Metastatic malignancies and the effect on arterial stiffness and blood pressure levels: the possible role of chemotherapy
Authors Res E, Kyvelou SM, Vlachopoulos C, Manousou K, Tousoulis D, Stefanadis C, Pektasides D
Received 7 November 2017
Accepted for publication 28 May 2018
Published 11 October 2018 Volume 2018:11 Pages 6785—6793
Checked for plagiarism Yes
Review by Single anonymous peer review
Peer reviewer comments 2
Editor who approved publication: Dr Faris Farassati
Eleni Res,1 Stella Maria Kyvelou,2 Charalambos Vlachopoulos,2 Kyriaki Manousou,1 Dimitris Tousoulis,3 Christodoulos Stefanadis,2 Dimitris Pektasides3
1Third Department of Medical Oncology, Agioi Anargyroi General Oncology Hospital of Kifissia, 2Cardiology Department, First Cardiology Clinic, Athens Medical School, Hippokration Hospital, 3Second Department of Internal Medicine, School of Medicine, University of Athens, Athens, Greece
Background: The aim of the prospective study was to evaluate blood pressure (BP) and the arterial stiffness before and after chemotherapy in three subgroups of patients with metastatic colorectal, renal cell, and gastrointestinal carcinoma and exploit, if possible, the effect of chemotherapy and biological agents in the event of cardiotoxicity.
Methods: A total of 171 patients were included in the study: 60 with kidney cancer, 18 with gastrointestinal stromal tumors (GISTs), and 93 with metastatic colorectal cancer. All patients were subjected to full clinical and laboratory evaluation before and after chemotherapy. Arterial-stiffness indices were assessed before the initiation and after the completion of chemotherapy by means of pulse wave velocity (PWV; Complior) and augmentation index (AIx; SphygmoCor).
Results: Patients in all three cancer cohorts exhibited significantly (P<0.001) higher levels of carotid–radial PWV, carotid–femoral PWV, and AIx postchemotherapy, which remained significant after adjustment for BP and body-mass index. AIx exhibited greater change in the bowel-cancer cohort compared to the kidney and GIST cohorts (median 3.6, 1.75, and 1.4, respectively; P<0.001), which remained significant after adjustment for BP and body-mass index. Multiple regression analysis showed that patients with higher baseline systolic BP, diastolic BP, ejection fraction, and carotid–femoral PWV exhibited smaller differences postchemotherapy, while AIx75 baseline levels showed no difference postchemotherapy.
Conclusion: There is a clear burden in arterial stiffness in patients under chemotherapy for kidney, GIST, and metastatic colorectal cancer, irrespective of BP and other confounders.
Keywords: malignancy, pulse wave velocity, target therapies
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