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From Detecting the Vulnerable Plaque to Managing the Vulnerable Patient Incidence, predictors, and outcomes associated with acute kidney injury in patients undergoing transcatheter aortic valve replacement: from the BRAVO-3 randomized trial Simple Electrocardiographic Measures Improve Sudden Arrhythmic Death Prediction in Coronary Disease Intravascular Ultrasound and Angioscopy Assessment of Coronary Plaque Components in Chronic Totally Occluded Lesions Coronary Access After TAVR Incidence and Outcomes of Surgical Bailout During TAVR : Insights From the STS/ACC TVT Registry Increased Risk of Valvular Heart Disease in Systemic Sclerosis: An Underrecognized Cardiac Complication Novel predictors of late lumen enlargement in distal reference segments after successful recanalization of coronary chronic total occlusion Impaired Retinal Microvascular Function Predicts Long-Term Adverse Events in Patients with Cardiovascular Disease Clinical Impact of Valvular Heart Disease in Elderly Patients Admitted for Acute Coronary Syndrome: Insights From the Elderly-ACS 2 Study

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.