IJCS | Volume 31, Nº4, July / August 2018

437 Borges et al. Oncocardiology and the symptom fatigue Int J Cardiovasc Sci. 2018;31(4)433-442 Review Article and breast cancer undergoing treatment resulted in a reduction of systolic and diastolic blood pressure and resting heart rate. A systematic review involving 4,826 participants with cancer, in turn, showed improved quality of life and functional capacity during and after a training program with exercises (tables 1 and 2). 38 Risks of cardiotoxicity The signs and symptoms of HF may be similar to those observed in oncological patients. Fatigue is a common clinical manifestation in both pathologies. In cancer, it can deteriorate due to oncological treatment, which increases the risk of injury to the myocardium, which in turn triggers cardiovascular complications. 39 The substantial decline in cardiopulmonary capacity is a consequence of immobility, chronic fatigue, loss Table 1 - Potential benefits of exercises before and after cancer treatment 38 Before treatment After treatment Improved cardiorespiratory and cardiovascular function Improved self-esteem, mood, and self-image Effects on body composition (preservation or increase in muscle mass, loss of fat mass) Reduced duration of hospitalization Improved muscle strength and flexibility Reduced stress, depression, and anxiety Improved immune system Reduced of serious adverse effectsk including nausea, fatigue and pain Source: Adapted from Mishra SI et al, 2012 38 Figure 1 - Conceptual map of fatigue related to cancer FATIGUE ASSOCIATED CANCER Chemotherapy Cardiotoxicity Cardiac failure Cardio-oncology Quality of life Survival of patients with cancer Subjective feeling of fatigue Subjective scales Piper Scale: multidimensional Fatigue pictogram Impact on daily activities Intensity of fatigue Dyspnea Fatigue Edema Diastolic dysfunction Systolic dysfunction Acute Subacute Chronic Reduction in hemoglobin levels Inflammation Adverse effects Peripheral myopathy Troponins BNP Strain echocardiography Hypothyroidism Depression Inactivity Menopause Sleep disorders Cardiac and hepatic dysfunction Pulmonary disease Physical conditioning Respiratory and peripheral muscle strength Functional capacity Improve patient care Cardiac surveillance affects defined as due to associated with evaluated with may be like reflects causes may be may lead to diagnosed by may cause studied by seeks may reduce leads to