Routine Ankle-Brachial Index (ABI) measurement: a window into atherosclerosis and early left ventricular dysfunction in patients diagnosed with cancer.
ABI
Atherosclerosis
Cardiotoxicity
LV GLS
LV dysfunction
PAD
Journal
Cardio-oncology (London, England)
ISSN: 2057-3804
Titre abrégé: Cardiooncology
Pays: England
ID NLM: 101689938
Informations de publication
Date de publication:
12 Sep 2024
12 Sep 2024
Historique:
received:
09
03
2024
accepted:
29
08
2024
medline:
12
9
2024
pubmed:
12
9
2024
entrez:
11
9
2024
Statut:
epublish
Résumé
Cancer therapy is considered to cause accelerated ischemia. Ankle-Brachial Index (ABI) measurement is an inexpensive, simple, available test for the early diagnosis of peripheral artery disease (PAD); however, it is not performed routinely. We aimed to evaluate the role of routine ABI measurement for the diagnosis of PAD among patients diagnosed with cancer and whether it correlates with left ventricular (LV) dysfunction. A retrospective, single-center study including patients diagnosed with cancer at Tel Aviv Sourasky Medical Center. The cohort included patients performing routine ABI and LV global longitudinal strain (GLS) echocardiography. The primary endpoint was the prevalence of PAD and whether it correlates with LV dysfunction, defined by LV GLS absolute value < 19%. The secondary composite endpoint evaluated the association between reduced ABI to LV dysfunction and all-cause mortality. Among 226 patients, PAD was diagnosed in 14 patients (6%). We revealed a positive correlation between ABI and LV GLS (r = 0.22, p < 0.01) with a reduced mean ABI score among patients with reduced LV GLS. A reduced mean ABI was observed among the positive composite endpoint group; however, it was not statistically significant (p = 0.35). We report, for the first time to our knowledge, the routine use of ABI testing among patients diagnosed with cancer. ABI showed a significant correlation to LV GLS, implying a potential tool in the early diagnosis of atherosclerosis and cardiotoxicity. Considering its low cost and availability, future prospective trials are needed to integrate its role in routine assessment.
Sections du résumé
BACKGROUND
BACKGROUND
Cancer therapy is considered to cause accelerated ischemia. Ankle-Brachial Index (ABI) measurement is an inexpensive, simple, available test for the early diagnosis of peripheral artery disease (PAD); however, it is not performed routinely. We aimed to evaluate the role of routine ABI measurement for the diagnosis of PAD among patients diagnosed with cancer and whether it correlates with left ventricular (LV) dysfunction.
METHODS
METHODS
A retrospective, single-center study including patients diagnosed with cancer at Tel Aviv Sourasky Medical Center. The cohort included patients performing routine ABI and LV global longitudinal strain (GLS) echocardiography. The primary endpoint was the prevalence of PAD and whether it correlates with LV dysfunction, defined by LV GLS absolute value < 19%. The secondary composite endpoint evaluated the association between reduced ABI to LV dysfunction and all-cause mortality.
RESULTS
RESULTS
Among 226 patients, PAD was diagnosed in 14 patients (6%). We revealed a positive correlation between ABI and LV GLS (r = 0.22, p < 0.01) with a reduced mean ABI score among patients with reduced LV GLS. A reduced mean ABI was observed among the positive composite endpoint group; however, it was not statistically significant (p = 0.35).
CONCLUSIONS
CONCLUSIONS
We report, for the first time to our knowledge, the routine use of ABI testing among patients diagnosed with cancer. ABI showed a significant correlation to LV GLS, implying a potential tool in the early diagnosis of atherosclerosis and cardiotoxicity. Considering its low cost and availability, future prospective trials are needed to integrate its role in routine assessment.
Identifiants
pubmed: 39261908
doi: 10.1186/s40959-024-00262-w
pii: 10.1186/s40959-024-00262-w
doi:
Types de publication
Journal Article
Langues
eng
Pagination
60Informations de copyright
© 2024. The Author(s).
