Aim. To study the traditional risk factors for cardiovascular disease (CVD), indicators of endothelial function and exercise tolerance in patients received complex treatment for cranial and craniospinal tumors in childhood, including radiation therapy.Material and methods. We compared examination data of 48 patients who underwent treatment for brain tumors using cranial and craniospinal irradiation in childhood (mean age, 21,7±4,3 years, mean period after the end of treatment, 6,9±5,4 years), and 20 healthy volunteers. Examination methods included assessment of lipid profile, vascular stiffness and endothelial function using the Photoplethysmography and occlusion test, cardiopulmonary test, and in patients who underwent craniospinal irradiation, also echocardiography and duplex ultrasound of extracranial arteries.Results. Compared to healthy individuals, patients after a brain tumor were found to have lower blood pressure, higher heart rate (HR), significantly lower exercise performance (peak oxygen consumption, 19,8±6,4 ml×min-1×kg vs 30,3±5,8 ml×min-1×kg, p<0,0001) and a higher prevalence of dyslipidemia (56% vs 5%, p<0,0001), as well as an increase in the augmentation index, indicating higher stiffness of large vessels (-7,3±16,3 vs -20,3±7,9, p=0,001), and a trend towards a decrease in the occlusion index (p=0,051). Echocardiography and duplex ultrasound revealed no radiation-associated abnormalities.Conclusion. Determining the mechanisms and prognostic significance of the identified risk factors for CVD (dyslipidemia, decreased exercise tolerance, increased heart rate and vascular stiffness) in this category of patients requires further research. Regular monitoring of risk factors, primarily the lipid profile, and the use of preventive measures for individuals with an increased risk of CVD should be recommended.
Background: Endothelial dysfunction is recognized as one of the early markers of cardiovascular disorders. It is supposed to be a potential predictor of cardiovascular complications in patients receiving adjuvant and neoadjuvant chemotherapy. Aim: To estimate the prevalence of endothelial dysfunction in solid cancer patients compared to that in individuals without any malignancies. Materials and methods: This observational study included 74 patients with solid malignancies, mostly gastrointestinal. Prior to polychemotherapy, all patients were examined for endothelial function of small and large arteries (AngioScan-01, Fiton, Russia) and peripheral artery stiffness (pulse wave contour analysis and occlusion test). The results were compared with those of the Russian population trials of endothelial dysfunction Meridian-RO (Ryazan region) and trial in the rural population of the Krasnodar region. Results: Compromised vasodilation and smaller arteries tone were found in 64.9% (48/74) of the cancer patients, while impaired vasodilation of larger muscular arteries was present in 94.6% (70/74) of the patients. According to the Meridian-RO trial in the Ryazan region, endothelial dysfunction had been found in 51.2% (n = 341) of women and 52.4% (n = 300) of men, whereas the Krasnodar regional population data had shown it in 68.4% (n = 353) of women and 71.7% (n = 253) of men. Conclusion: The prevalence of endothelial dysfunction in the patients with solid malignancies, who have not undergone any chemo- or radiation therapy, is significantly higher than in the population of comparable age, conventional cardiovascular risk factors, and comorbidities. No significant increase of vascular stiffness was identified.
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