Abstract 4968: Cardiovascular disparities amongst pancreatic ductal adenocarcinoma patients
Authors: Arunima Punjala, Vignesh Vudatha, Vashti Bandy, Maria Gergoudis, Leopoldo Fernandez, Wendy Bottinor, Jose Trevino
Journal: Cancer Research (2025)

Abstract Introduction: Pancreatic ductal adenocarcinoma (PDAC) is a lethal malignancy associated with skeletal muscle cachexia which results in chemotherapy intolerance, nutritional deficiencies, physical debilitation, and increased mortality. Survival time is significantly lower for those with cardiovascular-associated mortality, and Black patients face a disproportionately higher risk of overall and cardiovascular-associated mortality. Minimal literature exists on the impact of PDAC on cardiovascular function and the implications on disease course. The aim of this study is to utilize cardiac magnetic resonance imaging (CMR) to quantify changes in cardiovascular structure and function that can potentially identify patients with PDAC who are at increased risk for cardiovascular events. Methods: In this prospective observational study, treatment-naïve PDAC patients underwent non-contrasted CMR prior to initiation of therapy and six months after. Left ventricular mass was calculated using short axis cine images at end diastole. The maximal and minimal descending thoracic aortic areas were measured on 4-chamber cinematic sequences. Resting blood pressure was measured during the exam. Aortic distensibility (AD) was calculated using a validated equation and compared with age-appropriate reference values1. Variables were analyzed using a Mann-Whitney U Test with α = 0.1. Results: 22 patients underwent baseline CMR with 32% (7/22) receiving a follow-up scan. In total, 59% (13/22) were female, 41% (9/22) identified as Black, and 46% (10/22) were sarcopenic at baseline. Amongst all participants, 64% (14/22) demonstrated abnormal AD with Black participants demonstrating a significantly higher prevalence compared to White participants (89% vs. 50%, p=.087). Left ventricular mass index (LVMI) of 57 g/m2 or lower is a known predictor of major adverse cardiovascular events amongst cancer patients. All participants had a low LVMI with sarcopenic patients demonstrating lower LVMI relative to non-sarcopenic patients (50.7 g/m2 vs. 54.8 g/m2, p=0.623). There were no significant differences between baseline and follow-up scans. Conclusions: PDAC patients, particularly those who are Black or sarcopenic demonstrate abnormalities in cardiovascular function and structure prior to cancer therapy. These changes are known to be associated with adverse cardiac events and advocates for close cardiac monitoring, particularly in susceptible populations. Further studies are necessary to identify specific risk factors associated with these initial changes and interventions to optimize cardiovascular health. 1. Nethononda RM, Lewandowski AJ, Stewart R, Kylinterias I, Whitworth P, Francis J, Leeson P, Watkins H, Neubauer S, Rider OJ. Gender specific patterns of age-related decline in aortic stiffness: a cardiovascular magnetic resonance study including normal ranges. J Cardiovasc Magn Reson. 2015 Feb 19;17(1):20. Citation Format: Arunima Punjala, Vignesh Vudatha, Vashti Bandy, Maria Gergoudis, Leopoldo Fernandez, Wendy Bottinor, Jose Trevino. Cardiovascular disparities amongst pancreatic ductal adenocarcinoma patients [abstract]. In: Proceedings of the American Association for Cancer Research Annual Meeting 2025; Part 1 (Regular Abstracts); 2025 Apr 25-30; Chicago, IL. Philadelphia (PA): AACR; Cancer Res 2025;85(8_Suppl_1):Abstract nr 4968.