PATAGONIA: Prevalence of vAscular Toxicity AmonG lOng-term caNcer survIvors treated with Anthracyclines
Project "PI24/00260", funded by Instituto de Salud Carlos III (ISCIII) and co-funded by the European Union.
Principal Investigator: Inés García Lunar
Cardiovascular diseases (CVD) and cancer are the two main causes of mortality and are frequently associated. Anthracyclines (ACs), a family of chemotherapy drugs that are used to treat a wide number of tumors, are the primary agents responsible for chemotherapy-induced cardiotoxicity. The mechanisms that lead to cardiac toxicity due to ACs are not yet fully understood, nor are there any specific interventions with proven efficacy to prevent cardiac damage. The effect of ACs on the myocardium has been subject of extensive research over the past years. Nevertheless, one of the most intriguing aspects of AC-induced cardiotoxicity is that ventricular function is sometimes preserved during and immediately after chemotherapy, but the myocardium may become vulnerable to subsequent stressors, causing problems later in life. Strong evidence from both experimental studies and early clinical observations suggests that ACs may cause damage to the vasculature before the onset of cardiac dysfunction. Our hypothesis is that this mechanism (vascular involvement) could remain latent for a prolonged period of time and contribute to the development of AC-induced cardiomyopathy and, ultimately, heart failure years later. PATAGONIA (Prevalence of vAscular Toxicity AmonG lOng-term caNcer survIvors treated with Anthracyclines) aims to study in long-term cancer survivors the vascular consequences of prior treatment with ACs and the risk factors associated with the onset of late vascular and myocardial toxicity using non-invasive imaging technology.
This is a multicenter, retrospective cohort study including 2 groups: subjects previously exposed and not exposed to ACs. Study participants undergo a comprehensive cardiovascular assessment based on state-of-the-art, non-invasive imaging techniques. This includes a stress cardiac magnetic resonance (CMR) to calculate the coronary flow reserve as a surrogate of the coronary microcirculation status, as well as vascular ultrasound of the carotid and femoral arteries to assess atherosclerosis and vascular distensibility. The ultimate goal of this project is to improve understanding of cardiovascular health status in cancer survivors and to support earlier detection of treatment-related cardiac and vascular injury.
