P4.20 SHORT-TERM EFFECT OF ANTI-VEGF DRUGS ON HEART AND VESSELS

Abstract

Objectives: Drugs opposing the effect of vascular endothelial growth factor (anti-VEGF) inhibit angiogenesis slowing down and eventually stopping solid tumors growth. Nevertheless these drugs can cause hypertension (that seems to be correlated with cancer outcome) and cardiac dysfunction. We hypnotize there is a correlation between the early stiffening of cardiovascular system and the drug effectiveness. For this purpose we analyzed the short term changes in cardiovascular structure and function in patients treated with antiVEGF drugs. Methods: We enrolled 20 patients suffering from metastatic cancer (17 renal, 2 thyroid and 1 GIST), age 64±11 years (mean±SD). We measured blood pressures (BPs), cardiac and vascular parameters at baseline (B) and after two weeks of treatment (T1) (transthoracic echocardiography with 2D strain evaluation, cf-PWV, Aix). Results: At B our population showed normal BPs (mean±SD:121±17/69±9.5mmHg) and systolic function (EF: 59%,). Global longitudinal strain (GLS) was −21±3%, cf PWV was 12.1±3.3m/sec and Aix was 0.24±0,08%. At T1 we observed a significant increase in BPs (137±16/83±10mmHg, p<0.001 vs B), impaired GLS (−19±3%, p<0.005 vs B), and increased cf-PWV (13.5±3m/sec, p=0.01 vs B) while Aix rise didn’t reach statistical significance. Adjusting for PAS only strain impairment remained significative and it was not correlated with BP and PWV modifications. Conclusions: In the short term anti-VEGF drugs causes an increase of BP and of arterial stiffness, while myocardial deformation is impaired. The increase of PWV, without a significant change in Aix, may suggest that anti-VEGF drugs increase arterial stiffness, and, perhaps, have a less apparent effect on wave reflections.