Références
Angsutararux P, Luanpitpong S, Issaragrisil S. Chemotherapy-Induced Cardiotoxicity: Overview of the Roles of Oxidative Stress. Oxid Med Cell Longev. 2015;2015:1–13.
doi: 10.1155/2015/795602
Armenian SH, Lacchetti C, Barac A, Carver J, Constine LS, Denduluri N, Dent S, Douglas PS, Durand JB, Ewer M, Fabian C, Hudson M, Jessup M, Jones LW, Ky B, Mayer EL, Moslehi J, Oeffinger K, Ray K, Ruddy K, Lenihan D. Prevention and monitoring of cardiac dysfunction in survivors of adult cancers: American Society of Clinical Oncology Clinical Practice Guideline. J Clin Oncol. 2017;35(8):893–911.
doi: 10.1200/JCO.2016.70.5400
pubmed: 27918725
Plana JC, Galderisi M, Barac A, Ewer MS, Ky B, Scherrer-Crosbie M, Ganame J, Sebag IA, Agler DA, Badano LP, Banchs J, Cardinale D, Carver J, Cerqueira M, DeCara JM, Edvardsen T, Flamm SD, Force T, Griffin BP, Jerusalem G, Lancellotti P. Expert consensus for multimodality imaging evaluation of adult patients during and after cancer therapy: a report from the American Society of Echocardiography and the European Association of Cardiovascular Imaging. Eur Heart J Cardiovas Imaging. 2014;15(10):1063–93.
doi: 10.1093/ehjci/jeu192
Eidem BW. Identification of anthracycline cardiotoxicity: left ventricular ejection fraction is not enough. J Am Soc Echocardiogr. 2008;21(12):1290–2.
doi: 10.1016/j.echo.2008.10.008
pubmed: 19041570
Santoro C, Arpino G, Esposito R, Lembo M, Paciolla I, Cardalesi C, de Simone G, Trimarco B, De Placido S, Galderisi M. 2D and 3D strain for detection of subclinical anthracycline cardiotoxicity in breast cancer patients: a balance with feasibility. European Heart Journal - Cardiovascular Imaging. 2017;18(8):930–6.
doi: 10.1093/ehjci/jex033
pubmed: 28379383
Karlsen S, Dahlslett T, Grenne B, Sjøli B, Smiseth O, Edvardsen T, Brunvand H. Global longitudinal strain is a more reproducible measure of left ventricular function than ejection fraction regardless of echocardiographic training. Cardiovasc Ultrasound. 2019;17(1):18.
doi: 10.1186/s12947-019-0168-9
pubmed: 31477137
pmcid: 6720884
Krishnasamy R, Isbel NM, Hawley CM, Pascoe EM, Burrage M, Leano R, Haluska BA, Marwick TH, Stanton T. Left Ventricular Global Longitudinal Strain (GLS) Is a Superior Predictor of All-Cause and Cardiovascular Mortality When Compared to Ejection Fraction in Advanced Chronic Kidney Disease. PLoS ONE. 2015;10(5): e0127044.
doi: 10.1371/journal.pone.0127044
pubmed: 25978372
pmcid: 4433230
Arciniegas Calle MC, Sandhu NP, Xia H, Cha SS, Pellikka PA, Ye Z, Herrmann J, Villarraga HR. Two-dimensional speckle tracking echocardiography predicts early subclinical cardiotoxicity associated with anthracycline-trastuzumab chemotherapy in patients with breast cancer. BMC Cancer. 2018;18(1):1037.
doi: 10.1186/s12885-018-4935-z
pubmed: 30359235
pmcid: 6203211
Laufer-Perl M, Derakhshesh M, Milwidsky A, Mor L, Ravid D, Amrami N, Sherez J, Keren G, Topilsky Y, Arbel Y. Usefulness of Global Longitudinal Strain for Early Identification of Subclinical Left Ventricular Dysfunction in Patients With Active Cancer. Am J Cardiol. 2018;122(10):1784–9.
doi: 10.1016/j.amjcard.2018.08.019
pubmed: 30217373
Laufer-Perl M, Arnold JH, Mor L, Amrami N, Derakhshesh M, Moshkovits Y, Sadeh B, Arbel Y, Topilsky Y, Rozenbaum Z. The association of reduced global longitudinal strain with cancer therapy-related cardiac dysfunction among patients receiving cancer therapy. Clin Res Cardiol. 2020;109(2):255–62.
