Radiation Toxicity to the Cardiovascular System

Marmagkiolis, Konstantinos; Finch, William; Tsitlakidou, Despina; Josephs, Tyler; Iliescu, Cezar; Best, John F.; Yang, Eric H.

doi:10.1007/s11912-016-0502-4

Cited by 29 publications

(22 citation statements)

References 59 publications

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“…Radiation-Induced Conduction Dysfunction. Radiotherapy may affect the conduction system of the heart, leading to various types of arrhythmias [69]. The conduction system after radiation is rarely involved, but the range of the electrocardiogram after irradiation shows prolonged nonspecific ST-T, QT interval, decreased voltage, right bundle branch block, and sinus tachycardia [48].…”

Section: Radiation-induced Coronary Heartmentioning

confidence: 99%

Oxidative Stress in Radiation-Induced Cardiotoxicity

Zhang

Yang

Liu

et al. 2020

Oxidative Medicine and Cellular Longevity

122

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There is a distinct increase in the risk of heart disease in people exposed to ionizing radiation (IR). Radiation-induced heart disease (RIHD) is one of the adverse side effects when people are exposed to ionizing radiation. IR may come from various forms, such as diagnostic imaging, radiotherapy for cancer treatment, nuclear disasters, and accidents. However, RIHD was mainly observed after radiotherapy for chest malignant tumors, especially left breast cancer. Radiation therapy (RT) has become one of the main ways to treat all kinds of cancer, which is used to reduce the recurrence of cancer and improve the survival rate of patients. The potential cause of radiation-induced cardiotoxicity is unclear, but it may be relevant to oxidative stress. Oxidative stress, an accumulation of reactive oxygen species (ROS), disrupts intracellular homeostasis through chemical modification and damages proteins, lipids, and DNA; therefore, it results in a series of related pathophysiological changes. The purpose of this review was to summarise the studies of oxidative stress in radiotherapy-induced cardiotoxicity and provide prevention and treatment methods to reduce cardiac damage.

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Section: Radiation-induced Coronary Heartmentioning

confidence: 99%

Oxidative Stress in Radiation-Induced Cardiotoxicity

Zhang

Yang

Liu

et al. 2020

Oxidative Medicine and Cellular Longevity

122

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“…Chest irradiation used to treat thoracic cancers, such as lymphomas, is responsible for chronic pericarditis, coronary artery disease, myocardial fibrosis, and restrictive physiology, but also for valve disease including AS [30][31][32]. The prevalence of AS reaches 16% at 20 years after radiation therapy [33].…”

Section: In Patients With Previous Chest Radiotherapymentioning

confidence: 99%

The Onco-cardiologist Dilemma: to Implant, to Defer, or to Avoid Transcatheter Aortic Valve Replacement in Cancer Patients with Aortic Stenosis?

et al. 2019

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Purpose of Review Aging is associated with an increased prevalence of both cancer and heart disease. The progression of aortic valve calcification to aortic stenosis may be accelerated by both cardiovascular risk factors and cancer treatments, such as radiotherapy with mediastinal involvement. Symptomatic aortic stenosis is occasionally diagnosed in cancer patients undergoing cardiovascular evaluation; likewise, cancer is often recognized during assessment preceding aortic valve interventions. In these complex cases, physicians face difficult treatment decisions. Due to a myriad of clinical presentations of cancer and valve disease, specific guidelines for this patient population are not currently in place. Management is currently based on clinical judgment, on an individual basis. Recent Findings Patients with cancer in remission or with a favorable prognosis should be treated according to current cardiovascular guidelines. In these patients, aortic valve replacement can be performed either by surgery or transcatheter. Significant challenges arise in patients with active cancer, especially those receiving anti-cancer treatment. Recent data suggests that these patients can be offered aortic valve replacement, with a trend of favoring the transcatheter route in order to minimize perioperative This article is part of the Topical Collection on Cardio-Oncology

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“…Recently, Mehta et al (2018) highlighted those CVRFs that overlap with risk factors for breast cancer ; see Table 1, Figure 1). Cardiovascular risk factors can be enhanced during cancer treatment and lead to an increased risk of coronary artery disease (CAD) in survivors (Chang, Moudgil, Scarabelli, Okwuosa, & Yeh, 2017a;Chang, Okwuosa, Scarabelli, Moudgil & Yeh, 2017b;Darby et al, 2013;Greenlee et al, 2017;Hague et al, 2014;Marmagkiolis et al, 2016;Weaver, Jessup, & Mayer, 2013). Increased CVD morbidity and mortality may be attributed to preexisting CVD in newly diagnosed cancer patients, cardiotoxicity resulting in decreased ventricular function, and treatment effects that result in increased CVRFs such as dyslipidemia, hypertension, central adiposity, and metabolic syndrome (Azard & Denmark-Wahnefried, 2014;Cespedes Feliciano et al, 2016;Coviello, Knobf, & Laclergue, 2013;Gristina et al, 2015;Simon et al, 2018).…”

Section: Cardiovascular and Cancer Riskmentioning

confidence: 99%

“…The burden of CVR increases in the context of chemotherapy due to increase in weight, central obesity, cholesterol, blood sugar, or blood pressure; however, few studies have looked at pretreatment risk (Barac et al, 2015;Cardinale, Bacchiani, Begggiato, Colombo, & Cipolla, 2013;Pituskin et al, 2016). Patients previously treated with chemotherapy and radiation therapy are at increased CVR, with this risk higher than the actual risk of tumor recurrence (Barac et al, 2015;Darby et al, 2013;Greenlee et al, 2017;Haque et al, 2014;Marmagkiolis et al, 2016;Mehta & Bairey Merz, 2012;Ward et al, 2012;. In long-term cancer survivors, a higher incidence of hypertension, dyslipidemia, metabolic syndrome (particularly in breast cancer survivors), acute coronary syndromes, myocardial infarction (MI), and stroke have been reported (Barac et al, 2015;Coviello & Knopf, 2013;Darby et al, 2013;Greenlee et al, 2017;Haque et al, 2014;Marmagkiolis et al, 2016;.…”

Section: Cardiovascular and Cancer Riskmentioning

confidence: 99%

Cardiovascular and Cancer Risk: The Role of Cardio-oncology

Coviello¹

2018

JADPRO

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Cardio-oncology is a subspecialty of cardiology. It was created to address oncology data indicating that newly developed drugs for cancer treatment were having unanticipated cardiac side effects. Cardiooncology designs primary and secondary risk strategies through surveillance as well as interventions to reduce cardiovascular risk (CVR), prevent cardiotoxicities, and manage the side effects that may occur. Rather than discuss in detail the cardiotoxicities of specific therapies or radiation, this review article will explore the interplay of cancer, cancer treatment, and CVR. It will examine the link between CVR and cancer risk, define mechanisms associated with cardiotoxicity, and describe screening and surveillance for patients undergoing cancer treatment. Finally, effective preventative and management strategies used to reduce the incidence of cardiotoxicities in those receiving chemotherapeutics or radiation will be presented.

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Radiation Toxicity to the Cardiovascular System

Cited by 29 publications

References 59 publications

Oxidative Stress in Radiation-Induced Cardiotoxicity

Oxidative Stress in Radiation-Induced Cardiotoxicity

The Onco-cardiologist Dilemma: to Implant, to Defer, or to Avoid Transcatheter Aortic Valve Replacement in Cancer Patients with Aortic Stenosis?

Cardiovascular and Cancer Risk: The Role of Cardio-oncology

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