The Effect of Anthracycline Chemotherapy on Arterial Stiffness

Abstract

Objective: Anthracycline-derived chemotherapy for cancer treatment may cause dose-dependent irreversible heart failure. Arterial stifness is a predictor of cardiovascular events. We aimed to investigate the relationship between chemotherapy and arterial stiffness.

Material and Methods: Patients diagnosed non-Hodgkin's lymphoma, agreed to recieve anthracycline chemotherapy, were included in the study. Arterial stiffness was evaluated with applanation tonometer before, first and sixth cycles of chemotherapy.

Results: There was a tendency to increase first and sixth cycles pulse wave velocity values ​​before anthracycline chemotherapy [9.08 (8.12-9.76), 10.31 (8.22-12.62), 9.64 (8.22-12.62) m/s, p = 0.053] but those changes were not reach statistically significance. Augmentation index change did not significantly change between anthracycline chemotherapy cycles (p = 0.810). There was also a tendency to decrease first and sixth cycle subendocardial viabilty ratio values ​​before [151.60 (122.20-188.70) and after 124.30 (94.50-154.10), p = 0.058] chemotherapy.

Conclusion: Anthracycline chemotherapy tends to impaire arterial stiffness parameters

Keywords

• Chemotherapy,arterial stiffness,anthracyclin

Antrasiklin Kemoterapisinin Arteriyel Sertlik Üzerine Etkisi

Abstract

Öz:

Amaç: Kanser tedavisinde kullanılan antrasiklin türevli kemoterapi doz bağımlı olarak geri dönüşümsüz kalp yetersizliğine sebep olabilmektedir. Arteriyel sertlik kardiyovasküler olayların öngördürücüsüdür. Kemoterapi ile arteriyel sertlik arasındaki ilişkiyi araştırmak amaçlandı.

Gereç ve Yöntemler: Çalışmamıza, Hodgkin dışı lenfoma tanısı alan ve antrasiklin kemoterapisi alacak olan hastalar dahil edildi. Hastaların kemoterapi öncesi, ilk ve altıncı kür kemoterapi sonrası arteriyel sertlik aplanasyon tonometri ile değerlendirildi. 

Bulgular: Antrasiklin kemoterapi sonrası 1.kür ve 6.kür nabız dalga hızı değerlerinde bazale göre artış eğilimi vardı [9.08 (8.12-9.76), 10.31 (8.22-12.62), 9.64 (8.22-12.62) m/s, p = 0.053]. Antrasiklin kemoterapisiyle augmentasyon indeksinde anlamlı değişim olmadı (p=0.810). Tedavi öncesi bazal ve altıncı kür subendokardiyal viabilite oranı değerlerinde azalma eğilimi vardı [151.60 (122.20-188.70) and 124.30 (94.50-154.10), p = 0.058].

Sonuç: Antrasiklin kemoterapisi arteriyel sertlik parametlerini bozma eğilimi göstermektedir.

Keywords

• Kemoterapi,Antrasiklin,Arteriyel Sertlik

References

1. 1. Volkova M, Russell R 3rd. Anthracycline cardiotoxicity: prevalence, pathogenesis and treatment. Curr Cardiol Rev 2011;7:214–220.
2. 2. Gianni L, Herman EH, Lipshultz SE, Minotti G, Sarvazyan N, Sawyer DB.Anthracycline cardiotoxicity: From bench to bedside. J Clin Oncol 2008;26:3777-3784.
3. 3. Singal PK, Iliskovic N: Doxorubicin-induced cardiomyopathy. N Engl J Med.1998;339:900-905.
4. 4. Carver JR, Shapiro CL, Ng A,Jacobs L, Schwartz C, Virgo KS, Hagerty KL et al.: American Society of Clinical Oncology clinical evidence review on the ongoing care of adult cancer survivors: Cardiac and pulmonary late effects. J Clin Oncol 2007;25:3991-4008.
5. 5. Shirwany NA, Zou MH. Arterial stiffness: a brief review. Acta Pharmacol Sin 2010;31:1267–1276.
6. 6. Franklin SS, Gustin Wt, Wong ND, Larson MG, Weber MA, Kannel WB, et al. Hemodynamic patterns of age-related changes in blood pressure. The Framingham Heart Study. Circulation 1997;96:308–15.
7. 7. Sutton-Tyrrell K, Najjar SS, Boudreau RM, Venkitachalam L, Kupelian V, Simonsick EM, et al. Elevated aortic pulse wave velocity, a marker of arterial stiffness, predicts cardiovascular events in well-functioning older adults. Circulation 2005;111:3384–90.
8. 8. Chae CU, Pfeffer MA, Glynn RJ, Mitchell GF, Taylor JO, Hennekens CH. Increased pulse pressure and risk of heart failure in the elderly. JAMA 1999;281:634–9. Herceg-Cavrak V, ⦁ Ahel V, ⦁ Batinica M, ⦁ Matec L, Kardos D. Increased arterial stiffness in children treated with anthracyclines for malignant disease. ⦁ Coll Antropol. 2011;35:389-95.

