Chemotherapy acutely impairs neurovascular and hemodynamic responses in women with breast cancer
| Autor: | Max Sena Mano, Allan Robson Kluser Sales, Bruna Borges Carvalho, Marcelo V. Negrao, Ludhmila Abrahão Hajjar, Natalia G. Rocha, X. Edgar Toschi-Dias, Raphaela Villar Ramalho Groehs, Victor Debbas, Roberto Kalil Filho, Maria Urbana P. B. Rondon, Paulo M. Hoff, Laura Testa, Carlos Eduardo Negrão, Larissa Ferreira-Santos, Francisco R.M. Laurindo |
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| Rok vydání: | 2019 |
| Předmět: |
Adult
Oncology medicine.medical_specialty Sympathetic Nervous System Physiology medicine.medical_treatment Hemodynamics Antineoplastic Agents Breast Neoplasms 030204 cardiovascular system & hematology 03 medical and health sciences 0302 clinical medicine Breast cancer Cell-Derived Microparticles Heart Rate Physiology (medical) Internal medicine Humans Medicine Doxorubicin In patient Muscle Skeletal Cyclophosphamide Chemotherapy business.industry Peroneal Nerve Cancer Middle Aged medicine.disease Neurovascular bundle Chemotherapy Adjuvant Toxicity Female Endothelium Vascular SISTEMA NERVOSO SIMPÁTICO Cardiology and Cardiovascular Medicine business 030217 neurology & neurosurgery medicine.drug |
| Zdroj: | Repositório Institucional da USP (Biblioteca Digital da Produção Intelectual) Universidade de São Paulo (USP) instacron:USP |
| ISSN: | 1522-1539 0363-6135 |
| DOI: | 10.1152/ajpheart.00756.2018 |
| Popis: | The purpose of the present study was to test the hypothesis that doxorubicin (DX) and cyclophosphamide (CY) adjuvant chemotherapy (CHT) acutely impairs neurovascular and hemodynamic responses in women with breast cancer. Sixteen women (age: 47.0 ± 2.0 yr; body mass index: 24.2 ± 1.5 kg/m) with stage II-III breast cancer and indication for adjuvant CHT underwent two experimental sessions, saline (SL) and CHT. In the CHT session, DX (60 mg/m2) and CY (600 mg/m2) were administered over 45 min. In the SL session, a matching SL volume was infused in 45 min. Muscle sympathetic nerve activity (MSNA) from peroneal nerve (microneurography), calf blood flow (CBF; plethysmography) and calf vascular conductance (CVC), heart rate (HR; electrocardiography), and beat-to-beat blood pressure (BP; finger plethysmography) were measured at rest before, during, and after each session. Venous blood samples (5 ml) were collected before and after both sessions for assessment of circulating endothelial microparticles (EMPs; flow cytometry), a surrogate marker for endothelial damage. MSNA and BP responses were increased ( P < 0.001), whereas CBF and CVC responses were decreased ( P < 0.001), during and after CHT session when compared with SL session. Interestingly, the vascular alterations were also observed at the molecular level through an increased EMP response to CHT ( P = 0.03, CHT vs. SL session). No difference in HR response was observed ( P > 0.05). Adjuvant CHT with DX and CY in patients treated for breast cancer increases sympathetic nerve activity and circulating EMP levels and, in addition, reduces muscle vascular conductance and elevates systemic BP. These responses may be early signs of CHT-induced cardiovascular alterations and may represent potential targets for preventive interventions. NEW & NOTEWORTHY It is known that chemotherapy regimens increase the risk of cardiovascular events in patients treated for cancer. Here, we identified that a single cycle of adjuvant chemotherapy with doxorubicin and cyclophosphamide in women treated for breast cancer dramatically increases sympathetic nerve activity and circulating endothelial microparticle levels, reduces the muscle vascular conductance, and elevates systemic blood pressure. |
| Databáze: | OpenAIRE |
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