Please use this identifier to cite or link to this item: http://hdl.handle.net/2440/90766
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Type: Journal article
Title: Early and late changes in markers of aortic stiffness with breast cancer therapy
Author: Grover, S.
Lou, P.
Bradbrook, C.
Cheong, K.
Kotasek, D.
Leong, D.
Koczwara, B.
Selvanayagam, J.
Citation: Internal Medicine Journal, 2015; 45(2):140-147
Publisher: Wiley
Issue Date: 2015
ISSN: 1444-0903
1445-5994
Statement of
Responsibility: 
S. Grover, P. W. Lou, C. Bradbrook, K. Cheong, D. Kotasek, D. P. Leong, B. Koczwara and J. B. Selvanayagam
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.
Keywords: cardiotoxicity; chemotherapy; aortic distensibility; pulse wave velocity; anthracyclines; trastuzumab
Rights: © 2014 Royal Australasian College of Physicians
RMID: 0030026663
DOI: 10.1111/imj.12645
Appears in Collections:Medicine publications

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