Department of Cardiovascular Medicine, Cleveland Clinic, Cleveland, OH, USA.
Department of Cardiovascular Imaging, Cleveland Clinic, Cleveland, OH, USA.
Curr Cardiol Rep. 2020 Oct 10;22(12):167. doi: 10.1007/s11886-020-01411-0.
Radiation-associated valvular disease (RAVD) is characterized by late valvular manifestations following radiation exposure to the mediastinum. Review of current guidelines was performed to examine best practices to reduce risk and optimize outcomes in this patient population.
Early and consistent screening and comprehensive and careful planning are critical in managing RAVD. Due to long latency periods, serial screening and targeted evaluation of risk factors are essential to early detection. Varying and complex presentations of RAVD require an integrated team of experienced specialists equipped with multimodality imaging-based screening protocols to stratify risk, plan intervention, and evaluate treatment response. Patients with valvular manifestations associated with radiation therapy call for an individualized plan of care involving longitudinal multimodality imaging-based screening and experienced decision-making regarding timing and strategy of intervention to improve patient outcomes.
放射性心脏瓣膜病（RAVD）的特征是纵隔放射后出现迟发性瓣膜表现。本文回顾了当前的指南，以探讨降低该患者人群风险和优化结局的最佳实践。
早期和持续的筛查以及全面和仔细的规划对于管理 RAVD 至关重要。由于潜伏期长，因此需要进行连续筛查和针对危险因素的靶向评估，以实现早期发现。RAVD 的表现多样且复杂，需要由经验丰富的专家组成的综合团队，配备基于多模态成像的筛查方案，以对风险进行分层、规划干预措施并评估治疗反应。有瓣膜表现的放射性心脏瓣膜病患者需要个体化的护理计划，包括基于多模态成像的纵向筛查以及关于干预时机和策略的经验丰富的决策，以改善患者结局。
