Radyoterapinin Kardiyak Komplikasyonları ve Kalp Damar Cerrahisi Açısından Zorlukları
Özet
Modern kanser tedavilerinde sağ kalım sürelerinin uzaması, radyoterapinin (RT) uzun dönemli kardiyovasküler komplikasyonlarını daha belirgin hale getirmiştir. Radyoterapinin neden olduğu kardiyak hastalıklar (RNKH), primer malignitelerden sonra ikinci en yaygın morbidite ve mortalite nedeni olarak kabul edilmektedir. İyonize radyasyon, perikard, miyokard, koroner arterler, ileti sistemi ve kalp kapaklarında akut veya kronik hasarlara yol açar. Bu patolojilerin temel mekanizmasında, endotel hasarı, pro-fibrotik ve inflamatuar sitokinlerin (özellikle TGF-ß) salınımı ve artan ekstraselüler matriks üretimiyle tetiklenen yaygın fibrozis ile aterosklerotik süreçler yer alır. Klinik tablolar akut perikarditten konstrüktif perikardite, restriktif kardiyomiyopatiden ciddi proksimal koroner arter darlıklarına ve kapak yetmezliklerine kadar geniş bir yelpazede ortaya çıkabilir. Yaş, hipertansiyon ve sigara gibi geleneksel risk faktörleri RNKH gelişimini artırır. Bu komplikasyonlar kalp damar cerrahisi açısından ciddi zorluklar barındırır; mediastinal fibrozis, greft hasarı ve zayıf doku iyileşmesi gibi faktörler cerrahi müdahalelerin mortalite ve morbiditesini yükseltir. Korunmada radyasyon dozunun düşürülmesi, erken tanısal görüntüleme ve risk faktörü modifikasyonu hayati önem taşımaktadır.
Prolonged survival rates in modern cancer therapies have rendered the long-term cardiovascular complications of radiotherapy (RT) more prominent. Radiotherapy-induced heart diseases (RIHD) are considered the second most common cause of morbidity and mortality after primary malignancies. Ionizing radiation causes acute or chronic damage to the pericardium, myocardium, coronary arteries, conduction system, and heart valves. The primary mechanism behind these pathologies involves endothelial damage, release of pro-fibrotic and inflammatory cytokines (especially TGF-ß), and widespread fibrosis alongside atherosclerotic processes triggered by increased extracellular matrix production. Clinical presentations can vary widely, ranging from acute pericarditis to constrictive pericarditis, restrictive cardiomyopathy to severe proximal coronary artery stenoses, and valvular insufficiencies. Traditional risk factors such as age, hypertension, and smoking increase the development of RIHD. These complications pose significant challenges for cardiovascular surgery; factors like mediastinal fibrosis, graft damage, and poor tissue healing elevate the mortality and morbidity of surgical interventions. Reducing the radiation dose, early diagnostic imaging, and risk factor modification are of vital importance for prevention.
Referanslar
American Cancer Society. Cancer treatment and survivorship facts & figures 2014–2015. www.cancer.org.
Specht L, Yahalom J, Ilidge T, et al. Modern radiation therapy for hodgkin lymphoma: field and dose guidelines from the International Lymphoma Radiation Oncology Group (ILROG). International Journal of Radiation Oncology* Biology* Physics. 2014; 89(4), 854–862. doi: 10.1016/j.ijrobp.2013.05.005
Shimizu Y, Kodama K, Nishi N, et al. Radiation exposure and circulatory disease risk: Hiroshima and Nagasaki atomic bomb survivor data,1950-2003. BMJ, 2010; 340:b5349. doi:10.1136/bmj.b5349
Baskar R, Lee KA, Yeo R, et al.Cancer and radiation therapy: current advances and future directions. International journal of medical sciences, 2012; 9:193–199. doi:10.7150/ijms.3635
Brown KN, John RR. Radiation Induced Coronary Artery Disease 2021. https://europepmc.org
Lee PJ, Mallik R. Cardiovascular effects of radiation therapy: practical approach to radiation therapy-induced heart disease. Cardiology in review, 2005; 13:80-86. doi: 10.1097/01.crd.0000131188.41589. c5
Rakıcı SGS, Ural F, Bedir A. Serum troponin i as an early marker in determining radiotherapy-induced cardiac damage. Basic Res. J. Med. Clin. Sci, 2012; 1(3), 51-59.
Darby SC, Mc Gale P, Taylor CW, et al. Long-term mortality from heart disease and lung cancer after radiotherapy for early breast cancer: prospective cohort study of about 300,000 women in US SEER cancer registries. The lancet oncology, 2005; 6:557–565. doi: 10.1016/S1470-2045(05)70251-5
Donnellan E, Phelan D, Mc Carthy CP, et al. Radiation-induced heart disease: A practical guide to diagnosis and management. Cleve Clin J Med., 2016; 83:914-922. doi: 10.3949/ccjm.83a.15104
Schultz-Hector S, Trott KR. Radiation-induced cardiovascular diseases: is the epidemiologic evidence compatible with the radiobiologic data? International Journal of Radiation Oncology* Biology*Physics, 2007; 67(1):10–18. doi:10.1016/j.ijrobp.2006.08.071
Ehrhart EJ, Segarini P, Tsang ML, et al. Latent transforming growth factor beta1 activation in situ: quantitative and functional evidence after low-dose gamma-irradiation. The FASEB Journal, 1997; 11:991–1002. doi:10.1096/fasebj.11.12.9337152
Anscher MS, Marks LB, Shafman TD, et al. Using plasma transforming growth factor beta-1 during radiotherapy to select patients for dose escalation. Journal of clinical oncology, 2001; 19:3758–3765. doi:10.1200/JCO.2001.19.17.3758
Boerma M, Hauer-Jensen M. Preclinical research into basic mechanisms of radiation-induced heart disease. Cardiol Res Pract., 2011; 858262. doi:10.4061/2011/858262
Stewart JR, Fajardo LF. Radiation-induced heart disease: an update. Progress in cardiovascular diseases, 1984; 27(3):173–194. doi:10.1016/0033-0620(84)90003-3
Rodemann HP, Binder A, Bamberg M. Radiation-induced fibrosis: experimental studies. Late Sequelae in Oncology 1995; 93-97, Berlin: Springer.
Virmani R, Farb A, Carter AJ, et al. Pathology of radiation-induced coronary artery disease in human and pig. Cardiovascular radiation medicine, 1999; 1:98–101. doi:10.1016/S1522-1865(98)00010-9
Veinot JP, Edwards WD. Pathology of radiation-induced heart disease: a surgical and autopsy study of 27 cases. Human pathology, 1996; 27(8), 766–773. doi: 10.1016/s0046-8177(96)90447-5
Brosius FC, Waller BF, Roberts WC. Radiation heart disease. Analysis of 16 young (aged 15 to 33 years) necropsy patients who received over 3,500 Rads to the heart. The American journal of medicine, 1981; 70(3), 519–530. doi: 10.1016/0002-9343(81)90574-x
Mousavi N, Nohria A. Radiation-induced cardiovascular disease. Current treatment options in cardiovascular medicine, 2013; 15(5):507–517. doi:10.1007/s11936-013-0259-0.
