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Updated: Apr 20, 2026
Measuring the Carotid to Femoral Pulse Wave Velocity Cf-PWV to Evaluate Arterial Stiffness
Published on: May 3, 2018
Early and late changes in markers of aortic stiffness with breast cancer therapy
S Grover1, P W Lou, C Bradbrook
1Cardiology Department, Flinders Medical Centre, Adelaide, South Australia, Australia; Flinders Cardiac Cardiovascular Magnetic Resonance Department, Flinders Medical Centre, Adelaide, South Australia, Australia; Health Sciences, Flinders University, Adelaide, South Australia, Australia; Heart Health, South Australian Health and Medical Research Institute, Adelaide, South Australia, Australia.
Background:
Anthracyclines and trastuzumab are well recognised to cause cardiac toxicity. Further to their effects on left ventricular (LV) function, anthracyclines in particular are considered to cause negative arterial remodelling. Whether these changes reverse is unknown. In addition, whether trastuzumab causes specific effects on arterial remodelling is yet undetermined.
Methods:
Patients receiving these agents for treatment of breast cancer and healthy volunteers prospectively underwent clinical evaluation and cardiovascular magnetic resonance (CMR) imaging at baseline, 1, 4 and 14 months post-therapy, including functional assessment, measurement of aortic pulse wave velocity (PWV) using velocity encoded imaging and distensibility at ascending aorta (AA) and proximal descending aorta (PDA).
Results:
Twenty-nine patients pretherapy and 12 volunteers demonstrated no differences in PWV, distensibility and LV function. Among cancer subjects, PWV increased acutely, P = 0.002 (4 months), then decreased by 14 months (P < 0.001). In addition, a decrease was observed in distensibility at the AA within 1 (P = 0.001) and 4 months (P < 0.001) of commencing therapy. At the PDA, only significant reduction was observed at 14 month distensibility when compared with baseline, P < 0.001. Patients with anthracycline exposure only had a greater reduction in aortic distensibility in the AA with time, P = 0.005 at 1 month, P < 0.001 at 4 months and P = 0.009 at 14 months.
Conclusion:
Acute changes are observed in PWV and distensibility at the AA following contemporary breast cancer chemotherapy and partially reverse a year after therapy is discontinued, with more severe effects seen with anthracyclines.
Insights
Breast cancer chemotherapy, including anthracyclines, causes acute arterial stiffening that partially reverses after treatment. Anthracyclines lead to more severe arterial remodeling effects.
Area of Science:
- Cardiovascular Medicine
- Oncology
- Medical Imaging
Background:
- Anthracyclines and trastuzumab are known cardiotoxins, potentially causing negative arterial remodeling.
- The reversibility of chemotherapy-induced arterial changes and trastuzumab's specific arterial effects remain unclear.
Purpose of the Study:
- To investigate arterial remodeling changes following anthracycline and trastuzumab therapy in breast cancer patients.
- To assess the reversibility of these arterial changes post-therapy.
Main Methods:
- Prospective study using cardiovascular magnetic resonance (CMR) imaging in breast cancer patients and healthy volunteers.
- Measurements included aortic pulse wave velocity (PWV) and distensibility at the ascending aorta (AA) and proximal descending aorta (PDA) at baseline and 1, 4, and 14 months post-therapy.
Main Results:
- Chemotherapy induced acute increases in PWV and decreases in AA distensibility, with partial reversal by 14 months.
- Anthracycline-exposed patients showed greater reductions in AA distensibility.
- Significant reductions in PDA distensibility were observed at 14 months.
Conclusions:
- Contemporary breast cancer chemotherapy causes acute arterial stiffening and reduced distensibility, particularly with anthracyclines.
- These arterial changes partially reverse approximately one year after therapy cessation.
