Kearney M.C.,Cardiff Metropolitan University |
Gallop-Evans E.,Velindre Cancer Center Cardiff |
Cockcroft J.R.,Cardiff Metropolitan University |
Stohr E.J.,Cardiff Metropolitan University |
And 5 more authors.
European Journal of Clinical Investigation | Year: 2017
Background: The cardiac dysfunction associated with anthracycline-based chemotherapy cancer treatment can exist subclinically for decades before overt presentation. Stress echocardiography, the measurement of left ventricular (LV) deformation and arterial haemodynamic evaluation, has separately been used to identify subclinical cardiovascular (CV) dysfunction in several patient groups including those with hypertension and diabetes. The purpose of the present cross-sectional study was to determine whether the combination of these techniques could be used to improve the characterisation of subclinical CV dysfunction in long-term cancer survivors previously treated with anthracyclines. Materials and methods: Thirteen long-term cancer survivors (36 ± 10 years) with prior anthracycline exposure (11 ± 8 years posttreatment) and 13 age-matched controls were recruited. Left ventricular structure, function and deformation were assessed using echocardiography. Augmentation index was used to quantify arterial haemodynamic load and was measured using applanation tonometry. Measurements were taken at rest and during two stages of low-intensity incremental cycling. Results: At rest, both groups had comparable global LV systolic, diastolic and arterial function (all P > 0·05); however, longitudinal deformation was significantly lower in cancer survivors (-18 ± 2 vs. -20 ± 2, P < 0·05). During exercise, this difference between groups persisted and further differences were uncovered with significantly lower apical circumferential deformation in the cancer survivors (-24 ± 5 vs. -29 ± 5, -29 ± 5 vs. 35 ± 8 for first and second stage of exercise respectively, both P < 0·05). Conclusion: In contrast to resting echocardiography, the measurement of LV deformation at rest and during exercise provides a more comprehensive characterisation of subclinical LV dysfunction. Larger studies are required to determine the clinical relevance of these preliminary findings. © 2017 Stichting European Society for Clinical Investigation Journal Foundation.
Evans M.,Velindre Cancer Center Cardiff |
Powell N.G.,University of Cardiff
Head and Neck | Year: 2014
The incidence of oropharyngeal carcinoma is increasing in many countries of the developed world, largely because of cancers caused by infection with human papillomavirus (HPV). HPV-positive patients may ask questions that fall outside the remit of traditional consultations held in head and neck clinics. The purpose of this article is to highlight key messages about HPV and oropharyngeal cancer that are relevant to patients. Key messages include: HPV is a very common virus that transiently infects most people at some point in their lives; HPV infection is transmitted by normal sexual activity and is not a marker of promiscuity or abnormal sexual practices; HPV infections may be acquired many years before a cancer develops and infection does not imply recent infidelity; long-term partners of HPV-positive patients do not seem to be at increased risk of HPV infection. © 2014 Wiley Periodicals, Inc. Head Neck 36: 1529-1533, 2014 © 2014 Wiley Periodicals, Inc.