Walker CM, Saldana DA, Gladish GW, et al. Cardiac complications of oncologic therapy. Radiographics., 2013; 33:1801-1815. doi: 10.1148/rg.336125005
Rehammar JC, Jensen MB, McGale P, et al. Risk of heart disease in relation to radiotherapy and chemotherapy with anthracyclines among 19,464 breast cancer patients in Denmark, 1977-2005. Radiotherapy and Oncology, 2017; 123(2):299-305. doi: 10.1016/j.radonc.2017.03.012
Nathan PC, Amir E, Abdel-Qadir H. Cardiac outcomes in survivors of pediatric and adult cancers. Canadian Journal of Cardiology, 2016; 32(7):871–880. doi:10.1016/j.cjca.2016.02.065.
Taunk NK, Haffty BG, Kostis JB, et al. Radiation-induced heart disease: pathologic abnormalities and putative mechanisms. Frontiers in oncology, 2015; 5:39. doi:10.3389/fonc.2015.00039.
Kouchoukos NT, Blackstone EU, Hanley FL, Kirklin JK. (2013). Kirklin/Barratt-Boyes Cardiac Surgery (Fourth Edit). Philadelphia: Elsevier
Ling LH, Oh JK, Schaff HV, et al. Constrictive pericarditis in the modern era: evolving clinical spectrum and impact on outcome after pericardiectomy. Circulation, 1999; 100(13), 1380–1386. doi: 10.1161/01.cir.100.13.1380
Chello M, Mastroroberto P, Romano R, et al. Changes in the proportion of types I and III collagen in the left ventricular wall of patients with post-irradiative pericarditis. Cardiovascular surgery, 1996;4(2):222–226. doi:10.1016/0967-2109(96)82320-9
Heidenreich PA, Hancock SL, Lee BK, et al. Asymptomatic cardiac disease following mediastinal irradiation. Journal of the American College of Cardiology, 2003; 42: 743-749. doi: 10.1016/s0735-1097(03)00759-9
Marks LB, Yu X, Prosnitz RG, et al. The incidence and functional consequences of RT-associated cardiac perfusion defects. International Journal of Radiation Oncology* Biology* Physics, 2005; 63(1):214–223. doi:10.1016/j.ijrobp. 2005.01.029
Madan R, Benson R, Sharma DN, et al. Radiation induced heart disease: Pathogenesis, management and review literature. Journal of the Egyptian National Cancer Institute, 2015; 27: 187-193. doi: 10.1016/j.jnci.2015.07.005
Yusuf SW, Howell RM, Gomez D, et al. Radiation-related heart and vascular disease. Future Oncology, 2015; 11(14), 2067-2076. doi: 10.2217/fon.15.129
Filopei J, Frishman W. Radiation-induced heart disease. Cardiology in review, 2012; 20:184-188. doi: 10.1097/CRD.0b013e3182431c23
Mulrooney DA, Armstrong GT, Huang S, et al. Cardiac outcomes in adult survivors of childhood cancer exposed to cardiotoxic therapy: a cross-sectional study. Annals of internal medicine, 2016; 164(2):93–101. doi:10.7326/M15-0424.
Al-Kindi SG, Oliveira GH. Heart transplantation outcomes in radiation-induced restrictive cardiomyopathy. Journal of cardiac failure, 2016; 22(6):475–478. doi:10.1016/j.cardfail.2016.03.014.
Darby SC, McGale P, Taylor CW, et al. Long-term mortality from heart disease and lung cancer after radiotherapy for early breast cancer: prospective cohort study of about 300,000 women in US SEER cancer registries. The lancet oncology, 2005; 6:557–565. doi: 10.1016/S1470-2045(05)70251-5
Fajardo LF. Is the pathology of radiation injury different in small vs large blood vessels? Cardiovascular radiation medicine, 1999; 1(1):108-110. doi:10.1016/s1522-1865(98)00012-2.
Rak J, Chomicz L, Wiczk J, et al. Mechanisms of Damage to DNA Labeled with Electrophilic Nucleobases Induced by Ionizing or UV Radiation. The Journal of Physical Chemistry B, 2015; 119(26):8227-8238. doi: 10.1021/acs.jpcb.5b03948
Azimzadeh O, Sievert W, Sarioglu H, et al. Integrative proteomics and targeted transcriptomics analyses in cardiac endothelial cells unravel mechanisms of long-term radiation-induced vascular dysfunction. Journal of proteome research, 2005; 14:1203–1219. doi: 10.1021/pr501141b
Hoving S, Heeneman S, Gijbels MJ, et al. Single-dose and fractionated irradiation promote initiation and progression of atherosclerosis and induce an inflammatory plaque phenotype in ApoE(−/−) mice. International Journal of Radiation Oncology* Biology* Physics, 2008; 71:848–857. doi: 10.1016/j.ijrobp.2008.02.031
Stewart FA, Heeneman S, TePoele J, et al. Ionizing radiation accelerates the development of atherosclerotic lesions in ApoE-/- mice and predisposes to an inflammatory plaque phenotype prone to hemorrhage. The American journal of pathology, 2006;168(2):649–658. doi:10.2353/ajpath.2006.050409
Rehammar JC, Jensen MB, McGale P, et al. Risk of heart disease in relation to radiotherapy and chemotherapy with anthracyclines among 19,464 breast cancer patients in Denmark, 1977-2005. Radiotherapy and Oncology, 2017; 123(2):299-305. doi:10.1016/j.radonc.2017.03.012
Heidenreich PA, Hancock SL, Lee BK, et al. Asymptomatic cardiac disease following mediastinal irradiation. Journal of the American College of Cardiology, 2003; 42: 743-749. doi: 10.1016/s0735- 1097(03)00759-9
McEniery PT, Dorosti K, Schiavone WA, et al. Clinical and angiographic features of coronary artery disease after chest irradiation. The American journal of cardiology, 1987; 60:1020–1024. doi: 10.1016/0002-9149(87)90345-6
Nilsson G, Holmberg L, Garmo H, et al. Distribution of coronary artery stenosis after radiation for breast cancer. Journal of clinical oncology, 2012; 30(4):380–386. doi:10.1200/JCO.2011.34.5900
Van Nimwegen FA, Schaapveld M, Cutter DJ, et al. Radiation dose-response relationship for risk of coronary heart disease in survivors of hodgkin lymphoma. Journal of clinical oncology, 2016; 34:235–243. doi: 10.1200/JCO.2015.63.4444
Boekel NB, Schaapveld M, Gietema JA, et al. Cardiovascular disease risk in a large, population-based cohort of breast cancer survivors. International Journal of Radiation Oncology* Biology* Physics, 2016;94:1061–1072. doi: 10.1016/j.ijrobp.2015.11.040
Gartner R, Jensen MB, Nielsen J, et al. Prevalence of and factors associated with persistent pain following breast cancer surgery. JAMA, 2009; 368:987–998. doi: 10.1001/jama.2009.1568
Jones LW, Liu Q, Armstrong GT, et al. Exercise and risk of major cardiovascular events in adult survivors of childhood hodgkin lymphoma: a report from the childhood cancer survivor study. Journal of Clinical Oncology, 2014; 32:3643–3650. doi: 10.1200/JCO.2014.56.7511
Mc Gale P, Darby SC, Hall P, et al. Incidence of heart disease in 35,000 women treated with radiotherapy for breast cancer in Denmark and Sweden. Radiotherapy and Oncology, 2011; 100: 167-175. doi:10.1016/j.radonc.2011.06.016
Lancellotti P, Nkomo VT, Badano LP, et al. Expert consensus for multi-modality imaging evaluation of cardiovascular complications of radiotherapy in adults: a report from the European Association of Cardiovascular Imaging and the American Society of Echocardiography. European Heart Journal– Cardiovascular Imaging, 2013; 14:721–740. doi:10.1093/ehjci/jet123
Cuomo JR, Sharma GK, Conger PD, et al. Novel concepts in radiation-induced cardiovascular disease. World journal of cardiology, 2016; 8(9):504–519. doi:10.4330/wjc.v8.i9.504.
