Skip to main content
Hauptrubriken
CME Facharzt-Training Webinare Zeitschriften Bücher e.Medpedia Podcast
Service
Jobbörse Info & Hilfe
Fachgebiete
Anästhesiologie Allgemeinmedizin Arbeitsmedizin Augenheilkunde Chirurgie Dermatologie Gynäkologie und Geburtshilfe HNO Innere Medizin Kardiologie Neurologie Onkologie und Hämatologie Orthopädie und Unfallchirurgie Pädiatrie Pathologie Psychiatrie Radiologie Rechtsmedizin Urologie Zahnmedizin
Themen
Typ-2-Diabetes und Adipositas Klimawandel und Gesundheit Neues aus dem Markt COVID-19 Praxis und Beruf Seltene Erkrankungen GOÄ & EBM Panorama
Sammlungen
Kasuistiken Algorithmen & Infografiken Blickdiagnosen Arthropedia FlapFinder (für Dermatochirurgen) Videos Kongressberichterstattung Medizin für Apothekerinnen und Apotheker Für Ärztinnen und Ärzte in Weiterbildung Für Medizinstudierende

Live-Webinar "Urologie und Sexualmedizin in der Praxis"

Häufige urologisch-sexualmedizinische Themen in der Praxis sind das Thema des MMW-Webinars am 5. Juni von 17.30 bis 19 Uhr. Konkret geht es um die Frage, wann bei Harnwegsinfektionen auf Antibiotika verzichtet werden kann, und um ein Update zur Therapie von Libido- und Potenzstörungen des Mannes. Der dritte Vortrag behandelt sexuell übertragbare Krankheiten. Stellen Sie Ihre Fragen an die Experten und sammeln Sie 2 CME-Punkte. Jetzt gleich anmelden!
Erweiterte Suche
Anmelden
nach oben
Current Cardiology Reports
Erschienen in: Current Cardiology Reports 12/2020

01.12.2020 | Valvular Heart Disease (TL Kiefer, Section Editor)

Radiation-Associated Valvular Disease

verfasst von: Samantha Xu, Eoin Donnellan, Milind Y. Desai

Erschienen in: Current Cardiology Reports | Ausgabe 12/2020

Einloggen, um Zugang zu erhalten

Abstract

Purpose of Review

Radiation-associated valvular disease (RAVD) is characterized by late valvular manifestations following radiation exposure to the mediastinum. Review of current guidelines was performed to examine best practices to reduce risk and optimize outcomes in this patient population.

Recent Findings

Early and consistent screening and comprehensive and careful planning are critical in managing RAVD. Due to long latency periods, serial screening and targeted evaluation of risk factors are essential to early detection. Varying and complex presentations of RAVD require an integrated team of experienced specialists equipped with multimodality imaging-based screening protocols to stratify risk, plan intervention, and evaluate treatment response.

