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Development and validation of a simple risk score to predict 30-day readmission after percutaneous coronary intervention in a cohort of medicare patients Predicting Major Adverse Events in Patients With Acute Myocardial Infarction Dynamic Myocardial Ultrasound Localization Angiography Association Between Living in Food Deserts and Cardiovascular Risk Dynamic atrioventricular delay programming improves ventricular electrical synchronization as evaluated by 3D vectorcardiography Heart Failure With Preserved, Borderline, and Reduced Ejection Fraction: 5-Year Outcomes A VOYAGER Meta-Analysis of the Impact of Statin Therapy on Low-Density Lipoprotein Cholesterol and Triglyceride Levels in Patients With Hypertriglyceridemia Post-Stroke Cardiovascular Complications and Neurogenic Cardiac Injury: JACC State-of-the-Art Review Impact of Optimal Medical Therapy on 10-Year Mortality After Coronary Revascularization Universal Definition of Myocardial Infarction

Review Article2018 Jun 12. [Epub ahead of print]

JOURNAL:Curr Probl Cancer. Article Link

Cardiovascular effects of radiation therapy

Armanious MA, Mohammadi H, Khodor S et al. Keywords: Atherosclerosis; Autonomic dysfunction; Carotid artery stenosis; Radiation therapy

ABSTRACT


Radiation therapy (RT) plays a prominent role in the treatment of many cancers. With increasing use of RT and high overall survival rates, the risks associated with RT must be carefully considered. Of these risks, the cardiovascular and autonomic toxicities have been of significant concern. In fact, cardiovascular disease is the leading cause of nonmalignancy-related death in cancer survivors. The manifestations of radiation induced cardiac injury include the acute toxicities of myopericarditis and late toxicities including constrictive pericarditis, restrictive cardiomyopathy, coronary artery disease, valvular heart disease, heart failure, and conduction abnormalities. Neck and cranial RT have also been associated with significant long-term toxicities including accelerated occlusive carotid artery disease, autonomic dysfunction due to baroreceptor damage, and development of metabolic syndromes due to damage to the hypothalamic-pituitary axis. The clinical manifestations of radiation induced disease may not present until several years following the delivery of radiation. We review the adverse effects of RT on these organ systems and discuss risk reduction strategies that may effectively mitigate some of these adverse outcomes.