title: Radiation-induced valvular heart disease.
abstract: Radiation to the mediastinum is a key component of treatment with curative intent for a range of cancers including Hodgkin's lymphoma and breast cancer. Exposure to radiation is associated with a risk of radiation-induced heart valve damage characterised by valve fibrosis and calcification. There is a latent interval of 10-20 years between radiation exposure and development of clinically significant heart valve disease. Risk is related to radiation dose received, interval from exposure and use of concomitant chemotherapy. Long-term outlook and the risk of valve surgery are related to the effects of radiation on mediastinal structures including pulmonary fibrosis and pericardial constriction. Dose prediction models to predict the risk of heart valve disease in the future and newer radiation techniques to reduce the radiation dose to the heart are being developed. Surveillance strategies for this cohort of cancer survivors at risk of developing significant heart valve complications are required.
authors.affiliation: Department of Clinical Oncology, Imperial College Healthcare NHS Trust, London, UK.
authors.forename: Dorothy M
authors.initials: DM
authors.lastname: Gujral
authors.affiliation: Echocardiography Laboratory, Bart's Heart Centre, St Bartholomew's Hospital, London, UK Valvular Heart Disease Clinic, Bart's Heart Centre, St Bartholomew's Hospital, London, UK.
authors.forename: Guy
authors.initials: G
authors.lastname: Lloyd
authors.affiliation: Echocardiography Laboratory, Bart's Heart Centre, St Bartholomew's Hospital, London, UK Valvular Heart Disease Clinic, Bart's Heart Centre, St Bartholomew's Hospital, London, UK.
authors.forename: Sanjeev
authors.initials: S
authors.lastname: Bhattacharyya
mesh_terms: D000293:Adolescent; D000328:Adult; D019560:Echocardiography, Three-Dimensional; D017548:Echocardiography, Transesophageal; D005260:Female; D006349:Heart Valve Diseases / Q000000981:diagnostic imaging / Q000453:epidemiology* / Q000503:physiopathology / Q000601:surgery; D019918:Heart Valve Prosthesis Implantation; D006351:Heart Valves / Q000000981:diagnostic imaging / Q000503:physiopathology / Q000528:radiation effects* / Q000601:surgery; D006801:Humans; D008297:Male; D008875:Middle Aged; D015995:Prevalence; D011379:Prognosis; D011829:Radiation Dosage; D000069079:Radiation Exposure / Q000009:adverse effects / Q000517:prevention & control; D011832:Radiation Injuries / Q000000981:diagnostic imaging / Q000453:epidemiology* / Q000503:physiopathology / Q000601:surgery; D011878:Radiotherapy / Q000009:adverse effects*; D018570:Risk Assessment; D012307:Risk Factors; D013997:Time Factors; D055815:Young Adult