Heart and Vascular Institute, Department of Cardiovascular Medicine, Cleveland Clinic, 9500 Euclid Avenue, Desk J1-5, Cleveland, OH, 44195, USA.
Curr Cardiol Rep. 2019 Jul 27;21(9):97. doi: 10.1007/s11886-019-1192-y.
This review highlights the literature related to pericardial injury following radiation for oncologic diseases.
Radiation-associated pericardial disease can have devastating consequences. Unfortunately, there is considerably less evidence regarding pericardial syndromes following thoracic radiation as compared to other cardiovascular outcomes. Pericardial complications of radiation may arise acutely or have an insidious onset several decades after treatment. Transthoracic echocardiography is the screening imaging modality of choice, while cardiac magnetic resonance imaging further characterizes the pericardium and guides treatment decision-making. Cardiac CT can be useful for assessing pericardial calcification. Ongoing efforts to lessen inadvertent cardiac injury are directed towards the revision of radiation techniques and protocols. As survival of mediastinal and thoracic malignancies continues to improve, radiation-associated pericardial disease is increasingly relevant. Though advances in radiation oncology demonstrate promise in curtailing cardiotoxicity, the long-term effects pertaining to pericardial complications remain to be seen.
本文重点介绍了与肿瘤疾病放射治疗后心包损伤相关的文献。
放射相关的心包疾病可能会产生毁灭性的后果。不幸的是,与其他心血管结果相比,关于放射性胸内治疗后出现心包综合征的证据要少得多。放射引起的心包并发症可能是急性的,也可能在治疗后几十年逐渐出现。经胸超声心动图是首选的筛查成像方式,而心脏磁共振成像则进一步描述了心包,并指导治疗决策。心脏 CT 可用于评估心包钙化。目前正在努力减少无意中心脏损伤,方法是修改放射技术和方案。随着纵隔和胸部恶性肿瘤患者的生存率持续提高,放射相关的心包疾病越来越受到关注。尽管放射肿瘤学的进展在减轻心脏毒性方面显示出了希望,但与心包并发症相关的长期影响仍有待观察。