Particularities of arterial stiffness dynamics on the background of breast cancer chemotherapy
- Authors: Yushchuk E.N.1, Medvedeva E.G.1, Filonenko D.A.2, Ivanova S.V.1, Zhukova L.G.2, Sapunova D.A.1
-
Affiliations:
- Yevdokimov Moscow State University of Medicine and Dentistry
- Loginov Moscow Clinical Scientific and Practical Center
- Issue: Vol 95, No 8 (2023)
- Pages: 621-626
- Section: Original articles
- URL: https://journals.rcsi.science/0040-3660/article/view/148306
- DOI: https://doi.org/10.26442/00403660.2023.08.202327
- ID: 148306
Cite item
Full Text
Abstract
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.
Full Text
##article.viewOnOriginalSite##About the authors
Elena N. Yushchuk
Yevdokimov Moscow State University of Medicine and Dentistry
Author for correspondence.
Email: ndlena@mail.ru
ORCID iD: 0000-0003-0065-5624
д-р мед. наук, проф., зав. каф. клинической функциональной диагностики ФГБОУ ВО «МГМСУ им. А.И. Евдокимова»
Russian Federation, MoscowElizaveta G. Medvedeva
Yevdokimov Moscow State University of Medicine and Dentistry
Email: ndlena@mail.ru
ORCID iD: 0000-0002-5011-5346
ассистент каф. клинической функциональной диагностики ФГБОУ ВО «МГМСУ им. А.И. Евдокимова»
Russian Federation, MoscowDaria A. Filonenko
Loginov Moscow Clinical Scientific and Practical Center
Email: ndlena@mail.ru
ORCID iD: 0000-0002-7224-3111
канд. мед. наук, зав. дневным стационаром ГБУЗ «МКНПЦ им. А.С. Логинова»
Russian Federation, MoscowSvetlana V. Ivanova
Yevdokimov Moscow State University of Medicine and Dentistry
Email: ndlena@mail.ru
ORCID iD: 0000-0001-7370-9297
д-р мед. наук, проф. каф. клинической функциональной диагностики ФГБОУ ВО «МГМСУ им. А.И. Евдокимова»
Russian Federation, MoscowLiudmila G. Zhukova
Loginov Moscow Clinical Scientific and Practical Center
Email: ndlena@mail.ru
ORCID iD: 0000-0003-4848-6938
д-р мед. наук, проф., зам. дир. по онкологии ГБУЗ «МКНПЦ им. А.С. Логинова»
Russian Federation, MoscowDaria A. Sapunova
Yevdokimov Moscow State University of Medicine and Dentistry
Email: ndlena@mail.ru
ORCID iD: 0000-0001-7847-4693
канд. мед. наук, доц. каф. клинической функциональной диагностики ФГБОУ ВО «МГМСУ им. А.И. Евдокимова»
Russian Federation, MoscowReferences
- Злокачественные новообразования в России в 2021 году (заболеваемость и смертность). Под ред. А.Д. Каприна, В.В. Старинского, А.О. Шахзадовой. М.: МНИОИ им. П.А. Герцена − филиал ФГБУ «НМИЦ радиологии» Минздрава России, 2022 [Zlokachestvennye novoobrazovaniia v Rossii v 2021 godu (zabolevaemost' i smertnost'). Pod red. AD Kaprina, VV Starinskogo, AO Shakhzadovoi. Moscow: MNIOI im. P.A. Gertsena − filial FGBU «NMITs radiologii» Minzdrava Rossii, 2022 (in Russian)].
- Sung H, Ferlay J, Siegel RL, et al. Global Cancer Statistics 2020: GLOBOCAN Estimates of Incidence and Mortality Worldwide for 36 Cancers in 185 Countries. CA Cancer J Clin. 2021;71(3):209-49. doi: 10.3322/caac.21660
- Wild CP, Weiderpass E, Stewart BW. World cancer report: cancer research for cancer prevention, in World cancer reports, World Health Organization: IACR, 2020.
- Балмаганбетова Ф.К., Нургалиева Р.Е., Тухватшин Р.Р., и др. Современные аспекты эпидемиологии рака молочной железы: обзор литературы. West Kazakhstan Medical Journal. 2020;62(2):125-33. [Balmaganbetova FK, Nurgalieva RE, Tuhvatshin RR, et al. Modern aspects of breast cancer epidemiology:literature review. West Kazakhstan Medical Journal. 2020;62(2):125-33 (in Russian)].
