Promotion of Arterial Stiffness by Childhood Cancer and Its Characteristics in Adult Long-Term Survivors
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Promotion of Arterial Stiffness by Childhood Cancer and Its Characteristics in Adult Long-Term Survivors. / Arnold, Natalie; Merzenich, Hiltrud; Wingerter, Arthur; Schulz, Andreas; Schneider, Astrid; Prochaska, Jürgen H; Göbel, Sebastian; Neu, Marie A; Henninger, Nicole; Panova-Noeva, Marina; Eckerle, Susan; Spix, Claudia; Schmidtmann, Irene; Lackner, Karl J; Beutel, Manfred E; Pfeiffer, Norbert; Münzel, Thomas; Faber, Jörg; Wild, Philipp S.
In: J AM HEART ASSOC, Vol. 10, No. 5, e015609, 02.2021.Research output: SCORING: Contribution to journal › SCORING: Journal article › Research › peer-review
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TY - JOUR
T1 - Promotion of Arterial Stiffness by Childhood Cancer and Its Characteristics in Adult Long-Term Survivors
AU - Arnold, Natalie
AU - Merzenich, Hiltrud
AU - Wingerter, Arthur
AU - Schulz, Andreas
AU - Schneider, Astrid
AU - Prochaska, Jürgen H
AU - Göbel, Sebastian
AU - Neu, Marie A
AU - Henninger, Nicole
AU - Panova-Noeva, Marina
AU - Eckerle, Susan
AU - Spix, Claudia
AU - Schmidtmann, Irene
AU - Lackner, Karl J
AU - Beutel, Manfred E
AU - Pfeiffer, Norbert
AU - Münzel, Thomas
AU - Faber, Jörg
AU - Wild, Philipp S
PY - 2021/2
Y1 - 2021/2
N2 - 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.
AB - 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.
KW - Adolescent
KW - Adult
KW - Cancer Survivors
KW - Cardiovascular Diseases/epidemiology
KW - Child
KW - Child, Preschool
KW - Female
KW - Follow-Up Studies
KW - Germany/epidemiology
KW - Humans
KW - Incidence
KW - Male
KW - Middle Aged
KW - Neoplasms/complications
KW - Prevalence
KW - Retrospective Studies
KW - Risk Assessment/methods
KW - Risk Factors
KW - Survival Rate/trends
KW - Time Factors
KW - Vascular Stiffness
KW - Young Adult
U2 - 10.1161/JAHA.119.015609
DO - 10.1161/JAHA.119.015609
M3 - SCORING: Journal article
C2 - 33624513
VL - 10
JO - J AM HEART ASSOC
JF - J AM HEART ASSOC
SN - 2047-9980
IS - 5
M1 - e015609
ER -
