Aortic stiffness and left ventricular function in patients with differentiated thyroid cancer

Gazdag, Annamaria; Nagy, Endre; Erdei, Annamária; Bodor, Miklós; Berta, Eszter; Szabó, Zoltán; Jenei, Zoltán

doi:10.1007/s40618-014-0143-0

Cited by 17 publications

(17 citation statements)

References 53 publications

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“…Thyroid stimulating hormone (TSH) suppression is a key step for DTC treatment and has been applied wildly in clinical practice. However, long-term TSH suppression may lead to an exogenous subclinical hyperthyroidism and increase thyroxine (T4) level and T4/triiodothyronine (T3) level [ 3 ], which may induce many adverse reactions and negative effects on cardiac function [ 4 – 6 ]. At present, the specific TSH suppression level to the best therapeutic effect is controversial.…”

Section: Introductionmentioning

confidence: 99%

Thyroid stimulating hormone suppression time on cardiac function of patients with differentiated thyroid carcinoma

Wang¹,

Liu²,

Jin³

et al. 2018

Cancer Cell Int

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BackgroundThis study was to investigate the influence of thyroid stimulating hormone (TSH) suppression time on the cardiac function of differentiated thyroid carcinoma (DTC) patients.Methods105 DTC patients were divided into strict TSH suppression group (model group, TSH ≤ 0.1 mU/L) and general TSH suppression group (control group, TSH > 0.1 mU/L). According to the suppression time, these two groups were respectively divided into three groups: group within half a year, group between half a year and a year and group more than a year. Gated myocardial perfusion imaging was applied to observe differences of left ventricle (LV) myocardial perfusion, LV diastolic and systolic function and LV systolic synchrony in every group.ResultsThe left ventricular diastolic function, systolic synchrony and myocardial perfusion level of model group decreased with prolonged suppression time. The values of left ventricular EF, PFR and BPM in patients less than half a year were higher than those in 6 months to 1 year for control group.ConclusionThyroid stimulating hormone suppression can influence the cardiac function of patients and with the prolongation of suppression time, regardless of the level of TSH suppression, the possibility of cardiac function depression in patients will increase. TSH may lower the risk of cardiovascular disease in high-risk patients than those in TSH patients with moderate or low risk. The drugs improving cardiac function should be used cooperatively in different suppression period to decrease the occurrence rate of cardiac adverse reactions.

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Section: Introductionmentioning

confidence: 99%

Thyroid stimulating hormone suppression time on cardiac function of patients with differentiated thyroid carcinoma

Wang¹,

Liu²,

Jin³

et al. 2018

Cancer Cell Int

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“…Elastography is a subtype of ultrasonography, which evaluates the stiffness-deformability index. It is more objectively than the palpation [47] . Recent studies show that the malignant lesions tend to be more vascularized and 3 times stiffer than the surrounding tissues, while benign nodules are less than 1.7 times stiffer than normal tissue [48] .…”

Section: Discussionmentioning

confidence: 99%

Elastography reduces over-medical procedures in thyroid nodules: a systematic review and meta-analysis

Ke¹,

Cheng²,

Jian-cang³

et al. 2020

Preprint

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Background To evaluate the diagnostic performance of elastography in the differentiating the malignancy from thyroid nodule. Methods The literature published in English or Chinese prior to December 2019 which diagnosed by elastography in thyroid nodules were reviewed and summarized. According the inclusion and exclusion criteria, the elegant theses were reserved. Quality of each study was evaluated by the qu ality a ssessment of d iagnostic a ccuracy s tudies tool (QUADAS). Comprehensive Meta-Analysis Version 2.0 was used to describe primary results and explore homogeneity. Publication bias analysis was evaluated by Review Manager 5.3. Meta-Disc version 1.4 was applied to explore threshold effect, and pool sensitivity and specificity. A Summary ROC curve was constructed to calculate the area under the curve. Results As the heterogeneity was mild, we performance on random effect model. The publication bias was negligible. The elastography showed high accuracy in the diagnosis of malignant. The pooled sensitivity and specificity with corresponding 95% confidence interval were 0.80 (0.78, 0.82) and 0.80 (0.79, 0.81) respectively. AUC of sROC was 0.9087. Sensitivity analysis demonstrated that the pooled estimates were stable and reliable. Conclusions The elastography has obvious sensitivity and specificity in differentiate malignant from the thyroid nodule. Several different types of elastography could achieve the same aim, but the cut-off value is associate with the purpose of the screen program and the subtypes of the technique.

