Anthracycline Chemotherapy and Cardiovascular Function and Fitness in Breast Cancer Patients

Abstract

Chemotherapy using anthracyclines is among the most effective pharmacological therapy available in the treatment of cancer. However, they are often accompanied by profound adverse complications of cardiovascular system called cardiotoxicity. Some of these side effects can lead to progressive cardiovascular diseases. Currently, it is not known if anthracycline chemotherapy is associated with vascular dysfunction and cardiovascular fitness impairment in breast cancer patients. PURPOSE: To investigate the association between anthracycline chemotherapy and cardiovascular functions in breast cancer patients. METHODS: Fifteen breast cancer patients aged 45±3 years were compared with fourteen age-, sex-, and body composition-matched healthy females. The anthracycline chemotherapy treatment consisted of 4 cycles of doxorubicin (60 mg/m2) and cyclophosphamide (600 mg/m2) repeated every 3 weeks. Breast cancer patients had been undergoing second or third cycle of chemotherapy treatments. RESULTS: There were no significant group differences in height, body fat, resting heart rate, systolic and diastolic blood pressure. Maximal oxygen consumption was not different between cancer patients and healthy controls (26.7±1.4 vs. 26.6±0.9 ml/kg/min). Ankle-brachial index was not different but carotid artery intima-media thickness was higher (p<0.05) in cancer patients than in healthy controls (0.50±0.02 vs 0.45±0.01 mm). Brachial-ankle pulse wave velocity, an index of arterial stiffness, was greater (p<0.05) in cancer patients than in healthy controls (1325±48 vs. 1158±38 cm/sec). CONCLUSIONS: These results suggest that anthracycline chemotherapy is associated with vascular stiffening in breast cancer patients. Prospective intervention studies are needed to confirm the findings from this cross-sectional study. Supported by Government research budget Chulalongkorn University 2016 and The 100th Anniversary Chulalongkorn University Fund for Doctoral Scholarship.