Papageorgiou Christos, Zagouri Flora, Tampakis Konstantinos, Georgakopoulou Rebecca, Manios Efstathios, Kafouris Pavlos, Benetos Georgios, Koutagiar Iosif, Anagnostopoulos Constantinos, Dimopoulos Meletios A, Toutouzas Konstantinos
Department of Clinical Therapeutics, Alexandra Hospital, School of Medicine, National and Kapodistrian University of Athens, Athens, Greece.
Experimental Surgery and Translational Research, Biomedical Research Foundation Academy of Athens, Athens, Greece.
Front Cardiovasc Med. 2021 Feb 23;8:638895. doi: 10.3389/fcvm.2021.638895. eCollection 2021.
Chemotherapy regimens for breast cancer treatment can promote vascular dysfunction and lead to high cardiovascular risk. To investigate the cardiovascular burden and vascular inflammation in metastatic breast cancer patients receiving CDK 4/6 inhibitors or everolimus in addition to standard hormonal treatment. 22 consecutive female patients with metastatic breast cancer were enrolled. Relative wall thickness (RWT) and left ventricle mass (LVM) measurements by transthoracic echocardiography were obtained followed by 24-h ambulatory blood pressure monitoring, and F-fluorodeoxyglucose positron-emission tomography/computed tomography imaging. Uptake of the radiotracer in the aortic wall was estimated as tissue-to-background ratio (TBR). Each patient was assessed for the aforementioned parameters before the initiation and after 6 months of treatment. At follow up, patients assigned to CDK 4/6 treatment demonstrated increased 24-h systolic blood pressure (SBP) ( = 0.004), daytime SBP ( = 0.004) and night time SBP ( = 0.012) (Group effect). The 24-h mean arterial pressure measurements were also higher in CDK 4/6 population, in comparison to everolimus that displayed firm values (Group effect- = 0.035, Interaction effect- = 0.023). Additionally, 24 h diastolic blood pressure recordings in CDK 4/6 therapy were higher opposed to everolimus that remained consistent (Interaction effect- = 0.010). In CDK 4/6 group, TBR aorta also increased significantly, whereas TBR values in everolimus remained stable (Interaction effect- = 0.049). Both therapeutic regimens displayed statistically significant damaging effect to RWT and LVM. CDK 4/6 inhibitors and hormonal treatment can lead to increased vascular inflammation, and higher blood pressure compared to the combination of everolimus and hormonal treatment. Moreover, both treatment strategies promoted left ventricle remodeling.
用于乳腺癌治疗的化疗方案可促进血管功能障碍并导致高心血管风险。为了研究除标准激素治疗外接受CDK 4/6抑制剂或依维莫司治疗的转移性乳腺癌患者的心血管负担和血管炎症。连续纳入22例转移性乳腺癌女性患者。通过经胸超声心动图测量相对壁厚度（RWT）和左心室质量（LVM），随后进行24小时动态血压监测和F-氟脱氧葡萄糖正电子发射断层扫描/计算机断层扫描成像。放射性示踪剂在主动脉壁中的摄取量以组织与本底比值（TBR）估算。在治疗开始前和治疗6个月后对每位患者进行上述参数评估。随访时，接受CDK 4/6治疗的患者24小时收缩压（SBP）升高（P = 0.004）、日间SBP升高（P = 0.004）和夜间SBP升高（P = 0.012）（组效应）。与显示稳定值的依维莫司相比，CDK 4/6组的24小时平均动脉压测量值也更高（组效应 - P = 0.035，交互效应 - P = 0.023）。此外，与保持一致的依维莫司相比，CDK 4/6治疗组的24小时舒张压记录更高（交互效应 - P = 0.010）。在CDK 4/6组中，主动脉TBR也显著增加，而依维莫司组的TBR值保持稳定（交互效应 - P = 0.049）。两种治疗方案对RWT和LVM均显示出统计学上的显著损害作用。与依维莫司和激素治疗联合相比，CDK 4/6抑制剂和激素治疗可导致血管炎症增加和血压升高。此外，两种治疗策略均促进了左心室重塑。
