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Behavioral Exercise Training to Reduce Cardiovascular Disease Risk in Men Undergoing Androgen Deprivation Therapy

行为运动训练可降低接受雄激素剥夺治疗的男性心血管疾病风险

基本信息

批准号：
10740615
负责人：
Alexander Russell Lucas
金额：
$ 12.35万
依托单位：
VIRGINIA COMMONWEALTH UNIVERSITY
依托单位国家：
美国
项目类别：
财政年份：
2023
资助国家：
美国
起止时间：
2023-08-25 至 2028-07-31
项目状态：
未结题

来源：
https://reporter.nih.gov/project-details/10740615
关键词：
Acceleration Activities of Daily Living Address Adoption Aerobic Exercise Age Behavior Therapy Behavioral Body Composition Buffers Cancer Center Cancer Patient Cancer Survivor Cardiac Cardiac Output Cardiopulmonary Cardiovascular Diseases Cardiovascular Physiology Cardiovascular system Clinic Clinical Trials Communities Conduct Clinical Trials Data Development Plans Diagnosis Dropout Education Educational Intervention Effectiveness Environment Event Exercise Exercise Test Fatigue Fatty acid glycerol esters Functional disorder Future Geography Goals Guidelines Health Health education Heart failure Home Imaging Techniques Impairment Individual Intervention Interview Intramuscular Learning Module Left Magnetic Resonance Maintenance Malignant Neoplasms Malignant neoplasm of prostate Measures Medical center Mentored Research Scientist Development Award Mentors Metabolic Metabolic syndrome Methodology Methods Morbidity - disease rate Muscle Musculoskeletal Musculoskeletal System Myocardial dysfunction Obesity Outcome Oxygen Participant Patients Peripheral Physical Function Physical activity Population Prostate Cancer therapy Qualifying Race Randomized Research Research Design Research Personnel Research Project Grants Sampling Skeletal Muscle Structure Surveys Symptoms Testing Training Training Programs Treatment Side Effects United States Department of Veterans Affairs Venous Ventricular Virginia Walking Work aged androgen deprivation therapy arm cardiac magnetic resonance imaging cardiovascular disorder risk cardiovascular health cardiovascular risk factor career career development comparison control coronary fibrosis design disorder risk effective intervention evidence base exercise capacity exercise intervention exercise intolerance exercise prescription exercise program exercise training experience future implementation health care availability health related quality of life heart function high risk improved insight intervention effect intervention refinement intraperitoneal lean body mass male men mortality muscle form novel older men outcome prediction preservation programs prostate cancer risk recruit remote delivery resistance exercise skills strength training therapy design treatment effect vigorous intensity

项目摘要

1 PROJECT SUMMARY 2 A primary goal of this K01 proposal is to equip the candidate, Dr. Alexander Lucas, with the expertise to become 3 an independent investigator who is able to utilize state-of-the-art imaging techniques to evaluate subclinical 4 outcomes that predict future cardiovascular (CV) events in cancer patients, and that respond to behavioral 5 adaptations (i.e., exercise). Prostate cancer (PC) patients undergoing androgen deprivation therapy (ADT) 6 experience deleterious changes in CV risk factors (body composition, exercise intolerance, metabolic 7 dysfunction). Exercise training interventions are an effective non-pharmacological approach for managing these 8 negative effects of treatment. Furthermore, the use of non-invasive methods to determine CV and 9 musculoskeletal contributors to exercise capacity can inform the design of more precise exercise prescriptions 10 to address specific functional deficits in men initiating ADT. However, while supervised exercise training is 11 effective, many men lack access to such programs and establishing whether home-based behavioral exercise 12 programs can effectively improve exercise capacity (peak VO2) is important. Dr. Lucas’s preliminary data from 13 PC patients and other populations of cancer survivors support the feasibility and potential of exercise training to 14 limit treatment side effects. The proposed research project will provide critical data important for determining 15 whether exercise training leads to improvements in aerobic fitness (peak VO2), and whether central and/or 16 peripheral factors and components of body composition are key determinants of peak VO2 among men 17 undergoing treatment with ADT. Our primary hypothesis is that a combined aerobic and resistance training 18 intervention will improve peak VO2 by maintaining cardiovascular function, enhancing oxygen extraction at the 19 muscle, maintaining lean body mass, and reducing accumulation of fat mass. We propose a 2-arm, randomized 20 controlled trial to test a 12-week home-based and remotely delivered exercise intervention among 21 60 men undergoing ADT for intermediate to high-risk PC (Aim 1). We will use highly sensitive, non- 22 invasive cardiac magnetic resonance (CMR) imaging techniques with cardiopulmonary exercise testing 23 (CPET) to test effects of the intervention. We will also determine the relative contribution of central and peripheral 24 components of peak VO2 and their association with body composition (Aim 2). Surveys and qualitative semi- 25 structured interviews will be conducted with men who complete or dropout of the intervention to assess 26 intervention acceptability and to refine both content and delivery of a future intervention to be tested in a larger 27 RCT. This work focuses on optimizing cardiovascular health in men diagnosed with prostate cancer – a growing 28 population. The proposed K01 will provide essential training for the candidate, who will work closely with an 29 expert mentoring team with regard to study design and execution and the Career Development Plan. A specific 30 goal of training is to also gain advanced skills in design and conduct of clinical trials thus supporting the 31 implementation of future programs aiming to improve health outcomes in diverse communities.

1项目总结