High-Intensity Interval Training to Reduce Cardiovascular Disease Risk Following Chemotherapy for Breast Cancer

PRIMARY OBJECTIVES:

I. To investigate the short-term and prolonged effects of HIIT-all extremity non-weight-bearing exercise (ANE), MICT-ANE and usual care (UC) on endothelial function (flow-mediated dilation; FMD) assessed by high-resolution ultrasonography in women who have recently completed chemotherapy for primary non-metastatic breast cancer.

II. To investigate the durability of the endothelial effects of HIIT-ANE versus (vs.) MICT-ANE.

SECONDARY OBJECTIVES:

I. To investigate the short-term and prolonged effects of HIIT-ANE, MICT-ANE and UC on cardiac function (global longitudinal strain; GLS) assessed by speckle tracking echocardiography in women who have recently completed chemotherapy for primary non-metastatic breast cancer.

II. To investigate the durability of the cardiac effects of HIIT-ANE vs. MICT-ANE.

III. Examine the feasibility, tolerability, and safety of HIIT-ANE and MICT-ANE in this patient population.

EXPLORATORY OBJECTIVE:

I. To gain preliminary mechanistic insight on the impact of HIIT-ANE and MICT-ANE on circulating factors associated with cancer, cancer therapy and exercise including biomarkers of cardiac damage, endothelial dysfunction, inflammation, oxidative stress.

OUTLINE: Patients are randomized to 1 of 3 groups.

GROUP I: Patients are provided an all-extremity stationary bicycle and participate in an at-home based supervised HIIT cycling sessions over 40 minutes 3 days a week for 12 weeks. Additionally, patients wear an accelerometer to monitor activity and undergo blood sample collection, echocardiography, dual X-ray absorptiometry (DXA) scan and ultrasonography throughout study.

GROUP II: Patients are provided an all-extremity stationary bicycle and participate in an at-home based supervised MICT cycling sessions over 47 minutes 3 days a week for 12 weeks. Additionally, patients wear an accelerometer to monitor activity and undergo blood sample collection, echocardiography, DXA scan and ultrasonography throughout study.

GROUP III: Patients continue to participate in usual habitual physical activity during 12 week intervention period and 12 week observation period then may optionally participate in supervised HIIT or MICT exercise programs 3 days a week for 12 weeks after completion of all study assessments. Additionally, patients wear an accelerometer to monitor activity and undergo blood sample collection, echocardiography, DXA scan and ultrasonography throughout study.

After completion of study intervention, patients are followed up for 12 weeks observation period, then at 2 visits within 1-2 weeks.