doi: 10.1007/s00392-019-01508-9
pubmed: 31214777
Chang HM, Moudgil R, Scarabelli T, Okwuosa TM, Yeh ETH. Cardiovascular Complications of Cancer Therapy: Best Practices in Diagnosis, Prevention, and Management: Part 1. J Am Coll Cardiol. 2017;70(20):2536–51.
doi: 10.1016/j.jacc.2017.09.1096
pubmed: 29145954
pmcid: 5825187
Mozos I, Borzak G, Caraba A, Mihaescu R. Arterial stiffness in hematologic malignancies. Onco Targets Ther. 2017;10:1381–8.
doi: 10.2147/OTT.S126852
pubmed: 28424554
pmcid: 5344421
Novo S, Carità P, Corrado E, Muratori I, Pernice C, Tantillo R, Novo G. Preclinical carotid atherosclerosis enhances the global cardiovascular risk and increases the rate of cerebro- and cardiovascular events in a five-year follow-up. Atherosclerosis. 2010;211(1):287–90.
doi: 10.1016/j.atherosclerosis.2010.01.019
pubmed: 20171636
Bhatt DL, Steg PG, Ohman EM, Hirsch AT, Ikeda Y, Mas JL, Goto S, Liau CS, Richard AJ, Röther J, Wilson PW, REACH Registry Investigators. International prevalence, recognition, and treatment of cardiovascular risk factors in outpatients with atherothrombosis. JAMA. 2006;295(2):180–9.
doi: 10.1001/jama.295.2.180
pubmed: 16403930
Gonçalves-Martins G, Gil-Sala D, Tello-Díaz C, Tenezaca-Sari X, Marrero C, Puig T, Gayarre R, Fité J, Bellmunt-Montoya S. Prevalence of Peripheral Arterial Disease and Associated Vascular Risk Factors in 65-Years-Old People of Northern Barcelona. J Clin Med. 2021;10(19):4467.
doi: 10.3390/jcm10194467
pubmed: 34640483
pmcid: 8509737
Hirsch AT, Criqui MH, Treat-Jacobson D, Regensteiner JG, Creager MA, Olin JW, Krook SH, Hunninghake DB, Comerota AJ, Walsh ME, McDermott MM, Hiatt WR. Peripheral arterial disease detection, awareness, and treatment in primary care. JAMA. 2001;286(11):1317–24.
doi: 10.1001/jama.286.11.1317
pubmed: 11560536
Ichihashi S, Desormais I, Hashimoto T, Magne J, Kichikawa K, Aboyans V. Accuracy and Reliability of the Ankle Brachial Index Measurement Using a Multicuff Oscillometric Device Versus the Doppler Method. European journal of vascular and endovascular surgery: the official journal of the European Society for Vascular Surgery. 2020;60(3):462–8.
doi: 10.1016/j.ejvs.2020.06.013
pubmed: 32763120
Wei B, Qian C, Fang Q, Wang Y. The Prognostic Value of Peripheral Artery Disease in Heart Failure: Insights from a Meta-analysis. Heart Lung Circ. 2016;25(12):1195–202.
doi: 10.1016/j.hlc.2016.04.002
pubmed: 27161297
Lyon AR, Lopez-Fernandez T, Couch LS, Asteggiano R, Aznar MC, Bergler-Klein J, Boriani G, Cardinale D, Cordoba R, Cosyns B, Cutter DJ, de Azambuja E, de Boer RA, Dent SF, Farmakis D, Gevaert SA, Gorog DA, Herrmann J, Lenihan D, Moslehi J, ESC Scientific Document Group. 2022 ESC Guidelines on cardio-oncology developed in collaboration with the European Hematology Association (EHA), the European Society for Therapeutic Radiology and Oncology (ESTRO) and the International Cardio-Oncology Society (IC-OS) Developed by the task force on cardio-oncology of the European Society of Cardiology (ESC). Eur Heart J Cardiovasc Imaging. 2022;43(41):4229–361.
