scholarly journals Arterial Stiffness in Breast Cancer Patients Treated with Anthracycline and Trastuzumab-Based Regimens

2018 ◽  
Vol 2018 ◽  
pp. 1-6 ◽  
Author(s):  
Özlem Yersal ◽  
Ufuk Eryilmaz ◽  
Hakan Akdam ◽  
Nezih Meydan ◽  
Sabri Barutca

Aims. Cardiovascular diseases are the primary cause of premature morbidity and mortality in early breast cancer patients after treatment with cardiotoxic chemotherapeutic agents. Arterial stiffness is an independent risk factor for future cardiovascular diseases and can be used as a predictive marker of subclinical cardiac damage. The aim of this study is to analyze the arterial stiffness in breast cancer patients who are in the follow-up period after receiving anthracycline-based chemotherapy regimens with trastuzumab. Methods and Material. We enrolled 45 HER2-positive breast cancer patients who are on follow-up at least for six months after completion of adjuvant chemotherapy with trastuzumab, and cardiovascular risk matched 30 control volunteers. The measurements were done with pulse wave analyzing machine. Results. Mean pulse wave velocity was higher in breast cancer patients compared to controls. The pulse wave velocity was significantly higher in patients receiving aromatase inhibitors compared to patients under tamoxifen. It was also significantly higher in postmenopausal breast cancer patients than postmenopausal controls. Conclusions. Arterial stiffness measurements may predict the breast cancer survivors with higher risk for cardiovascular events earlier in the follow-up period, and necessary preventive approaches and/or treatments can be applied.

2015 ◽  
Vol 33 (28_suppl) ◽  
pp. 48-48
Author(s):  
Shramana Mitul Banerjee ◽  
Jackie Newby ◽  
Shahab Khan ◽  
Virginia Homfray ◽  
Diane Whittaker ◽  
...  

48 Background: Electrochemotherapy (ECT) combines the administration of poorly permeable chemotherapeutic agents with electroporation. It has been shown to be effective when compared with other treatments. This study assessed how breast cancer patients were benefited and identified potential problems at a designated treatment centre. Methods: This was a single centre prospective study of patients with cutaneous metastases from breast cancer. Patients who fulfilled NICE UK (National Institute Of Clinical Excellence) and local guidelines were treated. Gabapentin was given prior to general anaesthesia. Intravenous Bleomycin 15,000IU/m2 was given as a bolus. Treatment was commenced 8 minutes later with Cliniporator. Electrical pulses were delivered via an electrode inserted through the skin surface. Treatment response, disease progression free duration, post-operative pain and length of in-patient stay (LOS) were recorded. Patients recorded a symptom diary post treatment. Results: 20 treatments were performed in 16 patients from 2011-2015 with 53 separate areas treated. 8 patients had diffuse lesions, 5 had discrete lesions and 3 had both diffuse and discrete areas. 16 patients were being treated with ECT for the first time and 4 patients required 2 treatments. Median LOS was 3 days. Median follow up was 6 months (range 3-12).12 patients had complete response (75%) and 4 patients partial response. There was no disease progression for 6 months or more in 9 patients (56%) and 2 further patients had disease stabilised for 3 months with systemic or cutaneous progression in the remaining patients in 3 months or less. There were no deaths or immediate adverse events from ECT. 5 Patients (31%) with extensive diffuse chest wall disease reported persistent discomfort post treatment requiring extended period of post treatment analgesia. Conclusions: Electrochemotherapy is safe and effective treatment for cutaneous metastases. Appropriate patient selection for treatment, pre-emptive analgesia, post treatment support and follow up is essential in order to maximise the benefits and minimise potential side-effects particularly in extensive chest wall disease.


Author(s):  
Wiktoria Wojciechowska ◽  
Andrzej Januszewicz ◽  
Tomasz Drożdż ◽  
Marta Rojek ◽  
Justyna Bączalska ◽  
...  

