<clinical_study>
  <!-- This xml conforms to an XML Schema at:
    https://clinicaltrials.gov/ct2/html/images/info/public.xsd -->
  <required_header>
    <download_date>ClinicalTrials.gov processed this data on September 20, 2023</download_date>
    <link_text>Link to the current ClinicalTrials.gov record.</link_text>
    <url>https://clinicaltrials.gov/ct2/show/NCT04467411</url>
  </required_header>
  <id_info>
    <org_study_id>2-049-18</org_study_id>
    <nct_id>NCT04467411</nct_id>
  </id_info>
  <brief_title>Randomised Controlled Study of Physical Exercise Intervention in Breast Cancer Patients at Risk of Anthracycline-induced Cardiomyopathy: The EMBRACE Study</brief_title>
  <acronym>EMBRACE</acronym>
  <official_title>Randomised Controlled Study of Physical Exercise Intervention in Breast Cancer Patients at Risk of Anthracycline-induced Cardiomyopathy:The EMBRACE Study</official_title>
  <sponsors>
    <lead_sponsor>
      <agency>University of Aberdeen</agency>
      <agency_class>Other</agency_class>
    </lead_sponsor>
  </sponsors>
  <source>University of Aberdeen</source>
  <oversight_info>
    <has_dmc>No</has_dmc>
    <is_fda_regulated_drug>No</is_fda_regulated_drug>
    <is_fda_regulated_device>No</is_fda_regulated_device>
  </oversight_info>
  <brief_summary>
    <textblock>
      Cardiomyopathy is a condition that affects the heart muscle, whereby it becomes enlarged,&#xD;
      thick or rigid. When the heart muscle becomes involved, it affects the pumping action of the&#xD;
      heart. This condition can affect as many as 10% of all patients after undergoing&#xD;
      anthracycline cancer drug therapy and unfortunately carries the worst prognosis of all&#xD;
      cardiomyopathies. To date, there is no effective intervention that will prevent a patient&#xD;
      from developing this condition. The research conducted will look to see if an energy&#xD;
      imbalance in the heart predates the onset of detrimental changes to the pumping function of&#xD;
      the heart, if this is detected then we can act earlier to prevent the pumping function&#xD;
      deteriorating.&#xD;
    </textblock>
  </brief_summary>
  <detailed_description>
    <textblock>
      There is emerging cellular and experimental evidence that cardiac energetic status is reduced&#xD;
      after anthracycline treatment, however, this has not been tested in the human heart. The&#xD;
      researchers hypothesize that cardiac energetic status is reduced in the human heart after&#xD;
      administration of anthracycline therapy in breast cancer patients, inline with the evidence&#xD;
      available from all other types of cardiomyopathies. The researchers propose to use in vivo&#xD;
      31Phosphorus cardiac spectroscopy to measure the cardiac energetic status at the beginning&#xD;
      and at the end of the cycles of chemotherapy in the hearts of breast cancer patients who are&#xD;
      administered epirubicin (the most modern anthracycline to date) and compare this with the&#xD;
      cardiac energetic status of age and gender matched healthy controls. Further, the researchers&#xD;
      wish to explore if the myopathy-induced effect of anthracyclines extends to the skeletal&#xD;
      muscle as well, by examining skeletal muscle biopsies in these patients.&#xD;
    </textblock>
  </detailed_description>
  <overall_status>Recruiting</overall_status>
  <start_date type="Actual">February 1, 2020</start_date>
  <completion_date type="Anticipated">August 30, 2030</completion_date>