Küpeli S, Hazirolan T, Varan A, et al. Evaluation of coronary artery disease by computed tomography angiography in patients treated for childhood Hodgkin’s lymphoma. Journal of Clinical Oncology, 2010; 28:1025–1030. doi: 10.1200/JCO.2009.25.2627
Yeboa DN, Evans SB. Contemporary breast radiotherapy and cardiac toxicity. In Seminars in radiation oncology, 2016; 26:71–78. doi: 10.1016/j.semradonc.2015.09.003
Handa N, McGregor CG, Danielson GK, et al. Coronary artery bypass grafting in patients with previous mediastinal radiation therapy. The Journal of thoracic and cardiovascular surgery, 1999; 117:1136–1143. doi: 10.1016/s0022-5223(99)70250-3
Wu W, Masri A, Popovic ZB, et al. Long-term survival of patients with radiation heart disease undergoing cardiac surgery: a cohort study. Circulation, 2013; 127:1476–1484. doi:10.1161/CIRCULATIONAHA.113.001435
Liang JJ, Sio TT, Slusser JP, et al. Outcomes after percutaneous coronary intervention with stents in patients treated with thoracic external beam radiation for cancer. JACC: Cardiovascular Interventions, 2014; 7:1412–1420. doi: 10.1016/j.jcin.2014.05.035
Reed G W, Masri A, Griffin B P, et al. Long-term mortality in patients with radiation-associated coronary artery disease treated with percutaneous coronary intervention. Circulation: Cardiovascular Interventions, 2016; 9(6), e003483 doi: 10.1161/CIRCINTERVENTIONS.115.003483.
Stone GW, Sabik JF, Serruys PW, et al. Everolimus-eluting stents or bypass surgery for left main coronary artery disease. New England Journal of Medicine, 2016; 375:2223–2235. doi: 10.1056/NEJ-Moa1915922
Möllmann H, Bestehorn K, Bestehorn M, et al. In-hospital outcome of transcatheter vs. surgical aortic valve replacement in patients with aortic valve stenosis: complete dataset of patients treated in 2013 in Germany. Clinical Research in Cardiology, 2016;105:553–559. doi: 10.1007/s00392-016-0962-4
Finch W, Shamsa K, Lee MS. Cardiovascular complications of radiation. Reviews in cardiovascular medicine, 2014; 15: 232-244.
Tötterman K J, Pesonen E, Siltanen P. Radiation-related chronic heart disease. Chest, 1983; 83(6):875–878. doi:10.1378/chest.83.6.875
Strender LE, Lindahl J, Larsson LE. Incidence of heart disease and functional significance of changes in the electrocardiogram 10 years after radiotherapy for breast cancer. Cancer, 1986; 57(5):929–934. doi:10.1002/1097-0142(19860301)
Shapiro CL, Hardenbergh PH, Gelman R, et al. Cardiac effects of adjuvant doxorubicin and radiation therapy in breast cancer patients. Journal of Clinical Oncology, 1998; 16(11):3493–3501. doi: 10.1200/JCO.1998.16.11.3493
Kostis JB, McCrone K, Moreyra AE, et al. Premature ventricular complexes in the absence of identifiable heart dis-ease. Circulation, 1981; 63(6):1351–1356. doi:10.1161/01.CIR.63.6.1351
Adams M J, Lipshultz S E, Schwartz C, et al. Radiation-associated cardiovascular disease: mani-festations and management. In Seminars in radiation oncology, 2003; 13(3):346–356. doi:10.1016/S1053-4296(03)00026-2.2003.
Hoca A, Yildiz M, Ozyigit G. Evaluation of the effects of medias-tinal radiation therapy on autonomic nervous system. Medical oncology, 2012; 29(5):3581–3586. doi:10.1007/s12032-012-0237-5.
Aung T, Fan W, Krishnamurthy M. Recurrent syncope, orthostatic hypotension and volatile hypertension: think outside the box. Journal of community hospital internal medicine perspectives, 2013; 3(2). doi:10.3402/jchimp.v3i2.20741.
McGale P, Darby SC, Hall P, et al. Incidence of heart disease in 35,000 women treated with radiotherapy for breast cancer in Denmark and Sweden. Radiotherapy and Oncology, 2011; 100: 167-175. doi:10.1016/j.radonc.2011.06.016
Bijl JM, Roos MM, van Leeuwen-Segarceanu EM, et al. Assessment of valvular disorders in survivors of Hodgkin’s lymphoma treated by mediastinal radiotherapy, chemotherapy. The American journal of cardiology, 2016; 117(4):691–696. doi:10.1016/j.amjcard.2015.11.027.
Aleman BM, van den Belt-Dusebout AW, De Bruin ML, et al. Late cardiotoxicity after treatment for Hodgkin lymphoma. Blood, 2007; 109: 1878-1886. doi:10.1182/blood-2006-07-034405
Cutter DJ, Schaapveld M, Darby SC, et al. Risk of valvular heart disease after treatment for Hodgkin lymphoma. Journal of the National Cancer Institute, 2015; 107 (4). doi:10.1093/jnci/djv008.
Brosius FC, Waller BF, Roberts WC. Radiation heart disease. Analysis of 16 young (aged 15 to 33 years) necropsy patients who received over 3,500 Rads to the heart. The American journal of medicine, 1981;70(3), 519–530. doi: 10.1016/0002-9343(81)90574-x
Groarke JD, Nguyen PL, Nohria A, et al. Cardiovascular complications of radiation therapy for thoracic malignancies: the role for non-invasive imaging for detection of cardiovascular disease. European heart journal, 2014; 35 (10):612–623. doi:10.1093/eurheartj/eht114.
Wethal T, Lund MB, Edvardsen T, et al. Valvular dysfunction and left ventricular changes in Hodgkin’s lymphoma survivors. A longitudinal study. British journal of cancer, 2009; 101: 575-581. doi: 10.1038/sj.bjc.6605191
American Cancer Society. Cancer treatment and survivorship facts & figures 2014–2015. www.cancer.org.
