Key result
Anthracycline-treated adult survivors of childhood cancers exhibited significantly greater resting carotid intima-media thickness (0.44 vs 0.41 mm) and arterial stiffness that worsened during exercise compared to healthy controls.
Why the study?
Emerging evidence suggests potential arterial damage with anthracycline-based chemotherapy, prompting evaluation of resting and exercise arterial function in adult survivors of childhood cancers.
Does a history of anthracycline treatment in childhood cancer survivors cause arterial dysfunction at rest and during exercise compared to healthy controls?
Cross-Sectional (n=156)
Yes
Does a history of anthracycline treatment in childhood cancer survivors cause arterial dysfunction at rest and during exercise compared to healthy controls?
Adult survivors of childhood cancers treated with anthracyclines exhibit significant arterial dysfunction at rest that worsens during exercise compared to healthy controls.
Supports arterial monitoring in anthracycline survivors; leaves open prognostic value of exercise-induced changes.
Emerging evidence suggests potential arterial damage with the use of anthracycline-based chemotherapeutic regimens. We determined arterial function at rest and during exercise in anthracycline-treated adult survivors of childhood cancers. Ninety-six adult survivors (54 males) aged 25.0 ± 5.9 years and 60 (30 males) healthy controls were studied. Central systolic blood pressure (cSBP) and radial augmentation index (rAI) was determined by applanation tonometry. Carotid arterial stiffness and intima-media thickness (IMT) were assessed using high-resolution ultrasound. At rest, survivors had significantly greater carotid IMT ( p < 0.001) and stiffness index (p < 0.001), and higher cSBP ( p = 0.037), rAI ( p = 0.004) and rAI adjusted for a heart rate of 75/min ( p = 0.009) than controls. At submaximal supine exercise testing, survivors had significantly greater percentage increase in carotid stiffness than controls ( p < 0.001). Among survivors, 32 and 53% had respectively carotid IMT and exercise stiffness index exceeding normal (> + 2SD of controls). The slopes of increase in carotid IMT ( p < 0.001) and exercise-induced changes in carotid stiffness ( p < 0.001) with age were significantly greater in survivors than controls. Multivariate analysis revealed carotid IMT (β = 0.32, p < 0.001) to be an significant correlate of dynamic percentage increase in stiffness index during exercise. Arterial dysfunction is evident at rest and worsens during exercise in anthracycline-treated adult survivors of childhood cancers.
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Li et al. (2018) conducted a cross-sectional in Childhood cancer survivors previously treated with anthracyclines (n=156). Anthracycline chemotherapy vs. Healthy controls was evaluated on Resting carotid intima-media thickness (IMT) in mm (p=<0.001). Anthracycline-treated adult survivors of childhood cancers exhibited significantly greater resting carotid intima-media thickness (0.44 vs 0.41 mm) and arterial stiffness that worsened during exercise compared to healthy controls.
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