Hirsch AT, Haskal ZJ, Hertzer NR, Bakal CW, Creager MA, Halperin JL, Hiratzka LF, Murphy WR, Olin JW, Puschett JB, Rosenfield KA, Sacks D, Stanley JC, Taylor LM Jr, White CJ, White J, White RA, Antman EM, Smith SC Jr, Adams CD, ... Vascular Disease Foundation. ACC/AHA 2005 Practice Guidelines for the management of patients with peripheral arterial disease (lower extremity, renal, mesenteric, and abdominal aortic): a collaborative report from the American Association for Vascular Surgery/Society for Vascular Surgery, Society for Cardiovascular Angiography and Interventions, Society for Vascular Medicine and Biology, Society of Interventional Radiology, and the ACC/AHA Task Force on Practice Guidelines (Writing Committee to Develop Guidelines for the Management of Patients With Peripheral Arterial Disease): endorsed by the American Association of Cardiovascular and Pulmonary Rehabilitation; National Heart, Lung, and Blood Institute; Society for Vascular Nursing; TransAtlantic Inter-Society Consensus; and Vascular Disease Foundation. Circulation. 2006;113(11):e463–e654.
Alexandre J, Cautela J, Ederhy S, Damaj GL, Salem JE, Barlesi F, Farnault L, Charbonnier A, Mirabel M, Champiat S, Cohen-Solal A, Cohen A, Dolladille C, Thuny F. Cardiovascular Toxicity Related to Cancer Treatment: A Pragmatic Approach to the American and European Cardio-Oncology Guidelines. J Am Heart Assoc. 2020;9(18): e018403.
doi: 10.1161/JAHA.120.018403
pubmed: 32893704
pmcid: 7727003
Oikonomou EK, Kokkinidis DG, Kampaktsis PN, Amir EA, Marwick TH, Gupta D, Thavendiranathan P. Assessment of Prognostic Value of Left Ventricular Global Longitudinal Strain for Early Prediction of Chemotherapy-Induced Cardiotoxicity: A Systematic Review and Meta-analysis. JAMA cardiology. 2019;4(10):1007–18.
doi: 10.1001/jamacardio.2019.2952
pubmed: 31433450
pmcid: 6705141
Hoffmann S, Jensen JS, Iversen AZ, Sogaard P, Galatius S, Olsen NT, Bech J, Fritz-Hansen T, Biering-Sorensen T, Badskjaer J, Pietersen A, Mogelvang R. Tissue Doppler echocardiography improves the diagnosis of coronary artery stenosis in stable angina pectoris. Eur Heart J Cardiovasc Imaging. 2012;13(9):724–9.
doi: 10.1093/ehjci/jes001
pubmed: 22323549
Hoffmann S, Mogelvang R, Sogaard P, Iversen AZ, Hvelplund A, Schaadt BK, Fritz-Hansen T, Galatius S, Risum N, Biering-Sørensen T, Jensen JS. Tissue Doppler echocardiography reveals impaired cardiac function in patients with reversible ischaemia. European journal of echocardiography : the journal of the Working Group on Echocardiography of the European Society of Cardiology. 2011;12(8):628–34.
doi: 10.1093/ejechocard/jer094
pubmed: 21757478
Biering-Sørensen T, Hoffmann S, Mogelvang R, Zeeberg Iversen A, Galatius S, Fritz-Hansen T, Bech J, Jensen JS. Myocardial strain analysis by 2-dimensional speckle tracking echocardiography improves diagnostics of coronary artery stenosis in stable angina pectoris. Circ Cardiovasc Imaging. 2014;7(1):58–65.
doi: 10.1161/CIRCIMAGING.113.000989
pubmed: 24186963
Elimelech C, Zornitzki L, Konigstein M, Rozenbaum Z, Arnold JH, Havakuk O, Revivo M, Flint N, Khoury S, Topilsky Y, Banai S, Laufer-Perl M. Baseline Left Ventricle Longitudinal Strain as a Predictor for Clinical Improvement Following Coronary Sinus Reducer Implantation. Am J Cardiol. 2023;204:77–83.
doi: 10.1016/j.amjcard.2023.07.026
pubmed: 37541151
Laufer-Perl M, Arnold JH, Moshkovits Y, Havakuk O, Shmilovich H, Chausovsky G, Sivan A, Szekely Y, Arbel Y, Banai S, Topilsky Y, Rozenbaum Z. Evaluating the role of left ventricle global longitudinal strain in myocardial perfusion defect assessment. Int J Cardiovasc Imaging. 2022;38(2):289–96.
doi: 10.1007/s10554-021-02399-6
pubmed: 34498200