Acute chemotherapy-induced cardiovascular changes in patients with testicular cancer.
OBJECTIVE
After cisplatin- and bleomycin-containing chemotherapy for testicular cancer, part of the patient population will develop acute or long-term cardiovascular toxicity. It is largely unknown whether standard tests can be used to assess chemotherapy-induced cardiovascular changes.


METHODS
In 65 testicular cancer patients (median age, 27 years; range, 18 to 48 years), we measured the following cardiovascular parameters before and within 10 weeks after completion of cisplatin-based chemotherapy: platelet numbers, plasma levels of hemostatic and fibrinolytic factors, 24-hour ambulatory blood pressure, baroreflex sensitivity, intima-media thickness of the common carotid artery, and flow-mediated vasodilation of the brachial artery.


RESULTS
Compared with prechemotherapy values, the intima-media thickness of the carotid artery and plasma von Willebrand factor levels increased significantly after treatment. Platelet numbers and plasma levels of other hemostatic and fibrinolytic factors did not appear to change significantly. Blood pressure decreased significantly, but flow-mediated vasodilation and baroreflex sensitivity did not change.


CONCLUSIONS
In testicular cancer patients treated with cisplatin-based chemotherapy, we found an increase in plasma von Willebrand factor levels and in the intima-media thickness of the carotid artery. These changes may indicate chemotherapy-induced vascular damage and be of prognostic significance for the development of cardiovascular complications in the long term.
Nuver
Janine
J
Department of Medical Oncology, University of Groningen and University Medical Center Groningen, Groningen, the Netherlands.
Smit
Andries J
AJ
van der Meer
Jan
J
van den Berg
Maarten P
MP
van der Graaf
Winette T A
WT
Meinardi
Martin T
MT
Sleijfer
Dirk Th
DT
Hoekstra
Harald J
HJ
van Gessel
Anne I
AI
van Roon
Arie M
AM
Gietema
Jourik A
JA
D000293:Adolescent; D000328:Adult; D000971:Antineoplastic Combined Chemotherapy Protocols / Q000008:administration & dosage / Q000009:adverse effects* / Q000627:therapeutic use; D015415:Biomarkers / Q000097:blood; D001761:Bleomycin / Q000008:administration & dosage / Q000009:adverse effects; D002318:Cardiovascular Diseases / Q000139:chemically induced*; D002339:Carotid Arteries / Q000187:drug effects / Q000473:pathology; D002945:Cisplatin / Q000008:administration & dosage / Q000009:adverse effects; D005047:Etoposide / Q000008:administration & dosage / Q000009:adverse effects; D006801:Humans; D008297:Male; D008875:Middle Aged; D011237:Predictive Value of Tests; D011379:Prognosis; D011446:Prospective Studies; D013736:Testicular Neoplasms / Q000188:drug therapy*; D017539:Tunica Intima / Q000187:drug effects / Q000473:pathology; D014841:von Willebrand Factor / Q000032:analysis
D015415:Biomarkers; D014841:von Willebrand Factor; D001761:Bleomycin; D005047:Etoposide; D002945:Cisplatin