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Cardiovascular late effects in adult survivors of childhood cancer

10 December 2008

PhD ceremony: mw. C.A.J. Brouwer, 13.15 uur, Academiegebouw, Broerstraat 5, Groningen

Thesis: Cardiovascular late effects in adult survivors of childhood cancer

Promotor(s): prof. W.A. Kamps, prof. J.A. Gietema, prof. E.G.E. de Vries

Faculty: Medical Sciences


One of the most important causes of morbidity and mortality in childhood cancer survivors is cardiovascular damage. The aim of this thesis is to gain insight in the prevalence of (sub)clinical cardiac and/or vascular damage and cardiovascular risk factors in childhood cancer survivors in association with previous cancer treatment. The studies described in this thesis show an increased prevalence of cardiac and vascular damage and cardiovascular risk factors in the survivors compared with the healthy controls. Especially, the finding of diastolic dysfunction (disturbed relaxation of the left chamber of the heart) is remarkable and not described before in such a large cohort of survivors by load-independent echocardiography parameters. Diastolic dysfunction in childhood cancer survivors is associated with previous chest irradiation and with a higher dose of anthracyclines (a specific group of cytostatics). Subclinical vascular damage is associated with previous irradiation, especially when delivered on the neck. Furthermore, the survivors had more often an unfavourable cardiovascular risk profile compared with the controls. This was mainly indicated by a higher prevalence of the metabolic syndrome, which is a clustering of cardiovascular risk factors. Additionally, survivors treated with cranial irradiation are at risk to develop overweight, while anthracycline-treated survivors are at risk to develop underweight. Our finding of a higher prevalence of cardiovascular risk factors in childhood cancer survivors compared with controls is important, because the presence of risk factors may serve as potential intervention targets in the prevention and/or early treatment of (sub)clinical cardiovascular disease.


Last modified:15 September 2017 3.37 p.m.

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