Radiation-Induced Cardiovascular Disease.
OBJECTIVE
Thoracic radiation therapy is an effective treatment for several malignancies, such as Hodgkin's lymphoma and breast cancer. Over the years, however, the incidence of cardiovascular events has increased in these patients, notably in younger survivors who do not have traditional risk factors. This review summarizes the pathology, incidence, clinical presentation, and management of cardiac events after radiation therapy.


RESULTS
Mediastinal radiation therapy accelerates the atherosclerosis process, resulting in early onset coronary artery disease. Valvular disease due to radiation therapy typically affects the left-sided valves, with aortic regurgitation being the most common. Rarely, it may lead to aortic stenosis requiring surgical interventions. Pericardial involvement includes acute and chronic pericardial disease and pericardial effusion. New studies are investigating the prevalence and pathogenesis of autonomic dysfunction in cancer survivors who have undergone mediastinal and neck radiation. Radiation therapy itself causes vascular endothelial dysfunction, resulting in clinical cardiovascular events, manifesting many years after completion of therapy. There remains little guidance regarding screening and therapies to prevent cardiovascular events in this population.
University of Texas MD Anderson Cancer Center, Houston, TX, 77030, USA.
Deepa
D
Raghunathan
Heart of England Foundation Trust, Birmingham, UK.
Misha Iftikhar
MI
Khilji
University of Texas MD Anderson Cancer Center, Houston, TX, 77030, USA.
Saamir A
SA
Hassan
University of Texas MD Anderson Cancer Center, Houston, TX, 77030, USA. syusuf@mdanderson.org.
Syed Wamique
SW
Yusuf
D066126:Cardiotoxicity / Q000175:diagnosis / Q000209:etiology* / Q000628:therapy; D002318:Cardiovascular Diseases / Q000175:diagnosis / Q000209:etiology* / Q000628:therapy; D006801:Humans; D011878:Radiotherapy / Q000009:adverse effects*; D016896:Treatment Outcome
Cardiovascular disease; Radiation