Specht L, Yahalom J, Ilidge T, et al. Modern radiation therapy for hodgkin lymphoma: field and dose guidelines from the International Lymphoma Radiation Oncology Group (ILROG). International Journal of Radiation Oncology* Biology* Physics. 2014; 89(4), 854–862. doi: 10.1016/j.ijrobp.2013.05.005
Shimizu Y, Kodama K, Nishi N, et al. Radiation exposure and circulatory disease risk: Hiroshima and Nagasaki atomic bomb survivor data,1950-2003. BMJ, 2010; 340:b5349. doi:10.1136/bmj.b5349
Baskar R, Lee KA, Yeo R, et al.Cancer and radiation therapy: current advances and future directions. International journal of medical sciences, 2012; 9:193–199. doi:10.7150/ijms.3635
Brown KN, John RR. Radiation Induced Coronary Artery Disease 2021. https://europepmc.org
Lee PJ, Mallik R. Cardiovascular effects of radiation therapy: practical approach to radiation therapy-induced heart disease. Cardiology in review, 2005; 13:80-86. doi: 10.1097/01.crd.0000131188.41589. c5
Rakıcı SGS, Ural F, Bedir A. Serum troponin i as an early marker in determining radiotherapy-induced cardiac damage. Basic Res. J. Med. Clin. Sci, 2012; 1(3), 51-59.
Darby SC, Mc Gale P, Taylor CW, et al. Long-term mortality from heart disease and lung cancer after radiotherapy for early breast cancer: prospective cohort study of about 300,000 women in US SEER cancer registries. The lancet oncology, 2005; 6:557–565. doi: 10.1016/S1470-2045(05)70251-5
Donnellan E, Phelan D, Mc Carthy CP, et al. Radiation-induced heart disease: A practical guide to diagnosis and management. Cleve Clin J Med., 2016; 83:914-922. doi: 10.3949/ccjm.83a.15104
Schultz-Hector S, Trott KR. Radiation-induced cardiovascular diseases: is the epidemiologic evidence compatible with the radiobiologic data? International Journal of Radiation Oncology* Biology*Physics, 2007; 67(1):10–18. doi:10.1016/j.ijrobp.2006.08.071
Ehrhart EJ, Segarini P, Tsang ML, et al. Latent transforming growth factor beta1 activation in situ: quantitative and functional evidence after low-dose gamma-irradiation. The FASEB Journal, 1997; 11:991–1002. doi:10.1096/fasebj.11.12.9337152
Anscher MS, Marks LB, Shafman TD, et al. Using plasma transforming growth factor beta-1 during radiotherapy to select patients for dose escalation. Journal of clinical oncology, 2001; 19:3758–3765. doi:10.1200/JCO.2001.19.17.3758
Boerma M, Hauer-Jensen M. Preclinical research into basic mechanisms of radiation-induced heart disease. Cardiol Res Pract., 2011; 858262. doi:10.4061/2011/858262
Stewart JR, Fajardo LF. Radiation-induced heart disease: an update. Progress in cardiovascular diseases, 1984; 27(3):173–194. doi:10.1016/0033-0620(84)90003-3
Rodemann HP, Binder A, Bamberg M. Radiation-induced fibrosis: experimental studies. Late Sequelae in Oncology 1995; 93-97, Berlin: Springer.
Virmani R, Farb A, Carter AJ, et al. Pathology of radiation-induced coronary artery disease in human and pig. Cardiovascular radiation medicine, 1999; 1:98–101. doi:10.1016/S1522-1865(98)00010-9
Veinot JP, Edwards WD. Pathology of radiation-induced heart disease: a surgical and autopsy study of 27 cases. Human pathology, 1996; 27(8), 766–773. doi: 10.1016/s0046-8177(96)90447-5
Brosius FC, Waller BF, Roberts WC. Radiation heart disease. Analysis of 16 young (aged 15 to 33 years) necropsy patients who received over 3,500 Rads to the heart. The American journal of medicine, 1981; 70(3), 519–530. doi: 10.1016/0002-9343(81)90574-x
Mousavi N, Nohria A. Radiation-induced cardiovascular disease. Current treatment options in cardiovascular medicine, 2013; 15(5):507–517. doi:10.1007/s11936-013-0259-0.
Walker CM, Saldana DA, Gladish GW, et al. Cardiac complications of oncologic therapy. Radiographics., 2013; 33:1801-1815. doi: 10.1148/rg.336125005
Rehammar JC, Jensen MB, McGale P, et al. Risk of heart disease in relation to radiotherapy and chemotherapy with anthracyclines among 19,464 breast cancer patients in Denmark, 1977-2005. Radiotherapy and Oncology, 2017; 123(2):299-305. doi: 10.1016/j.radonc.2017.03.012
Nathan PC, Amir E, Abdel-Qadir H. Cardiac outcomes in survivors of pediatric and adult cancers. Canadian Journal of Cardiology, 2016; 32(7):871–880. doi:10.1016/j.cjca.2016.02.065.
Taunk NK, Haffty BG, Kostis JB, et al. Radiation-induced heart disease: pathologic abnormalities and putative mechanisms. Frontiers in oncology, 2015; 5:39. doi:10.3389/fonc.2015.00039.
Kouchoukos NT, Blackstone EU, Hanley FL, Kirklin JK. (2013). Kirklin/Barratt-Boyes Cardiac Surgery (Fourth Edit). Philadelphia: Elsevier
Ling LH, Oh JK, Schaff HV, et al. Constrictive pericarditis in the modern era: evolving clinical spectrum and impact on outcome after pericardiectomy. Circulation, 1999; 100(13), 1380–1386. doi: 10.1161/01.cir.100.13.1380
Chello M, Mastroroberto P, Romano R, et al. Changes in the proportion of types I and III collagen in the left ventricular wall of patients with post-irradiative pericarditis. Cardiovascular surgery, 1996;4(2):222–226. doi:10.1016/0967-2109(96)82320-9
Heidenreich PA, Hancock SL, Lee BK, et al. Asymptomatic cardiac disease following mediastinal irradiation. Journal of the American College of Cardiology, 2003; 42: 743-749. doi: 10.1016/s0735-1097(03)00759-9
Marks LB, Yu X, Prosnitz RG, et al. The incidence and functional consequences of RT-associated cardiac perfusion defects. International Journal of Radiation Oncology* Biology* Physics, 2005; 63(1):214–223. doi:10.1016/j.ijrobp. 2005.01.029
Madan R, Benson R, Sharma DN, et al. Radiation induced heart disease: Pathogenesis, management and review literature. Journal of the Egyptian National Cancer Institute, 2015; 27: 187-193. doi: 10.1016/j.jnci.2015.07.005
Yusuf SW, Howell RM, Gomez D, et al. Radiation-related heart and vascular disease. Future Oncology, 2015; 11(14), 2067-2076. doi: 10.2217/fon.15.129
Filopei J, Frishman W. Radiation-induced heart disease. Cardiology in review, 2012; 20:184-188. doi: 10.1097/CRD.0b013e3182431c23
Mulrooney DA, Armstrong GT, Huang S, et al. Cardiac outcomes in adult survivors of childhood cancer exposed to cardiotoxic therapy: a cross-sectional study. Annals of internal medicine, 2016; 164(2):93–101. doi:10.7326/M15-0424.
Al-Kindi SG, Oliveira GH. Heart transplantation outcomes in radiation-induced restrictive cardiomyopathy. Journal of cardiac failure, 2016; 22(6):475–478. doi:10.1016/j.cardfail.2016.03.014.
