Chemotherapy-treated testicular cancer survivors had a lower E/A-ratio than stage I patients and healthy controls, indicating impaired left ventricular relaxation.
Cross-Sectional (n=181)
Does prior cisplatin-based chemotherapy impair left ventricular and cardiac autonomic function in survivors of testicular cancer compared to non-chemotherapy patients and healthy controls?
Survivors of testicular cancer treated with cisplatin-based chemotherapy exhibit echocardiographic signs of impaired left ventricular relaxation compared to healthy controls and non-chemotherapy patients.
BACKGROUND: Following cisplatin-based chemotherapy, survivors of testicular cancer have a high prevalence of cardiovascular risk factors and an increased risk of cardiovascular disease. Cardiac function has not been extensively studied and no comparisons have been made with men from the general population. DESIGN: Left ventricular and cardiac autonomic function were evaluated in chemotherapy-treated testicular cancer patients, in stage I patients after orchidectomy only, and in healthy men using Doppler echocardiography wall motion score index, peak early (E) and atrial filling (A) velocities across the mitral valve, E/A-ratio, isovolumetric relaxation time, and deceleration time of the early peak flow and measurements of N-terminal pro-brain natriuretic peptide and baroreflex sensitivity. Furthermore, 24-h ambulatory blood pressure was measured. RESULTS: Ninety chemotherapy-treated patients (median age 37 years, range 20-65; median follow up of 7 years, range 3-13) were compared with 44 stage I patients (median age 36 years, range 24-63) and 47 healthy controls (median age 37 years, range 22-55). Wall motion score index was less than 1.5 in all participants. Chemotherapy-treated patients had a higher peak A-wave and a lower E/A-ratio than stage I patients and controls. Isovolumetric relaxation and deceleration times did not differ between groups. Age, 24-h diastolic blood pressure and treatment with chemotherapy were significantly associated with E/A-ratio. Natriuretic peptide levels were normal. Baroreflex sensitivity was similar in the three groups. CONCLUSIONS: Chemotherapy-treated testicular cancer survivors have a lower E/A-ratio than healthy subjects from the general population, which may indicate impaired relaxation of the left ventricle and reflect the high prevalence of cardiovascular risk factors previously reported in these men.
Nuver et al. (Mon,) conducted a cross-sectional in Testicular cancer survivors (n=181). Cisplatin-based chemotherapy vs. Stage I patients (orchidectomy only) and healthy controls was evaluated on Left ventricular and cardiac autonomic function (including E/A-ratio). Chemotherapy-treated testicular cancer survivors had a lower E/A-ratio than stage I patients and healthy controls, indicating impaired left ventricular relaxation.