Anthracycline chemotherapy impairs the structure and diastolic function of the left ventricle and induces negative arterial remodelling.

BACKGROUND: Anthracycline affects various cell lines, which may contribute to left ventricular (LV) dysfunction and vascular remodelling. AIM: To assess the complex influence of anthracycline chemotherapy on the echocardiographic parameters of LV systolic and diastolic function and indices of vascular function and structure. METHODS: 35 women (age 50 ± 9 years old) with breast cancer scheduled for standard anthracycline chemotherapy were enrolled into the study. Examinations were performed at the baseline and six months after the last dose of anthracycline with a clinical follow-up of 9-12 months. LV systolic and diastolic function were assessed by: ejection fraction, transmitral flow, isovolumetric relaxation time, Tei index, mitral ring movement velocity and E/E' ratio. Vascular parameters, including flow-mediated dilatation, intima-media thickness (IMT), aortic compliance, common carotid artery (CCA) compliance, and stiffness indices b were measured. RESULTS: None of the patients revealed any cardiovascular symptoms during follow-up. LV systolic function parameters remained normal. However, LV end-diastolic diameter (46 ± 3.5 vs. 48 ± 4 mm, p = 0.004) and LV end-diastolic volume (101 ± 25 vs. 112 ± 26 mL, p = 0.01) increased. The diastolic function changed - the Tei index increased (0.49 ± 0.09 vs. 0.54 ± 0.1, p = 0.04) and E' (p = 0.049), A' (p = 0.02) and S (p = 0.01) decreased. The E/E' index increased (p < 0.0001) within the LV lateral wall. We observed an increase in carotid IMT (p < 0.0001), a decrease in aortic compliance (p = 0.042) and CCA compliance (p = 0.004), and an increase in aorta as well as the CCA stiffness indices (p = 0.046, p = 0.003, respectively). CONCLUSIONS: Standard-dose anthracycline chemotherapy is associated with LV dilatation and diastolic dysfunction, regardless of the preserved global systolic function. It coexists with negative structural arterial remodelling.

The indexes of arterial structure and function in women with simple obesity: a preliminary study.

Obesity is associated with an increased risk of cardiovascular disorders. The aim of the present study was to compare the indexes of arterial structure and function in women with simple obesity and healthy individuals. Twenty-two women with simple obesity (body mass index [BMI]: 33.6 +/- 2.9 kg/m(2), age: 29.7 +/- 6.2 years), and 34 healthy women were included in the study. Healthy subjects were divided into two subgroups according to their age (<35 and >45 years): Control A-16 young women (age <35 years, BMI: 24.0 +/- 3.0 kg/m(2)), and Control B-18 older women (age >45 years, BMI: 25.8 +/- 2.9 kg/m(2)). Noninvasive, high-resolution, vascular ultrasound was used to evaluate the endothelial-dependent vasodilatation: flow-mediated dilatation of brachial artery (FMD); the arterial structure: intima-media thickness (IMT) of common carotid artery (CCA); and the compliance parameters corresponding to structural changes in large arteries (PWV: pulse wave velocity; PP: pulse pressure; TAC: total arterial compliance; Ao C: aorta compliance, CCA C: CCA compliance, stiffness indexes). Endothelial-dependent vasodilatation as represented by FMD was comparable in the obese group (16.8% +/- 7.9%; median: 15.5%) and healthy subjects (Control A: 14.1% +/- 4.7%; median: 13.6%; Control B: 13.9% +/- 6.5%; median: 13.0%). The mean value of IMT was significantly increased (P < 0.05) in Control B group (0.67 +/- 0.07 mm) in comparison to both obese patients (0.58 +/- 0.09 mm) and Control A group (0.53 +/- 0.05 mm). The compliance parameters (PWV, AoC, CCA C, stiffness indexes) were impaired in obese patients and Control B patients as compared to Control A individuals. PWV and stiffness indexes were significantly increased, and the AoC, CCA C-diameter, CCA C-area were significantly decreased. Simple obesity constitutes an important risk factor accelerating arterial stiffness in women.