Darby SC, McGale P, Taylor CW, et al. Long-term mortality from heart disease and lung cancer after radiotherapy for early breast cancer: prospective cohort study of about 300,000 women in US SEER cancer registries. The lancet oncology, 2005; 6:557–565. doi: 10.1016/S1470-2045(05)70251-5
Fajardo LF. Is the pathology of radiation injury different in small vs large blood vessels? Cardiovascular radiation medicine, 1999; 1(1):108-110. doi:10.1016/s1522-1865(98)00012-2.
Rak J, Chomicz L, Wiczk J, et al. Mechanisms of Damage to DNA Labeled with Electrophilic Nucleobases Induced by Ionizing or UV Radiation. The Journal of Physical Chemistry B, 2015; 119(26):8227-8238. doi: 10.1021/acs.jpcb.5b03948
Azimzadeh O, Sievert W, Sarioglu H, et al. Integrative proteomics and targeted transcriptomics analyses in cardiac endothelial cells unravel mechanisms of long-term radiation-induced vascular dysfunction. Journal of proteome research, 2005; 14:1203–1219. doi: 10.1021/pr501141b
Hoving S, Heeneman S, Gijbels MJ, et al. Single-dose and fractionated irradiation promote initiation and progression of atherosclerosis and induce an inflammatory plaque phenotype in ApoE(−/−) mice. International Journal of Radiation Oncology* Biology* Physics, 2008; 71:848–857. doi: 10.1016/j.ijrobp.2008.02.031
Stewart FA, Heeneman S, TePoele J, et al. Ionizing radiation accelerates the development of atherosclerotic lesions in ApoE-/- mice and predisposes to an inflammatory plaque phenotype prone to hemorrhage. The American journal of pathology, 2006;168(2):649–658. doi:10.2353/ajpath.2006.050409
Rehammar JC, Jensen MB, McGale P, et al. Risk of heart disease in relation to radiotherapy and chemotherapy with anthracyclines among 19,464 breast cancer patients in Denmark, 1977-2005. Radiotherapy and Oncology, 2017; 123(2):299-305. doi:10.1016/j.radonc.2017.03.012
Heidenreich PA, Hancock SL, Lee BK, et al. Asymptomatic cardiac disease following mediastinal irradiation. Journal of the American College of Cardiology, 2003; 42: 743-749. doi: 10.1016/s0735- 1097(03)00759-9
McEniery PT, Dorosti K, Schiavone WA, et al. Clinical and angiographic features of coronary artery disease after chest irradiation. The American journal of cardiology, 1987; 60:1020–1024. doi: 10.1016/0002-9149(87)90345-6
Nilsson G, Holmberg L, Garmo H, et al. Distribution of coronary artery stenosis after radiation for breast cancer. Journal of clinical oncology, 2012; 30(4):380–386. doi:10.1200/JCO.2011.34.5900
Van Nimwegen FA, Schaapveld M, Cutter DJ, et al. Radiation dose-response relationship for risk of coronary heart disease in survivors of hodgkin lymphoma. Journal of clinical oncology, 2016; 34:235–243. doi: 10.1200/JCO.2015.63.4444
Boekel NB, Schaapveld M, Gietema JA, et al. Cardiovascular disease risk in a large, population-based cohort of breast cancer survivors. International Journal of Radiation Oncology* Biology* Physics, 2016;94:1061–1072. doi: 10.1016/j.ijrobp.2015.11.040
Gartner R, Jensen MB, Nielsen J, et al. Prevalence of and factors associated with persistent pain following breast cancer surgery. JAMA, 2009; 368:987–998. doi: 10.1001/jama.2009.1568
Jones LW, Liu Q, Armstrong GT, et al. Exercise and risk of major cardiovascular events in adult survivors of childhood hodgkin lymphoma: a report from the childhood cancer survivor study. Journal of Clinical Oncology, 2014; 32:3643–3650. doi: 10.1200/JCO.2014.56.7511
Mc Gale P, Darby SC, Hall P, et al. Incidence of heart disease in 35,000 women treated with radiotherapy for breast cancer in Denmark and Sweden. Radiotherapy and Oncology, 2011; 100: 167-175. doi:10.1016/j.radonc.2011.06.016
Lancellotti P, Nkomo VT, Badano LP, et al. Expert consensus for multi-modality imaging evaluation of cardiovascular complications of radiotherapy in adults: a report from the European Association of Cardiovascular Imaging and the American Society of Echocardiography. European Heart Journal– Cardiovascular Imaging, 2013; 14:721–740. doi:10.1093/ehjci/jet123
Cuomo JR, Sharma GK, Conger PD, et al. Novel concepts in radiation-induced cardiovascular disease. World journal of cardiology, 2016; 8(9):504–519. doi:10.4330/wjc.v8.i9.504.
Küpeli S, Hazirolan T, Varan A, et al. Evaluation of coronary artery disease by computed tomography angiography in patients treated for childhood Hodgkin’s lymphoma. Journal of Clinical Oncology, 2010; 28:1025–1030. doi: 10.1200/JCO.2009.25.2627
Yeboa DN, Evans SB. Contemporary breast radiotherapy and cardiac toxicity. In Seminars in radiation oncology, 2016; 26:71–78. doi: 10.1016/j.semradonc.2015.09.003
Handa N, McGregor CG, Danielson GK, et al. Coronary artery bypass grafting in patients with previous mediastinal radiation therapy. The Journal of thoracic and cardiovascular surgery, 1999; 117:1136–1143. doi: 10.1016/s0022-5223(99)70250-3
Wu W, Masri A, Popovic ZB, et al. Long-term survival of patients with radiation heart disease undergoing cardiac surgery: a cohort study. Circulation, 2013; 127:1476–1484. doi:10.1161/CIRCULATIONAHA.113.001435
Liang JJ, Sio TT, Slusser JP, et al. Outcomes after percutaneous coronary intervention with stents in patients treated with thoracic external beam radiation for cancer. JACC: Cardiovascular Interventions, 2014; 7:1412–1420. doi: 10.1016/j.jcin.2014.05.035
Reed G W, Masri A, Griffin B P, et al. Long-term mortality in patients with radiation-associated coronary artery disease treated with percutaneous coronary intervention. Circulation: Cardiovascular Interventions, 2016; 9(6), e003483 doi: 10.1161/CIRCINTERVENTIONS.115.003483.
Stone GW, Sabik JF, Serruys PW, et al. Everolimus-eluting stents or bypass surgery for left main coronary artery disease. New England Journal of Medicine, 2016; 375:2223–2235. doi: 10.1056/NEJ-Moa1915922
Möllmann H, Bestehorn K, Bestehorn M, et al. In-hospital outcome of transcatheter vs. surgical aortic valve replacement in patients with aortic valve stenosis: complete dataset of patients treated in 2013 in Germany. Clinical Research in Cardiology, 2016;105:553–559. doi: 10.1007/s00392-016-0962-4
Finch W, Shamsa K, Lee MS. Cardiovascular complications of radiation. Reviews in cardiovascular medicine, 2014; 15: 232-244.
