Promotion of Arterial Stiffness by Childhood Cancer and Its Characteristics in Adult Long‐Term Survivors
Background Vascular alterations induced by antineoplastic treatment might be considered as a possible underlying mechanism of increased cardiovascular sequelae in childhood cancer survivors (CCSs). We aimed to evaluate arterial stiffness among long‐term CCSs and to compare the data against a populat...
| Main Authors: | , , , , , , , , , , , , , , , , , , |
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| Format: | Article |
| Language: | English |
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Wiley
2021-03-01
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| Series: | Journal of the American Heart Association: Cardiovascular and Cerebrovascular Disease |
| Subjects: | |
| Online Access: | https://www.ahajournals.org/doi/10.1161/JAHA.119.015609 |
| _version_ | 1811332358683492352 |
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| author | Natalie Arnold Hiltrud Merzenich Arthur Wingerter Andreas Schulz Astrid Schneider Jürgen H. Prochaska Sebastian Göbel Marie A. Neu Nicole Henninger Marina Panova‐Noeva Susan Eckerle Claudia Spix Irene Schmidtmann Karl J. Lackner Manfred E. Beutel Norbert Pfeiffer Thomas Münzel Jörg Faber Philipp S. Wild |
| author_facet | Natalie Arnold Hiltrud Merzenich Arthur Wingerter Andreas Schulz Astrid Schneider Jürgen H. Prochaska Sebastian Göbel Marie A. Neu Nicole Henninger Marina Panova‐Noeva Susan Eckerle Claudia Spix Irene Schmidtmann Karl J. Lackner Manfred E. Beutel Norbert Pfeiffer Thomas Münzel Jörg Faber Philipp S. Wild |
| author_sort | Natalie Arnold |
| collection | DOAJ |
| description | Background Vascular alterations induced by antineoplastic treatment might be considered as a possible underlying mechanism of increased cardiovascular sequelae in childhood cancer survivors (CCSs). We aimed to evaluate arterial stiffness among long‐term CCSs and to compare the data against a population‐based sample. Methods and Results Arterial stiffness was assessed by digital photoplethysmography (stiffness index; m/s) among 1002 participants of the CVSS (Cardiac and Vascular Late Sequelae in Long‐Term Survivors of Childhood Cancer) study, diagnosed with neoplasia (1980–1990) before an age of 15 years. A population‐based sample from the GHS (Gutenberg Health Study) (n=5252) was investigated for comparison. All subjects underwent a comprehensive, standardized clinical examination in the same study center. CCSs had higher stiffness index (β=0.66 m/s; 95% CI, 0.51–0.80 m/s) in multivariable linear regression analysis after adjustment for cardiovascular risk factors compared with the population sample of comparable age range. Stiffer vessels were found among CCSs also in absence of arterial hypertension (β=0.66; 95% CI, 0.50–0.81) or history of chemotherapy/radiotherapy (β=0.56; 95% CI, 0.16–0.96) in fully adjusted models. Moreover, stiffness index differed by tumor entity, with highest values in bone and renal tumors. Almost 5.2‐fold higher prevalence of stiffness index values exceeding age‐specific, population‐based reference limits was observed among CCSs compared with GHS participants. Conclusions This is the first study demonstrating increased arterial stiffness among long‐term CCSs. The data suggest that vascular compliance might differ in survivors of childhood cancer from the established development concept for arterial stiffness in the population; cancer growth and antineoplastic treatment might be relevant determinants of the pathobiological features. Registration URL: https://www.clinicaltrials.gov; Unique identifier: NCT02181049. |
| first_indexed | 2024-04-13T16:35:34Z |
| format | Article |
| id | doaj.art-cead5c07c5e94a6c861e3c7a79ffc7e8 |
| institution | Directory Open Access Journal |
| issn | 2047-9980 |
| language | English |
| last_indexed | 2024-04-13T16:35:34Z |
| publishDate | 2021-03-01 |
| publisher | Wiley |
| record_format | Article |
| series | Journal of the American Heart Association: Cardiovascular and Cerebrovascular Disease |
| spelling | doaj.art-cead5c07c5e94a6c861e3c7a79ffc7e82022-12-22T02:39:27ZengWileyJournal of the American Heart Association: Cardiovascular and Cerebrovascular Disease2047-99802021-03-0110510.1161/JAHA.119.015609Promotion of Arterial Stiffness by Childhood Cancer and Its Characteristics in Adult Long‐Term SurvivorsNatalie Arnold0Hiltrud Merzenich1Arthur Wingerter2Andreas Schulz3Astrid Schneider4Jürgen H. Prochaska5Sebastian Göbel6Marie A. Neu7Nicole Henninger8Marina Panova‐Noeva9Susan Eckerle10Claudia Spix11Irene Schmidtmann12Karl J. Lackner13Manfred E. Beutel14Norbert Pfeiffer15Thomas Münzel16Jörg Faber17Philipp S. Wild18Preventive Cardiology and Preventive Medicine Centre for Cardiology University Medical Centre of the Johannes Gutenberg–University Mainz Mainz GermanyInstitute for Medical Biostatistics, Epidemiology and Informatics University Medical Centre of the Johannes Gutenberg–University Mainz Mainz GermanyDepartment of Pediatric Hematology/Oncology/Hemostaseology Centre for Pediatric and Adolescent Medicine University Medical Centre of the Johannes–Gutenberg University Mainz Mainz GermanyPreventive Cardiology and Preventive Medicine Centre for Cardiology University Medical Centre of the Johannes Gutenberg–University Mainz Mainz GermanyInstitute for Medical Biostatistics, Epidemiology and Informatics University Medical Centre of the Johannes Gutenberg–University Mainz Mainz GermanyPreventive Cardiology and