In a cross-sectional analysis of a case-control study in 2015, we revealed the association between increased arterial stiffness (pulse wave velocity) and aircraft noise exposure. In June 2020, we evaluated the long-term effects, and the impact of a sudden decline in noise exposure during the coronavirus disease 2019 (COVID-19) lockdown, on blood pressure and pulse wave velocity, comparing 74 participants exposed to long-term day-evening-night aircraft noise level > 60 dB and 75 unexposed individuals. During the 5-year follow-up, the prevalence of hypertension increased in the exposed (42% versus 59%, P =0.048) but not in the unexposed group. The decline in noise exposure since April 2020 was accompanied with a significant decrease of noise annoyance, 24-hour systolic (121.2 versus 117.9 mm Hg; P =0.034) and diastolic (75.1 versus 72.0 mm Hg; P =0.003) blood pressure, and pulse wave velocity (10.2 versus 8.8 m/s; P =0.001) in the exposed group. Less profound decreases of these parameters were noticed in the unexposed group. Significant between group differences were observed for declines in office and night-time diastolic blood pressure and pulse wave velocity. Importantly, the difference in the reduction of pulse wave velocity between exposed and unexposed participants remained significant after adjustment for covariates (−1.49 versus −0.35 m/s; P =0.017). The observed difference in insomnia prevalence between exposed and unexposed individuals at baseline was no more significant at follow-up. Thus, long-term aircraft noise exposure may increase the prevalence of hypertension and accelerate arterial stiffening. However, even short-term noise reduction, as experienced during the COVID-19 lockdown, may reverse those unfavorable effects.


QJM ◽  
2020 ◽  
Vol 113 (9) ◽  
pp. 633-642 ◽  
Author(s):  
E Oikonomou ◽  
G Vogiatzi ◽  
G Lazaros ◽  
S Tsalamandris ◽  
A Goliopoulou ◽  
...  

Abstract Background It has been long hypothesized that emotional factors and depression may play role in the development of cardiovascular diseases. Aim The aim of this study was to examine the association between depression, arterial stiffness and atheromatic burden in carotid arteries. Design and methods Corinthia study is a cross-sectional epidemiological study conducted in subjects aged 40–99 years, inhabitants of the homonym region of Greece. Intima media thickness (IMT) was measured in the left and right common carotid artery, carotid bulb and internal carotid artery. The average of the measurements (mean IMT) and the maximum IMT were determined as the representative value of carotid atherosclerosis burden. Pulse wave velocity was used to evaluate arterial stiffness. The Zung Self-Rating Depression Scale was used to evaluate depressive symptoms in subjects <65 years and the Geriatric Depression Scale in those >65 years. Results In this analysis, we included data from 1510 participants. In older subjects (i.e. >65 years), maximum IMT was significantly increased in subjects with depression compared to those without (1.57 ± 0.97 mm vs. 1.74 ± 1.05 mm, P = 0.04). Similarly, the prevalence of atheromatic plaques was higher in subjects with depression (46% vs. 34%, P = 0.005). In the younger subgroup (<65years), there was no difference in mean and maximum IMT. Pulse wave velocity was found higher in the presence of depression (8.35 ± 2.36m/s vs. 7.88 ± 1.77m/s, P = 0.007). No differences emerged for the rest of the variables assessed in the individual subgroups. Conclusions There is an age-dependent association between depression, arterial stiffness and carotid atheromatic burden highlighting the interplay between cardiovascular diseases and emotional status.


Circulation ◽  
2014 ◽  
Vol 129 (suppl_1) ◽  
Author(s):  
Nicholas M Edwards ◽  
Philip R Khoury ◽  
Elaine M Urbina

Introduction: The beneficial effects of vigorous physical activity (VPA) on arterial stiffness have been established, but the effect of changes in VPA over time on these vascular measures is unclear. Hypothesis: Increases in VPA will be associated with improvement in measures of arterial stiffness. Methods: As part of a longitudinal study of the effects of obesity & diabetes on cardiovascular health, 317 subjects (mean age 17.2 years at baseline, 38% male, 63% non-Caucasian) were enrolled and followed up 5 years later. Anthropometrics, accelerometer-measured physical activity, blood pressure, central and peripheral measures of arterial stiffness (pulse wave velocity (PWV), brachial distensibility (BrachD), and augmentation index (AI)), and blood (lipids & metabolic tests) were collected. General linear modeling was performed to test for the independent relationship of change in VPA with change of arterial stiffness. Results: Overall, VPA increased slightly (0.2 minutes) from baseline to follow up. Increased VPA from baseline to follow up was significantly associated (P = 0.0364) with a decrease in PWV but was not associated with a change in BrachD nor AI. The effect of change in VPA on change in PWV was independent of change in glucose (P = 0.024), but not independent of changes in BMI, blood pressure, lipids, or CRP. Conclusions: Increase in vigorous physical activity during late adolescence is significantly associated with improved pulse wave velocity. This relationship may be mediated through improvements in other cardiovascular risk factors such as body mass index, blood pressure, and lipids.


