Evidence map›Paper›PMID 36999538›Full record

ArticleJournal of cachexia, sarcopenia and muscle2023

Cardiac wasting in head and neck cancer and in cardiac autopsies from different cancer types: A study in a chemo-naïve setting.

Sara Calamelli, Samantha Noto, Alessandra Baldoni, Alessandra Casarin, Alessandro Calzavara, Irene Bolgan, Silvia Coccato, Salvatore Saccà, Licia Laurino, Giuseppe Azzarello and 1 more

Open access · goldAbstract read
In one paragraph

Article in Journal of cachexia, sarcopenia and muscle, 2023. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 1 paper.

0numbers the graph read from it
0cells of the map it votes in
1citing papers in PubMed
1.1field-weighted citation impact, top 21% of its field
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

1 citing paper in PubMed, 5 citations in OpenAlex.

  1. Article
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

11 authors at 4 institutions in 1 country.

Sara CalamelliDepartment of Cardiology, Local Health Unit 3 Serenissima, Mirano, Venice, Italy.
Samantha NotoDepartment of Pathology, Local Health Unit 3 Serenissima, Mestre, Venice, Italy.
Alessandra BaldoniDepartment of Oncology, Local Health Unit 3 Serenissima, Mirano, Venice, Italy.
Alessandra CasarinDepartment of Oncology, Local Health Unit 3 Serenissima, Mirano, Venice, Italy.
Alessandro CalzavaraDepartment of Information Systems, Local Health Unit 3 Serenissima, Dolo, Venice, Italy.
Irene BolganDepartment of Information Systems, Local Health Unit 3 Serenissima, Dolo, Venice, Italy.
Silvia CoccatoDepartment of Oncology, Local Health Unit 3 Serenissima, Mirano, Venice, Italy.
Salvatore SaccàDepartment of Cardiology, Local Health Unit 3 Serenissima, Mirano, Venice, Italy.
Licia LaurinoDepartment of Pathology, Local Health Unit 3 Serenissima, Mestre, Venice, Italy.
Giuseppe AzzarelloDepartment of Oncology, Local Health Unit 3 Serenissima, Mirano, Venice, Italy.
Simonetta AusoniDepartment of Biomedical Science, University of Padova, Padova, Italy.ORCID 0000-0001-5157-9364
Ospedale di Mirano · ITCa' Foscari University of Venice · ITOspedale dell' Angelo · ITUniversity of Padua · IT

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

backgroundCardiac wasting is a detrimental consequence of cancer that has been traditionally ignored and often misinterpreted as an iatrogenic effect.

methodsWe conducted a retrospective study on 42 chemo-naive patients affected by locally advanced head and neck cancer (HNC). Based on unintentional weight loss, patients were divided into cachectic and non-cachectic. Left ventricular mass (LVM), LV wall thickness (LVWT), interventricular septal (IVS) thickness, left ventricular internal diameter diastolic (LVIDd), left ventricular internal diameter systolic (LVIDs), internal ventricular septum diastolic (IVSd), left ventricular posterior wall thickness diastolic (LVPWd) and LV ejection fraction (LVEF) were analysed by echocardiography. In parallel, we retrospectively analysed 28 cardiac autoptic specimens of patients who either died of cancer before chemotherapy or with a diagnosis of cancer at autopsy. Presence or absence of myocardial fibrosis at microscopic observation was used for sample stratification. Conventional histology was performed.

resultsCachectic and non-cachectic patients had a significantly different value of LVWT and IVS thickness and LVPWd. LVWT was 9.08 ± 1.57 versus 10.35 ± 1.41 mm (P = 0.011) in cachectic and non-cachectic patients, IVS was 10.00 mm (8.50-11.00) versus 11.00 mm (10.00-12.00) (P = 0.035), and LVPWd was 9.0 (8.5-10.0) and 10.00 mm (9.5-11.0) (P = 0.019) in cachectic and non-cachectic patients. LVM adjusted for body surface area or height squared did not differ between the two populations. Similarly, LVEF did not show any significant decline. At multivariate logistic regression analysis for some independent predictors of weight loss, only LVWT maintained significant difference between cachectic and non-cachectic patients (P = 0.035, OR = 0.240; P = 0.019). The secondary analysis on autoptic specimens showed no significant change in heart weight, whereas LVWT declined from 9.50 (7.25-11.00) to 7.50 mm (6.00-9.00) in cardiac specimens with myocardial fibrosis (P = 0.043). These data were confirmed in multivariate logistic regression analysis (P = 0.041, OR = 0.502). Histopathological analysis confirmed severe atrophy of cardiomyocytes, fibrosis and oedema as compared with controls.

conclusionsSubtle changes in heart structure and function occur early in HNC patients. These can be detected with routine echocardiography and may help to select appropriate cancer treatment regimens for these patients. Histopathological analysis provided conclusive evidence that atrophy of cardiomyocytes, oedema and fibrosis occur during cancer progression and may precede the onset of overt cardiac pathology. To our knowledge, this is the first clinical study that establishes a direct relationship between tumour progression and cardiac remodelling in HNCs and the first pathological study conducted on human cardiac autopsies from selected chemo-naïve cancer patients.

Indexed as

Head and Neck NeoplasmsAtrophyAutopsyCachexiaFibrosisHumansRetrospective StudiesAutoptic analysisCardiac wastingChemo-naive patientsHead and neck cancerLeft ventricular wall thickness

Identifiers

PMID36999538
PMCPMC10235872
OpenAlexW4362458041

What OpenQuestion holds

Textmetadata
LicenceCC BY-NC-ND
Read underepoch 390

Registered trials

None linked

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.