Division of Hematology/Oncology, University of Minnesota, 420 Delaware Street, S.E., MMC 480, Minneapolis, MN, 55455, USA.
Masonic Cancer Center, University of Minnesota, Minneapolis, MN, USA.
Breast Cancer Res Treat. 2017 Nov;166(2):541-547. doi: 10.1007/s10549-017-4447-6. Epub 2017 Aug 11.
Aromatase inhibitors (AI) have been shown to reduce breast cancer-related mortality in women with estrogen positive (ER+) breast cancer. The use of AIs, however, has been associated with higher rates of hypertension, hyperlipidemia, and cardiovascular (CV) events.
A cross-sectional study of 25 healthy postmenopausal women and 36 women with curative intent breast cancer on an AI was performed to assess endothelial dysfunction, an indicator of risk for CV events. Consented subjects underwent vascular testing using the HDI/Pulse Wave CR-2000 Cardiovascular Profiling System and the EndoPAT2000 system.
Mean age was 61.7 and 59.6 years (cases, controls). Most subjects were Caucasian and overweight. Controls had a lower mean systolic blood pressure (128.6 mmHg vs. 116.2 mmHg, p = 0.004). Median estradiol levels were reduced in cases (2 vs. 15 pg/ml, p < 0.0001). EndoPAT ratio (0.8 vs. 2.7, p < 0.0001) was significantly reduced in cases as compared to controls. Median large artery elasticity (12.9 vs. 14.6 ml/mmHg × 10, p = 0.12) and small artery elasticity (5.2 vs. 7.0 ml/mmHg × 100, p = 0.07) were also reduced though not statistically significant. There was no correlation between use of chemotherapy, radiation therapy, type of AI, or duration of AI use and endothelial function. When adjusting for differences in blood pressure, results remained significant.
Breast cancer cases on AIs have reductions in endothelial function, a predictor of adverse CV disease.
Vascular function changes in breast cancer cases on AIs compared to postmenopausal women. Further work is needed to evaluate vascular changes over time.
芳香化酶抑制剂（AI）已被证明可降低雌激素阳性（ER+）乳腺癌患者的乳腺癌相关死亡率。然而，使用 AI 与高血压、高血脂和心血管（CV）事件的发生率较高有关。
对 25 名健康绝经后妇女和 36 名接受 AI 治疗的有治愈意图的乳腺癌妇女进行了一项横断面研究，以评估内皮功能障碍，这是 CV 事件风险的一个指标。同意的受试者使用 HDI/Pulse Wave CR-2000 心血管特征分析系统和 EndoPAT2000 系统进行血管测试。
平均年龄分别为 61.7 岁和 59.6 岁（病例组、对照组）。大多数受试者为白种人且超重。对照组的平均收缩压较低（128.6mmHg 与 116.2mmHg，p=0.004）。病例组的中位雌二醇水平降低（2pg/ml 与 15pg/ml，p<0.0001）。与对照组相比，病例组的 EndoPAT 比值（0.8 与 2.7，p<0.0001）显著降低。中位大动脉弹性（12.9 与 14.6ml/mmHg×10，p=0.12）和小动脉弹性（5.2 与 7.0ml/mmHg×100，p=0.07）也降低，但无统计学意义。使用化疗、放疗、AI 类型或 AI 使用时间与内皮功能之间无相关性。调整血压差异后，结果仍有统计学意义。
接受 AI 治疗的乳腺癌患者的内皮功能降低，这是不良 CV 疾病的预测指标。
与绝经后妇女相比，接受 AI 治疗的乳腺癌患者的血管功能发生变化。需要进一步研究以评估随时间的血管变化。
