Anthracycline Causes Impaired Vascular Endothelial Function and Aortic Stiffness in Long Term Survivors of Childhood Cancer
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- 作者：Zoltan Jenei (1)
Edit Bárdi (2)
Mária Tünde Magyar (3)
ágnes Horváth (1)
Gy?rgy Paragh (1)
Csongor Kiss (2) - 关键词：Childhood cancer ; Survivors ; Endothelial dysfunction ; Stiffness
- 刊名：Pathology & Oncology Research
- 出版年：2013
- 出版时间：July 2013
- 年：2013
- 卷：19
- 期：3
- 页码：375-383
- 全文大小：268KB
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Edit Bárdi (2)
Mária Tünde Magyar (3)
ágnes Horváth (1)
Gy?rgy Paragh (1)
Csongor Kiss (2)
1. Department of Medicine, University of Debrecen Medical and Health Science Center, 4025, Nagyerdei krt. 98, Debrecen, Hungary
2. Department of Pediatric Hematology-Oncology, Medical and Health Science Center of University Debrecen, Debrecen, Hungary
3. Department of Neurology, Medical and Health Science Center of University Debrecen, Debrecen, Hungary - ISSN：1532-2807
文摘
Vascular and endothelial functions were investigated in long term survivors of childhood cancer exposed to anthracycline treatment. We enrolled 96 long-term survivors (57 males and 39 females, mean age 14.9?±-.3?year) of different childhood cancers and 72 age-, sex-, bodyweight- and blood pressure matched controls (39 males and 33 females, mean age 13.7?±-.9?year). Aortic stiffness was characterized by echocardiography. Brachial artery endothelial function was assessed by flow-mediated dilatation (FMD%) and nitrate-mediated dilatation (NTG%). Results were compared between three subgroups: anthracycline treated, only chemotherapy treated and control subgroups. The cumulative anthracycline dose was less than 350?mg/m2. The healthy control subgroup had a significantly greater FMD response (13.13?±-.40?%), and lower stiffness index (2.08?±-.6) than both the anthracycline (7.12?±-.28?% and 6.45?±-.25, respectively) and only chemotherapy treated (10.17?±-.23?% and 4.12?±-.32, respectively) subgroups. In the anthracycline treated subgroup a significantly (p-lt;-.01) lower FMD% response, and higher stiffness index were detected than in the only chemotherapy treated subgroup. Higher triglyceride level, higher cumulative anthracycline dose and lower age at the start of treatment were found to be associated independently with impairment of FMD% response and aortic stiffness. We found a significant negative correlation between FMD and aortic stiffness (p-lt;-.001) and a positive correlation between FMD and distensibility (p-lt;-.0001) Childhood cancer long term survivors exposed to anthracycline treatment exhibit a marked preclinical vasculopathy, characterized by endothelial dysfunction and increased arterial stiffness, contributing to a deteriorated cardiovascular function.