Pathology of experimental radiation pancarditis. I. Observation on radiation-induced heart injuries following a single dose of x-ray irradiation to rabbit heart with special reference to its pathogenesis.

Radiation-induced heart injuries were morphologically studied by using the rabbits irradiated with a single dose of 3,000R (group I) or 300R of X-ray group II) from 1 hour until 6 months. There was no essential difference in the lesions of the hearts from group I and that of group II. Acute epicarditis was found as early as 1 hour after irradiation and it became maximum in severity at 1-2 days. In the myocardium, there were degeneration and resolution of the myocardial cell, various architectural changes of mitochondria, and disorganization of the intercalated disc. Polymorphonuclear cell infiltration and endothelial injuries of the capillaries occurred in the interstitial tissue. In addition, endocarditis with or without thrombus formation was often found. Acute inflammation was seen in the myocardium of group II rather later than that of group I, but it disappeared earlier. In the later stage, fibrosis finally occurred in the epicardium and endocardium. Glycoprotein degeneration of the muscle cells and fibrosis appeared in the myocardium. The pathogenesis of radiation pancarditis is thought to be dependent not only on the disturbance of microcirculation caused by endothelial cell damage of the capillaries, but also on alterations of the myocardial mitochondria as a result of direct injury.