“…The late effects of radiation-induced heart disease, including myocardial fibrosis, often manifest many years to decades after thoracic tumour radiation [78,79] and may be due to a variety of pathophysiological processes. These pathways have been previously reviewed [57,75], and can include radiation-induced vascular injury [80], thrombosis [81,82], myofibroblast activation, collagen deposition [57], myocardial ischaemia and cell death [72]. Following radiation, many profibrotic cytokines and factors have been implicated in the development of radiation-induced fibrosis [57], and these may serve as potential biomarkers to evaluate the radiation therapy fibrotic response.…”