Mousavi Negareh, Nohria Anju
Section of Cardiology, Department of Medicine, St. Joseph's Health Care Center, 30 The Queensway, Toronto, ON, Canada.
Curr Treat Options Cardiovasc Med. 2013 Oct;15(5):507-17. doi: 10.1007/s11936-013-0259-0.
Thoracic radiation remains an effective treatment for many types of neoplasms. The clinical benefit of radiation therapy on cancer mortality is counterbalanced by an increased risk of cardiovascular events in survivors. The long-term cardiovascular sequelae of thoracic radiation include premature coronary artery disease, valvular disease, pericardial disease, myocardial disease with systolic and especially diastolic dysfunction, and conduction system abnormalities. Radiation heart disease progresses over time and may manifest decades after the initial exposure. Since the risk of cardiac complications is significantly increased following chest irradiation, appropriate screening and long-term cardiac follow-up of these patients is essential. This article will summarize the pathophysiological features, clinical presentations, and current recommendations for screening and prevention of the wide spectrum of radiation induced cardiovascular disease.
胸部放疗仍然是多种肿瘤的有效治疗方法。放疗对癌症死亡率的临床益处被幸存者心血管事件风险增加所抵消。胸部放疗的长期心血管后遗症包括早发性冠状动脉疾病、瓣膜疾病、心包疾病、伴有收缩功能尤其是舒张功能障碍的心肌疾病以及传导系统异常。放射性心脏病会随着时间推移而进展，可能在初次照射后数十年才出现症状。由于胸部放疗后心脏并发症的风险显著增加，对这些患者进行适当的筛查和长期心脏随访至关重要。本文将总结广泛的放射性心血管疾病的病理生理特征、临床表现以及目前的筛查和预防建议。