  <primary_completion_date type="Anticipated">August 30, 2030</primary_completion_date>
  <study_type>Observational</study_type>
  <has_expanded_access>No</has_expanded_access>
  <study_design_info>
    <observational_model>Case-Control</observational_model>
    <time_perspective>Prospective</time_perspective>
  </study_design_info>
  <primary_outcome>
    <measure>Cardiac Energetics</measure>
    <time_frame>At baseline</time_frame>
    <description>Cardiac MRI and MRS</description>
  </primary_outcome>
  <primary_outcome>
    <measure>Cardiac Energetics</measure>
    <time_frame>Through study completion, up to sixteen weeks</time_frame>
    <description>Cardiac MRI and MRS</description>
  </primary_outcome>
  <secondary_outcome>
    <measure>Cardiac Imaging</measure>
    <time_frame>At baseline</time_frame>
    <description>Echocardiography</description>
  </secondary_outcome>
  <secondary_outcome>
    <measure>Cardiac Imaging</measure>
    <time_frame>Through study completion, up to sixteen weeks</time_frame>
    <description>Echocardiography</description>
  </secondary_outcome>
  <secondary_outcome>
    <measure>Blood Biomarkers</measure>
    <time_frame>At baseline</time_frame>
    <description>BNP and Troponins</description>
  </secondary_outcome>
  <secondary_outcome>
    <measure>Blood Biomarkers</measure>
    <time_frame>Through study completion, up to sixteen weeks</time_frame>
    <description>BNP and Troponins</description>
  </secondary_outcome>
  <secondary_outcome>
    <measure>Histology</measure>
    <time_frame>At baseline</time_frame>
    <description>Histology of skeletal muscle biopsies</description>
  </secondary_outcome>
  <secondary_outcome>
    <measure>Histology</measure>
    <time_frame>Through study completion, up to sixteen weeks</time_frame>
    <description>Histology of skeletal muscle biopsies</description>
  </secondary_outcome>
  <number_of_groups>2</number_of_groups>
  <enrollment type="Anticipated">12</enrollment>
  <condition>Breast Cancer</condition>
  <arm_group>
    <arm_group_label>Breast Cancer Group</arm_group_label>
    <description>Breast Cancer Group</description>
  </arm_group>
  <arm_group>
    <arm_group_label>Healthy Volunteer</arm_group_label>
    <description>Healthy Volunteer Group</description>
  </arm_group>
  <biospec_retention>Samples With DNA</biospec_retention>
  <biospec_descr>
    <textblock>
      Blood samples and skeletal muscle biopsies&#xD;
    </textblock>
  </biospec_descr>
  <eligibility>
    <study_pop>
      <textblock>
        Healthy volunteers and patients diagnosed with breast cancer who have been scheduled for&#xD;
        the first cycle of anthracycline therapy.&#xD;
      </textblock>
    </study_pop>
    <sampling_method>Probability Sample</sampling_method>
    <criteria>
      <textblock>
        Inclusion Criteria:&#xD;
&#xD;
          -  A patient who has been diagnosed with breast cancer and has been scheduled for a first&#xD;
             cycle of anthracycline therapy.&#xD;
&#xD;
          -  Participant who is willing and able to give informed consent for participation in the&#xD;
             study.&#xD;
&#xD;
          -  Healthy (gender and age matched) volunteers willing to give informed consent for&#xD;
             participation in the study.&#xD;
&#xD;
        Exclusion Criteria:&#xD;
&#xD;
          -  Contraindication to magnetic resonance scanning such as an implantable cardiac device.&#xD;
      </textblock>
    </criteria>
    <gender>Female</gender>
    <gender_based>Yes</gender_based>