2021 ◽  
Vol 12 (1) ◽  
pp. 169-177
Author(s):  
A. I. P. Wiegerinck ◽  
A. Thomsen ◽  
J. Hisdal ◽  
H. Kalvøy ◽  
C. Tronstad

Abstract The leading cause of health loss and deaths worldwide are cardiovascular diseases. A predictor of cardiovascular diseases and events is the arterial stiffness. The pulse wave velocity (PWV) can be used to estimate arterial stiffness non-invasively. The tonometer is considered as the gold standard for measuring PWV. This approach requires manual probe fixation above the artery and depends on the skills of the operator. Electrical impedance plethysmography (IPG) is an interesting alternative using skin surface sensing electrodes, that is miniaturizable, cost-effective and allows measurement of deeper arteries. The aim of this pilot study was to explore if IPG can be a suitable technique to measure pulse wave velocity in legs as an alternative for the tonometer technique. The PWV was estimated by differences in the ECG-gated pulse arrival times (PAT) at the a. femoralis, a. popliteal, a. tibialis dorsalis and a. dorsalis pedis in nine healthy young adults using IPG and the SphygmoCor tonometer as a reference. The estimated PWV results from bioimpedance and the tonometer were fairly in agreement, and the beat-to-beat variability in PAT was similar. This pilot study indicates that the use of IPG may be a good alternative for estimating PWV in the legs.


Angiology ◽  
2021 ◽  
pp. 000331972110211
Author(s):  
Buyun Jia ◽  
Chongfei Jiang ◽  
Yun Song ◽  
Chenfangyuan Duan ◽  
Lishun Liu ◽  
...  

Increased arterial stiffness is highly prevalent in patients with hypertension and is associated with cardiovascular (CV) risk. Increased white blood cell (WBC) counts may also be an independent risk factor for arterial stiffness and CV events. The aim of the study was to investigate the relationship between differential WBC counts and brachial-ankle pulse wave velocity (baPWV) in hypertensive adults. A total of 14 390 participants were included in the final analysis. A multivariate linear regression model was applied for the correlation analysis of WBC count and baPWV. Higher WBC counts were associated with a greater baPWV: adjusted β = 10 (95% CI, 8-13, P < .001). The same significant association was also found when WBC count was assessed as categories or quartiles. In addition, the effect of differential WBC subtypes, including neutrophil count and lymphocyte count on baPWV, showed the similar results. These findings showed that baPWV has positive associations with differential WBC counts in hypertensive adults.


2021 ◽  
Vol 11 (1) ◽  
Author(s):  
Ji-Hee Haam ◽  
Young-Sang Kim ◽  
Doo-Yeoun Cho ◽  
Hyejin Chun ◽  
Sang-Woon Choi ◽  
...  

AbstractRecent evidence suggests that cellular perturbations play an important role in the pathogenesis of cardiovascular diseases. Therefore, we analyzed the association between the levels of urinary metabolites and arterial stiffness. Our cross-sectional study included 330 Korean men and women. The brachial-ankle pulse wave velocity was measured as a marker of arterial stiffness. Urinary metabolites were evaluated using a high-performance liquid chromatograph-mass spectrometer. The brachial-ankle pulse wave velocity was found to be positively correlated with l-lactate, citrate, isocitrate, succinate, malate, hydroxymethylglutarate, α-ketoisovalerate, α-keto-β-methylvalerate, methylmalonate, and formiminoglutamate among men. Whereas, among women, the brachial-ankle pulse wave velocity was positively correlated with cis-aconitate, isocitrate, hydroxymethylglutarate, and formiminoglutamate. In the multivariable regression models adjusted for conventional cardiovascular risk factors, three metabolite concentrations (urine isocitrate, hydroxymethylglutarate, and formiminoglutamate) were independently and positively associated with brachial-ankle pulse wave velocity. Increased urine isocitrate, hydroxymethylglutarate, and formiminoglutamate concentrations were associated with brachial-ankle pulse wave velocity and independent of conventional cardiovascular risk factors. Our findings suggest that metabolic disturbances in cells may be related to arterial stiffness.


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