{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,22]],"date-time":"2026-10-22T04:09:37Z","timestamp":1792642177553,"version":"4.5.0"},"reference-count":27,"publisher":"Ovid Technologies (Wolters Kluwer Health)","issue":"5","content-domain":{"domain":["www.ahajournals.org"],"crossmark-restriction":true},"short-container-title":["JAHA"],"published-print":{"date-parts":[[2021,3,2]]},"abstract":"<jats:sec xml:lang=\"en\">\n            <jats:title>Background<\/jats:title>\n            <jats:p xml:lang=\"en\">Vascular alterations induced by antineoplastic treatment might be considered as a possible underlying mechanism of increased cardiovascular sequelae in childhood cancer survivors (CCSs). We aimed to evaluate arterial stiffness among long\u2010term CCSs and to compare the data against a population\u2010based sample.<\/jats:p>\n          <\/jats:sec>\n          <jats:sec xml:lang=\"en\">\n            <jats:title>Methods and Results<\/jats:title>\n            <jats:p xml:lang=\"en\">Arterial stiffness was assessed by digital photoplethysmography (stiffness index; m\/s) among 1002 participants of the CVSS (Cardiac and Vascular Late Sequelae in Long\u2010Term Survivors of Childhood Cancer) study, diagnosed with neoplasia (1980\u20131990) before an age of 15\u00a0years. A population\u2010based sample from the GHS (Gutenberg Health Study) (n=5252) was investigated for comparison. All subjects underwent a comprehensive, standardized clinical examination in the same study center. CCSs had higher stiffness index (\u03b2=0.66\u00a0m\/s; 95% CI, 0.51\u20130.80 m\/s) in multivariable linear regression analysis after adjustment for cardiovascular risk factors compared with the population sample of comparable age range. Stiffer vessels were found among CCSs also in absence of arterial hypertension (\u03b2=0.66; 95% CI, 0.50\u20130.81) or history of chemotherapy\/radiotherapy (\u03b2=0.56; 95% CI, 0.16\u20130.96) in fully adjusted models. Moreover, stiffness index differed by tumor entity, with highest values in bone and renal tumors. Almost 5.2\u2010fold higher prevalence of stiffness index values exceeding age\u2010specific, population\u2010based reference limits was observed among CCSs compared with GHS participants.<\/jats:p>\n          <\/jats:sec>\n          <jats:sec xml:lang=\"en\">\n            <jats:title>Conclusions<\/jats:title>\n            <jats:p xml:lang=\"en\">This is the first study demonstrating increased arterial stiffness among long\u2010term CCSs. The data suggest that vascular compliance might differ in survivors of childhood cancer from the established development concept for arterial stiffness in the population; cancer growth and antineoplastic treatment might be relevant determinants of the pathobiological features.<\/jats:p>\n          <\/jats:sec>\n          <jats:sec xml:lang=\"en\">\n            <jats:title>Registration<\/jats:title>\n            <jats:p xml:lang=\"en\">\n              URL:\n              <jats:ext-link xmlns:xlink=\"http:\/\/www.w3.org\/1999\/xlink\" ext-link-type=\"uri\" xlink:href=\"https:\/\/www.clinicaltrials.gov\">https:\/\/www.clinicaltrials.gov<\/jats:ext-link>\n              ; Unique identifier: NCT02181049.\n            <\/jats:p>\n          <\/jats:sec>","DOI":"10.1161\/jaha.119.015609","type":"journal-article","created":{"date-parts":[[2021,2,24]],"date-time":"2021-02-24T10:14:35Z","timestamp":1614161675000},"update-policy":"https:\/\/doi.org\/10.1161\/crossmarkpolicy","source":"Crossref","is-referenced-by-count":12,"title":["Promotion of Arterial Stiffness by Childhood Cancer and Its Characteristics in Adult Long\u2010Term Survivors"],"prefix":"10.1161","volume":"10","author":[{"given":"Natalie","family":"Arnold","sequence":"first","affiliation":[{"name":"Preventive Cardiology and Preventive Medicine Centre for Cardiology University Medical Centre of the Johannes Gutenberg\u2013University Mainz Mainz Germany"},{"name":"German Centre for Cardiovascular Research Partner Site Rhine\u2010Main Mainz Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Hiltrud","family":"Merzenich","sequence":"additional","affiliation":[{"name":"Institute for Medical Biostatistics, Epidemiology and Informatics University 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Gutenberg\u2013University Mainz Mainz Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Susan","family":"Eckerle","sequence":"additional","affiliation":[{"name":"Department of Pediatric Hematology\/Oncology\/Hemostaseology Centre for Pediatric and Adolescent Medicine University Medical Centre of the Johannes\u2013Gutenberg University Mainz Mainz Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Claudia","family":"Spix","sequence":"additional","affiliation":[{"name":"Institute for Medical Biostatistics, Epidemiology and Informatics University Medical Centre of the Johannes Gutenberg\u2013University Mainz Mainz Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-8743-6752","authenticated-orcid":false,"given":"Irene","family":"Schmidtmann","sequence":"additional","affiliation":[{"name":"German Childhood Cancer Registry Institute for Medical Biostatistics, Epidemiology and Informatics 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