    <gender_description>Only females are eligible to take part in the study</gender_description>
    <minimum_age>18 Years</minimum_age>
    <maximum_age>N/A</maximum_age>
    <healthy_volunteers>Accepts Healthy Volunteers</healthy_volunteers>
  </eligibility>
  <overall_official>
    <last_name>Dana Dawson, MD</last_name>
    <role>Principal Investigator</role>
    <affiliation>University of Aberdeen</affiliation>
  </overall_official>
  <overall_contact>
    <last_name>Maheshi Gunasekara, MD</last_name>
    <phone>01224559573</phone>
    <email>maheshi.gunasekara1@abdn.ac.uk</email>
  </overall_contact>
  <overall_contact_backup>
    <last_name>Amelia Rudd, MSc</last_name>
    <phone>01224559573</phone>
    <phone_ext>01467642401</phone_ext>
    <email>a.e.rudd@abdn.ac.uk</email>
  </overall_contact_backup>
  <location>
    <facility>
      <name>Cardiovascular Research Facility</name>
      <address>
        <city>Aberdeen</city>
        <state>Aberdeenshire</state>
        <zip>AB25 2ZD</zip>
        <country>United Kingdom</country>
      </address>
    </facility>
    <status>Recruiting</status>
    <contact>
      <last_name>Maheshi Gunasekara, MD</last_name>
      <phone>01224559573</phone>
      <email>maheshi.gunasekara1@abdn.ac.uk</email>
    </contact>
    <contact_backup>
      <last_name>Amelia Rudd, MSc</last_name>
      <phone>01224559573</phone>
      <phone_ext>01467642401</phone_ext>
      <email>a.e.rudd@abdn.ac.uk</email>
    </contact_backup>
  </location>
  <location_countries>
    <country>United Kingdom</country>
  </location_countries>
  <reference>
    <citation>Zamorano JL, Lancellotti P, Rodriguez Munoz D, Aboyans V, Asteggiano R, Galderisi M, Habib G, Lenihan DJ, Lip GYH, Lyon AR, Lopez Fernandez T, Mohty D, Piepoli MF, Tamargo J, Torbicki A, Suter TM; ESC Scientific Document Group. 2016 ESC Position Paper on cancer treatments and cardiovascular toxicity developed under the auspices of the ESC Committee for Practice Guidelines: The Task Force for cancer treatments and cardiovascular toxicity of the European Society of Cardiology (ESC). Eur Heart J. 2016 Sep 21;37(36):2768-2801. doi: 10.1093/eurheartj/ehw211. Epub 2016 Aug 26. No abstract available. Erratum In: Eur Heart J. 2016 Dec 24;:</citation>
    <PMID>27567406</PMID>
  </reference>
  <reference>
    <citation>Felker GM, Thompson RE, Hare JM, Hruban RH, Clemetson DE, Howard DL, Baughman KL, Kasper EK. Underlying causes and long-term survival in patients with initially unexplained cardiomyopathy. N Engl J Med. 2000 Apr 13;342(15):1077-84. doi: 10.1056/NEJM200004133421502.</citation>
    <PMID>10760308</PMID>
  </reference>
  <reference>
    <citation>Maslov MY, Chacko VP, Hirsch GA, Akki A, Leppo MK, Steenbergen C, Weiss RG. Reduced in vivo high-energy phosphates precede adriamycin-induced cardiac dysfunction. Am J Physiol Heart Circ Physiol. 2010 Aug;299(2):H332-7. doi: 10.1152/ajpheart.00727.2009. Epub 2010 May 21.</citation>
    <PMID>20495142</PMID>
  </reference>
  <reference>
    <citation>Menna P, Salvatorelli E, Minotti G. Anthracycline degradation in cardiomyocytes: a journey to oxidative survival. Chem Res Toxicol. 2010 Jan;23(1):6-10. doi: 10.1021/tx9003424.</citation>
    <PMID>19954191</PMID>
  </reference>
  <reference>
    <citation>Higgins AY, O'Halloran TD, Chang JD. Chemotherapy-induced cardiomyopathy. Heart Fail Rev. 2015 Nov;20(6):721-30. doi: 10.1007/s10741-015-9502-y.</citation>
    <PMID>26338137</PMID>
  </reference>
  <reference>
