Reply: Comment on ‘Chemotherapy for testicular cancer induces acute alterations in diastolic heart function'

Sir,

We thank you for the response and valuable comments (Dieckmann, 2014). We appreciate your contribution by pointing out that, besides experimental data (Nuver et al, 2010), there is growing clinical evidence of acute cardiovascular toxicity of chemotherapy in TC patients, which is most likely based on vascular wall damage. Previous studies have suggested not only chronic atherosclerotic effects of chemotherapy for TC, but also more acute effects of thrombo-embolic origin (Dieckmann et al, 2010). The increased von Willebrand factor found in patients directly after chemotherapy contributes to the idea of acute vascular toxicity of chemotherapy (Dieckmann et al, 2011). It is indeed important for clinicians treating patients with TC, to appreciate the acute as well as the more chronic vascular effects of cisplatin-based chemotherapy.