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5-Fluorouracil induces arterial vasocontractions
T Südhoff1, M-D Enderle, M Pahlke
1Department of Internal Medicine, Ruhr-University Bochum, Knappschaftskrankenhaus, Bochum, Germany. thomas.suedoff@klinikum-passau.de
Summary
5-fluorouracil (5-FU) chemotherapy causes arterial contractions, a likely precursor to cardiotoxicity. These contractions are reproducible and preventable with glyceroltrinitrate, offering insights into 5-FU
Area of Science:
- Oncology
- Cardiology
- Pharmacology
Background:
- Symptomatic cardiotoxicity affects 2-10% of cancer patients treated with 5-fluorouracil (5-FU).
- The underlying mechanisms of 5-FU-induced cardiotoxicity remain largely unknown.
Purpose of the Study:
- To investigate the impact of intravenous chemotherapy (CTX), specifically 5-FU, on brachial artery diameter.
- To explore the potential role of big endothelin in 5-FU-associated vascular changes.
Main Methods:
- High-resolution ultrasound assessed brachial artery diameter in 60 cancer patients (30 on 5-FU, 30 on non-5-FU CTX).
- Plasma big endothelin levels were measured before and after chemotherapy administration.
- Reproducibility and prevention of 5-FU-induced contractions were evaluated.
Main Results:
- 50% of patients receiving 5-FU exhibited brachial artery contraction post-chemotherapy, unlike those on non-5-FU CTX.
- 5-FU-associated contractions were reproducible upon re-exposure and preventable with glyceroltrinitrate.
- A trend towards increased big endothelin levels was observed after 5-FU, but not after non-5-FU CTX.
Conclusions:
- Arterial vessel contractions are a common finding with 5-FU administration.
- These contractions are likely an initial step in the pathophysiology of 5-FU-induced cardiotoxicity.
- Glyceroltrinitrate effectively prevents 5-FU-induced arterial contractions during bolus administration.