ABC | Volume 111, Nº5, November 2018

Original Article Souza et al Arterial Stiffness and Cardiotoxicity Arq Bras Cardiol. 2018; 111(5):721-728 Table 2 – Longitudinal evaluation of heart parameters Hemodynamic variables Pre-chemo Post-1chemo Post-4chemo p Value Peripheral SBP, mmHg 125.7 ± 17 123.3 ± 18.2 123.7 ± 8.3 0.244 * Peripheral DBP, mmHg 79.9 ± 14 78.4 ± 10.2 80 ± 11.7 0.988 * Mean blood pressure, mmHg 100.3 ± 11.2 98.6 ± 11.4 100.3 ±10.1 0.879 † PP, mmHg 45.8 ± 12.4 42.5 ± 16.1 43 ±7.6 0.527 * Heart rate, bpm 76.4 ± 18.1 73.9 ± 16.8 78 ±15.7 0.055 * Central SBP, mmHg 117.1 ± 14 115.3± 13.3 116.2± 9.7 0.731 † Central DBP, mmHg 79.7± 10.7 79.5 ± 10.9 81.8 ± 10.7 0.815 † PP N amplification 1.30 ± 0.11 1.25 ± 0.10 1.28 ± 0.10 0.428 † Stroke volume, mL/m 2 67.4 ± 14.5 68.2 ± 13.5 64.4 ±11.8 0.144 † Cardiac output, L/minute 5.1 ± 0.6 4.9 ± 0.6 5 ± 0.5 0.521 † Total vascular resistance, mmHg/mL 1.2 ± 0.14 1.25 ± 0.16 1.24 ± 0.22 0.675 * Cardiac index, L/min/m 2 2.8 ± 0.3 2.7 ± 0.5 2.7 ± 0.4 0.918 * Augmentation pressure, mmHg 8.8 ± 6.1 7.7 ± 5.1 7.7 ± 3.3 0.110 * Reflection coefficient, % 67.2 ± 7 69.8 ± 6.1 67.6 ± 6.2 0.136 † Augmentation index 26.6 ± 10.8 23.2 ± 11.6 24.4 ± 10.6 0.144 † PWV,m/s 7.61 ± 1.28 7.49 ± 1.20 7.45 ± 1.15 0.507 † Results expressed as mean ± standard deviation, or median ± difference between the third and first quartiles. For all measured variables, there were three missing data on the measurements after four cycles. *Friedman test; † analysis of variance for repeated measures. Pre-chemo: before chemotherapy; post‑1chemo: after the first cycle of chemotherapy; post-4chemo: after the fourth cycle of chemotherapy; SBP: systolic blood pressure; DBP: diastolic blood pressure; PP: pulse pressure; PWV: pulse wave velocity. cardiovascular event is high, with values higher than 60% when evaluated within 2 years. With this, cardiovascular disease has become a major cause of morbidity and mortality among cancer survivors. 24,25 The main mechanism established for the increase in HF secondary to the use of doxorubicin is the direct myocardial damage of these agents (type I cardiotoxicity). The severity of the heart diseases triggered by chemotherapeutic agents seems to depend on the frequency and dose of the medicines administered; on the genetic characteristics; and on other cardiovascular comorbidities previously present. 11,26 The mechanism related to myocardial damage seems to occur due to the production of free radicals from the reduction of the quinone group of B ring in the anthracyclic structure, Figure 2 – Box diagrams for pulse wave velocity (PWV) at the three times assessed: before, after the first cycle of chemotherapy, and after the fourth cycle (pre-chemo, post-1chemo, and post-4chemo). p value refers to analysis of single-factor variance. 10 9 8 7 6 Pre-chemo Post-1chemo Post-4chemo p = 0.905 PWV (m/s) 724