Wu Rong, Zeng Yuecan
Department of Medical Oncology, Shengjing Hospital of China Medical University, 39 Huaxiang Road, Shenyang 110022, PR China.
Med Hypotheses. 2009 Mar;72(3):263-6. doi: 10.1016/j.mehy.2008.09.051. Epub 2008 Dec 17.
Radiation-induced heart disease (RIHD) is the potentially lethal side effect of radiation therapy. Clinical trials and epidemiologic studies show the adverse impact of RIHD on the outcome of long-term cancer survivors. However, what factors affect RIHD and how RIHD develop are not yet clear. On the other hand, as we all known, angiotensin II (Ang II) and aldosterone play a vital pathophysiological role in the common cardiovascular disease, including hypertension, atherosclerosis, heart failure, myocardial infarction and cardiac hypertrophy. The pathophysiology of these various syndromes is similar, starting by prior microvascular injury that leads to subsequent myocardium ischemia, all of which cause late fibrous scars. So the pathophysiology of RIHD is similar to the common heart diseases induced by angiotensin-aldosterone. But the effect of angiotensin-aldosterone on RIHD has little been studied. Thus, in the present hypothesis we suggest that angiotensin II-aldosterone plays an important pathophysical role in RIHD, which was confirmed by our pilot study.
放射性心脏病（RIHD）是放射治疗潜在的致命副作用。临床试验和流行病学研究表明RIHD对长期癌症幸存者的预后有不良影响。然而，哪些因素影响RIHD以及RIHD如何发展尚不清楚。另一方面，众所周知，血管紧张素II（Ang II）和醛固酮在常见心血管疾病（包括高血压、动脉粥样硬化、心力衰竭、心肌梗死和心脏肥大）中发挥着至关重要的病理生理作用。这些不同综合征的病理生理学相似，始于先前的微血管损伤，进而导致随后的心肌缺血，所有这些都会导致晚期纤维瘢痕形成。因此，RIHD的病理生理学与血管紧张素-醛固酮诱导的常见心脏病相似。但血管紧张素-醛固酮对RIHD的影响鲜有研究。因此，在本假说中，我们认为血管紧张素II-醛固酮在RIHD中起重要的病理生理作用，这一观点已得到我们初步研究的证实。
