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Sixteen women (age: 47.0\u2009\u00b1\u20092.0 yr; body mass index: 24.2\u2009\u00b1\u20091.5 kg\/m) with stage II-III breast cancer and indication for adjuvant CHT underwent two experimental sessions, saline (SL) and CHT. In the CHT session, DX (60 mg\/m<jats:sup>2<\/jats:sup>) and CY (600 mg\/m<jats:sup>2<\/jats:sup>) were administered over 45 min. In the SL session, a matching SL volume was infused in 45 min. Muscle sympathetic nerve activity (MSNA) from peroneal nerve (microneurography), calf blood flow (CBF; plethysmography) and calf vascular conductance (CVC), heart rate (HR; electrocardiography), and beat-to-beat blood pressure (BP; finger plethysmography) were measured at rest before, during, and after each session. Venous blood samples (5 ml) were collected before and after both sessions for assessment of circulating endothelial microparticles (EMPs; flow cytometry), a surrogate marker for endothelial damage. MSNA and BP responses were increased ( P &lt; 0.001), whereas CBF and CVC responses were decreased ( P &lt; 0.001), during and after CHT session when compared with SL session. Interestingly, the vascular alterations were also observed at the molecular level through an increased EMP response to CHT ( P = 0.03, CHT vs. SL session). No difference in HR response was observed ( P &gt; 0.05). Adjuvant CHT with DX and CY in patients treated for breast cancer increases sympathetic nerve activity and circulating EMP levels and, in addition, reduces muscle vascular conductance and elevates systemic BP. These responses may be early signs of CHT-induced cardiovascular alterations and may represent potential targets for preventive interventions. <\/jats:p><jats:p> NEW &amp; NOTEWORTHY It is known that chemotherapy regimens increase the risk of cardiovascular events in patients treated for cancer. Here, we identified that a single cycle of adjuvant chemotherapy with doxorubicin and cyclophosphamide in women treated for breast cancer dramatically increases sympathetic nerve activity and circulating endothelial microparticle levels, reduces the muscle vascular conductance, and elevates systemic blood pressure. <\/jats:p>","DOI":"10.1152\/ajpheart.00756.2018","type":"journal-article","created":{"date-parts":[[2019,4,19]],"date-time":"2019-04-19T10:26:16Z","timestamp":1555669576000},"page":"H1-H12","source":"Crossref","is-referenced-by-count":20,"title":["Chemotherapy acutely impairs neurovascular and hemodynamic responses in women with breast cancer"],"prefix":"10.1152","volume":"317","author":[{"given":"Allan Robson Kluser","family":"Sales","sequence":"first","affiliation":[{"name":"Heart Institute (InCor), University of S\u00e3o Paulo Medical School, S\u00e3o Paulo, Brazil"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Marcelo Vailati","family":"Negr\u00e3o","sequence":"additional","affiliation":[{"name":"Cancer Institute of the State of S\u00e3o Paulo, University of S\u00e3o Paulo Medical School, S\u00e3o Paulo, Brazil"},{"name":"Department of Thoracic\/Head and Neck Medical Oncology, The University of Texas, MD Anderson Cancer Center, Houston, Texas"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Laura","family":"Testa","sequence":"additional","affiliation":[{"name":"Cancer Institute of the State of S\u00e3o Paulo, University of S\u00e3o Paulo Medical School, S\u00e3o Paulo, Brazil"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Larissa","family":"Ferreira-Santos","sequence":"additional","affiliation":[{"name":"Heart Institute (InCor), University of S\u00e3o Paulo Medical School, S\u00e3o Paulo, Brazil"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Raphaela Villar Ramalho","family":"Groehs","sequence":"additional","affiliation":[{"name":"Heart Institute (InCor), University of S\u00e3o Paulo Medical School, S\u00e3o Paulo, Brazil"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Bruna","family":"Carvalho","sequence":"additional","affiliation":[{"name":"Heart Institute (InCor), University of S\u00e3o Paulo Medical School, S\u00e3o Paulo, Brazil"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-5226-2956","authenticated-orcid":false,"given":"Edgar","family":"Toschi-Dias","sequence":"additional","affiliation":[{"name":"Heart Institute (InCor), University of S\u00e3o Paulo Medical School, S\u00e3o Paulo, Brazil"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Natalia Galito","family":"Rocha","sequence":"additional","affiliation":[{"name":"Department of Physiology and Pharmacology, Fluminense Federal University, Niteroi, Brazil"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Francisco Rafael Martins","family":"Laurindo","sequence":"additional","affiliation":[{"name":"Heart Institute (InCor), University of S\u00e3o Paulo Medical School, S\u00e3o Paulo, Brazil"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Victor","family":"Debbas","sequence":"additional","affiliation":[{"name":"Heart Institute (InCor), University of S\u00e3o Paulo Medical School, S\u00e3o Paulo, Brazil"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Maria Urbana P. 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