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A group of patients who will not be trained will be evaluated at baseline (pre) and after 16 weeks.

They are oriented to maintain lifestyle changes

Patients will complete 16 weeks of training including 40 minutes of aerobic training, 15 minutes of resistive exercise and 5 minutes of relaxation.

Patients undergo 16 weeks of physical training

exercise training

Amanda Gonzales Rodrigues

Carlos Eduardo Negrao, PHD

Roberto Kalil Filho, PHD

New therapies for cancer increased patient survival, but led to the recognition of adverse effects associated with cancer treatment, such as the use of chemotherapy. Cardiotoxicity is the most significant adverse effect, which affect the functional capacity and quality of life and is associated with high morbidity and mortality, regardless of the oncological prognosis. One of the manifestations of cardiotoxicity is ventricular dysfunction that can lead to heart failure. Neuro humoral hyperactivation with increased sympathetic nerve activity is a typical manifestation of heart failure and is associated with worse prognosis. Studies have shown that physical training significantly reduces sympathetic nerve activity in addition to improving muscle blood flow, reversing effects on skeletal muscle and improving quality of life. The hypothesis is that physical training may reduce sympathetic nerve activity and vasoconstrictor status in patients with heart failure caused by anthracyclines, as well as improving baroreflex and chemoreflex sensibility, mechanoreflex and metaborreflex control and skeletal myopathy.

The investigators included patients\> 18 years, left ventricular ejection fraction \<= 0.55, functional class (NYHA) I-III, under medical treatment for heart failure. Patients with coronary artery disease, moderate to severe valve disease, positive Chagas serology, inability to participate in an exercise program are excluded.

Primary outcome: Muscle sympathetic nerve activity Secondary outcome: arterial baroreflex sensitivity, peripheral chemorreflex sensitivity, mecanic and muscuclar metaborreflex control, ubiquitin proteasome system activity.

Patients were divided into 2 groups-trained (n = 10) and non-trained (n = 10). Patients in the trained group will complete 16 weeks of aerobic training. Evaluation of cardiac function, functional capacity, quality of life and biochemical evaluation (troponin, hs-CRP and BNP). For muscle evaluation will be performed biopsy of the vastus lateralis muscle

Effect of Physical Training in Patients With Heart Failure Caused by Chemotherapy for Cancer Treatment

The sympathetic nervous activity is assessed by the microneurography technique

Evaluation of muscular sympathetic nervous activity at rest by the technique of microneurography, evaluation of the muscular blood flow by venous occlusion plethysmography technique

InCor Heart Institute

Cancer Institute of Sao Paulo

Hospital Sirio-Libanes

University of Sao Paulo General Hospital

Study title	NCT ID	Conditions	Interventions	Eligibility	Organization	Link
Effect of Physical Training in Patients With Heart Failure Caused by Chemotherapy for Cancer Treatment	NCT04047901	Insufficiency;C... Cancer Cardiotoxicity Heart Failure	exercise traini...	18 Years -	University of Sao Paulo General Hospital
Effect of Physical Training in Patients With Heart Failure Caused by Chemotherapy for Cancer Treatment	NCT04047901	Insufficiency;C... Cancer Cardiotoxicity Heart Failure	exercise traini...	18 Years -	University of Sao Paulo General Hospital

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