Journal Article

Increased Skeletal Muscle Fat in Patients With Haematological Cancer Is Associated With Reduced Cardiorespiratory Fitness

Howden, Erin J., Burnham, Lauren, Saner, Nicholas J., Haykowsky, Mark J., La Gerche, Andre, Foulkes, Stephen J., Thompson, Richard, Dillon, Hayley T.

2026

Overview

Background Patients with haematological cancer often exhibit reduced cardiorespiratory fitness and an elevated risk of cardiovascular disease. The mechanisms underlying this impairment are multifactorial, but the contribution of skeletal muscle fat infiltration has not been evaluated. This study aimed to compare thigh skeletal muscle fat fraction (SMFF) in patients with haematological cancer to healthy controls and to assess the contribution of SMFF to cardiorespiratory fitness in this cohort. Methods We performed a cross‐sectional analysis of patients with haematological cancer (n = 70, 61% male, age: 51 ± 16 years) and age‐ and sex‐matched healthy controls (n = 70, 61% male, age: 50 ± 15 years). Thigh SMFF was assessed via magnetic resonance imaging. We also measured cardiorespiratory fitness (peak oxygen uptake, V̇O2peak), global longitudinal strain (GLS) via echocardiography and haemoglobin concentrations in the haematological cancer cohort. Hierarchical multiple regression analysis was performed to identify predictors of V̇O2peak. Results SMFF was higher in the haematological cancer cohort versus the healthy control cohort (11.0% ± 3.4% vs. 8.8% ± 3.8%, p = 0.001). V̇O2peak was significantly lower than predicted values for the haematological cancer cohort (mean difference; 9.61 ± 8.30 mL.kg−1.min−1, p < 0.001). The multiple regression analysis accounted for 35% of the variance in V̇O2peak with both SMFF (β = −0.40, ΔR2 = 0.14, p = 0.002) and haemoglobin concentrations (β = 0.50, ΔR2 = 0.23, p < 0.001) being significant independent predictors of V̇O2peak, while skeletal muscle volume (β = 0.00, ΔR2 = 0.00, p = 0.767), GLS (β = 0.06, ΔR2 = 0.00, p = 0.509), prior anthracycline treatment (β = 0.00, ΔR2 = 0.00, p = 0.962) and clinical diagnosis (β = 0.00, ΔR2 = 0.00, p = 0.555) were not. Conclusions SMFF is increased in haematological cancer patients and contributes to reduced V̇O2peak. Consequently, increased SMFF may be an important target to improve cardiovascular health and cardiorespiratory fitness in this population.

• Publisher: John Wiley & Sons, Inc,Wiley
• Subject: Adipose Tissue / Adult / Age / Aged / Anthropometry / Body mass index / Cancer therapies / Cardiorespiratory Fitness / Cardiovascular health / Chemotherapy / Chronic illnesses / Contraindications / Cross-Sectional Studies / Exercise / Female / Hematologic Neoplasms - complications / Hematologic Neoplasms - physiopathology / Hematology / Hemoglobin / Humans / Hypertension / intermuscular fat / leukaemia / Leukemia / Magnetic Resonance Imaging / Male / Medical diagnosis / Middle Aged / Muscle function / Muscle, Skeletal - diagnostic imaging / Muscle, Skeletal - pathology / Muscle, Skeletal - physiopathology / Musculoskeletal system / Myelodysplastic syndromes / Original / Oxygen Consumption / Patients / Physical fitness / Regression analysis / Research ethics / skeletal muscle