Evaluation of sub-acute changes in cardiac function after cisplatin-based combination chemotherapy for testicular cancer

R. Altena, E. C. de Haas, J. Nuver, C. A. J. Brouwer, M. P. van den Berg, A. J. Smit, A. Postma, D. Th Sleijfer, J. A. Gietema*

*Corresponding author for this work

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Abstract

Long-term cardiovascular morbidity is increasingly observed in chemotherapy-treated testicular cancer survivors, but little is known of early sub-clinical changes in cardiac function. We prospectively evaluated cardiac function in testicular cancer patients by echocardiography. Systolic (Wall Motion Score Index) and diastolic (E/A-ratio and Tissue Velocity Imaging (TVI)) parameters, and serum levels of N-Terminal pro-Brain Natriuretic Peptide (NT-proBNP) were assessed before the start of chemotherapy and 1 year later. Echocardiography data were compared with an age-matched group of healthy controls. Forty-two patients treated with bleomycin, etoposide and cisplatin were evaluated (median age 27 years, range 18-50). Systolic function and E/A-ratio did not change, whereas the median TVI decreased (12.0 vs 10.0 cm s(-1); P = 0.002). Median levels of NT-proBNP increased (5 vs 18 pmol l(-1), P = 0.034). Compared with controls, TVI before the start of chemotherapy was not significantly different. In conclusion, we found that at a median of 10 months after cisplatin-based treatment for testicular cancer, TVI decreased significantly, indicating a deterioration of diastolic cardiac function. Serum levels of NT-proBNP increased. The prognostic significance of these changes for future cardiovascular morbidity is not clear. British Journal of Cancer (2009) 100, 1861-1866. doi: 10.1038/sj.bjc.6605095 www.bjcancer.com Published online 19 May 2009 (C) 2009 Cancer Research UK

Original languageEnglish
Pages (from-to)1861-1866
Number of pages6
JournalBritish Jounal of Cancer
Volume100
Issue number12
DOIs
Publication statusPublished - 9-Jun-2009

Keywords

  • testicular cancer
  • cardiovascular toxicity
  • echocardiography
  • prospective
  • LONG-TERM SURVIVORS
  • VENTRICULAR EJECTION FRACTION
  • DIASTOLIC HEART-FAILURE
  • CONVENTIONAL ECHOCARDIOGRAPHY
  • CARDIOVASCULAR-DISEASE
  • NATRIURETIC PEPTIDE
  • METABOLIC SYNDROME
  • CARDIOTOXICITY
  • ANTHRACYCLINES
  • CARDIOLOGY

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