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.

Telomere length and chromosomal instability for predicting individual radiosensitivity and risk via machine learning

“…Better prediction of a cancer patient's individual response to radiation therapy and risk for developing adverse late health effects remains a prime objective for the treatment modality in general [1][2][3][4][5][6][7] , and particularly in regard to pediatric patients 8 . Over recent years, a variety of approaches for predicting radiation late effects have been developed 10-20 , albeit with varying degrees of compromise between cost-effectiveness, throughput, and predictive power.…”

“…Radiation late effects are a broad class of negative and often permanent health effects experienced by cancer patients long after radiation therapy 1,2 , which can include cardiovascular disease 3 , pulmonary and arterial fibrosis 4 , cognitive deficits 5 , bone fractures 6 , and secondary cancers 7 . Such late effects are of particular concern for pediatric patients 8 , and risks for radiation late effects are highly dependent on patient-intrinsic factors as well, including genetics, age, sex, and lifestyle 1,2,9 .…”

Biomarkers of radiation‐induced vascular injury

“…As longevity of cancer patients improves, an emphasis on long‐term RT‐induced side effects among cancer survivors will assume increasing importance. RT‐induced vascular injury may contribute to a cascade of events that accelerate the progression of chronic aging‐related disorders . Premature onset of atherosclerosis may lead to myocardial infarction and stroke and contribute to accelerated aging.…”

“…RT-induced vascular injury may contribute to a cascade of events that accelerate the progression of chronic aging-related disorders. 2,3 Premature onset of atherosclerosis may lead to myocardial infarction and stroke and contribute to accelerated aging. Developing predictive tools for vascular injury may facilitate surveillance, monitoring, and/or early interventions.…”

A review of cardiovascular disease induced by radiation

“…Radiation associated damage is 79% more common in left sided valves according to autopsy series [11][12][13]. Beside deterioration in myocardium, endocardium and heart valves, conduction system may also be affected by radiation [14]. Radiation stimulates sympathetic nervous system by enhancing beta adrenergic receptors.…”