Vascular Dysfunction in Breast Cancer Patients Receiving
Anthracycline Chemotherapy: A Cross-Sectional Study
Siripanya S, MSc¹, Parinyanitikul N, MD², Tanaka H, PhD³, Suksom D, PhD¹ , ⁴
Affiliation : ¹ Faculty of Sports Science, Chulalongkorn University, Bangkok, Thailand ² Faculty of Medicine, Chulalongkorn University, Bangkok, Thailand ³ Department of Kinesiology and Health Education, The University of Texas at Austin, Austin, TX, USA ⁴ Exercise Physiology in Special Population Research Group, Chulalongkorn University, Bangkok, Thailand
Background: Anthracycline has been commonly used in first-line chemotherapy in breast cancer. Little is known about the
early vascular changes in the course of anthracycline chemotherapy in patients with breast cancer.
Objective: To determine whether vascular complications could occur shortly after anthracycline chemotherapy treatment in patients with breast cancer.
Materials and Methods: Twenty-nine middle-aged female participants, including healthy controls (CON; n = 10), breast cancer patients who had not received any chemotherapy treatment (BC; n = 9), and breast cancer patients undergoing the anthracycline chemotherapy (BC+AC; n = 10), were studied. Carotid artery intima-media thickness (IMT) and flow-mediated dilation (FMD), an index of endothelium-dependent vasodilation, were measured using the ultrasound machine. Brachial-ankle pulse wave velocity (baPWV) was measured as an index of arterial stiffness using a non-invasive vascular screening device.
Results: There were no significant group differences in age, height, body weight, body mass index, body fat, resting heart rate, blood pressure, maximal oxygen consumption, and the amount of physical activity. FMD was lower while IMT and baPWV were greater in the BC+AC group than in the CON and BC groups (all p<0.05). FMD was negatively associated with baPWV (r=–0.42, p=0.02) and IMT (r=–0.51, p=0.01). IMT was positively associated with baPWV (r=0.42, p=0.02).
Conclusion: Patients received anthracycline chemotherapy showed reduced vascular functions within two to three months of exposure to the treatment. These unfavorable changes can be considered not only as risk factors but also as earliest sub-clinical markers.
Keywords : Flow-mediated dilatation, Intima-media thickness, Arterial stiffness, Endothelial dysfunction
All Articles
Download