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通过超快超声成像测量接受蒽环类药物治疗的儿童癌症幸存者的局部动脉僵硬度。

Local arterial stiffness measured by ultrafast ultrasound imaging in childhood cancer survivors treated with anthracyclines.

作者信息

Rasouli Rahna, Baranger Jerome, Slorach Cameron, Hui Wei, Venet Maelys, Nguyen Minh B, Henry Matthew, Gopaul Josh, Nathan Paul C, Mertens Luc, Villemain Olivier

机构信息

Division of Cardiology, Department of Pediatrics, The Hospital for Sick Children, University of Toronto, Toronto, ON, Canada.

Division of Hematology/Oncology, Department of Pediatrics, The Hospital for Sick Children, University of Toronto, Toronto, ON, Canada.

出版信息

Front Cardiovasc Med. 2023 Jun 6;10:1150214. doi: 10.3389/fcvm.2023.1150214. eCollection 2023.

Abstract

BACKGROUND

There is conflicting literature regarding the long-term effect of anthracycline treatment on arterial stiffness. This study assessed local arterial stiffness using ultrafast ultrasound imaging (UUI) in anthracycline treated childhood cancer survivors, at rest and during exercise.

METHODS

20 childhood cancer survivors (mean age 21.02 ± 9.45 years) treated with anthracyclines (mean cumulative dose 200.7 ± 126.80 mg/m) and 21 healthy controls (mean age 26.00 ± 8.91 years) were included. Participants completed a demographic survey, fasting bloodwork for cardiovascular biomarkers, and performed a submaximal exercise test on a semi-supine bicycle. Pulse wave velocity (PWV) was measured in the left common carotid artery by direct pulse wave imaging using UUI at rest and submaximal exercise. Both PWV at the systolic foot (PWV-SF) and dicrotic notch (PWV-DN) were measured. Central (carotid-femoral) PWV was obtained by applanation tonometry. Carotid measurements were taken by conventional ultrasound. Measures were compared using two-tailed Students -test or Chi-squared test, as appropriate.

RESULTS

There was no statistically significant difference ( > 0.05) between childhood cancer survivors and healthy controls in demographic parameters (age, sex, weight, height, BMI), blood biomarkers (total cholesterol, triglycerides, LDL-c, HDL-c, hs-CRP, fasting glucose, insulin, Hb A1c), cardiovascular parameters (intima media thickness, systolic and diastolic blood pressure, heart rate, carotid diameters, distensibility) or PWV measured by UUI at rest or at exercise. There was also no difference in the cardiovascular adaptation between rest and exercise in the two groups ( > 0.05). Multivariate analysis revealed age ( = 0.024) and LDL-c ( = 0.019) to be significant correlates of PWV-SF in childhood cancer survivors, in line with previously published data.

CONCLUSION

We did not identify a significant impact of anthracycline treatment in young survivors of childhood cancer on local arterial stiffness in the left common carotid artery as measured by UUI.

摘要

背景

关于蒽环类药物治疗对动脉僵硬度的长期影响,文献报道存在矛盾。本研究采用超快超声成像(UUI)评估接受蒽环类药物治疗的儿童癌症幸存者在静息和运动状态下的局部动脉僵硬度。

方法

纳入20名接受蒽环类药物治疗的儿童癌症幸存者(平均年龄21.02±9.45岁,平均累积剂量200.7±126.80mg/m)和21名健康对照者(平均年龄26.00±8.91岁)。参与者完成了人口统计学调查、空腹血液心血管生物标志物检测,并在半卧位自行车上进行了次极量运动试验。在静息和次极量运动状态下,使用UUI通过直接脉搏波成像测量左颈总动脉的脉搏波速度(PWV)。测量了收缩期波峰(PWV-SF)和重搏波切迹(PWV-DN)处的PWV。通过压平式眼压计获得中心(颈动脉-股动脉)PWV。通过传统超声进行颈动脉测量。根据情况,使用双尾t检验或卡方检验比较测量结果。

结果

儿童癌症幸存者与健康对照者在人口统计学参数(年龄、性别、体重、身高、BMI)、血液生物标志物(总胆固醇、甘油三酯、低密度脂蛋白胆固醇、高密度脂蛋白胆固醇、高敏C反应蛋白、空腹血糖、胰岛素、糖化血红蛋白A1c)、心血管参数(内膜中层厚度、收缩压和舒张压、心率、颈动脉直径、扩张性)或静息或运动时通过UUI测量的PWV方面,均无统计学显著差异(P>0.05)。两组在静息和运动之间的心血管适应性也无差异(P>0.05)。多因素分析显示,年龄(P=0.024)和低密度脂蛋白胆固醇(P=0.019)是儿童癌症幸存者PWV-SF的显著相关因素,与先前发表的数据一致。

结论

我们未发现蒽环类药物治疗对儿童癌症年轻幸存者左颈总动脉局部动脉僵硬度有显著影响,该局部动脉僵硬度通过UUI测量。

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