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The cardiac impact of cisplatin-based chemotherapy in survivors of testicular cancer: a 30-year follow-up

AIMS: Cisplatin-based chemotherapy (CBCT) is essential in the treatment of metastatic testicular cancer (TC) but has been associated with long-term risk of cardiovascular morbidity and mortality. Furthermore, cisplatin can be detected in the body decades after treatment. We aimed to evaluate the lon...

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Autores principales: Bjerring, Anders W, Fosså, Sophie D, Haugnes, Hege S, Nome, Ragnhild, Stokke, Thomas M, Haugaa, Kristina H, Kiserud, Cecilie E, Edvardsen, Thor, Sarvari, Sebastian I
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Oxford University Press 2020
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7984731/
https://www.ncbi.nlm.nih.gov/pubmed/33152065
http://dx.doi.org/10.1093/ehjci/jeaa289
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author Bjerring, Anders W
Fosså, Sophie D
Haugnes, Hege S
Nome, Ragnhild
Stokke, Thomas M
Haugaa, Kristina H
Kiserud, Cecilie E
Edvardsen, Thor
Sarvari, Sebastian I
author_facet Bjerring, Anders W
Fosså, Sophie D
Haugnes, Hege S
Nome, Ragnhild
Stokke, Thomas M
Haugaa, Kristina H
Kiserud, Cecilie E
Edvardsen, Thor
Sarvari, Sebastian I
author_sort Bjerring, Anders W
collection PubMed
description AIMS: Cisplatin-based chemotherapy (CBCT) is essential in the treatment of metastatic testicular cancer (TC) but has been associated with long-term risk of cardiovascular morbidity and mortality. Furthermore, cisplatin can be detected in the body decades after treatment. We aimed to evaluate the long-term impact of CBCT on cardiac function and morphology in TC survivors 30 years after treatment. METHODS AND RESULTS: TC survivors treated with CBCT (1980–94) were recruited from the longitudinal Norwegian Cancer Study in Testicular Cancer Survivors and compared with a control group matched for sex, age, smoking status, and heredity for coronary artery disease. All participants underwent laboratory tests, blood pressure measurement, and 2D and 3D echocardiography including 2D speckle-tracking strain analyses. Ninety-four TC survivors, on average 60 ± 9 years old, received a median cumulative cisplatin dose of 780 mg (IQR 600–800). Compared with controls, TC survivors more frequently used anti-hypertensive (55% vs. 24%, P < 0.001) and lipid-lowering medication (44% vs. 18%, P < 0.001). TC survivors had worse diastolic function parameters with higher E/e′-ratio (9.8 ± 3.2 vs. 7.7 ± 2.5, P < 0.001), longer mitral deceleration time (221 ± 69 vs. 196 ± 57ms, P < 0.01), and higher maximal tricuspid regurgitation velocity (25 ± 7 vs. 21 ± 4 m/s, P = 0.001). The groups did not differ in left or right ventricular systolic function, prevalence of arrhythmias, or valvular heart disease. Cumulative cisplatin dose did not correlate with cardiac parameters. CONCLUSION: No signs of overt or subclinical reduction in systolic function were identified. Long-term cardiovascular adverse effects three decades after CBCT may be limited to metabolic dysfunction and worse diastolic function in TC survivors.
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spelling pubmed-79847312021-03-26 The cardiac impact of cisplatin-based chemotherapy in survivors of testicular cancer: a 30-year follow-up Bjerring, Anders W Fosså, Sophie D Haugnes, Hege S Nome, Ragnhild Stokke, Thomas M Haugaa, Kristina H Kiserud, Cecilie E Edvardsen, Thor Sarvari, Sebastian I Eur Heart J Cardiovasc Imaging Original Articles AIMS: Cisplatin-based chemotherapy (CBCT) is essential in the treatment of metastatic testicular cancer (TC) but has been associated with long-term risk of cardiovascular morbidity and mortality. Furthermore, cisplatin can be detected in the body decades after treatment. We aimed to evaluate the long-term impact of CBCT on cardiac function and morphology in TC survivors 30 years after treatment. METHODS AND RESULTS: TC survivors treated with CBCT (1980–94) were recruited from the longitudinal Norwegian Cancer Study in Testicular Cancer Survivors and compared with a control group matched for sex, age, smoking status, and heredity for coronary artery disease. All participants underwent laboratory tests, blood pressure measurement, and 2D and 3D echocardiography including 2D speckle-tracking strain analyses. Ninety-four TC survivors, on average 60 ± 9 years old, received a median cumulative cisplatin dose of 780 mg (IQR 600–800). Compared with controls, TC survivors more frequently used anti-hypertensive (55% vs. 24%, P < 0.001) and lipid-lowering medication (44% vs. 18%, P < 0.001). TC survivors had worse diastolic function parameters with higher E/e′-ratio (9.8 ± 3.2 vs. 7.7 ± 2.5, P < 0.001), longer mitral deceleration time (221 ± 69 vs. 196 ± 57ms, P < 0.01), and higher maximal tricuspid regurgitation velocity (25 ± 7 vs. 21 ± 4 m/s, P = 0.001). The groups did not differ in left or right ventricular systolic function, prevalence of arrhythmias, or valvular heart disease. Cumulative cisplatin dose did not correlate with cardiac parameters. CONCLUSION: No signs of overt or subclinical reduction in systolic function were identified. Long-term cardiovascular adverse effects three decades after CBCT may be limited to metabolic dysfunction and worse diastolic function in TC survivors. Oxford University Press 2020-11-05 /pmc/articles/PMC7984731/ /pubmed/33152065 http://dx.doi.org/10.1093/ehjci/jeaa289 Text en © The Author(s) 2020. Published by Oxford University Press on behalf of the European Society of Cardiology. http://creativecommons.org/licenses/by-nc/4.0/ This is an Open Access article distributed under the terms of the Creative Commons Attribution Non-Commercial License (http://creativecommons.org/licenses/by-nc/4.0/), which permits non-commercial re-use, distribution, and reproduction in any medium, provided the original work is properly cited. For commercial re-use, please contact journals.permissions@oup.com
spellingShingle Original Articles
Bjerring, Anders W
Fosså, Sophie D
Haugnes, Hege S
Nome, Ragnhild
Stokke, Thomas M
Haugaa, Kristina H
Kiserud, Cecilie E
Edvardsen, Thor
Sarvari, Sebastian I
The cardiac impact of cisplatin-based chemotherapy in survivors of testicular cancer: a 30-year follow-up
title The cardiac impact of cisplatin-based chemotherapy in survivors of testicular cancer: a 30-year follow-up
title_full The cardiac impact of cisplatin-based chemotherapy in survivors of testicular cancer: a 30-year follow-up
title_fullStr The cardiac impact of cisplatin-based chemotherapy in survivors of testicular cancer: a 30-year follow-up
title_full_unstemmed The cardiac impact of cisplatin-based chemotherapy in survivors of testicular cancer: a 30-year follow-up
title_short The cardiac impact of cisplatin-based chemotherapy in survivors of testicular cancer: a 30-year follow-up
title_sort cardiac impact of cisplatin-based chemotherapy in survivors of testicular cancer: a 30-year follow-up
topic Original Articles
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7984731/
https://www.ncbi.nlm.nih.gov/pubmed/33152065
http://dx.doi.org/10.1093/ehjci/jeaa289
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