Tötterman K J, Pesonen E, Siltanen P. Radiation-related chronic heart disease. Chest, 1983; 83(6):875–878. doi:10.1378/chest.83.6.875
Strender LE, Lindahl J, Larsson LE. Incidence of heart disease and functional significance of changes in the electrocardiogram 10 years after radiotherapy for breast cancer. Cancer, 1986; 57(5):929–934. doi:10.1002/1097-0142(19860301)
Shapiro CL, Hardenbergh PH, Gelman R, et al. Cardiac effects of adjuvant doxorubicin and radiation therapy in breast cancer patients. Journal of Clinical Oncology, 1998; 16(11):3493–3501. doi: 10.1200/JCO.1998.16.11.3493
Kostis JB, McCrone K, Moreyra AE, et al. Premature ventricular complexes in the absence of identifiable heart dis-ease. Circulation, 1981; 63(6):1351–1356. doi:10.1161/01.CIR.63.6.1351
Adams M J, Lipshultz S E, Schwartz C, et al. Radiation-associated cardiovascular disease: mani-festations and management. In Seminars in radiation oncology, 2003; 13(3):346–356. doi:10.1016/S1053-4296(03)00026-2.2003.
Hoca A, Yildiz M, Ozyigit G. Evaluation of the effects of medias-tinal radiation therapy on autonomic nervous system. Medical oncology, 2012; 29(5):3581–3586. doi:10.1007/s12032-012-0237-5.
Aung T, Fan W, Krishnamurthy M. Recurrent syncope, orthostatic hypotension and volatile hypertension: think outside the box. Journal of community hospital internal medicine perspectives, 2013; 3(2). doi:10.3402/jchimp.v3i2.20741.
McGale P, Darby SC, Hall P, et al. Incidence of heart disease in 35,000 women treated with radiotherapy for breast cancer in Denmark and Sweden. Radiotherapy and Oncology, 2011; 100: 167-175. doi:10.1016/j.radonc.2011.06.016
Bijl JM, Roos MM, van Leeuwen-Segarceanu EM, et al. Assessment of valvular disorders in survivors of Hodgkin’s lymphoma treated by mediastinal radiotherapy, chemotherapy. The American journal of cardiology, 2016; 117(4):691–696. doi:10.1016/j.amjcard.2015.11.027.
Aleman BM, van den Belt-Dusebout AW, De Bruin ML, et al. Late cardiotoxicity after treatment for Hodgkin lymphoma. Blood, 2007; 109: 1878-1886. doi:10.1182/blood-2006-07-034405
Cutter DJ, Schaapveld M, Darby SC, et al. Risk of valvular heart disease after treatment for Hodgkin lymphoma. Journal of the National Cancer Institute, 2015; 107 (4). doi:10.1093/jnci/djv008.
Brosius FC, Waller BF, Roberts WC. Radiation heart disease. Analysis of 16 young (aged 15 to 33 years) necropsy patients who received over 3,500 Rads to the heart. The American journal of medicine, 1981;70(3), 519–530. doi: 10.1016/0002-9343(81)90574-x
Groarke JD, Nguyen PL, Nohria A, et al. Cardiovascular complications of radiation therapy for thoracic malignancies: the role for non-invasive imaging for detection of cardiovascular disease. European heart journal, 2014; 35 (10):612–623. doi:10.1093/eurheartj/eht114.
Wethal T, Lund MB, Edvardsen T, et al. Valvular dysfunction and left ventricular changes in Hodgkin’s lymphoma survivors. A longitudinal study. British journal of cancer, 2009; 101: 575-581. doi: 10.1038/sj.bjc.6605191
American Cancer Society. Cancer treatment and survivorship facts & figures 2014–2015. www.cancer.org.
Specht L, Yahalom J, Ilidge T, et al. Modern radiation therapy for hodgkin lymphoma: field and dose guidelines from the International Lymphoma Radiation Oncology Group (ILROG). International Journal of Radiation Oncology* Biology* Physics. 2014; 89(4), 854–862. doi: 10.1016/j.ijrobp.2013.05.005
Shimizu Y, Kodama K, Nishi N, et al. Radiation exposure and circulatory disease risk: Hiroshima and Nagasaki atomic bomb survivor data,1950-2003. BMJ, 2010; 340:b5349. doi:10.1136/bmj.b5349
Baskar R, Lee KA, Yeo R, et al.Cancer and radiation therapy: current advances and future directions. International journal of medical sciences, 2012; 9:193–199. doi:10.7150/ijms.3635
Brown KN, John RR. Radiation Induced Coronary Artery Disease 2021. https://europepmc.org
Lee PJ, Mallik R. Cardiovascular effects of radiation therapy: practical approach to radiation therapy-induced heart disease. Cardiology in review, 2005; 13:80-86. doi: 10.1097/01.crd.0000131188.41589. c5
Rakıcı SGS, Ural F, Bedir A. Serum troponin i as an early marker in determining radiotherapy-induced cardiac damage. Basic Res. J. Med. Clin. Sci, 2012; 1(3), 51-59.
Darby SC, Mc Gale P, Taylor CW, et al. Long-term mortality from heart disease and lung cancer after radiotherapy for early breast cancer: prospective cohort study of about 300,000 women in US SEER cancer registries. The lancet oncology, 2005; 6:557–565. doi: 10.1016/S1470-2045(05)70251-5
Donnellan E, Phelan D, Mc Carthy CP, et al. Radiation-induced heart disease: A practical guide to diagnosis and management. Cleve Clin J Med., 2016; 83:914-922. doi: 10.3949/ccjm.83a.15104
Schultz-Hector S, Trott KR. Radiation-induced cardiovascular diseases: is the epidemiologic evidence compatible with the radiobiologic data? International Journal of Radiation Oncology* Biology*Physics, 2007; 67(1):10–18. doi:10.1016/j.ijrobp.2006.08.071
Ehrhart EJ, Segarini P, Tsang ML, et al. Latent transforming growth factor beta1 activation in situ: quantitative and functional evidence after low-dose gamma-irradiation. The FASEB Journal, 1997; 11:991–1002. doi:10.1096/fasebj.11.12.9337152
Anscher MS, Marks LB, Shafman TD, et al. Using plasma transforming growth factor beta-1 during radiotherapy to select patients for dose escalation. Journal of clinical oncology, 2001; 19:3758–3765. doi:10.1200/JCO.2001.19.17.3758
Boerma M, Hauer-Jensen M. Preclinical research into basic mechanisms of radiation-induced heart disease. Cardiol Res Pract., 2011; 858262. doi:10.4061/2011/858262
Stewart JR, Fajardo LF. Radiation-induced heart disease: an update. Progress in cardiovascular diseases, 1984; 27(3):173–194. doi:10.1016/0033-0620(84)90003-3
Rodemann HP, Binder A, Bamberg M. Radiation-induced fibrosis: experimental studies. Late Sequelae in Oncology 1995; 93-97, Berlin: Springer.
Virmani R, Farb A, Carter AJ, et al. Pathology of radiation-induced coronary artery disease in human and pig. Cardiovascular radiation medicine, 1999; 1:98–101. doi:10.1016/S1522-1865(98)00010-9
Veinot JP, Edwards WD. Pathology of radiation-induced heart disease: a surgical and autopsy study of 27 cases. Human pathology, 1996; 27(8), 766–773. doi: 10.1016/s0046-8177(96)90447-5
Brosius FC, Waller BF, Roberts WC. Radiation heart disease. Analysis of 16 young (aged 15 to 33 years) necropsy patients who received over 3,500 Rads to the heart. The American journal of medicine, 1981; 70(3), 519–530. doi: 10.1016/0002-9343(81)90574-x
Mousavi N, Nohria A. Radiation-induced cardiovascular disease. Current treatment options in cardiovascular medicine, 2013; 15(5):507–517. doi:10.1007/s11936-013-0259-0.
