title: Longitudinal changes in cardiac function after cisplatin-based chemotherapy for testicular cancer.
abstract: BACKGROUND
  Cross-sectional studies showed that treatment with cisplatin chemotherapy for testicular cancer is associated with an increased incidence of cardiac dysfunction. We investigated longitudinal progression of and contributing factors to cardiac dysfunction in testicular cancer survivors.
  
  
  METHODS
  Cardiac assessments were carried out before 10 months (range 7-15 months) and 6.9 years (range 4.9-9.7 years) after start of cisplatin-based chemotherapy, consisting of echocardiography [systolic function (left ventricular ejection fraction, LVEF), diastolic function (myocardial tissue velocities; tissue velocity imaging of early diastole, TVI Et)] and plasma biomarkers (N-Terminal pro brain natriuretic peptide, NT-proBNP; galectin-3).
  
  
  RESULTS
  In 37 patients [median age 34 years (range 24-51 years)], the incidence of abnormal TVI Et increased from 0% at baseline and 4.5% at 10 months (in 27 patients) to 16.7% at 6.9 years post-chemotherapy (P = 0.03). One patient developed LVEF <50%; no other systolic abnormalities occurred. Hypertension, obesity and age were associated with larger decreases in TVI Et. Changes in NT-proBNP and galectin-3 were not related to echocardiographic abnormalities.
  
  
  CONCLUSIONS
  In this longitudinal cohort study, we observed a gradual decline in diastolic parameters after cisplatin-based chemotherapy for testicular cancer, whereas the rate of systolic dysfunction remains low. The association of larger declines in diastolic parameters with hypertension and obesity stresses the need to monitor and treat cardiovascular risk factors.
authors: Department of Medical Oncology, University Medical Center Groningen, Groningen, The Netherlands.
authors: R
authors: R
authors: Altena
authors: Y M
authors: YM
authors: Hummel
authors: J
authors: J
authors: Nuver
authors: A J
authors: AJ
authors: Smit
authors: J D
authors: JD
authors: Lefrandt
authors: R A
authors: RA
authors: de Boer
authors: A A
authors: AA
authors: Voors
authors: M P
authors: MP
authors: van den Berg
authors: E G E
authors: EG
authors: de Vries
authors: H M
authors: HM
authors: Boezen
authors: J A
authors: JA
authors: Gietema
mesh_terms: D000328:Adult; D000971:Antineoplastic Combined Chemotherapy Protocols / Q000009:adverse effects* / Q000627:therapeutic use; D001761:Bleomycin / Q000008:administration & dosage / Q000009:adverse effects; D002945:Cisplatin / Q000008:administration & dosage / Q000009:adverse effects*; D018450:Disease Progression; D004452:Echocardiography; D005047:Etoposide / Q000008:administration & dosage / Q000009:adverse effects; D037502:Galectin 3 / Q000097:blood; D006331:Heart Diseases / Q000097:blood / Q000139:chemically induced* / Q000000981:diagnostic imaging / Q000503:physiopathology; D006801:Humans; D008137:Longitudinal Studies; D008297:Male; D008875:Middle Aged; D020097:Natriuretic Peptide, Brain / Q000097:blood; D013736:Testicular Neoplasms / Q000097:blood / Q000188:drug therapy* / Q000601:surgery; D018487:Ventricular Dysfunction, Left / Q000139:chemically induced; D055815:Young Adult
chemical_list: D037502:Galectin 3; D001761:Bleomycin; D020097:Natriuretic Peptide, Brain; D005047:Etoposide; D002945:Cisplatin