Non-invasive assessment of vascular system function and damage induced by anthracycline treatment in the pediatric cancer survivors



Year of publication 2022
Type Conference abstract
Description Anthracyclines remain among the most widely prescribed and effective anticancer agents. Unfortunately, life-threatening cardiotoxicity continues to compromise their usefulness. There are several predictive factors of cardiotoxicity: cumulative dose, total dose administered per day or course, rate of administration, order of administration, age, gender, anamnestic or current cardiovascular disorders, electrolyte imbalance. This study aimed to evaluate the influence of anthracyclines on cardiovascular stiffness parameters estimated from the pulse wave (PW). PW was measured in 87 cancer survivors treated with anthracyclines in childhood (A) and in 175 healthy age-matched controls (C). The patients were treated with anthracycline antibiotics with cumulative dose of doxorubicin (ADR) or daunorubicin (DNR) 220 (180 – 240) mg/m2, cyclofosfamid (CYCLO) 3.000 (2.800 – 3.300) mg/m2 or vincristine (VCR) 12 (12-15) mg/m2). Both patients and controls were divided into four age groups (12 – 14, 15 – 17, 18 – 20 and 21 – 24 years). Pulse wave (PW) was measured by applanation tonometry (Sphygmocor; AtCor Medical, Australia).Central PW augmentation index (AI) and augmentation pressure (AP), both normalized to heart rate of 75 bpm and to the pulse height, and pulse wave velocity (PWV) were calculated as parameters of arterial wall stiffness. Central Buckberg sub-endocardial viability ratio (SEVR) was calculated as a parameter of diastolic function. In age groups 12 – 14 and 21 – 24 we found significant differences in all parameters that reflect arterial stiffness or cardiac diastolic function. Whereas, AP and AI were higher in A in all subgroups with significant differences in the 12 – 14 and 21 – 24 groups. PWV in the 12 – 14 age group was lower in A in comparison with C, but in 21 – 24 age group it was the opposite as it became higher in A than in C. SEVR in age groups 12 – 14 and 15 – 17 was higher in A but once again in older age group (21 – 24) it became lower in comparison with C. Anthracycline cardiotoxicity is being studied all over the world. In this project, the impact of anthracycline treatment on cardiovascular disease (CVD) was shown at the preclinical level. Moreover, we suggest that anthracycline cardiotoxicity also influences sympathovagal balance. In this case, the development of the vascular system was suspended in younger age (lower PWV values) while it accelerated during later periods of growth, which is reflected in our results.
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