Aortic stiffness increases upon receipt of anthracycline chemotherapy.
PURPOSE Cancer survivors exposed to anthracyclines experience an increased risk of cardiovascular (CV) events. We hypothesized that anthracycline use may increase aortic stiffness, a known predictor of CV events. PATIENTS AND METHODS We performed a prospective, case-control study involving 53 patients: 40 individuals who received an anthracycline for the treatment of breast cancer, lymphoma, or leukemia (cases), and 13 age- and sex-matched controls. Each participant underwent phase-contrast cardiovascular magnetic resonance measures of pulse wave velocity (PWV) and aortic distensibility (AoD) in the thoracic aorta at baseline, and 4 months after initiation of chemotherapy. Four one-way analyses of covariance models were fit in which factors known to influence thoracic aortic stiffness were included as covariates in the models. Results At the 4-month follow-up visit, aortic stiffness remained similar to baseline in the control participants. However, in the participants receiving anthracyclines, aortic stiffness increased markedly (relative to baseline), as evidenced by a decrease in AoD (P < .0001) and an increase in PWV (P < .0001). These changes in aortic stiffness persisted after accounting for age, sex, cardiac output, administered cardioactive medications, and underlying clinical conditions known to influence aortic stiffness, such as hypertension or diabetes (P < .0001). CONCLUSION A significant increase in aortic stiffness occurs within 4 months of exposure to an anthracycline which was not seen in an untreated control group. These results indicate that previously regarded cardiotoxic cancer therapy adversely increases thoracic aortic stiffness, a known independent predictor of adverse cardiovascular events.
Chaosuwannakit
Narumol
N
Wake Forest University Health Sciences, Bowman Gray Campus, Medical Center Blvd, Winston-Salem, North Carolina 27157-1045, USA.
D'Agostino
Ralph
R
Hamilton
Craig A
CA
Lane
Kimberly S
KS
Ntim
William O
WO
Lawrence
Julia
J
Melin
Susan A
SA
Ellis
Leslie R
LR
Torti
Frank M
FM
Little
William C
WC
Hundley
W Gregory
WG
D000328:Adult; D000368:Aged; D018943:Anthracyclines / Q000009:adverse effects*; D001011:Aorta / Q000187:drug effects* / Q000502:physiology; D016022:Case-Control Studies; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D011446:Prospective Studies
D018943:Anthracyclines