EFFECT OF ANTHRACYCLINE THERAPY ON CARDIOVASCULAR REGULATION AND PHYSICAL ACTIVITY
  E. Závodná, Z. Nováková, N. Honzíková, B. Fišer, M. Jíra, *J. Šťastná, *H. Hrstková Department of Physiology and *I. Department of Paediatrics, Fakulty of Medicine, Masaryk University in Brno, Czech Republic
 

The aim of the study: We followed effect of anthracycline therapy on physical activity, body and cardiovascular parameters in children treated for malignant tumor.

Methods: We examined 21 children and adolescents after antitumor therapy (M; 15.5±3.2 years) and 32 healthy subjects (Co; 15.7±2.1 years). In group M, 8 subjects had a non-cardiotoxic therapy (A0), and 13 children were treated with anthracyclines (A+) that have cardiotoxic side effects. In all subjects, we recorded non-invasively (Finapres) beat-to-beat systolic (SBP) and diastolic (DBP) blood pressure and inter-beat intervals (IBI). Baroreflex sensitivity was estimated by spectral analysis as BRS (ms/mmHg) and BRSf (mHz/mmHg). The physical activity was evaluated on the basis of the questionnaires completed by all subjects for one week.

Results: In group A+ vs. A0 and Co, we found significantly lower SBP (p < 0.001). A+ compared with Co had higher BRSf (p < 0.001); lower weight (p < 0.05) and height (p < 0.05); lower total physical activity (p < 0.01) and physical activity related to 1 kg of body weight (p < 0.01). In whole group M, we found negative correlation between dose of anthracyclines and SBP (r = -0.60; p < 0.01) and total physical activity (r = -0.43; p<0.05). The hierarchical multiple regression in group M shown that SBP (total correlation r=0.68; p<0.01) was significantly related to the duration of period without antitumor therapy and to the dosage of anthracyclines. BRSf significantly correlated (total correlation r=0.8; p<0.01) with body weight, physical activity related to 1 kg of body weight, time since therapy and SBP.

Conclusion: The subjects treated for a malignant tumor by anthracyclines had increased parasympathetic and decreased sympathetic tonic activity as was documented by lower systolic blood pressure and higher baroreflex sensitivity. This effect is not a result of a physical training as it is seen in healthy population, but it could be a consequence of a cardiotoxic and neurotoxic therapy or of a disease.

Supported by grants: IGA: NR/8006-3 and MSM: 0021622402.