    <citation>Jones LW, Haykowsky MJ, Swartz JJ, Douglas PS, Mackey JR. Early breast cancer therapy and cardiovascular injury. J Am Coll Cardiol. 2007 Oct 9;50(15):1435-41. doi: 10.1016/j.jacc.2007.06.037. Epub 2007 Sep 24.</citation>
    <PMID>17919562</PMID>
  </reference>
  <reference>
    <citation>Truong J, Yan AT, Cramarossa G, Chan KK. Chemotherapy-induced cardiotoxicity: detection, prevention, and management. Can J Cardiol. 2014 Aug;30(8):869-78. doi: 10.1016/j.cjca.2014.04.029. Epub 2014 May 4.</citation>
    <PMID>25064580</PMID>
  </reference>
  <reference>
    <citation>Kitzman DW, Brubaker PH, Herrington DM, Morgan TM, Stewart KP, Hundley WG, Abdelhamed A, Haykowsky MJ. Effect of endurance exercise training on endothelial function and arterial stiffness in older patients with heart failure and preserved ejection fraction: a randomized, controlled, single-blind trial. J Am Coll Cardiol. 2013 Aug 13;62(7):584-92. doi: 10.1016/j.jacc.2013.04.033. Epub 2013 May 9.</citation>
    <PMID>23665370</PMID>
  </reference>
  <reference>
    <citation>Coats AJ, Adamopoulos S, Radaelli A, McCance A, Meyer TE, Bernardi L, Solda PL, Davey P, Ormerod O, Forfar C, et al. Controlled trial of physical training in chronic heart failure. Exercise performance, hemodynamics, ventilation, and autonomic function. Circulation. 1992 Jun;85(6):2119-31. doi: 10.1161/01.cir.85.6.2119.</citation>
    <PMID>1591831</PMID>
  </reference>
  <reference>
    <citation>O'Connor CM, Whellan DJ, Lee KL, Keteyian SJ, Cooper LS, Ellis SJ, Leifer ES, Kraus WE, Kitzman DW, Blumenthal JA, Rendall DS, Miller NH, Fleg JL, Schulman KA, McKelvie RS, Zannad F, Pina IL; HF-ACTION Investigators. Efficacy and safety of exercise training in patients with chronic heart failure: HF-ACTION randomized controlled trial. JAMA. 2009 Apr 8;301(14):1439-50. doi: 10.1001/jama.2009.454.</citation>
    <PMID>19351941</PMID>
  </reference>
  <reference>
    <citation>Hegde SM, Claggett B, Shah AM, Lewis EF, Anand I, Shah SJ, Sweitzer NK, Fang JC, Pitt B, Pfeffer MA, Solomon SD. Physical Activity and Prognosis in the TOPCAT Trial (Treatment of Preserved Cardiac Function Heart Failure With an Aldosterone Antagonist). Circulation. 2017 Sep 12;136(11):982-992. doi: 10.1161/CIRCULATIONAHA.117.028002. Epub 2017 Jun 21.</citation>
    <PMID>28637881</PMID>
  </reference>
  <reference>
    <citation>Pandey A, Garg S, Khunger M, Darden D, Ayers C, Kumbhani DJ, Mayo HG, de Lemos JA, Berry JD. Dose-Response Relationship Between Physical Activity and Risk of Heart Failure: A Meta-Analysis. Circulation. 2015 Nov 10;132(19):1786-94. doi: 10.1161/CIRCULATIONAHA.115.015853. Epub 2015 Oct 5.</citation>
    <PMID>26438781</PMID>
  </reference>
  <reference>
    <citation>Myers J, Prakash M, Froelicher V, Do D, Partington S, Atwood JE. Exercise capacity and mortality among men referred for exercise testing. N Engl J Med. 2002 Mar 14;346(11):793-801. doi: 10.1056/NEJMoa011858.</citation>
    <PMID>11893790</PMID>
  </reference>
  <reference>
    <citation>Schmitz KH, Courneya KS, Matthews C, Demark-Wahnefried W, Galvao DA, Pinto BM, Irwin ML, Wolin KY, Segal RJ, Lucia A, Schneider CM, von Gruenigen VE, Schwartz AL; American College of Sports Medicine. American College of Sports Medicine roundtable on exercise guidelines for cancer survivors. Med Sci Sports Exerc. 2010 Jul;42(7):1409-26. doi: 10.1249/MSS.0b013e3181e0c112. Erratum In: Med Sci Sports Exerc. 2011 Jan;43(1):195.</citation>
    <PMID>20559064</PMID>
  </reference>
  <reference>
