Department of Kinesiology, Kansas State University , Manhattan, Kansas.
J Appl Physiol (1985). 2018 Oct 1;125(4):1141-1149. doi: 10.1152/japplphysiol.00394.2018. Epub 2018 Aug 9.
Cancer patients with a history of anticancer chemotherapy are at an increased cardiovascular disease risk compared with cancer-free populations. Therefore, we tested the hypothesis that cancer patients receiving adjuvant chemotherapy would have a lower cutaneous microvascular reactivity and lower endothelium-dependent flow-mediated dilation (FMD) of the brachial artery compared with matched cancer-free control subjects. To test this hypothesis, we performed a case control study with seven cancer patients receiving adjuvant chemotherapy and seven matched healthy reference control subjects. Red blood cell flux was measured as an index of cutaneous blood flow via laser Doppler flowmetry. Acetylcholine (ACh)-mediated vasodilation was determined by iontophoresis. Data were expressed as percent increase in cutaneous vascular conductance. Endothelium-dependent FMD of the brachial artery via ultrasonography was determined as an index of macrovessel endothelial function. Cutaneous microvascular reactivity was attenuated in cancer patients compared with control subjects [cancer: 959.9 ± 187.3%, control: 1,556.8 ± 222.2%; P = 0.03, effect size (ES) = 1.1]. Additionally, cancer patients demonstrated a significantly lower area under the curve response to ACh iontophoresis compared with healthy control subjects. Brachial artery FMD was also significantly lower in cancer patients compared with control subjects (cancer: 2.2 ± 0.6%, control: 6.6 ± 1.4%; P = 0.006, ES = 1.6), which was significantly associated with measurements of microvascular reactivity. These findings suggest that decreases in vascular reactivity can occur during cancer chemotherapy, which may have implications for the long-term risk of cardiovascular disease morbidity and mortality. NEW & NOTEWORTHY Cancer survivors treated with chemotherapy experience an increased risk of cardiovascular events, linked to both cardiac and vascular toxicity. The major finding of this study is that microvascular reactivity and macrovascular endothelium-dependent flow-mediated dilation are lower in cancer patients currently receiving adjuvant chemotherapy compared with healthy counterparts.
与无癌症人群相比，接受过抗癌化疗的癌症患者患心血管疾病的风险增加。因此，我们假设接受辅助化疗的癌症患者的皮肤微血管反应性和肱动脉内皮依赖性血流介导的扩张（FMD）会低于匹配的无癌症对照。为了验证这一假设，我们进行了一项病例对照研究，纳入 7 名接受辅助化疗的癌症患者和 7 名匹配的健康参考对照。通过激光多普勒血流仪测量红细胞通量作为皮肤血流的指标。通过离子电渗测定乙酰胆碱（ACh）介导的血管扩张。数据表示为皮肤血管传导的百分比增加。通过超声心动图确定肱动脉内皮依赖性 FMD 作为大血管内皮功能的指标。与对照组相比，癌症患者的皮肤微血管反应性减弱[癌症：959.9±187.3%，对照组：1556.8±222.2%；P=0.03，效应量（ES）=1.1]。此外，与健康对照组相比，癌症患者对 ACh 离子电渗的曲线下面积反应明显降低。与对照组相比，癌症患者的肱动脉 FMD 也明显较低（癌症：2.2±0.6%，对照组：6.6±1.4%；P=0.006，ES=1.6），这与微血管反应性的测量值显著相关。这些发现表明，在癌症化疗期间可能会发生血管反应性降低，这可能对心血管疾病发病率和死亡率的长期风险产生影响。本研究的主要发现是，与健康对照组相比，目前正在接受辅助化疗的癌症患者的微血管反应性和大血管内皮依赖性血流介导的扩张较低。