Preventive Medicine Centre for Cardiology University Medical Centre of the Johannes Gutenberg–University Mainz Mainz GermanyGerman Centre for Cardiovascular Research Partner Site Rhine‐Main Mainz GermanyDepartment of Pediatric Hematology/Oncology/Hemostaseology Centre for Pediatric and Adolescent Medicine University Medical Centre of the Johannes–Gutenberg University Mainz Mainz GermanyDepartment of Pediatric Hematology/Oncology/Hemostaseology Centre for Pediatric and Adolescent Medicine University Medical Centre of the Johannes–Gutenberg University Mainz Mainz GermanyGerman Centre for Cardiovascular Research Partner Site Rhine‐Main Mainz GermanyDepartment of Pediatric Hematology/Oncology/Hemostaseology Centre for Pediatric and Adolescent Medicine University Medical Centre of the Johannes–Gutenberg University Mainz Mainz GermanyInstitute for Medical Biostatistics, Epidemiology and Informatics University Medical Centre of the Johannes Gutenberg–University Mainz Mainz GermanyGerman Childhood Cancer Registry Institute for Medical Biostatistics, Epidemiology and Informatics University Medical Centre of the Johannes Gutenberg–University Mainz Mainz GermanyGerman Centre for Cardiovascular Research Partner Site Rhine‐Main Mainz GermanyClinic for Psychosomatic Medicine and Psychotherapy University Medical Centre of the Johannes Gutenberg–University Mainz Mainz GermanyDepartment of Ophthalmology University Medical Centre of the Johannes Gutenberg–University Mainz Mainz GermanyGerman Centre for Cardiovascular Research Partner Site Rhine‐Main Mainz GermanyDepartment of Pediatric Hematology/Oncology/Hemostaseology Centre for Pediatric and Adolescent Medicine University Medical Centre of the Johannes–Gutenberg University Mainz Mainz GermanyPreventive Cardiology and Preventive Medicine Centre for Cardiology University Medical Centre of the Johannes Gutenberg–University Mainz Mainz GermanyBackground Vascular alterations induced by antineoplastic treatment might be considered as a possible underlying mechanism of increased cardiovascular sequelae in childhood cancer survivors (CCSs). We aimed to evaluate arterial stiffness among long‐term CCSs and to compare the data against a population‐based sample. Methods and Results Arterial stiffness was assessed by digital photoplethysmography (stiffness index; m/s) among 1002 participants of the CVSS (Cardiac and Vascular Late Sequelae in Long‐Term Survivors of Childhood Cancer) study, diagnosed with neoplasia (1980–1990) before an age of 15 years. A population‐based sample from the GHS (Gutenberg Health Study) (n=5252) was investigated for comparison. All subjects underwent a comprehensive, standardized clinical examination in the same study center. CCSs had higher stiffness index (β=0.66 m/s; 95% CI, 0.51–0.80 m/s) in multivariable linear regression analysis after adjustment for cardiovascular risk factors compared with the population sample of comparable age range. Stiffer vessels were found among CCSs also in absence of arterial hypertension (β=0.66; 95% CI, 0.50–0.81) or history of chemotherapy/radiotherapy (β=0.56; 95% CI, 0.16–0.96) in fully adjusted models. Moreover, stiffness index differed by tumor entity, with highest values in bone and renal tumors. Almost 5.2‐fold higher prevalence of stiffness index values exceeding age‐specific, population‐based reference limits was observed among CCSs compared with GHS participants. Conclusions This is the first study demonstrating increased arterial stiffness among long‐term CCSs. The data suggest that vascular compliance might differ in survivors of childhood cancer from the established development concept for arterial stiffness in the population; cancer growth and antineoplastic treatment might be relevant determinants of the pathobiological features. Registration URL: https://www.clinicaltrials.gov; Unique identifier: NCT02181049.https://www.ahajournals.org/doi/10.1161/JAHA.119.015609arterial stiffnesschildhood cancer survivorsgeneral population |
| spellingShingle | Natalie Arnold Hiltrud Merzenich Arthur Wingerter Andreas Schulz Astrid Schneider Jürgen H. Prochaska Sebastian Göbel Marie A. Neu Nicole Henninger Marina Panova‐Noeva Susan Eckerle Claudia Spix Irene Schmidtmann Karl J. Lackner Manfred E. Beutel Norbert Pfeiffer Thomas Münzel Jörg Faber Philipp S. Wild Promotion of Arterial Stiffness by Childhood Cancer and Its Characteristics in Adult Long‐Term Survivors Journal of the American Heart Association: Cardiovascular and Cerebrovascular Disease arterial stiffness childhood cancer survivors general population |
| title | Promotion of Arterial Stiffness by Childhood Cancer and Its Characteristics in Adult Long‐Term Survivors |
| title_full | Promotion of Arterial Stiffness by Childhood Cancer and Its Characteristics in Adult Long‐Term Survivors |
| title_fullStr | Promotion of Arterial Stiffness by Childhood Cancer and Its Characteristics in Adult Long‐Term Survivors |
| title_full_unstemmed | Promotion of Arterial Stiffness by Childhood Cancer and Its Characteristics in Adult Long‐Term Survivors |
| title_short | Promotion of Arterial Stiffness by Childhood Cancer and Its Characteristics in Adult Long‐Term Survivors |
| title_sort | promotion of arterial stiffness by childhood cancer and its characteristics in adult long term survivors |
| topic | arterial stiffness childhood cancer survivors general population |
| url | https://www.ahajournals.org/doi/10.1161/JAHA.119.015609 |
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