    <citation>Chicco AJ, Schneider CM, Hayward R. Exercise training attenuates acute doxorubicin-induced cardiac dysfunction. J Cardiovasc Pharmacol. 2006 Feb;47(2):182-9. doi: 10.1097/01.fjc.0000199682.43448.2d.</citation>
    <PMID>16495754</PMID>
  </reference>
  <reference>
    <citation>Hydock DS, Wonders KY, Schneider CM, Hayward R. Voluntary wheel running in rats receiving doxorubicin: effects on running activity and cardiac myosin heavy chain. Anticancer Res. 2009 Nov;29(11):4401-7.</citation>
    <PMID>20032385</PMID>
  </reference>
  <reference>
    <citation>Hornsby WE, Douglas PS, West MJ, Kenjale AA, Lane AR, Schwitzer ER, Ray KA, Herndon JE 2nd, Coan A, Gutierrez A, Hornsby KP, Hamilton E, Wilke LG, Kimmick GG, Peppercorn JM, Jones LW. Safety and efficacy of aerobic training in operable breast cancer patients receiving neoadjuvant chemotherapy: a phase II randomized trial. Acta Oncol. 2014 Jan;53(1):65-74. doi: 10.3109/0284186X.2013.781673. Epub 2013 Aug 19.</citation>
    <PMID>23957716</PMID>
  </reference>
  <reference>
    <citation>Jones LW, Liang Y, Pituskin EN, Battaglini CL, Scott JM, Hornsby WE, Haykowsky M. Effect of exercise training on peak oxygen consumption in patients with cancer: a meta-analysis. Oncologist. 2011;16(1):112-20. doi: 10.1634/theoncologist.2010-0197. Epub 2011 Jan 6. Erratum In: Oncologist. 2011;16(2):260.</citation>
    <PMID>21212429</PMID>
  </reference>
  <reference>
    <citation>Gouspillou G, Scheede-Bergdahl C, Spendiff S, Vuda M, Meehan B, Mlynarski H, Archer-Lahlou E, Sgarioto N, Purves-Smith FM, Konokhova Y, Rak J, Chevalier S, Taivassalo T, Hepple RT, Jagoe RT. Anthracycline-containing chemotherapy causes long-term impairment of mitochondrial respiration and increased reactive oxygen species release in skeletal muscle. Sci Rep. 2015 Mar 3;5:8717. doi: 10.1038/srep08717.</citation>
    <PMID>25732599</PMID>
  </reference>
  <reference>
    <citation>Octavia Y, Tocchetti CG, Gabrielson KL, Janssens S, Crijns HJ, Moens AL. Doxorubicin-induced cardiomyopathy: from molecular mechanisms to therapeutic strategies. J Mol Cell Cardiol. 2012 Jun;52(6):1213-25. doi: 10.1016/j.yjmcc.2012.03.006. Epub 2012 Mar 21.</citation>
    <PMID>22465037</PMID>
  </reference>
  <reference>
    <citation>Perry CG, Lally J, Holloway GP, Heigenhauser GJ, Bonen A, Spriet LL. Repeated transient mRNA bursts precede increases in transcriptional and mitochondrial proteins during training in human skeletal muscle. J Physiol. 2010 Dec 1;588(Pt 23):4795-810. doi: 10.1113/jphysiol.2010.199448. Epub 2010 Oct 4.</citation>
    <PMID>20921196</PMID>
  </reference>
  <reference>
    <citation>Stephens NA, Gallagher IJ, Rooyackers O, Skipworth RJ, Tan BH, Marstrand T, Ross JA, Guttridge DC, Lundell L, Fearon KC, Timmons JA. Using transcriptomics to identify and validate novel biomarkers of human skeletal muscle cancer cachexia. Genome Med. 2010 Jan 15;2(1):1. doi: 10.1186/gm122.</citation>
    <PMID>20193046</PMID>
  </reference>
  <reference>
    <citation>Barwell ND, Malkova D, Moran CN, Cleland SJ, Packard CJ, Zammit VA, Gill JM. Exercise training has greater effects on insulin sensitivity in daughters of patients with type 2 diabetes than in women with no family history of diabetes. Diabetologia. 2008 Oct;51(10):1912-9. doi: 10.1007/s00125-008-1097-6. Epub 2008 Jul 29.</citation>
    <PMID>18663427</PMID>
  </reference>
  <reference>
    <citation>Dawson DK, Neil CJ, Henning A, Cameron D, Jagpal B, Bruce M, Horowitz J, Frenneaux MP. Tako-Tsubo Cardiomyopathy: A Heart Stressed Out of Energy? JACC Cardiovasc Imaging. 2015 Aug;8(8):985-7. doi: 10.1016/j.jcmg.2014.10.004. Epub 2014 Nov 1. No abstract available.</citation>
