Cancer Treatment; Combination Drug Therapy; Data; Data Analyses; Dedications; Development; Development Plans; Diabetes Mellitus; Diagnosis; Dyslipidemias; Event; Exercise; Foundations; Funding; General Population; Goals; Health Promotion; Heart Valve Diseases; Heart failure; Hodgkin Disease; Hypertension; Incidence; Individual; Intention; Intervention; Knowledge; Late Effects; Life; Malignant Childhood Neoplasm; Malignant Neoplasms; Metabolic; Methods; Monoclonal Antibodies; Morbidity - disease rate; Myocardial Infarction; Myocardial Ischemia; National Cancer Institute; Neck; Nurses; Obesity; Oncology Nurse; Patient Self-Report; Physical Fitness; Physical activity; Play; Population; Prospective, cohort study; Quality of life; Radiation; Reporting; Research; Research Personnel; Resources; Risk Factors; Role; Scientist; Siblings; Site; Stroke; Structure; Survivors; Testing; Time; Topoisomerase Inhibitors; Training; Tyrosine Kinase Inhibitor; United States; Work; age group; cancer complication; cancer therapy; cancer type; cardiovascular risk factor; career; career development; chemoradiation; chemotherapy; clinical care; cohort; experience; improved; mortality; mortality risk; negative affect; research and development; risk stratification; secondary analysis; skills; survivorship; young adult

ABSTRACT Many cancer survivors are at risk for cardiovascular complications after treatment. These complications can include cardiovascular risk factors (CVRF) such as diabetes, hypertension, dyslipidemia, and obesity and cardiovascular disease (CVD) such as heart failure, valvular heart disease, ischemic heart disease/myocardial infarction, and stroke. Those diagnosed between 15 and 20 years old are considered adolescent and young adult survivors (AYA) and frequently treated with cardiotoxic treatments which may increase their risk for CVRF and CVD. Yet little research has focused on understanding CVRF and CVD incidence in this population. An understanding of the incidence and time to onset of CVRF and CVD in this population is needed to inform surveillance and health promotion interventions. Health promotion interventions, such as exercise, may protect against the development of CVRF and CVD, because exercise has been shown to mitigate CVRF and CVD in other populations. Yet an understanding of the relationships between CVRF, CVD and exercise is unclear among this population. Utilizing data from the Childhood Cancer Survivor Study (CCSS), we will assess the incidence and time to onset of CVRF and CVD as well as relationships between CVRF, CVD and exercise for those diagnosed with cancer in the 15-to-20-year-old age group. We will identify if interventions, such as exercise, are needed for this population and if the need is increased for those who receive cardiotoxic treatments. Guided by the Cancer Survivor Research Framework, the study will address the following specific aims in 15-20 year old AYA cancer survivors: 1) Compare the incidence and time to onset of CVRF between survivors who were exposed and not exposed to cardiotoxic treatment and according to the type of cardiotoxic cancer treatments (chemotherapy, radiation, or chemo + radiation) received, 2) Compare the incidence and time to onset of CVD between survivors who were exposed and not exposed to cardiotoxic treatments and according to the type of cardiotoxic cancer treatments received, and 3) Examine longitudinal associations between self-report exercise (weekly metabolic equivalence tasks) and the incidence of CVRF and CVD in survivors across three time points (1999, 2007, and 2014). The accompanying career development plan will provide training in a) the unique needs and experiences of adult survivors of AYA cancers, b) the role exercise plays in mitigating CVRF and CVD for cancer survivors, and c) longitudinal and secondary data analyses methods. Together, the career development and research plan will support the development of an independent nurse scientist in cancer survivorship, cardiotoxicity, and exercise. This proposal will generate important knowledge related to cardiovascular complications for cancer survivors by creating risk stratification for receipt of cardiotoxic treatments. Additionally, this research will increase understanding of the effects that exercise has on CVRF and CVD, laying the foundation for future research focused on developing and testing interventions to mitigate CVRF and CVD among cancer survivors diagnosed between 15-and-20-years of age.

抽象的 治疗后，许多癌症幸存者有患心血管并发症的风险。这些并发症可能 包括心血管危险因素（CVRF），例如糖尿病，高血压，血脂异常和肥胖，以及 心血管疾病（CVD），例如心力衰竭，瓣膜心脏病，缺血性心脏病/心肌病 梗塞和中风。那些被诊断在15到20岁之间的人被认为是青春期和年轻的 成人幸存者（AYA），经常接受心脏毒性治疗，这可能会增加其CVRF的风险 和CVD。然而，很少的研究重点是了解该人群中的CVRF和CVD发病率。一个 需要了解该人群中CVRF和CVD发作的发病率和时间以告知 监视和健康促进干预措施。健康促进干预措施（例如锻炼）可能会保护 反对CVRF和CVD的开发，因为已显示运动可以减轻CVRF和CVD 其他人群。然而，对CVRF，CVD和运动之间关系的理解尚不清楚 这个人口。利用儿童癌症幸存者研究（CCSS）的数据，我们将评估发病率 以及CVRF和CVD发作的时间以及CVRF，CVD与锻炼之间的关系 在15至20岁的年龄组中被诊断出患有癌症。我们将确定干预措施（例如锻炼）是否是 对于那些接受心脏毒性疗法的人来说，这种人群需要增加需求。指导 癌症幸存者研究框架，该研究将解决15-20岁的以下特定目标 AYA癌症幸存者：1）比较在幸存者之间的发病率和时间 暴露于心脏毒性治疗，并根据心脏毒性癌治疗的类型 （化学疗法，放射线或化学 +辐射）接受，2）比较CVD发作的发病率和时间 在暴露且未暴露于心脏毒性治疗的幸存者之间 心脏毒性癌症治疗和3）检查自我报告运动之间的纵向关联 （每周代谢等效任务）以及三个时间点幸存者中CVRF和CVD的发生率 （1999，2007和2014）。随附的职业发展计划将为a）独特需求提供培训 和AYA癌的成年幸存者的经历，b）练习在减轻CVRF和CVD方面的角色扮演 癌症幸存者以及c）纵向和二级数据分析方法。一起职业发展 研究计划将支持开发癌症生存的独立护士科学家， 心脏毒性和运动。该建议将产生与心血管有关的重要知识 癌症幸存者的并发症是通过创造风险分层来接受心脏毒性治疗。此外， 这项研究将增加对运动对CVRF和CVD的影响的理解 未来研究的基础着重于制定和测试干预措施，以减轻CVRF和CVD 癌症幸存者被诊断出15岁至20岁。