e-Poster Presentation Clinical Oncology Society of Australia Annual Scientific Meeting 2020

Cardiovascular health is impaired in men with prostate cancer prior to treatment (#256)

Ashley Bigaran 1 2 , Eva Zopf 1 , Liam Wiggins 3 , Mark Trevaskis 1 , Michael Baker 4 , André La Gerche 2 , Prue Cormie 1 5 6 , Erin Howden 2
  1. Mary MacKillop Institute of Health Research, Australian Catholic University, Melbourne, VIC, Australia
  2. Dept. of Sports Cardiology, Baker Institute, Melbourne, VIC, Australia
  3. School of Behavioural and Health Sciences, Australian Catholic University, Melbourne, VIC, Australia
  4. School of Behavioural and Health Sciences, Australian Catholic University, Sydney, NSW, Australia
  5. Peter MacCallum Cancer Centre, Melbourne, VIC, Australia
  6. The Sir Peter MacCallum Department of Oncology, University of Melbourne, Melbourne, VIC, Australia

Introduction: Prostate cancer (PC) treatments such as androgen deprivation therapy (ADT) have been associated with an increased risk of cardiovascular disease (CVD). However, it is unclear whether men with PC have an elevated risk of CVD prior to initiating ADT. 

Aim: This study aimed to evaluate cardiovascular health in men with PC, compared to aged-matched non-cancer controls (CON).

Methods: 18 men with PC commencing ADT (68.1±7.4yrs) and 9 CON (64.2±8.9yrs) were recruited. Left ventricular (LV) mass, LV ejection fraction (LVEF), and global longitudinal strain (GLS) were quantified by echocardiography. A cardiopulmonary exercise test was performed to quantify peak oxygen uptake (VO2peak). Endothelial function (flow-mediated dilation [FMD]), arterial stiffness (central pulse wave velocity [cPWV], augmentation index [AIx]), and body composition (DXA) was also assessed.

Results: Men with PC had lower VO2peak (23.8±5.2 vs 32.6±8.8ml/kg/min, p=0.02), peak power (179.2±65.9 vs 252±66.5Watts, p=0.02) and peak heart rate (146±21 vs 163.7±11.7bpm, p=0.01), compared to CON. LVEF (60.2±4.2 vs 60.3±3%, p=0.94) and GLS (-18.8±1.4 vs -19.6±1.7%, p=0.19) were similar between groups however, LV mass was higher in PC (90.5±17.5 vs 77.5±13.4g/m2, p=0.06). cPWV was similar between groups (10.3±2.4 vs 9.1±1.7ms, p=0.23) as was central systolic pressure (123.1±12.8 vs 116±12.8mmHg, p =0.19), AIx (26.9±7.1 vs 24.2±9.2%, p=0.41) and FMD (6.3±2.5 vs 5.3±1.9%, p=0.32). Total mass (87.8±19.5 vs 80.6±10.8kg, p=0.23), lean mass (57.6±9.1 vs 57.1±5.1kg, p=0.86) and body fat percentage (29.7±7.3 vs 25.4±8.7%, p=0.19) was also similar between groups.

Conclusion: Preliminary evidence suggests PC patients have a distinctively lower VO2peak and elevated LV mass, compared to CON. While other markers did not reach statistical significance, men with PC tended to demonstrate greater levels of impairment than CON. These findings suggest men with PC have an increased risk of CVD independent of treatment.