    <PMID>25499134</PMID>
  </reference>
  <reference>
    <citation>Naressi A, Couturier C, Castang I, de Beer R, Graveron-Demilly D. Java-based graphical user interface for MRUI, a software package for quantitation of in vivo/medical magnetic resonance spectroscopy signals. Comput Biol Med. 2001 Jul;31(4):269-86. doi: 10.1016/s0010-4825(01)00006-3.</citation>
    <PMID>11334636</PMID>
  </reference>
  <verification_date>August 2022</verification_date>
  <study_first_submitted>July 2, 2020</study_first_submitted>
  <study_first_submitted_qc>July 8, 2020</study_first_submitted_qc>
  <study_first_posted type="Actual">July 13, 2020</study_first_posted>
  <last_update_submitted>August 30, 2022</last_update_submitted>
  <last_update_submitted_qc>August 30, 2022</last_update_submitted_qc>
  <last_update_posted type="Actual">September 2, 2022</last_update_posted>
  <responsible_party>
    <responsible_party_type>Sponsor</responsible_party_type>
  </responsible_party>
  <condition_browse>
    <!-- CAUTION:  The following MeSH terms are assigned with an imperfect algorithm            -->
    <mesh_term>Breast Neoplasms</mesh_term>
    <mesh_term>Cardiomyopathies</mesh_term>
  </condition_browse>
  <patient_data>
    <sharing_ipd>No</sharing_ipd>
  </patient_data>
  <!-- Results have not yet been posted for this study                                          -->
</clinical_study>


download date: ClinicalTrials.gov processed this data on September 20, 2023
link text: Link to the current ClinicalTrials.gov record.
url: https://clinicaltrials.gov/ct2/show/NCT04467411
org study id: 2-049-18
nct id: NCT04467411
lead sponsor: 
has dmc: No
is fda regulated drug: No
is fda regulated device: No
Cardiomyopathy is a condition that affects the heart muscle, whereby it becomes enlarged,
      thick or rigid. When the heart muscle becomes involved, it affects the pumping action of the
      heart. This condition can affect as many as 10% of all patients after undergoing
      anthracycline cancer drug therapy and unfortunately carries the worst prognosis of all
      cardiomyopathies. To date, there is no effective intervention that will prevent a patient
      from developing this condition. The research conducted will look to see if an energy
      imbalance in the heart predates the onset of detrimental changes to the pumping function of
      the heart, if this is detected then we can act earlier to prevent the pumping function
      deteriorating.
There is emerging cellular and experimental evidence that cardiac energetic status is reduced
      after anthracycline treatment, however, this has not been tested in the human heart. The
      researchers hypothesize that cardiac energetic status is reduced in the human heart after
      administration of anthracycline therapy in breast cancer patients, inline with the evidence
      available from all other types of cardiomyopathies. The researchers propose to use in vivo
      31Phosphorus cardiac spectroscopy to measure the cardiac energetic status at the beginning
      and at the end of the cycles of chemotherapy in the hearts of breast cancer patients who are
      administered epirubicin (the most modern anthracycline to date) and compare this with the
      cardiac energetic status of age and gender matched healthy controls. Further, the researchers
      wish to explore if the myopathy-induced effect of anthracyclines extends to the skeletal
      muscle as well, by examining skeletal muscle biopsies in these patients.