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“…Сосудистая жесткость является интегральным показателем сердечно-сосудистого риска, и повышенное значение ее показателей, таких как скорость пульсовой волны (СПВ), индекс аугментации, центральное САД (цСАД) и центральное ДАД (цДАД), отражает субклиническое поражение сердечно-сосудистой системы [13]. Имеются данные о повышении жесткости магистральных артерий у больных онкологическими заболеваниями [14].…”

Section: Discussionunclassified

Atherosclerosis of brachiocephalic arteries and arterial stiffness in patients with breast cancer

et al. 2019

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Cardiovascular toxicity is one of the important problems of clinical oncology. Atherosclerosis progression was demonstrated in patients with cancer and chemotherapy.Te aim– to evaluate the vascular wall characteristics and to determine the predictors of AS of brachiocephalic arteries progression during anticancer therapy in patients with breast cancer.Methods.Te study involved 43 patients with newly diagnosed breast cancer (BC) (II–III stage) with overexpression of HER2; median age 50 (40;57) years. All patients underwent neoadjuvant drug therapy with antracyclines, taxanes and trastuzumab followed by surgery, radiation and hormone therapy according to the indications. Before anticancer therapy the general clinical examination was conducted and lipid profle, plasma lipoprotein (a) [Lp(a)] level, titres of autoantibodies IgM and IgG to lipoproteins and their oxidized derivatives were estimated. Te vascular wall stiﬀness (pulse wave velocity on the carotid-femoral (PWVcf) and shoulder-ankle (PWVsa) segments, the central pressure, carotid intima-media thickness (CIMT) and the degree of stenosis of the brachiocephalic arteries) were determined at baseline and at each stage of anticancer therapy. Te atherosclerosis progression was determined if the new stenosis (≥15%) or increase of preexisting stenosis (≥5%) were revealed; CIMT increase ≥ 0.1 mm. Te parameters of cellular immunity (peripheral blood lymphocyte phenotyping via direct immunoﬂuorescence and ﬂow cytometry), lipid spectrum parameters, serum concentration of Lp (a), autoantibodies IgM and IgG against lipoproteins and their oxidized derivatives, as well as PWVсf and PWVsa were assessed in 17 BC patients before the onset of neoadjuvant therapy and in 20 healthy women.Results.BC patients and healthy women were comparable in traditional cardiovascular risk factors but diﬀered in PWVsa and PWVcf levels (p<0.05). In BC patients the activation of T-cell immunity with the stimulation of both subpopulations with pro-inﬂammatory and regulatory properties was observed (p<0.05). Te direct correlations between the content of activated T-lymphocytes (T-act), T-helpers (T) 1 and PWVsa (p<0.05), as well as T-act, T1 and T2 and PWVcf (p<0.05) were revealed in the general group. Te decrease of systolic blood pressure (SBP), central SBP (SBPc), central diastolic blood pressure (DBPc), PWVcf and PWVsa levels accompanied with a temporary heart rate increase were observed during anticancer therapy; SBP, SBPc, PWVcf levels restored by the end of the follow-up period. Te CIMT increase was detected in 22 (51%), and the atherosclerosis progression in 26 (60%) BC patients during anticancer therapy. Lp (a) level above 12.8 mg/dl was associated with CIMT increase (p<0.05). Age > 48 years and radiation therapy were risk factors for CIMT increase and atherosclerosis progression (p<0.05), respectively.Conclusions. Te vascular stiﬀness is increased in BC patients, which is associated with the activation of eﬀector subpopulations of T-lymphocytes and the elevation of circulating level of both pro-atherogenic and anti-atherogenic T-cells. Te level of Lp (a) above 12.8 mg/dl is associated with atherosclerosis progression, which requires further research. Age and radiation therapy are the risk factors for atherosclerosis progression during anticancer therapy.

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Aortic stiffness and left ventricular function in patients with differentiated thyroid cancer

Cited by 17 publications

References 53 publications

Thyroid stimulating hormone suppression time on cardiac function of patients with differentiated thyroid carcinoma

Thyroid stimulating hormone suppression time on cardiac function of patients with differentiated thyroid carcinoma

Elastography reduces over-medical procedures in thyroid nodules: a systematic review and meta-analysis

Atherosclerosis of brachiocephalic arteries and arterial stiffness in patients with breast cancer

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