Ventricular-Arterial Coupling in Breast Cancer Patients After Treatment With Anthracycline-Containing Adjuvant Chemotherapy

The Oncologist
Graeme J KoelwynNeil D Eves

Abstract

Anthracycline-containing chemotherapy (Anth-C) is associated with long-term cardiovascular mortality. Although cardiovascular risk assessment has traditionally focused on the heart, evidence has demonstrated that vascular dysfunction also occurs during and up to 1 year following Anth-C. Whether vascular dysfunction persists long-term or negatively influences cardiac function remains unknown. Hence, the present study evaluated ventricular-arterial coupling, in concert with measures of vascular structure and function, in the years following Anth-C. Arterial elastance (Ea), end-systolic elastance (Ees), and ventricular-arterial coupling (Ea/Ees) were measured during rest and exercise using echocardiography. Resting vascular function (flow-mediated dilation) and structure (carotid intima-media thickness, arterial stiffness) were also measured. Thirty breast cancer survivors (6.5 ± 3.6 years after Anth-C) with normal left ventricular ejection fraction (LVEF) (60% ± 6%) and 30 matched controls were studied. At rest, no differences were found in Ea, Ees, Ea/Ees, or LVEF between groups. The normal exercise-induced increase in Ees was attenuated in survivors at 50% and 75% of maximal workload (p < .01). Ea/Ees was also higher at all wor...Continue Reading

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Citations

Feb 3, 2018·Integrative Cancer Therapies·Rhys I BeaudryMark J Haykowsky
Jul 12, 2018·Circulation. Heart Failure·Amanda J Favreau-LessardSanjeev A Francis
May 24, 2019·Circulation Research·Joshua A CowgillDouglas B Sawyer
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Jul 11, 2020·Journal of the American Heart Association·Shannon K ParrCarl J Ade
May 29, 2021·Clinical Science·Anna NarezkinaAlice E Zemljic-Harpf

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