Radiation-Induced Cardiovascular Disease: A Clinical Perspective

Abstract

Cancer survival has improved dramatically, and this has led to the manifestation of late side effects of multimodality therapy. Radiation (RT) to the thoracic malignancies results in unintentional irradiation of the cardiac chambers. RT-induced microvascular ischemia leads to disruption of capillary endothelial framework, and injury to differentiated myocytes results in deposition of collagen and fibrosis. Coexistence of risk factors of metabolic syndrome and preexisting atherosclerosis in addition to RT exposure results in accelerated occurrence of major coronary events. Hence, it becomes pertinent to understand the underlying pathophysiology and clinical manifestations of RT-induced cardiovascular disease to devise optimal preventive and surveillance strategies.

Keywords: biomarkers; cancer; cardiovascular disease; ischemic heart disease; radiation.

Figure 1

Time trends of clinical and experimental studies reporting on radiation-induced heart disease in PubMed.

Figure 2

Proposed algorithm for follow-up in irradiated patients with thoracic malignancies. DM, diabetes mellitus; HT, hypertension; CRD, chronic renal disease; CAD, coronary artery disease; BNP, brain natriuretic peptide; TnI, troponin I; TnT, troponin T; RT, radiation.