Early and late changes in markers of aortic stiffness with breast cancer therapy

S. Grover, P. W. Lou, C. Bradbrook, K. Cheong, D. Kotasek, D. P. Leong, B. Koczwara, J. B. Selvanayagam

Research output: Contribution to journalArticle

22 Citations (Scopus)

Abstract

Background: Anthracyclines and trastuzumab are well recognised to cause cardiac toxicity. Further to their effects on left ventricular (LV) function, anthracyclines in particular are considered to cause negative arterial remodelling. Whether these changes reverse is unknown. In addition, whether trastuzumab causes specific effects on arterial remodelling is yet undetermined. Methods: Patients receiving these agents for treatment of breast cancer and healthy volunteers prospectively underwent clinical evaluation and cardiovascular magnetic resonance (CMR) imaging at baseline, 1, 4 and 14 months post-therapy, including functional assessment, measurement of aortic pulse wave velocity (PWV) using velocity encoded imaging and distensibility at ascending aorta (AA) and proximal descending aorta (PDA). Results: Twenty-nine patients pretherapy and 12 volunteers demonstrated no differences in PWV, distensibility and LV function. Among cancer subjects, PWV increased acutely, P = 0.002 (4 months), then decreased by 14 months (P < 0.001). In addition, a decrease was observed in distensibility at the AA within 1 (P = 0.001) and 4 months (P < 0.001) of commencing therapy. At the PDA, only significant reduction was observed at 14 month distensibility when compared with baseline, P < 0.001. Patients with anthracycline exposure only had a greater reduction in aortic distensibility in the AA with time, P = 0.005 at 1 month, P < 0.001 at 4 months and P = 0.009 at 14 months. Conclusion: Acute changes are observed in PWV and distensibility at the AA following contemporary breast cancer chemotherapy and partially reverse a year after therapy is discontinued, with more severe effects seen with anthracyclines.

LanguageEnglish
Pages140-147
Number of pages8
JournalInternal Medicine Journal
Volume45
Issue number2
DOIs
Publication statusPublished - 1 Feb 2015

Keywords

  • Anthracyclines
  • Aortic distensibility
  • Cardiotoxicity
  • Chemotherapy
  • Pulse wave velocity
  • Trastuzumab

ASJC Scopus subject areas

  • Internal Medicine

Cite this

Grover, S. ; Lou, P. W. ; Bradbrook, C. ; Cheong, K. ; Kotasek, D. ; Leong, D. P. ; Koczwara, B. ; Selvanayagam, J. B. / Early and late changes in markers of aortic stiffness with breast cancer therapy. In: Internal Medicine Journal. 2015 ; Vol. 45, No. 2. pp. 140-147.
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abstract = "Background: Anthracyclines and trastuzumab are well recognised to cause cardiac toxicity. Further to their effects on left ventricular (LV) function, anthracyclines in particular are considered to cause negative arterial remodelling. Whether these changes reverse is unknown. In addition, whether trastuzumab causes specific effects on arterial remodelling is yet undetermined. Methods: Patients receiving these agents for treatment of breast cancer and healthy volunteers prospectively underwent clinical evaluation and cardiovascular magnetic resonance (CMR) imaging at baseline, 1, 4 and 14 months post-therapy, including functional assessment, measurement of aortic pulse wave velocity (PWV) using velocity encoded imaging and distensibility at ascending aorta (AA) and proximal descending aorta (PDA). Results: Twenty-nine patients pretherapy and 12 volunteers demonstrated no differences in PWV, distensibility and LV function. Among cancer subjects, PWV increased acutely, P = 0.002 (4 months), then decreased by 14 months (P < 0.001). In addition, a decrease was observed in distensibility at the AA within 1 (P = 0.001) and 4 months (P < 0.001) of commencing therapy. At the PDA, only significant reduction was observed at 14 month distensibility when compared with baseline, P < 0.001. Patients with anthracycline exposure only had a greater reduction in aortic distensibility in the AA with time, P = 0.005 at 1 month, P < 0.001 at 4 months and P = 0.009 at 14 months. Conclusion: Acute changes are observed in PWV and distensibility at the AA following contemporary breast cancer chemotherapy and partially reverse a year after therapy is discontinued, with more severe effects seen with anthracyclines.",
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Grover, S, Lou, PW, Bradbrook, C, Cheong, K, Kotasek, D, Leong, DP, Koczwara, B & Selvanayagam, JB 2015, 'Early and late changes in markers of aortic stiffness with breast cancer therapy', Internal Medicine Journal, vol. 45, no. 2, pp. 140-147. https://doi.org/10.1111/imj.12645

Early and late changes in markers of aortic stiffness with breast cancer therapy. / Grover, S.; Lou, P. W.; Bradbrook, C.; Cheong, K.; Kotasek, D.; Leong, D. P.; Koczwara, B.; Selvanayagam, J. B.

In: Internal Medicine Journal, Vol. 45, No. 2, 01.02.2015, p. 140-147.

Research output: Contribution to journalArticle

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Grover S, Lou PW, Bradbrook C, Cheong K, Kotasek D, Leong DP et al. Early and late changes in markers of aortic stiffness with breast cancer therapy. Internal Medicine Journal. 2015 Feb 1;45(2):140-147. https://doi.org/10.1111/imj.12645