observational model: Case-Control
time perspective: Prospective
measure: Cardiac Energetics
time frame: At baseline
description: Cardiac MRI and MRS
measure: Cardiac Energetics
time frame: Through study completion, up to sixteen weeks
description: Cardiac MRI and MRS
measure: Cardiac Imaging
time frame: At baseline
description: Echocardiography
measure: Cardiac Imaging
time frame: Through study completion, up to sixteen weeks
description: Echocardiography
measure: Blood Biomarkers
time frame: At baseline
description: BNP and Troponins
measure: Blood Biomarkers
time frame: Through study completion, up to sixteen weeks
description: BNP and Troponins
measure: Histology
time frame: At baseline
description: Histology of skeletal muscle biopsies
measure: Histology
time frame: Through study completion, up to sixteen weeks
description: Histology of skeletal muscle biopsies
arm group label: Breast Cancer Group
description: Breast Cancer Group
arm group label: Healthy Volunteer
description: Healthy Volunteer Group
Blood samples and skeletal muscle biopsies
study pop: 
sampling method: Probability Sample
criteria: 
gender: Female
gender based: Yes
gender description: Only females are eligible to take part in the study
minimum age: 18 Years
maximum age: N/A
healthy volunteers: Accepts Healthy Volunteers
last name: Dana Dawson, MD
role: Principal Investigator
affiliation: University of Aberdeen
last name: Maheshi Gunasekara, MD
phone: 01224559573
email: maheshi.gunasekara1@abdn.ac.uk
last name: Amelia Rudd, MSc
phone: 01224559573
phone ext: 01467642401
email: a.e.rudd@abdn.ac.uk
facility: 
status: Recruiting
contact: 
contact backup: 
country: United Kingdom
citation: Zamorano JL, Lancellotti P, Rodriguez Munoz D, Aboyans V, Asteggiano R, Galderisi M, Habib G, Lenihan DJ, Lip GYH, Lyon AR, Lopez Fernandez T, Mohty D, Piepoli MF, Tamargo J, Torbicki A, Suter TM; ESC Scientific Document Group. 2016 ESC Position Paper on cancer treatments and cardiovascular toxicity developed under the auspices of the ESC Committee for Practice Guidelines: The Task Force for cancer treatments and cardiovascular toxicity of the European Society of Cardiology (ESC). Eur Heart J. 2016 Sep 21;37(36):2768-2801. doi: 10.1093/eurheartj/ehw211. Epub 2016 Aug 26. No abstract available. Erratum In: Eur Heart J. 2016 Dec 24;:
PMID: 27567406
citation: Felker GM, Thompson RE, Hare JM, Hruban RH, Clemetson DE, Howard DL, Baughman KL, Kasper EK. Underlying causes and long-term survival in patients with initially unexplained cardiomyopathy. N Engl J Med. 2000 Apr 13;342(15):1077-84. doi: 10.1056/NEJM200004133421502.
PMID: 10760308
citation: Maslov MY, Chacko VP, Hirsch GA, Akki A, Leppo MK, Steenbergen C, Weiss RG. Reduced in vivo high-energy phosphates precede adriamycin-induced cardiac dysfunction. Am J Physiol Heart Circ Physiol. 2010 Aug;299(2):H332-7. doi: 10.1152/ajpheart.00727.2009. Epub 2010 May 21.
PMID: 20495142
citation: Menna P, Salvatorelli E, Minotti G. Anthracycline degradation in cardiomyocytes: a journey to oxidative survival. Chem Res Toxicol. 2010 Jan;23(1):6-10. doi: 10.1021/tx9003424.
PMID: 19954191
citation: Higgins AY, O'Halloran TD, Chang JD. Chemotherapy-induced cardiomyopathy. Heart Fail Rev. 2015 Nov;20(6):721-30. doi: 10.1007/s10741-015-9502-y.
PMID: 26338137
citation: Jones LW, Haykowsky MJ, Swartz JJ, Douglas PS, Mackey JR. Early breast cancer therapy and cardiovascular injury. J Am Coll Cardiol. 2007 Oct 9;50(15):1435-41. doi: 10.1016/j.jacc.2007.06.037. Epub 2007 Sep 24.
PMID: 17919562
citation: Truong J, Yan AT, Cramarossa G, Chan KK. Chemotherapy-induced cardiotoxicity: detection, prevention, and management. Can J Cardiol. 2014 Aug;30(8):869-78. doi: 10.1016/j.cjca.2014.04.029. Epub 2014 May 4.
PMID: 25064580
citation: Kitzman DW, Brubaker PH, Herrington DM, Morgan TM, Stewart KP, Hundley WG, Abdelhamed A, Haykowsky MJ. Effect of endurance exercise training on endothelial function and arterial stiffness in older patients with heart failure and preserved ejection fraction: a randomized, controlled, single-blind trial. J Am Coll Cardiol. 2013 Aug 13;62(7):584-92. doi: 10.1016/j.jacc.2013.04.033. Epub 2013 May 9.
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responsible party type: Sponsor
mesh term: Breast Neoplasms
mesh term: Cardiomyopathies
sharing ipd: No