Ghnim Zahraa Sabah, Adhab Ayat Hussein, Mahdi Morug Salih, Kyada Ashishkumar, Roopashree R, Thakur Vishal, Kaur Manpreet, Gupta Anirudh, Mansoor Aseel Salah, Radi Usama Kadem, Abd Nasr Saadoun, Kadhim Munther
College of Pharmacy, Alnoor University, Nineveh, Iraq.
Department of Pharmacy, Al-Zahrawi University College, Karbala, Iraq.
Cardiovasc Toxicol. 2025 May 29. doi: 10.1007/s12012-025-10006-6.
Radiation-induced cardiac remodeling (RICR) is one of the complications of exposure to radiotherapy. These disorders may occur for a subset of cancer patients, when the heart remains in part or in full in the radiation field. Despite advancements in radiotherapy techniques, cardiotoxicity has remained a concern after radiotherapy. RICR includes complex pathophysiological processes, which can be initiated by oxidative stress and cardiomyocyte cell death and continue with inflammation, arrhythmia, vascular and valvular abnormalities, and fibrosis, collectively contributing to structural and functional changes in the heart. Some studies have suggested strategies for RICR encompass pharmacological interventions, including angiotensin-converting enzyme (ACE) inhibitors, natural products, antioxidants, and others, which aim to mitigate cardiac damage and improve outcomes. Advanced therapies, including stem cell and gene therapy, as well as some adjuvants and novel drugs targeting specific molecular pathways, represent future directions for treatment. This review aims to elucidate the mechanisms underlying RICR, highlight early detection strategies, and discuss current and emerging therapeutic approaches.
辐射诱发的心脏重塑（RICR）是放疗暴露的并发症之一。当心脏部分或全部处于辐射野中时，这些病症可能会在一部分癌症患者中出现。尽管放疗技术有所进步，但放疗后的心脏毒性仍然是一个令人担忧的问题。RICR包括复杂的病理生理过程，其可由氧化应激和心肌细胞死亡引发，并持续伴有炎症、心律失常、血管和瓣膜异常以及纤维化，这些共同导致心脏的结构和功能变化。一些研究表明，针对RICR的策略包括药物干预，如血管紧张素转换酶（ACE）抑制剂、天然产物、抗氧化剂等，其目的是减轻心脏损伤并改善预后。先进的治疗方法，包括干细胞和基因治疗，以及一些针对特定分子途径的佐剂和新药，代表了未来的治疗方向。本综述旨在阐明RICR的潜在机制，强调早期检测策略，并讨论当前和新兴的治疗方法。
