Evaluation of Anthracycline Related Arterial Stiffness in Childhood Cancer Survivors

Öz

Childhood cancer survivors have a significantly increased risk of cardiovascular morbidity and mortality. Improved screening methods are needed for early detection of cardiotoxicity. The aim of the study is to evaluate arterial stiffness as an indicator of vascular damage by oscillometric pulse wave analysis in childhood cancer survivors. A total of 38 patients and 25 age and gender matched healthy volunteers were included in this cross-sectional single centre study. All participants, underwent evaluation of arterial stiffness through non-invasive measurement of hemodynamic parameters such as pulse wave velocity (PWV) and central systolic blood pressure (c-SBP) with the Mobil-O-Graph® pulse wave analysis device. Left ventricular ejection fraction (LVEF) and left ventricular mass index (LVMI) were obtained by M-mode echocardiography. The median age of the childhood cancer survivors was 12.5 (4.25-18) and the median duration time after end of chemotherapy was 36 (12-116) months. Both groups were statistically similar in age, body mass index, LVEF and LVMI. Childhood cancer survivors had significantly lower peripheral systolic blood pressure compared to controls. Average c-SBP and PWV were similar between groups. Childhood cancer survivors > 15 years old also had similar PWV value with those < 15 years old. There were no signs of arterial stiffness in childhood cancer survivors late after chemotherapy according to the ambulatory oscillometric PWA. Longer follow-up duration may be required to determination of subclinical vascular damage

Anahtar Kelimeler

• anthracyclines
• arterial stiffness
• , cardiotoxicity
• pulse wave velocity,
• vascular toxicity

Çocukluk Çağı Kanser Sağ Kalanlarında Antrasiklin İlişkili Arteriyel Sertliğin Değerlendirilmesi

Öz

Çocukluk çağı kanser sağ kalanlarının kardiyovasküler morbidite ve mortalite riski önemli ölçüde artmıştır. Kardiyovasküler toksisitenin erken tespiti için gelişmiş tarama yöntemlerine ihtiyaç vardır. Çalışmanın amacı, çocukluk çağı kanseri sağ kalanlarında osilometrik nabız dalga analizi ile vasküler hasarın bir göstergesi olan arteriyel sertliği değerlendirmektir. Bu kesitsel, tek merkezli çalışmaya toplam 38 hasta ve 25 yaş ve cinsiyet uyumlu sağlıklı gönüllü çalışmaya dahil edildi. Tüm katılımcılar Mobil-O-Graph® marka nabız dalga analizi cihazı ile nabız dalga hızı (PWV) ve merkezi sistolik kan basıncı (c-SBP) gibi hemodinamik parametrelerin invazif olmayan ölçümü yoluyla arteriyel sertliğin değerlendirmesine tabi tutuldu. Sol ventrikül ejeksiyon fraksiyonu (LVEF) ve sol ventrikül kitle indeksi (LVMI) M-mod ekokardiyografi ile ölçüldü. Çocukluk çağı kanseri sağ kalanlarının medyan yaşı 12,5 (4,25-18) ve kemoterapi bitiminden sonraki medyan süresi 36 (12-116) aydı. Her iki grup da yaş, vücut kitle indeksi, LVEF ve LVMI açısından istatistiksel olarak benzerdi. Çocukluk çağı kanseri sağ kalanları, kontrollere kıyasla daha düşük periferik sistolik kan basıncına sahipti. Ortalama c-SBP ve PWV gruplar arasında benzerdi. Onbeş yaşından büyük çocukluk çağı kanseri sağ kalanları, 15 yaşından küçüklerle benzer PWV değerine sahipti. Ambulatuar osilometrik PWA ile çocukluk çağı kanseri sağ kalanlarında kronik dönemde subklinik arteriyel sertlik bulgusu tespit edilmedi. Subklinik vasküler hasarın tespiti için daha uzun takip süresi gerekli olabilir.

Anahtar Kelimeler

• antrasiklinler
• arterial stiffness
• kardiyak toksisite
• nabız dalga hızı
• vasküler toksisite

Kaynakça

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