title: Long-term effects of neck irradiation on cardiovascular autonomic function: a study in nasopharyngeal carcinoma patients after radiotherapy.
abstract: BACKGROUND
  Baroreflex failure has been reported as a late sequalum of neck radiotherapy. In this study we investigated cardiovascular autonomic function in patients after neck radiotherapy to determine predictive factors associated with outcome.
  
  
  METHODS
  Eighty-nine patients with nasopharyngeal carcinoma were evaluated ≥6 months after radiotherapy for cardiovascular autonomic function and compared with 48 control subjects. Inflammatory markers and carotid intima-media thickness were also assessed.
  
  
  RESULTS
  Autonomic parameters of heart rate response to deep breathing and Valsalva ratio were significantly lower in the patient group. Cardiovascular autonomic impairment was generally mild with relative sparing of the efferent cardiovagal pathway. By univariate and multivariate analyses, the time after radiotherapy and C-reactive protein level were significantly associated with the degree of cardiovascular autonomic dysfunction.
  
  
  CONCLUSIONS
  Radiation-induced cardiovascular autonomic impairment is a dynamic and progressive process that occurs long after radiotherapy. Chronic inflammation plays a major role in this process.
authors: Department of Neurology, Kaohsiung Chang Gung Memorial Hospital, Chang Gung University College of Medicine, 123 Ta Pei Road, Niao Sung District, Kaohsiung, Taiwan.
authors: Chih-Cheng
authors: CC
authors: Huang
authors: Tai-Lin
authors: TL
authors: Huang
authors: Hsuan-Chih
authors: HC
authors: Hsu
authors: Hui-Chun
authors: HC
authors: Chen
authors: Hsin-Ching
authors: HC
authors: Lin
authors: Chih-Yen
authors: CY
authors: Chien
authors: Fu-Min
authors: FM
authors: Fang
authors: Hsueh-Wen
authors: HW
authors: Chang
authors: Nai-Wen
authors: NW
authors: Tsai
authors: Wen-Neng
authors: WN
authors: Chang
authors: Shu-Fang
authors: SF
authors: Chen
authors: Tzu-Kong
authors: TK
authors: Lin
authors: Teng-Yeow
authors: TY
authors: Tan
authors: Chuang-Rung
authors: CR
authors: Chang
authors: Hung-Chen
authors: HC
authors: Wang
authors: Wei-Che
authors: WC
authors: Lin
authors: Cheng-Hsien
authors: CH
authors: Lu
mesh_terms: D001341:Autonomic Nervous System / Q000528:radiation effects*; D017704:Baroreflex / Q000502:physiology; D002097:C-Reactive Protein / Q000378:metabolism; D002277:Carcinoma; D002320:Cardiovascular Physiological Phenomena / Q000528:radiation effects*; D059168:Carotid Intima-Media Thickness; D015331:Cohort Studies; D003430:Cross-Sectional Studies; D005260:Female; D006339:Heart Rate / Q000502:physiology; D006439:Hemodynamics / Q000502:physiology / Q000528:radiation effects; D006801:Humans; D008297:Male; D008875:Middle Aged; D015999:Multivariate Analysis; D000077274:Nasopharyngeal Carcinoma; D009303:Nasopharyngeal Neoplasms / Q000503:physiopathology* / Q000532:radiotherapy*; D009333:Neck / Q000528:radiation effects*; D011237:Predictive Value of Tests; D013564:Sympathetic Nervous System / Q000502:physiology / Q000528:radiation effects; D016896:Treatment Outcome; D014636:Valsalva Maneuver
chemical_list: D002097:C-Reactive Protein