Walker CM, Saldana DA, Gladish GW, et al. Cardiac complications of oncologic therapy. Radiographics., 2013; 33:1801-1815. doi: 10.1148/rg.336125005
Rehammar JC, Jensen MB, McGale P, et al. Risk of heart disease in relation to radiotherapy and chemotherapy with anthracyclines among 19,464 breast cancer patients in Denmark, 1977-2005. Radiotherapy and Oncology, 2017; 123(2):299-305. doi: 10.1016/j.radonc.2017.03.012
Nathan PC, Amir E, Abdel-Qadir H. Cardiac outcomes in survivors of pediatric and adult cancers. Canadian Journal of Cardiology, 2016; 32(7):871–880. doi:10.1016/j.cjca.2016.02.065.
Taunk NK, Haffty BG, Kostis JB, et al. Radiation-induced heart disease: pathologic abnormalities and putative mechanisms. Frontiers in oncology, 2015; 5:39. doi:10.3389/fonc.2015.00039.
Kouchoukos NT, Blackstone EU, Hanley FL, Kirklin JK. (2013). Kirklin/Barratt-Boyes Cardiac Surgery (Fourth Edit). Philadelphia: Elsevier
Ling LH, Oh JK, Schaff HV, et al. Constrictive pericarditis in the modern era: evolving clinical spectrum and impact on outcome after pericardiectomy. Circulation, 1999; 100(13), 1380–1386. doi: 10.1161/01.cir.100.13.1380
Chello M, Mastroroberto P, Romano R, et al. Changes in the proportion of types I and III collagen in the left ventricular wall of patients with post-irradiative pericarditis. Cardiovascular surgery, 1996;4(2):222–226. doi:10.1016/0967-2109(96)82320-9
Heidenreich PA, Hancock SL, Lee BK, et al. Asymptomatic cardiac disease following mediastinal irradiation. Journal of the American College of Cardiology, 2003; 42: 743-749. doi: 10.1016/s0735-1097(03)00759-9
Marks LB, Yu X, Prosnitz RG, et al. The incidence and functional consequences of RT-associated cardiac perfusion defects. International Journal of Radiation Oncology* Biology* Physics, 2005; 63(1):214–223. doi:10.1016/j.ijrobp. 2005.01.029
Madan R, Benson R, Sharma DN, et al. Radiation induced heart disease: Pathogenesis, management and review literature. Journal of the Egyptian National Cancer Institute, 2015; 27: 187-193. doi: 10.1016/j.jnci.2015.07.005
Yusuf SW, Howell RM, Gomez D, et al. Radiation-related heart and vascular disease. Future Oncology, 2015; 11(14), 2067-2076. doi: 10.2217/fon.15.129
Filopei J, Frishman W. Radiation-induced heart disease. Cardiology in review, 2012; 20:184-188. doi: 10.1097/CRD.0b013e3182431c23
Mulrooney DA, Armstrong GT, Huang S, et al. Cardiac outcomes in adult survivors of childhood cancer exposed to cardiotoxic therapy: a cross-sectional study. Annals of internal medicine, 2016; 164(2):93–101. doi:10.7326/M15-0424.
Al-Kindi SG, Oliveira GH. Heart transplantation outcomes in radiation-induced restrictive cardiomyopathy. Journal of cardiac failure, 2016; 22(6):475–478. doi:10.1016/j.cardfail.2016.03.014.
Darby SC, McGale P, Taylor CW, et al. Long-term mortality from heart disease and lung cancer after radiotherapy for early breast cancer: prospective cohort study of about 300,000 women in US SEER cancer registries. The lancet oncology, 2005; 6:557–565. doi: 10.1016/S1470-2045(05)70251-5
Fajardo LF. Is the pathology of radiation injury different in small vs large blood vessels? Cardiovascular radiation medicine, 1999; 1(1):108-110. doi:10.1016/s1522-1865(98)00012-2.
Rak J, Chomicz L, Wiczk J, et al. Mechanisms of Damage to DNA Labeled with Electrophilic Nucleobases Induced by Ionizing or UV Radiation. The Journal of Physical Chemistry B, 2015; 119(26):8227-8238. doi: 10.1021/acs.jpcb.5b03948
Azimzadeh O, Sievert W, Sarioglu H, et al. Integrative proteomics and targeted transcriptomics analyses in cardiac endothelial cells unravel mechanisms of long-term radiation-induced vascular dysfunction. Journal of proteome research, 2005; 14:1203–1219. doi: 10.1021/pr501141b
Hoving S, Heeneman S, Gijbels MJ, et al. Single-dose and fractionated irradiation promote initiation and progression of atherosclerosis and induce an inflammatory plaque phenotype in ApoE(−/−) mice. International Journal of Radiation Oncology* Biology* Physics, 2008; 71:848–857. doi: 10.1016/j.ijrobp.2008.02.031
Stewart FA, Heeneman S, TePoele J, et al. Ionizing radiation accelerates the development of atherosclerotic lesions in ApoE-/- mice and predisposes to an inflammatory plaque phenotype prone to hemorrhage. The American journal of pathology, 2006;168(2):649–658. doi:10.2353/ajpath.2006.050409
Rehammar JC, Jensen MB, McGale P, et al. Risk of heart disease in relation to radiotherapy and chemotherapy with anthracyclines among 19,464 breast cancer patients in Denmark, 1977-2005. Radiotherapy and Oncology, 2017; 123(2):299-305. doi:10.1016/j.radonc.2017.03.012
Heidenreich PA, Hancock SL, Lee BK, et al. Asymptomatic cardiac disease following mediastinal irradiation. Journal of the American College of Cardiology, 2003; 42: 743-749. doi: 10.1016/s0735- 1097(03)00759-9
McEniery PT, Dorosti K, Schiavone WA, et al. Clinical and angiographic features of coronary artery disease after chest irradiation. The American journal of cardiology, 1987; 60:1020–1024. doi: 10.1016/0002-9149(87)90345-6
Nilsson G, Holmberg L, Garmo H, et al. Distribution of coronary artery stenosis after radiation for breast cancer. Journal of clinical oncology, 2012; 30(4):380–386. doi:10.1200/JCO.2011.34.5900
Van Nimwegen FA, Schaapveld M, Cutter DJ, et al. Radiation dose-response relationship for risk of coronary heart disease in survivors of hodgkin lymphoma. Journal of clinical oncology, 2016; 34:235–243. doi: 10.1200/JCO.2015.63.4444
Boekel NB, Schaapveld M, Gietema JA, et al. Cardiovascular disease risk in a large, population-based cohort of breast cancer survivors. International Journal of Radiation Oncology* Biology* Physics, 2016;94:1061–1072. doi: 10.1016/j.ijrobp.2015.11.040
Gartner R, Jensen MB, Nielsen J, et al. Prevalence of and factors associated with persistent pain following breast cancer surgery. JAMA, 2009; 368:987–998. doi: 10.1001/jama.2009.1568
Jones LW, Liu Q, Armstrong GT, et al. Exercise and risk of major cardiovascular events in adult survivors of childhood hodgkin lymphoma: a report from the childhood cancer survivor study. Journal of Clinical Oncology, 2014; 32:3643–3650. doi: 10.1200/JCO.2014.56.7511
Mc Gale P, Darby SC, Hall P, et al. Incidence of heart disease in 35,000 women treated with radiotherapy for breast cancer in Denmark and Sweden. Radiotherapy and Oncology, 2011; 100: 167-175. doi:10.1016/j.radonc.2011.06.016
Lancellotti P, Nkomo VT, Badano LP, et al. Expert consensus for multi-modality imaging evaluation of cardiovascular complications of radiotherapy in adults: a report from the European Association of Cardiovascular Imaging and the American Society of Echocardiography. European Heart Journal– Cardiovascular Imaging, 2013; 14:721–740. doi:10.1093/ehjci/jet123
Cuomo JR, Sharma GK, Conger PD, et al. Novel concepts in radiation-induced cardiovascular disease. World journal of cardiology, 2016; 8(9):504–519. doi:10.4330/wjc.v8.i9.504.
