Abstract
BackgroundEmerging evidence suggests potential arterial damage with the use of anthracycline-based chemotherapeutic regimens. We determined arterial function at rest and during exercise in anthracycline-treated adult survivors of childhood cancers.MethodsNinety-six adult survivors (54 males) aged 25.0 ± 5.9 years and 60 (30 males) healthy controls were studied. Central systolic blood pressure (cSBP) and radial augmentation index (rAI) was determined by applanation tonometry. Carotid arterial stiffness and intima-media thickness (IMT) were assessed using high-resolution ultrasound.ResultsAt rest, survivors had significantly greater carotid IMT (p < 0.001) and stiffness index (p < 0.001), and higher cSBP (p = 0.037), rAI (p = 0.004) and rAI adjusted for a heart rate of 75/min (p = 0.009) than controls. At submaximal supine exercise testing, survivors had significantly greater percentage increase in carotid stiffness than controls (p < 0.001). Among survivors, 32 and 53% had respectively carotid IMT and exercise stiffness index exceeding normal (> + 2SD of controls). The slopes of increase in carotid IMT (p < 0.001) and exercise-induced changes in carotid stiffness (p < 0.001) with age were significantly greater in survivors than controls. Multivariate analysis revealed carotid IMT (β = 0.32, p < 0.001) to be an significant correlate of dynamic percentage increase in stiffness index during exercise.ConclusionsArterial dysfunction is evident at rest and worsens during exercise in anthracycline-treated adult survivors of childhood cancers.
Highlights
Emerging evidence suggests potential arterial damage with the use of anthracycline-based chemotherapeutic regimens
Subjects Ninety-six anthracycline-treated adult survivors of childhood cancers who had been off treatment for at least 5 years were recruited from three public hospitals in Hong Kong
Survivors had significantly greater carotid intima-media thickness (IMT) (p < 0.001), carotid arterial stiffness index (p < 0.001), Central systolic blood pressure (cSBP) (p = 0.037), radial augmentation index (rAI) (p = 0.004), and rAI adjusted for a heart rate of 75/min (p = 0.009)
Summary
Emerging evidence suggests potential arterial damage with the use of anthracycline-based chemotherapeutic regimens. We determined arterial function at rest and during exercise in anthracycline-treated adult survivors of childhood cancers. Left ventricular dysfunction is well documented in anthracycline-treated long-term survivors of childhood cancers [1,2,3]. Recent large epidemiologic studies reaffirmed the increased risk of cardiovascular [6,7,8] and cerebrovascular [9] events in long-term survivors of childhood cancers. These findings implicate the possibility of an early onset. There is, a paucity of data on long-term alterations of arterial structure and function in adult survivors of childhood cancers. Studies on arterial function in cancer survivors reported to date were limited by the assessment of only the resting arterial function
Sign-in/Register to view highlights & summary Sign-in/Register to access full text options 
Free) 
Talk to us
Join us for a 30 min session where you can share your feedback and ask us any queries you have
Schedule a call
