Promotion of Arterial Stiffness by Childhood Cancer and Its Characteristics in Adult Long‐Term Survivors

Journal of the American Heart Association: Cardiovascular and Cerebrovascular Disease

Manfred E. Beutel¹  Norbert Pfeiffer²  Nicole Henninger³  Susan Eckerle³  Arthur Wingerter³  Marie A. Neu³  Jörg Faber³  Marina Panova‐Noeva⁴  Thomas Münzel⁴  Karl J. Lackner⁴  Sebastian Göbel⁴  Irene Schmidtmann⁵  Hiltrud Merzenich⁶  Claudia Spix⁶  Astrid Schneider⁶  Natalie Arnold⁷  Jürgen H. Prochaska⁷  Philipp S. Wild⁷  Andreas Schulz⁷ 

[1] Clinic for Psychosomatic Medicine and Psychotherapy University Medical Centre of the Johannes Gutenberg–University Mainz Mainz Germany;Department of Ophthalmology University Medical Centre of the Johannes Gutenberg–University Mainz Mainz Germany;Department of Pediatric Hematology/Oncology/Hemostaseology Centre for Pediatric and Adolescent Medicine University Medical Centre of the Johannes–Gutenberg University Mainz Mainz Germany;German Centre for Cardiovascular Research Partner Site Rhine‐Main Mainz Germany;German Childhood Cancer Registry Institute for Medical Biostatistics, Epidemiology and Informatics University Medical Centre of the Johannes Gutenberg–University Mainz Mainz Germany;Institute for Medical Biostatistics, Epidemiology and Informatics University Medical Centre of the Johannes Gutenberg–University Mainz Mainz Germany;Preventive Cardiology and Preventive Medicine Centre for Cardiology University Medical Centre of the Johannes Gutenberg–University Mainz Mainz Germany;

关键词: arterial stiffness;    childhood cancer survivors;    general population;   

DOI  :  10.1161/JAHA.119.015609

来源: DOAJ

【 摘 要 】

Background Vascular alterations induced by antineoplastic treatment might be considered as a possible underlying mechanism of increased cardiovascular sequelae in childhood cancer survivors (CCSs). We aimed to evaluate arterial stiffness among long‐term CCSs and to compare the data against a population‐based sample. Methods and Results Arterial stiffness was assessed by digital photoplethysmography (stiffness index; m/s) among 1002 participants of the CVSS (Cardiac and Vascular Late Sequelae in Long‐Term Survivors of Childhood Cancer) study, diagnosed with neoplasia (1980–1990) before an age of 15 years. A population‐based sample from the GHS (Gutenberg Health Study) (n=5252) was investigated for comparison. All subjects underwent a comprehensive, standardized clinical examination in the same study center. CCSs had higher stiffness index (β=0.66 m/s; 95% CI, 0.51–0.80 m/s) in multivariable linear regression analysis after adjustment for cardiovascular risk factors compared with the population sample of comparable age range. Stiffer vessels were found among CCSs also in absence of arterial hypertension (β=0.66; 95% CI, 0.50–0.81) or history of chemotherapy/radiotherapy (β=0.56; 95% CI, 0.16–0.96) in fully adjusted models. Moreover, stiffness index differed by tumor entity, with highest values in bone and renal tumors. Almost 5.2‐fold higher prevalence of stiffness index values exceeding age‐specific, population‐based reference limits was observed among CCSs compared with GHS participants. Conclusions This is the first study demonstrating increased arterial stiffness among long‐term CCSs. The data suggest that vascular compliance might differ in survivors of childhood cancer from the established development concept for arterial stiffness in the population; cancer growth and antineoplastic treatment might be relevant determinants of the pathobiological features. Registration URL: https://www.clinicaltrials.gov; Unique identifier: NCT02181049.

【 授权许可】

Unknown