title: Effects of Cancer Therapy Targeting Vascular Endothelial Growth Factor Receptor on Central Blood Pressure and Cardiovascular System.
abstract: BACKGROUND
  In the last 2 decades, new drugs that oppose the effects of vascular endothelial growth factor receptor (VEGFR), and thus angiogenesis, have considerably improved treatment of solid tumors. These anti-VEGFR drugs, however, are burdened by several side effects, particularly relevant on heart and vessels. The aim of this study was to analyze the changes in cardiovascular structure and function associated with use of anti-VEGFR drugs.
  
  
  METHODS
  Twenty-nine patients (27 affected by renal and 2 by thyroid cancer), received treatment with anti-VEGFR drugs. Brachial blood pressure (BP), central BP, carotid-femoral pulse wave velocity (cfPWV), augmentation index (Aix), and several echocardiographic markers of systolic and diastolic left ventricular functions including global longitudinal strain were measured before starting treatment (T0), after 2 (T1), and 6 weeks (T2) of treatment.
  
  
  RESULTS
  Anti-VEGFR treatment was accompanied by a significant increase of both peripheral (systolic BP +13±15.5mm Hg, diastolic BP +7.1±9.3mm Hg, P < 0.001) and central BP (systolic BP +14±14.2mm Hg, diastolic BP +7.3±10.4mm Hg, P < 0.001) and a significant raise of cfPWV (+1.3±1.8 m/sec, P = 0.003). There was also a significant alteration of markers of diastolic and subclinical left ventricular systolic function, including global longitudinal strain (-19.9±3.8% at T0, -17.8±2.6% at T2, P < 0.05). All the changes were already evident at T1, worsened at T2 in patients who maintained oncological treatment, but disappeared at T2 in patients in whom treatment was stopped.
  
  
  CONCLUSIONS
  All the changes regarding BP and cfPWV appear early after treatment initiation and seem to be reversible if treatment is stopped, instead diastolic and systolic left ventricular function are persistently altered by anti-VEGFR drugs.
authors.affiliation: Cardiology IV, "A.De Gasperis" Department, Ospedale Niguarda Ca' Granda, Milan, Italy;
authors.forename: Antonella
authors.initials: A
authors.lastname: Moreo
authors.affiliation: Cardiology IV, "A.De Gasperis" Department, Ospedale Niguarda Ca' Granda, Milan, Italy;
authors.forename: Paola
authors.initials: P
authors.lastname: Vallerio
authors.affiliation: Niguarda Cancer Center, Ospedale Niguarda Ca' Granda, Milan, Italy;
authors.forename: Riccardo
authors.initials: R
authors.lastname: Ricotta
authors.affiliation: Cardiology IV, "A.De Gasperis" Department, Ospedale Niguarda Ca' Granda, Milan, Italy; Health Science Department, Milano-Bicocca University, Milan, Italy;
authors.forename: Miriam
authors.initials: M
authors.lastname: Stucchi
authors.affiliation: Cardiology IV, "A.De Gasperis" Department, Ospedale Niguarda Ca' Granda, Milan, Italy; Health Science Department, Milano-Bicocca University, Milan, Italy;
authors.forename: Mattia
authors.initials: M
authors.lastname: Pozzi
authors.affiliation: Cardiology IV, "A.De Gasperis" Department, Ospedale Niguarda Ca' Granda, Milan, Italy;
authors.forename: Francesco
authors.initials: F
authors.lastname: Musca
authors.affiliation: Cardiology IV, "A.De Gasperis" Department, Ospedale Niguarda Ca' Granda, Milan, Italy; Health Science Department, Milano-Bicocca University, Milan, Italy;
authors.forename: Paolo
authors.initials: P
authors.lastname: Meani
authors.affiliation: Health Science Department, Milano-Bicocca University, Milan, Italy;
authors.forename: Alessandro
authors.initials: A
authors.lastname: Maloberti
authors.affiliation: Health Science Department, Milano-Bicocca University, Milan, Italy;
authors.forename: Rita
authors.initials: R
authors.lastname: Facchetti
authors.affiliation: Niguarda Cancer Center, Ospedale Niguarda Ca' Granda, Milan, Italy;
authors.forename: Sara
authors.initials: S
authors.lastname: Di Bella
authors.affiliation: Niguarda Cancer Center, Ospedale Niguarda Ca' Granda, Milan, Italy;
authors.forename: Maria Olga
authors.initials: MO
authors.lastname: Giganti
authors.affiliation: Niguarda Cancer Center, Ospedale Niguarda Ca' Granda, Milan, Italy;
authors.forename: Andrea
authors.initials: A
authors.lastname: Sartore-Bianchi
authors.affiliation: Niguarda Cancer Center, Ospedale Niguarda Ca' Granda, Milan, Italy;
authors.forename: Salvatore
authors.initials: S
authors.lastname: Siena
authors.affiliation: IRCSS, Istituto Auxologico Italiano, Milano, Italy.
authors.forename: Giuseppe
authors.initials: G
authors.lastname: Mancia
authors.affiliation: Cardiology IV, "A.De Gasperis" Department, Ospedale Niguarda Ca' Granda, Milan, Italy; Health Science Department, Milano-Bicocca University, Milan, Italy; cristina.giannattasio@ospedaleniguarda.it.
authors.forename: Cristina
authors.initials: C
authors.lastname: Giannattasio
mesh_terms: D000368:Aged; D000970:Antineoplastic Agents / Q000009:adverse effects*; D001158:Arteries / Q000187:drug effects*; D001794:Blood Pressure / Q000187:drug effects*; D002292:Carcinoma, Renal Cell / Q000188:drug therapy; D005260:Female; D006321:Heart / Q000187:drug effects*; D006801:Humans; D007191:Indazoles; D007211:Indoles / Q000009:adverse effects; D007680:Kidney Neoplasms / Q000188:drug therapy; D008297:Male; D008875:Middle Aged; D009536:Niacinamide / Q000009:adverse effects / Q000031:analogs & derivatives; D010671:Phenylurea Compounds / Q000009:adverse effects; D063177:Pulse Wave Analysis; D011743:Pyrimidines / Q000009:adverse effects; D011758:Pyrroles / Q000009:adverse effects; D040262:Receptors, Vascular Endothelial Growth Factor / Q000037:antagonists & inhibitors*; D000077157:Sorafenib; D013449:Sulfonamides / Q000009:adverse effects; D000077210:Sunitinib; D013964:Thyroid Neoplasms / Q000188:drug therapy; D059289:Vascular Stiffness / Q000187:drug effects
chemical_list: D000970:Antineoplastic Agents; D007191:Indazoles; D007211:Indoles; D010671:Phenylurea Compounds; D011743:Pyrimidines; D011758:Pyrroles; D013449:Sulfonamides; D009536:Niacinamide; C516667:pazopanib; D000077157:Sorafenib; D040262:Receptors, Vascular Endothelial Growth Factor; D000077210:Sunitinib
keywords: arterial stiffness; central blood pressure; global longitudinal strain; hypertension; pulse wave velocity; vascular endothelial growth factor receptor.