Understanding Radiation-Induced Vascular Disease

Weintraub, Neal L.; Jones, W. Keith; Manka, David

doi:10.1016/j.jacc.2009.11.053

Cited by 155 publications

(110 citation statements)

References 14 publications

(23 reference statements)

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“…109 Furthermore, atherosclerotic changes in coronary vessels and cardiac fibrosis are generally observed to be isolated to within regions subjected to the irradiation field. 110 These findings thus strongly indicate a role for radiation in contributing to cardiovascular morbidity.…”

Section: 97mentioning

confidence: 81%

Is the false-positive rate in mammography in North America too high?

Le¹,

Mothersill²,

Seymour³

et al. 2016

BJR

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The practice of investigating pathological abnormalities in the breasts of females who are asymptomatic is primarily employed using X-ray mammography. The importance of breast screening is reflected in the mortality-based benefits observed among females who are found to possess invasive breast carcinoma prior to the manifestation of clinical symptoms. It is estimated that population-based screening constitutes a 17% reduction in the breast cancer mortality rate among females affected by invasive breast carcinoma. In spite of the significant utility that screening confers in those affected by invasive cancer, limitations associated with screening manifest as potential harms affecting individuals who are free of invasive disease. Disease-free and benign tumour-bearing individuals who are subjected to diagnostic work-up following a screening examination constitute a population of cases referred to as false positives (FPs). This article discusses factors contributing to the FP rate in mammography and extends the discussion to an assessment of the consequences associated with FP reporting. We conclude that the mammography FP rate in North America is in excess based upon the observation of overtreatment of in situ lesions and the disproportionate distribution of detriment and benefit among the population of individuals recalled for diagnostic work-up subsequent to screening. To address the excessive incidence of FPs in mammography, we investigate solutions that may be employed to remediate the current status of the FP rate. Subsequently, it can be suggested that improvements in the breast-screening protocol, medical litigation risk, image interpretation software and the implementation of image acquisition modalities that overcome superimposition effects are promising solutions.

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Section: 97mentioning

confidence: 81%

Is the false-positive rate in mammography in North America too high?

Le¹,

Mothersill²,

Seymour³

et al. 2016

BJR

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“…Previous studies have suggested that ROS plays a key role in radiation-induced fibrosis [5,6]. STS is shown to possess antioxidant action [18,19].…”

Section: Discussionmentioning

confidence: 99%

“…Previous studies have showed that radiation could induce the production of ROS [6,7], which played a key role in cardiac fibrosis. As STS was shown to possess some antioxdant action, we examined the effect of STS on radiation-increased intracellular ROS generation.…”

Section: Effects Of Sts On Ros and Expressions Of Fibrosis-associatedmentioning

confidence: 99%

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Sodium tanshinone IIA sulfonate attenuates radiation-induced fibrosis damage in cardiac fibroblasts

et al. 2014

Journal of Asian Natural Products Research

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The main pathological change in radiation-induced heart disease is fibrosis. Emerging evidence has indicated that sodium tanshinone IIA sulfonate (STS) was used for treating ﬁbrosis diseases. The present study was undertaken to characterize the effect of STS on radiation-induced cardiac fibrosis (RICF) on cultured cardiac fibroblasts (CFs). CFs were irradiated with 1 or 2 Gy X-rays, and the expression of TGF-β1 and collagen I (Col-1) increased, indicating that low-dose X-rays promoted fibrosis damage effect. The fibrosis damage was accompanied by morphologic changes in the endoplasmic reticulum (ER), as well as an increase in the expression of the ER stress-related molecules, GRP78 and CHOP. Administration of STS reduced ROS production and decreased the expression of Col-1, TGF-β1, p-Smad2/3, GRP78, and CHOP in irradiated CFs, thus weakening the radiation-induced fibrosis damage and ER stress. Radiation-induced fibrosis damage was observed on a cellular level. The involvement of ER stress in radiation-induced fibrosis damage was demonstrated for the first time. STS attenuated the fibrosis damage effect in CFs and this effect may be related to its antioxidant action, and also related to its inhibition of ER stress and TGF-β1-Smad pathway. These results suggest that STS shows a good prospect in clinical prevention and treatment of RICF.

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“…33,72 DNA damage and activation of key pro-inflammatory pathways such as the NFκB pathway has been pointed out for traditional cardiovascular risk factors (CVRF) as well, which may explain why traditional CVRF can influence the type and extent of atherosclerosis after chest radiation. 51,57,62,71,73-75 …”

Section: Introductionmentioning

confidence: 99%

Evaluation and Management of Patients With Heart Disease and Cancer: Cardio-Oncology

Herrmann

Lerman

Sandhu

et al. 2014

Mayo Clinic Proceedings

334

289

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The care for patients with cancer has advanced greatly over the past decades. A combination of earlier cancer diagnosis and greater use of traditional and novel systemic treatments has decreased cancer-related mortality. Effective cancer therapies, however, can result in short- and long-term co-morbidities that can decrease the net clinical gain by impacting quality of life and survival. In particular, cardiovascular complications of cancer treatments can have a profound impact on the health of cancer patients and are more common among those with recognized or unrecognized underlying cardiovascular diseases. A new discipline termed “cardio-oncology” has thus evolved to address the cardiovascular needs of cancer patients and optimize their care in a multidisciplinary approach. This review provides a brief introduction and background on this emerging field and then focuses on its practical aspects including: cardiovascular risk assessment and prevention before cancer treatment, cardiovascular surveillance and therapy during cancer treatment, and cardiovascular monitoring and management after cancer therapy. The content of this review is based on a literature search of PubMed between January 1, 1960, and February 1, 2014 using the search terms cancer, cardiomyopathy, cardiotoxicity, cardio-oncology, chemotherapy, heart failure, and radiation.

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Understanding Radiation-Induced Vascular Disease

Cited by 155 publications

References 14 publications

Is the false-positive rate in mammography in North America too high?

Is the false-positive rate in mammography in North America too high?

Sodium tanshinone IIA sulfonate attenuates radiation-induced fibrosis damage in cardiac fibroblasts

Evaluation and Management of Patients With Heart Disease and Cancer: Cardio-Oncology

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