Anthracycline Causes Impaired Vascular Endothelial Function and Aortic Stiffness in Long Term Survivors of Childhood Cancer
- 16 December 2012
- journal article
- research article
- Published by Springer Science and Business Media LLC in Pathology and Oncology Research
- Vol. 19 (3), 375-383
- https://doi.org/10.1007/s12253-012-9589-6
Abstract
Vascular and endothelial functions were investigated in long term survivors of childhood cancer exposed to anthracycline treatment. We enrolled 96 long-term survivors (57 males and 39 females, mean age 14.9 ± 5.3 year) of different childhood cancers and 72 age-, sex-, bodyweight- and blood pressure matched controls (39 males and 33 females, mean age 13.7 ± 4.9 year). Aortic stiffness was characterized by echocardiography. Brachial artery endothelial function was assessed by flow-mediated dilatation (FMD%) and nitrate-mediated dilatation (NTG%). Results were compared between three subgroups: anthracycline treated, only chemotherapy treated and control subgroups. The cumulative anthracycline dose was less than 350 mg/m2. The healthy control subgroup had a significantly greater FMD response (13.13 ± 2.40 %), and lower stiffness index (2.08 ± 0.6) than both the anthracycline (7.12 ± 6.28 % and 6.45 ± 3.25, respectively) and only chemotherapy treated (10.17 ± 4.23 % and 4.12 ± 2.32, respectively) subgroups. In the anthracycline treated subgroup a significantly (p < 0.01) lower FMD% response, and higher stiffness index were detected than in the only chemotherapy treated subgroup. Higher triglyceride level, higher cumulative anthracycline dose and lower age at the start of treatment were found to be associated independently with impairment of FMD% response and aortic stiffness. We found a significant negative correlation between FMD and aortic stiffness (p < 0.001) and a positive correlation between FMD and distensibility (p < 0.0001) Childhood cancer long term survivors exposed to anthracycline treatment exhibit a marked preclinical vasculopathy, characterized by endothelial dysfunction and increased arterial stiffness, contributing to a deteriorated cardiovascular function.Keywords
This publication has 40 references indexed in Scilit:
- Aortic Stiffness Increases Upon Receipt of Anthracycline ChemotherapyJournal of Clinical Oncology, 2010
- The comparative effects of metoprolol and perindopril on aortic elasticity in young patients with prehypertensionBlood Pressure Monitoring, 2008
- Monitoring for Cardiovascular Disease in Survivors of Childhood Cancer: Report From the Cardiovascular Disease Task Force of the Children's Oncology GroupPEDIATRICS, 2008
- Endothelial Function in Young Adult Survivors of Childhood Acute Lymphoblastic LeukemiaJournal of Pediatric Hematology/Oncology, 2008
- Anthracyclines Cause Endothelial Injury in Pediatric Cancer Patients: A Pilot StudyJournal of Clinical Oncology, 2006
- Late effects on renal glomerular and tubular function in childhood cancer survivorsPediatric Blood & Cancer, 2004
- Cardiovascular Complications of Cancer TherapyCirculation, 2004
- Adriamycin-induced Cardiomyocyte and Endothelial Cell Apoptosis: In Vitro and In Vivo StudiesJournal of Molecular and Cellular Cardiology, 2002
- Multicentre analysis of anthracycline‐induced cardiotoxicity in children following treatment according to the nephroblastoma studies SIOP No.9/GPOH and SIOP 93‐01/GPOH*Medical and Pediatric Oncology, 2002
- Non-invasive detection of endothelial dysfunction in children and adults at risk of atherosclerosisThe Lancet, 1992