Key result
Anthracycline-containing chemotherapy in breast cancer patients was associated with a significant decrease in arterial stiffness, including a reduction in carotid-femoral pulse wave velocity from 9.32 to 7.85 m/s.
Why the study?
Cardio- and vasculotoxicity frequently occur during breast cancer chemotherapy, highlighting the need to evaluate arterial stiffness dynamics as potential markers of early toxic response.
Does anthracycline-containing chemotherapy alter arterial stiffness in women with breast cancer?
Cohort (n=20)
Yes
Does anthracycline-containing chemotherapy alter arterial stiffness in women with breast cancer?
Absolute Event Rate: 7.85% vs 9.32%
p-value: p=<0.05
Anthracycline-based chemotherapy in breast cancer patients is associated with early hemodynamic restructuring and a decrease in arterial stiffness indicators such as cfPWV and CAVI.
May signal early vasculotoxicity during anthracycline chemotherapy; leaves open predictive value pending larger validation studies.
BACKGROUND: Modern breast cancer chemotherapy regimens (BC) consider individual patient parameters and ranges of cardiotoxic doses. However, clinicians often record clinical and laboratory-instrumental signs of cardio- and vasculotoxicity in patients, which emphasizes the high importance of searching for markers of early toxic response. AIM: To study the characteristics of the response of arterial stiffness on the background of anthracycline-containing chemotherapy to determine potential markers of vasculotoxicity in BC patients. MATERIALS AND METHODS: 20 women with a BC were included. The patients received 4 cycles of chemotherapy in the doxorubicin + cyclophosphane (AC) regimen with an interval of 2-3 weeks, then they were injected with paclitaxel weekly for 12 injections, or docetaxel once every 3 weeks. All patients underwent TTE, arterial stiffness determination by the "gold standard" method and using volumetric sphygmography before the start of treatment, after the completion of the anthracycline component and after the end of taxanes. RESULTS: The average age of the patients was 45.5±5.31 years. After completing the course of anthracyclines, there was a significant increase in heart rate (from 65.6±9.3 to 73.3±10.1 beats/min.), a decrease in SBP (from 122.6±9.9 to 116.5±12.3 mmHg) and DBP (from 78.9±8.5 to 76.2±8.6 mmHg), a decrease in carotid femoral pulse wave velocity (cfPWV) (from 9.32±1.41 to 7.85±1.57 m/s), CAVI index on the left (from 6.78±0.81 to 6.5±0.88), the velocity of the cardio-ankle pulse wave on the right and left (from 6.7±0.6 to 6.5±0.7 m/s; from 7.0±0.6 to 6.3±0.8 m/sc, respectively). After the completion of the taxane, there was a tendency to increase these indicators, however, they remained significantly lower compared to the values before the start of treatment. CONCLUSION: A comparative analysis of arterial stiffness indicators at different stages of chemotherapy showed a more pronounced reaction of cfPWV, CAVI, cardio-ankle pulse wave to the administration of anthracyclines, which presumably may be associated with concomitant hemodynamic restructuring.
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Yushchuk et al. (2023) conducted a cohort in Breast cancer (n=20). Anthracycline-containing chemotherapy vs. Baseline (before treatment) was evaluated on Carotid-femoral pulse wave velocity (cfPWV) after anthracycline chemotherapy (p=<0.05). Anthracycline-containing chemotherapy in breast cancer patients was associated with a significant decrease in arterial stiffness, including a reduction in carotid-femoral pulse wave velocity from 9.32 to 7.85 m/s.
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