- Яндиева Р.А., Сарибекян Э.К., Мамедов М.Н. Кардиотоксичность при лечении онкологических заболеваний. Международный журнал сердца и сосудистых заболеваний. 2018;6(17):3-11 [Yandieva RA, Saribekyan EK, Mamedov MN. Cardiotoxicity of cancer therapy. International heart and vascular disease journal. 2018;6(17):3-11 (in Russian)].
- Vlachopoulos C, Xaplanteris P, Aboyans V, et al. The role of vascular biomarkers for primary and secondary prevention. A position paper from the European Society of Cardiology Working Group on peripheral circulation. Atherosclerosis. 2015;241(2):507-32. doi: 10.1016/j.atherosclerosis.2015.05.007
- Solomou E, Aznaouridis K, Masoura C, et al. Aortic wall stiffness as a side-effect of anti-cancer medication. Expert Rev Cardiovasc Ther. 2019;17(11):791-9. doi: 10.1080/14779072.2019.1691528
- Васюк Ю.А., Иванова С.В., Школьник Е.Л., и др. Согласованное мнение российских экспертов по оценке артериальной жесткости в клинической практике. Кардиоваскулярная терапия и профилактика. 2016;15(2):4-19 [Vasyuk YA, Ivanova SV, Shkolnik EL, et al. Consensus of Russian experts on the evaluation of arterial stiffness in clinical practice. Cardiovasc Ther Prev. 2016;15(2):4-19 (in Russian)]. doi: 10.15829/1728-8800-2016-2-4-19
- Parr SK, Liang J, Schadler KL, et al. Anticancer Therapy-Related Increases in Arterial Stiffness: A Systematic Review and Meta-Analysis. J Am Heart Assoc. 2020;9(14):e015598. doi: 10.1161/JAHA.119.015598
- Herrmann J, Yang EH, Iliescu CA, et al. Vascular toxicities of cancer therapies. Circulation. 2016;133(13):1272-89. doi: 10.1161/CIRCULATIONAHA.115.018347
- Sales ARK, Negrão MV, Testa L, et al. Chemotherapy acutely impairs neurovascular and hemodynamic responses in women with breast cancer. Am J Physiol Circ Physiol. 2019;317(1):H1-H12. doi: 10.1152/ajpheart.00756.2018
- Clayton ZS, Hutton DA, Mahoney SA, Seal DR. Anthracycline chemotherapy-mediated vascular dysfunction as a model of accelerated vascular aging. Aging and Cancer. 2021;2(1-2):45-69. doi: 10.1002/aac2.12033
- Lyon AR, López-Fernández T, Couch LS, et al. 2022 ESC Guidelines on cardio-oncology developed in collaboration with the European Hematology Association (EHA), the European Society for Therapeutic Radiology and Oncology (ESTRO) and the International Cardio-Oncology Society (IC-OS). Eur Heart J. 2022;43(41):4229-361. doi: 10.1093/eurheartj/ehac244
- Vlachopoulos C, Aznaouridis K, Terentes-Printzios D, et al. Prediction of cardiovascular events and all-cause mortality with brachial-ankle elasticity index. Hypertension. 2012;60(2):56-562. doi: 10.1161/HYPERTENSIONAHA.112.194779
- Mizia-Stec K, Gościńska A, Mizia M, et al. Anthracycline chemotherapy impairs the structure and diastolic function of the left ventricle and induces negative arterial remodelling. Kardiol Pol. 2013;71(7):681-90. doi: 10.5603/KP.2013.0154
- Souza CA, Simões R, Borges KB, et al. Arterial stiffness use for early monitoring of cardiovascular adverse events due to anthracycline chemotherapy in breast cancer patients. A pilot study. Arq Bras Cardiol. 2018;111(5):721-8. doi: 10.5935/abc.20180168
- Schneider C, González-Jaramillo N, Marcin T, et al. Time-dependent effect of anthracycline-based chemotherapy on central arterial stiffness: A systematic review and meta-analysis. Front Cardiovasc Med. 2022;9:873898. doi: 10.3389/fcvm.2022.873898
- Hershman DL, Till C, Shen S, et al. Association of cardiovascular risk factors with cardiac events and survival outcomes among patients with breast cancer enrolled in SWOG clinical trials. J Clin Oncol. 2018;36(26):2710-7. doi: 10.1200/JCO.2017.77.4414