9. 9. Herceg-Cavrak V, ⦁ Ahel V, ⦁ Batinica M, ⦁ Matec L, Kardos D. Increased arterial stiffness in children treated with anthracyclines for malignant disease. ⦁ Coll Antropol. 2011;35:389-95.
10. 10. Chaosuwannakit N, D'Agostino R Jr, Hamilton CA, Lane KS, Ntim WO, Lawrence J et al. Aortic stiffness increases upon receipt of anthracycline chemotherapy. J Clin Oncol 2010;28:166-72.
11. 11. Laurent S, Cockcroft J, Van Bortel L, Boutouyrie P, Giannattasio C, Hayoz D et al. European Network for Non-invasive Investigation of Large Arteries.Expert consensus document on arterial stiffness: methodological issues and clinical applications.Eur Heart J 2006;27:2588-605.
12. 12. Pauca AL, O'Rourke MF, Kon ND. Prospective evaluation of a method for estimating ascending aortic pressure from the radial artery pressure waveform. Hypertension 2001;38:932-7
13. 13. Wilkinson IB, MacCallum H, Flint L, Cockcroft JR, Newby DE, Webb DJ. The influence of heart rate on augmentation index and central arterial pressure in humans. J Physiol 2000;15:263-70.
14. 14. Von Hoff DD, Layard MW, Basa P, Davis HL Jr, Von Hoff AL, Rozencweig Met al. Risk factors for doxorubicin-induced congestive heart failure. Ann Intern Med 1979;91:710-7.
15. 15. Bloom MW, Hamo CE, Cardinale D, Ky B, Nohria A, Baer L et al. Cancer Therapy-Related Cardiac Dysfunction and Heart Failure: Part 1: Definitions, Pathophysiology, Risk Factors, and Imaging. Circ Heart Fail 2016;9:e002661.
16. 16. McGowan JV, Chung R, Maulik A, Piotrowska I, Walker JM, Yellon DM. Anthracycline Chemotherapy and Cardiotoxicity. Cardiovasc Drugs Ther 2017;31:63–75.
17. 17. Singal PK, Iliskovic N. Doxorubicin-induced cardiomyopathy. N Engl J Med. 1998;339:900–5.
18. 18. Wolf MB, Baynes JW. The anti-cancer drug, doxorubicin, causes oxidant stress-induced endothelial dysfunction. Biochim Biophys Acta 2006;1760: 267-71.
19. 19. Duquaine D, Hirsch GA, Chakrabarti A, Han Z, Kehrer C, Brook R et al. Rapid-onset endothelial dysfunction with adriamycin: evidence for a dysfunctional nitric oxide synthase. Vasc Med 2003;8:101-7.
20. 20. Miyazaki H, Matsuoka H, Cooke JP, Usui M, Ueda S, Okuda Set al. Endogenous nitric oxide synthase inhibitor: a novel marker of atherosclerosis. Circulation 1999;99:1141–1146.
21. 21. Gedikli O, Ozturk S, Yilmaz H, Baykan M, Kiris A, Durmus Iet al: Low total antioxidative capacity levels are associated with augmentation index but not pulse-wave velocity. Heart Vessels 2009;24:366-70