The present study aims to investigate the chronic effect of treatment with doxorubicin and cyclophosphamide on neurovascular control and blood pressure in women undergoing adjuvant treatment for breast cancer.
The development of new drugs and different adjuvant therapeutic regimens, based on the combination of anthracycline (A) and cyclophosphamide (C), have contributed greatly to improve survival rate in breast cancer patients. Despite the clinical benefits of this therapy, AC treatment can cause cardiovascular acute and chronic changes. In a recent investigation, we observed that an acute AC chemotherapy session increases sympathetic nervous activity and blood pressure in patients with breast cancer. The present study aims to investigate the chronic effects of AC regimen on sympathetic nervous activity, peripheral vasoconstriction, endothelial microparticles and blood pressure, in women with breast cancer.
Study Type
INTERVENTIONAL
Allocation
NA
Purpose
DIAGNOSTIC
Masking
NONE
Enrollment
15
Body weight, height and waist circumference
Microneurography technique.
Echocardiography.
Instituto do Coracao (InCor), Hospital das Clinicas HCFMUSP, Faculdade de Medicina, Universidade de Sao Paulo
São Paulo, São Paulo, Brazil
Muscle sympathetic nerve activity
Change in muscular sympathetic nerve activity measured by microneurography
Time frame: 15-20 days after the end of AC regimen
Muscle blood flow
Change in muscle blood flow measured by venous oclusion plethysmography
Time frame: 15-20 days after the end of AC regimen
Blood Pressure
Change in blood pressure measured by finometer
Time frame: 15-20 days after the and of AC regimen
Physical capacity
Change in physical capacity measured by cardiopulmonary exercise test
Time frame: 15-20 days after the end of AC regimen
Cardiac Function Impairment
Change in cardiac function measured by echocardiography
Time frame: 15-20 days after the end of AC regimen
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Electrocardiography
Non-invasive photoplethysmography.
Serum and Plasma will be extracted by centrifugation. Endothelial microparticles by flow cytometry Interleukin-6 and tumor necrosis factor α by ELISA, High-sensitive reactive serum C-reactive protein by immunoturbidimetric assay, NT- ProBNP According to Central Laboratory, Hospital das Clinicas, HCFMUSP, Faculdade de Medicina, Universidade de Sao Paulo. Endothelin-1 by immunoenzymatic method Nitric oxide by gas chemiluminescence Lipoperoxidation by fluorimetry Carbonyl by spectrophotometer, and Superoxide Dismutase (SOD) by colorimetry.
Venous occlusion plethysmography
Brachial ultrasound
Carotid ultrasound
Cardiopulmonary exercise test
Four session of intravenous (in bolus) infusion of doxorubicin 60mg/m2 and cyclophosphamide 600mg/m2 with an interval of 21 days between sessions.