Cardiovascular reflexes in patients with malignant disease

Martín, R.; Delgado, Juanpablo; Moltò, J. M.; Vicent, J. M.; Manzanares, Rafael; Insa, R; Matías-Guiu, J

doi:10.1007/bf02226960

Cited by 24 publications

(22 citation statements)

References 7 publications

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“…Gould et al did not report specific scores, but only compared means obtained in patients and in controls, so that no dysfunction scores are available from their study [11]. Bruera [5] and Martin [16] obtained slightly lower overall abnormality rates than we found in our study (52%, 50% versus 63%). Neither study calculated a dysfunction score, but both used the same tests as ours.…”

Section: Discussioncontrasting

confidence: 79%

“…Multiple conditions may impair its function (Table 1); most are found in primary neurologic disorders, diabetes mellitus, or chronic renal disease. There have been reports of autonomic dysfunction in cancer patients patients [1,2,4,5,6,7,8,11,12,13,15,16,17,19,20,22,23,24,25,26,27,28] (Table 2), but most are case reports. Our clinical experience suggests that this abnormality may be common in advanced cancer, where a fixed pulse rate, low blood pressure and symptoms of gastroparesis are common.…”

Section: Introductionmentioning

confidence: 94%

“…Two studies have evaluated patients with advanced cancer using the five cardiovascular tests used in our study. In one the subjects had breast cancer [16], and in the other a mixed group of patients with cancer and lymphoma was investigated [5]. However, the results were only reported as normal or abnormal; they were not scored or given a composite (dysfunction) score.…”

Section: Introductionmentioning

confidence: 99%

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Autonomic nervous system dysfunction in advanced cancer

Walsh

Nelson

2002

Support Care Cancer

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The autonomic nervous system (ANS) innervates every organ in the body and is largely involuntary. There have been reports of autonomic dysfunction in cancer patients, but most are case reports. There are suggestions that this abnormality may be common in advanced cancer. Inpatients and outpatients with advanced cancer were enrolled. Patients were excluded if they had a previous diagnosis of a disease associated with autonomic nervous system (ANS) abnormalities, or had taken or were taking drugs affecting the ANS. Autonomic function was evaluated using five bedside cardiovascular tests: (1) heart rate response to deep breathing, (2) heart rate response to standing, (3) heart rate response to the Valsalva maneuver, (4) blood pressure response to standing and (5) blood pressure response to static exercise. Each test result was scored according to a validated scale of 0,.5, or 1. The individual scores were added together and each patient received a dysfunction score: none (=0-1), mild (=1.5-2), moderate (=2.5-3) or severe (=3.5-5).Twenty-eight men and 22 women participated, median age was 64 years. The median ECOG performance status was 2. Lung and prostate cancer were the most common (N=9, 5). 245 tests were performed; 86 (35%) individual tests were normal or borderline. Composite dysfunction scores were calculated; all the participants had a score consistent with abnormality. The median number of symptoms was 6 (range 1-15). Twenty-eight rated at least one symptom as severe (median 2, range 0-5), but symptoms did not correlate with test abnormalities. The results reveal significant ANS dysfunction in advanced cancer. There are more invasive tests that may give more accurate descriptions of ANS abnormalities in this population. These tests may help define the lesion better than these simple bedside tests. Further research with sophisticated ANS testing is needed to clearly define this paraneoplastic syndrome.

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Section: Discussioncontrasting

confidence: 79%

Section: Introductionmentioning

confidence: 94%

Section: Introductionmentioning

confidence: 99%

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Autonomic nervous system dysfunction in advanced cancer

Walsh

Nelson

2002

Support Care Cancer

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“…There have been reports of increased rates of AF in patients with malignancies such as colorectal cancer. One hypothesis for Heart, Lung and Circulation Cardiac surgery and malignancy 2012;21:255-259 the finding of increased rates in AF in our population is that patients with malignancies have autonomic dysfunction [10,11], which in turn is related to increased rates of arrhythmia [12][13][14].…”

Section: Discussionmentioning

confidence: 96%

Cardiac Surgery in Patients with a History of Malignancy: Increased Complication Rate but Similar Mortality

Chan

Rosenfeldt

Chaudhuri

et al. 2012

Heart, Lung and Circulation

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“…Nevertheless some others hypothesis than the inflammatory one could be taken into account to explain the association between AF and cancer. In cancer, autonomic nervous system alterations are described and these alterations predispose to the development and the maintenance of AF [5,20]. Cancer is also associated with a hypercoagulable state with an increased thromboembolic risk [21] and this association could give reason to pulmonary micro-embolism as a factor predisposing AF.…”

Section: Discussionmentioning

confidence: 98%

First diagnosis of colorectal or breast cancer and prevalence of atrial fibrillation

et al. 2008

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Aim of the present study was to assess the prevalence of atrial fibrillation (AF) in patients with two different types of cancer. Recent epidemiologic and clinical studies support the hypothesis that AF is promoted and maintained by a broad spectrum of modulating factors. A total of 2,339 patients admitted to the Surgery Department of "Luigi Sacco Hospital, Milan," over the period 1987-2004 were eligible for the study. One thousand three hundred and seventeen patients were admitted consecutively with a first diagnosis of colorectal or breast cancer (cases). The remaining 1,022 were patients admitted to undergo non-neoplastic surgery (controls). Routine pre-surgery electrocardiogram available in patient charts was analysed by a cardiologist who was not aware of the present study to evaluate the presence of atrial fibrillation or other arrhythmias. Overall, AF was present in 3.6% cases and 1.6% controls. This corresponded to at least two times higher likelihood of having AF in cases compared to controls. Prevalence of AF increased with age both in cases and controls. Our study describes an increased prevalence of AF in two different types of cancer. Autonomic, endocrine, coagulation, and inflammatory alterations were previously described in both AF and cancer, and can provide the physiopathological basis to our clinical observation.

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Cardiovascular reflexes in patients with malignant disease

Cited by 24 publications

References 7 publications

Autonomic nervous system dysfunction in advanced cancer

Autonomic nervous system dysfunction in advanced cancer

Cardiac Surgery in Patients with a History of Malignancy: Increased Complication Rate but Similar Mortality

First diagnosis of colorectal or breast cancer and prevalence of atrial fibrillation

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