Küpeli S, Hazirolan T, Varan A, et al. Evaluation of coronary artery disease by computed tomography angiography in patients treated for childhood Hodgkin’s lymphoma. Journal of Clinical Oncology, 2010; 28:1025–1030. doi: 10.1200/JCO.2009.25.2627
Yeboa DN, Evans SB. Contemporary breast radiotherapy and cardiac toxicity. In Seminars in radiation oncology, 2016; 26:71–78. doi: 10.1016/j.semradonc.2015.09.003
Handa N, McGregor CG, Danielson GK, et al. Coronary artery bypass grafting in patients with previous mediastinal radiation therapy. The Journal of thoracic and cardiovascular surgery, 1999; 117:1136–1143. doi: 10.1016/s0022-5223(99)70250-3
Wu W, Masri A, Popovic ZB, et al. Long-term survival of patients with radiation heart disease undergoing cardiac surgery: a cohort study. Circulation, 2013; 127:1476–1484. doi:10.1161/CIRCULATIONAHA.113.001435
Liang JJ, Sio TT, Slusser JP, et al. Outcomes after percutaneous coronary intervention with stents in patients treated with thoracic external beam radiation for cancer. JACC: Cardiovascular Interventions, 2014; 7:1412–1420. doi: 10.1016/j.jcin.2014.05.035
Reed G W, Masri A, Griffin B P, et al. Long-term mortality in patients with radiation-associated coronary artery disease treated with percutaneous coronary intervention. Circulation: Cardiovascular Interventions, 2016; 9(6), e003483 doi: 10.1161/CIRCINTERVENTIONS.115.003483.
Stone GW, Sabik JF, Serruys PW, et al. Everolimus-eluting stents or bypass surgery for left main coronary artery disease. New England Journal of Medicine, 2016; 375:2223–2235. doi: 10.1056/NEJ-Moa1915922
Möllmann H, Bestehorn K, Bestehorn M, et al. In-hospital outcome of transcatheter vs. surgical aortic valve replacement in patients with aortic valve stenosis: complete dataset of patients treated in 2013 in Germany. Clinical Research in Cardiology, 2016;105:553–559. doi: 10.1007/s00392-016-0962-4
Finch W, Shamsa K, Lee MS. Cardiovascular complications of radiation. Reviews in cardiovascular medicine, 2014; 15: 232-244.
Tötterman K J, Pesonen E, Siltanen P. Radiation-related chronic heart disease. Chest, 1983; 83(6):875–878. doi:10.1378/chest.83.6.875
Strender LE, Lindahl J, Larsson LE. Incidence of heart disease and functional significance of changes in the electrocardiogram 10 years after radiotherapy for breast cancer. Cancer, 1986; 57(5):929–934. doi:10.1002/1097-0142(19860301)
Shapiro CL, Hardenbergh PH, Gelman R, et al. Cardiac effects of adjuvant doxorubicin and radiation therapy in breast cancer patients. Journal of Clinical Oncology, 1998; 16(11):3493–3501. doi: 10.1200/JCO.1998.16.11.3493
Kostis JB, McCrone K, Moreyra AE, et al. Premature ventricular complexes in the absence of identifiable heart dis-ease. Circulation, 1981; 63(6):1351–1356. doi:10.1161/01.CIR.63.6.1351
Adams M J, Lipshultz S E, Schwartz C, et al. Radiation-associated cardiovascular disease: mani-festations and management. In Seminars in radiation oncology, 2003; 13(3):346–356. doi:10.1016/S1053-4296(03)00026-2.2003.
Hoca A, Yildiz M, Ozyigit G. Evaluation of the effects of medias-tinal radiation therapy on autonomic nervous system. Medical oncology, 2012; 29(5):3581–3586. doi:10.1007/s12032-012-0237-5.
Aung T, Fan W, Krishnamurthy M. Recurrent syncope, orthostatic hypotension and volatile hypertension: think outside the box. Journal of community hospital internal medicine perspectives, 2013; 3(2). doi:10.3402/jchimp.v3i2.20741.
McGale P, Darby SC, Hall P, et al. Incidence of heart disease in 35,000 women treated with radiotherapy for breast cancer in Denmark and Sweden. Radiotherapy and Oncology, 2011; 100: 167-175. doi:10.1016/j.radonc.2011.06.016
Bijl JM, Roos MM, van Leeuwen-Segarceanu EM, et al. Assessment of valvular disorders in survivors of Hodgkin’s lymphoma treated by mediastinal radiotherapy, chemotherapy. The American journal of cardiology, 2016; 117(4):691–696. doi:10.1016/j.amjcard.2015.11.027.
Aleman BM, van den Belt-Dusebout AW, De Bruin ML, et al. Late cardiotoxicity after treatment for Hodgkin lymphoma. Blood, 2007; 109: 1878-1886. doi:10.1182/blood-2006-07-034405
Cutter DJ, Schaapveld M, Darby SC, et al. Risk of valvular heart disease after treatment for Hodgkin lymphoma. Journal of the National Cancer Institute, 2015; 107 (4). doi:10.1093/jnci/djv008.
Brosius FC, Waller BF, Roberts WC. Radiation heart disease. Analysis of 16 young (aged 15 to 33 years) necropsy patients who received over 3,500 Rads to the heart. The American journal of medicine, 1981;70(3), 519–530. doi: 10.1016/0002-9343(81)90574-x
Groarke JD, Nguyen PL, Nohria A, et al. Cardiovascular complications of radiation therapy for thoracic malignancies: the role for non-invasive imaging for detection of cardiovascular disease. European heart journal, 2014; 35 (10):612–623. doi:10.1093/eurheartj/eht114.
Wethal T, Lund MB, Edvardsen T, et al. Valvular dysfunction and left ventricular changes in Hodgkin’s lymphoma survivors. A longitudinal study. British journal of cancer, 2009; 101: 575-581. doi: 10.1038/sj.bjc.6605191
