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ESC Heart Fail. 2015 Sep;2(3):142-149. doi: 10.1002/ehf2.12048. Epub 2015 Jul 14.

The impact of cisplatinum-based chemotherapy on ventricular function and cardiovascular risk factors in female survivors after malignant germ cell cancer.

ESC heart failure

Klaus Murbraech, Olesya Solheim, Hanne M Aulie, Sophie D Fossa, Svend Aakhus

Affiliations

  1. Department of Cardiology, Rikshospitalet, Oslo University Hospital, Oslo, Norway.
  2. Department of Gynaecologic Oncology, Norwegian Radium Hospital, Oslo University Hospital, Oslo, Norway.
  3. National Resource Centre for Late Effects after Cancer Treatment, Norwegian Radium Hospital, Oslo University Hospital, Oslo, Norway.
  4. Department of Rheumathology, Rikshospitalet, Oslo University Hospital, Oslo, Norway.
  5. Institute of Clinical Medicine, Faculty of Medicine, University of Oslo, Oslo, Norway.

PMID: 28834675 PMCID: PMC6410543 DOI: 10.1002/ehf2.12048

Abstract

AIMS: Among male cancer survivors, cisplatinum-based chemotherapy (CBCT) is associated with impaired left ventricle (LV) diastolic function, increased risk of metabolic syndrome, and increased cardiovascular morbidity and mortality. Comparable data in females are limited. The long-term effects of cisplatin on right ventricle (RV) function are unknown in both genders. We aimed to investigate the impact of CBCT on cardiovascular risk factors and cardiac function in female survivors after malignant ovarian germ cell tumour (MOGCT).

METHODS AND RESULTS: This national cross-sectional follow-up study recruited MOGCT survivors, diagnosed from 1980-09 (n = 153). Seventy-four (48%) participated in out-patient visit, of whom 41 had received CBCT (62% of all CBCT): median age, 35 years (range, 18-64 years); median time since CBCT, 14 years (range, 5-31 years). Participants were categorized into high-CBCT (n = 19) and low-CBCT (n = 22) groups and compared with age-matched healthy females. All participants underwent laboratory tests and echocardiography to determine cardiac function. Compared with low-CBCT participants, the high-CBCT group showed significantly impaired RV function, as evaluated by tricuspid annular plane systolic excursion (22.6 ± 2.4 mm vs. 26.3 ± 3.6 mm; P < 0.001); RV S' (10.7 ± 1.9 cm/s vs. 12.4 ± 2.3 cm/s; P = 0.01); RV global longitudinal strain (-23.4 ± 2.4% vs. -25.7 ± 3.7%; P = 0.02), and tricuspid annular displacement (21 ± 2 mm vs. 24 ± 3 mm; P = 0.001). LV diastolic function was impaired in the high-CBCT group compared with controls. Patients and controls exhibited similar metabolic syndrome prevalences.

CONCLUSIONS: Among long-term survivors of MOGCT, CBCT was associated with impaired RV function and LV diastolic function. Unlike men, women do not appear to have an elevated risk of metabolic syndrome after CBCT.

© 2015 The Authors. ESC Heart Failure published by John Wiley & Sons Ltd on behalf of the European Society of Cardiology.

Keywords: Cardiac function; Cardiovascular risk factors; Cisplatinum; Echocardiography; Females

References

  1. Ann Oncol. 2003 Jan;14(1):91-6 - PubMed
  2. Semin Oncol. 1992 Apr;19(2 Suppl 5):19-23; discussion 23-4 - PubMed
  3. Br J Cancer. 2013 Aug 20;109(4):891-6 - PubMed
  4. Ann Oncol. 2011 Oct;22(10):2286-93 - PubMed
  5. J Clin Oncol. 2005 Dec 20;23(36):9130-7 - PubMed
  6. Urol Oncol. 2014 Jan;32(1):26.e9-15 - PubMed
  7. J Clin Oncol. 2010 Oct 20;28(30):4649-57 - PubMed
  8. Eur J Cancer. 2004 Mar;40(5):696-700 - PubMed
  9. J Am Soc Echocardiogr. 2004 Oct;17(10):1086-119 - PubMed
  10. Clin Sci (Lond). 2007 Sep;113(6):287-96 - PubMed
  11. J Clin Oncol. 2005 Jun 1;23(16):3718-25 - PubMed
  12. Circulation. 2005 Oct 25;112(17):2735-52 - PubMed
  13. ESC Heart Fail. 2015 Sep;2(3):142-149 - PubMed
  14. Obstet Gynecol. 2006 May;107(5):1075-85 - PubMed
  15. Br J Cancer. 2009 Jun 16;100(12):1861-6 - PubMed
  16. J Am Soc Echocardiogr. 2005 Dec;18(12):1440-63 - PubMed
  17. J Clin Oncol. 2006 Jan 20;24(3):467-75 - PubMed
  18. J Clin Oncol. 2014 Feb 20;32(6):571-8 - PubMed
  19. Eur J Surg Oncol. 2014 Jan;40(1):103-12 - PubMed
  20. Eur J Cancer. 2004 Mar;40(5):701-6 - PubMed
  21. Br J Cancer. 2013 Jul 9;109(1):60-7 - PubMed
  22. J Clin Oncol. 2007 Jul 10;25(20):2938-43 - PubMed
  23. Eur J Echocardiogr. 2009 Mar;10(2):165-93 - PubMed
  24. J Clin Oncol. 2007 Oct 1;25(28):4370-8 - PubMed
  25. J Am Soc Echocardiogr. 2010 Jul;23(7):685-713; quiz 786-8 - PubMed
  26. Br J Cancer. 1993 Sep;68(3):555-8 - PubMed
  27. Gynecol Oncol. 2013 Nov;131(2):330-5 - PubMed
  28. Ann Oncol. 2007 Feb;18(2):241-8 - PubMed
  29. Lancet Oncol. 2007 Sep;8(9):784-96 - PubMed
  30. Am J Cardiol. 1986 Feb 15;57(6):450-8 - PubMed
  31. Eur Heart J Cardiovasc Imaging. 2013 Dec;14(12):1140-9 - PubMed

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