Increased Arterial Stiffness in Children Treated with Anthracyclines for Malignant Disease

Survivors of childhood cancer have a significantly higher late morbidity and mortality from cardiovascular diseases. The aim of this study was to determine whether anthracyclines used in childhood could increase arterial stiffness, a well-known independent predictor of cardiovascular diseases. The study included 53 children and adolescents aged 6–20 years having completed anthracycline treatment for a malignant disease according to various protocols at least a year before. The patients were free from clinical or laboratory signs of the underlying disease or cardiac disease. Control group consisted of 45 age- and sex-matched healthy children. Arterial stiffness was determined by measuring aortic pulse wave velocity (PWVao) using oscillometric method (Arteriograph TensioMed device). PWVao value was significantly increased (6.24±1.34 m/s vs. 5.42±0.69 m/s; p<0.001) in patients having received anthracyclines as compared to control group. Increased arterial stiffness was present irrespective of the following parameters: age, sex, body mass index, systolic and diastolic blood pressure, mean arterial pressure and heart rate. It is possible that the effect of anthracycline on increased cardiovascular morbidity and mortality in long-term childhood cancer survivors is associated not only with cardiotoxicity, but also with increased arterial stiffness