Abstract 10400: Signs of Early Sub-Clinical Atherosclerosis in Childhood Cancer Survivors
Background: Cancer is the leading cause of death by disease among U.S. children; however, over the last two decades there has been a dramatic increase in survival in these individuals. Although free of cancer, childhood cancer survivors (CCS) are faced with a variety of chronic health problems including an increased risk of cardiovascular and metabolic abnormalities. The effect of cancer treatments on vascular structure and function in CCS has not been examined in childhood.
Methods: Measures of carotid artery stiffness (compliance and distensibility) and intima-media thickness (IMT), brachial artery endothelial-dependent dilation (EDD), and endothelial-independent dilation (EID) were obtained from ultrasound imaging in 319 CCS who were ≥5 years from diagnosis and 208 siblings who had never been diagnosed with cancer. Participants were 9-18 years of age at examination.
Results: CCS were shorter and had greater percent body fat and lower lean body mass compared to controls. Carotid cross-sectional distensibility (CSD) was lower in CCS compared to controls. Survivors of leukemia had lower CSD and compliance (CSC), indicating increased arterial stiffness, compared to controls. There were no significant differences in measures of carotid stiffness or EDD in survivors of solid tumors or central nervous system (CNS) tumors compared to controls. Carotid IMT was greater in survivors with CNS tumors compared to leukemia survivors. EDD was lower in leukemia survivors than in controls, and EID was greater in survivors of CNS tumors than in controls (Table).
Conclusion: These results demonstrate that early in life, CCS have arterial changes indicating increased risk for premature atherosclerosis and cardiovascular disease. Therefore, it is reasonable to advocate that efforts should be directed at monitoring and managing cardiovascular risk factors in CCS.
- © 2013 by American Heart Association, Inc.