- Academic Editors
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Background: Cardiovascular (CV) diseases are a cause of increased
long-term morbidity and mortality in childhood cancer survivors (CCSs) treated
with anthracyclines. These drugs may affect not only the heart, but also the
vascular system. Left ventricular-arterial coupling (LVAC) represents a reliable
parameter of altered ventricular and vascular performance, with validated
prognostic value and never investigated in this setting. Aim of this study was to
assess, in CCSs and matched controls, LVAC changes, performed with different
echocardiographic modalities, and their relationship with endothelial function.
Methods: Twenty survivors treated with anthracyclines for childhood
malignancies and a matched control group of 20 healthy subjects were enrolled.
Arterial elastance (Ea), end-systolic elastance (Ees), Ea/Ees ratio, as well as
three-dimensional (3D) LVAC (assessed by measurement of End Systolic Volume
[ESV]/Stroke Volume [SV] ratio) were performed at rest. Endothelial function was
evaluated by measurement of flow-mediated dilatation (FMD) of the brachial
artery. Results: 3D SV and 3D ESV/SV ratio resulted respectively
significantly lower and higher in CCSs than in controls, while Ea, Ees and Ea/Ees
ratio were not different among groups. A positive correlation between 3D ESV/SV
ratio and cumulative anthracycline doses, as well as with time after drug
exposure were also found. Mean FMD was similar in CCSs and controls (8.45