ArticlePsychosomatic medicine2015
Higher vagal activity as related to survival in patients with advanced breast cancer: an analysis of autonomic dysregulation.
Article in Psychosomatic medicine, 2015. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 55 papers, 2 of them syntheses that pooled it.
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The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
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Who cites it
55 citing papers in PubMed, 2 syntheses or guidelines pooled it.
- Pooled it
- Can Exercise Reduce the Autonomic Dysfunction of Patients With Cancer and Its Survivors? A Systematic Review and Meta-Analysis.Frontiers in psychology · 2021Pooled it
- Transcutaneous Vagal Nerve Stimulation Alone or in Combination With Radiotherapy Stimulates Lung Tumor Infiltrating Lymphocytes But Fails to Suppress Tumor Growth.Frontiers in immunology · 2021Trial
- Trial
- Secondary outcomes of a behavioral sleep intervention: A randomized clinical trial.Health psychology : official journal of the Division of Health Psychology, American Psychological Association · 2019Trial
- Recover your smile: Effects of a beauty care intervention on depressive symptoms, quality of life, and self-esteem in patients with early breast cancer.Psycho-oncology · 2019Trial
- Comfort in palliative sedation (Compas): a transdisciplinary mixed method study protocol for linking objective assessments to subjective experiences.BMC palliative care · 2018Trial
- Protocol for the MATCH study (Mindfulness and Tai Chi for cancer health): A preference-based multi-site randomized comparative effectiveness trial (CET) of Mindfulness-Based Cancer Recovery (MBCR) vs. Tai Chi/Qigong (TCQ) for cancer survivors.Contemporary clinical trials · 2017Trial
- Central nervous system and cancer: mechanistic insights and therapeutic opportunities CNS and cancer: a review.Medical oncology (Northwood, London, England) · 2026Review
- Article
- Cancer Neoaxonogenesis: Mechanisms and Factors Involved in the Recruitment of Peripheral Nerves by Cancer Tissue.International journal of molecular sciences · 2026Review
- Key role of the autonomic nervous system in breast cancer (Review).Experimental and therapeutic medicine · 2026Review
- Transcutaneous vagus nerve stimulation in breast cancer: a neuroimmune model to improve quality of life.Frontiers in oncology · 2026Article
- ECG-derived Poincaré plot graphical metrics for differentiating axillary lymph node metastasis in breast cancer.Frontiers in physiology · 2026Article
- The prognostic and protective roles of heart-rate variability in glioblastoma: making GBM less vague.Journal of neuro-oncology · 2025Article
- Cardiac autonomic dysfunction in patients with cancer: exploring the role of physical exercise.Journal of cancer research and clinical oncology · 2025Review
- Predictors and Clinical Impacts of Impaired Heart Rate Variability in Women with Breast Cancer.Medicina (Kaunas, Lithuania) · 2025Article
- Connection between heart rate variability alterations and cancer in tumor patients.World journal of cardiology · 2025Article
- A dyadic stress induction tool for experimental investigation of adult patients with cancer and their family caregivers.Annals of behavioral medicine : a publication of the Society of Behavioral Medicine · 2025Article
- How to properly evaluate cardiac vagal tone in oncology studies: a state-of-the-art review.Journal of the National Cancer Center · 2024Review
Corrections and comments
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Authors and funding
8 authors.
Funding
Abstract
objectiveHigh levels of high-frequency heart rate variability (HF-HRV), related to parasympathetic-nervous-system functioning, have been associated with longer survival in patients with myocardial infarction and acute trauma and in patients undergoing palliative care. From animal studies linking higher vagal activity with better immune system functioning and reduced metastases, we hypothesized that higher HF-HRV would predict longer survival in patients with metastatic or recurrent breast cancer (MRBC).
methodsEighty-seven patients with MRBC participated in a laboratory task including a 5-minute resting baseline electrocardiogram. HF-HRV was computed as the natural logarithm of the summed power spectral density of R-R intervals (0.15-0.50 Hz). In this secondary analysis of a study testing whether diurnal cortisol slope predicted survival, we tested the association between resting baseline HF-HRV on survival using Cox proportional hazards models.
resultsA total of 50 patients died during a median follow-up of 7.99 years. Higher baseline HF-HRV predicted significantly longer survival, with a hazard ratio of 0.75 (95% confidence interval = 0.60-0.92, p = .006). Visceral metastasis status and baseline heart rate were related to both HF-HRV and survival. However, a combination of HF-HRV and heart rate further improved survival prediction, with a hazard ratio of 0.64 (95% confidence interval = 0.48-0.85, p = .002).
conclusionsVagal activity of patients with MRBC strongly predicted their survival, extending the known predictive window of HF-HRV in cancer beyond palliative care. Vagal activity can be altered by behavioral, pharmacological, and surgical interventions and may be a promising target for extending life expectancy in patients with metastasizing cancer.
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