Summary

Patients with valvular manifestations associated with radiation therapy call for an individualized plan of care involving longitudinal multimodality imaging-based screening and experienced decision-making regarding timing and strategy of intervention to improve patient outcomes.
Literatur
1.
• Desai MY, Jellis CL, Kotecha R, Johnston DR, Griffin BP. Radiation-associated cardiac disease: a practical approach to diagnosis and management. JACC Cardiovasc Imaging. 2018;11:1132–49 Provided a comprehensive overview of the disease and pragmatic approaches to diagnosis and management.CrossRefPubMed
2.
3.
Donnellan E, Phelan D, Mccarthy CP, Collier P, Desai M, Griffin B. Radiation-induced heart disease: a practical guide to diagnosis and management. Cleve Clin J Med. 2016;83:914–22.CrossRefPubMed
4.
Donnellan E, Jellis CL, Griffin BP. Radiation-associated cardiac disease: from molecular mechanisms to clinical management. Curr Treat Options Cardiovasc Med. 2019;21(5):22.CrossRefPubMed
5.
Galper SL, Yu JB, Mauch PM, Strasser JF, Silver B, LaCasce A, et al. Clinically significant cardiac disease in patients with Hodgkin lymphoma treated with mediastinal irradiation. Blood. 2011;117:412–8.CrossRefPubMed
6.
Emami B, Lyman J, Brown A, Cola L, Goitein M, Munzenrider JE, et al. Tolerance of normal tissue to therapeutic irradiation. Int J Radiat Oncol Biol Phys. 1991;21:109–22.CrossRefPubMed
7.
Veinot JP, Edwards WD. Pathology of radiation-induced heart disease: a surgical and autopsy study of 27 cases. Hum Pathol. 1996;27:766–73.CrossRefPubMed
8.
•• Desai MY, Windecker S, Lancellotti P, et al. Prevention, diagnosis, and management of radiation-associated cardiac disease: JACC Scientific Expert Panel. J Am Coll Cardiol. 2019;74:905–27 A landmark scientific statement on radiation heart disease from a panel of experts.CrossRefPubMed
9.
Hayashi T, Morishita Y, Kubo Y, et al. Long-term effects of radiation dose on inflammatory markers in atomic bomb survivors. Am J Med. 2005;79:129–36.
10.
Nadlonek NA, Weyant MJ, Yu JA, Cleveland JC Jr, Reece TB, Meng X, et al. Radiation induces osteogenesis in human aortic valve interstitial cells. J Thorac Cardiovasc Surg. 2012;144:1466–70.CrossRefPubMedPubMedCentral
11.
Gagliardi G, Constine LS, Moiseenko V, Correa C, Pierce LJ, Allen AM, et al. Radiation dose-volume effects in the heart. Int J Radiat Oncol Biol Phys. 2010;76:S77–85.CrossRefPubMed
12.
Amromin GD, Gildenhorn HL, Solomon RD, Nadkarni BB, Jacobs ML. The synergism of X-irradiation and cholesterol-fat feeding on the development of coronary artery lesions. J Atheroscler Res. 1964;4:325–34.CrossRefPubMed
13.
Meyer RM, Gospodarowicz MK, Connors JM, Pearcey RG, Wells WA, Winter JN, et al. ABVD alone versus radiation-based therapy in limited-stage Hodgkin’s lymphoma. N Engl J Med. 2012;366:399–408.CrossRefPubMed
14.
Tamura A, Takahara Y, Mogi K, Katsumata M. Radiation-induced valvular disease is the logical consequence of irradiation. Gen Thorac Cardiovasc Surg. 2007;55:53–6.CrossRefPubMed
15.
Desai MY, Wu W, Masri A, Popovic ZB, Agarwal S, Smedira NG, et al. Increased aorto-mitral curtain thickness independently predicts mortality in patients with radiation-associated cardiac disease undergoing cardiac surgery. Ann Thorac Surg. 2014;97:1348–55.CrossRefPubMed
16.
Hull MC, Morris CG, Pepine CJ, Mendenhall NP. Valvular dysfunction and carotid , subclavian , and coronary artery disease treated with radiation therapy. Jama. 2003;290:2831–387.CrossRefPubMed
17.
Heidenreich PA, Hancock SL, Lee BK, Mariscal CS, Schnittger I. Asymptomatic cardiac disease following mediastinal irradiation. J Am Coll Cardiol. 2003;42:743–9.CrossRefPubMed
18.
Lancellotti P, Nkomo VT, Badano LP, Bergler-Klein J, Bogaert J, Davin L, et al. Expert consensus for multi-modality imaging evaluation of cardiovascular complications of radiotherapy in adults: a report from the European Association of Cardiovascular Imaging and the American Society of Echocardiography. Eur Heart J Cardiovasc Imaging. 2013;14(8):721–40.CrossRefPubMed
19.
Kamdar AR, Meadows TA, Roselli EE, Gorodeski EZ, Curtin RJ, Sabik JF, et al. Multidetector computed tomographic angiography in planning of reoperative cardiothoracic surgery. Ann Thorac Surg. 2008;85:1239–45.CrossRefPubMed
20.
Desai MY, Karunakaravel K, Wu W, Agarwal S, Smedira NG, Lytle BW, et al. Pulmonary fibrosis on multidetector computed tomography and mortality in patients with radiation-associated cardiac disease undergoing cardiac surgery. J Thorac Cardiovasc Surg. 2014;148:475–81.CrossRefPubMed
21.
Otto CM, Kumbhani DJ, Alexander KP, et al. ACC expert consensus decision pathway for transcatheter aortic valve replacement in the management of adults with aortic stenosis: a report of the American College of Cardiology Task Force on clinical expert consensus documents. J Am Coll Cardiol. 2017;2017(69):1313–46.CrossRef
22.
Lancellotti P, Suter TM, López-Fernández T, Galderisi M, Lyon AR, van der Meer P, et al. Cardio-oncology services: rationale, organization, and implementation. Eur Heart J. 2019;40:1756–63.CrossRefPubMed
23.
Donis N, Oury C, Moonen M, Lancellotti P. Treating cardiovascular complications of radiotherapy: a role for new pharmacotherapies. Expert Opin Pharmacother. 2018;19:431–42.CrossRefPubMed
24.
Van Der Veen SJ, Ghobadi G, De Boer RA, et al. ACE inhibition attenuates radiation-induced cardiopulmonary damage. Radiother Oncol. 2015;114:96–103.CrossRefPubMed
25.
Haydont V, Bourgier C, Pocard M, Lusinchi A, Aigueperse J, Mathe D, et al. Pravastatin inhibits the rho/CCN2/extracellular matrix cascade in human fibrosis explants and improves radiation-induced intestinal fibrosis in rats. Clin Cancer Res. 2007;13:5331–40.CrossRefPubMed
26.
Gürses I, Özeren M, Serin M, Yücel N, Erkal HŞ. Histopathological evaluation of melatonin as a protective agent in heart injury induced by radiation in a rat model. Pathol Res Pract. 2014;210:863–71.CrossRefPubMed
27.
Gu A, Jie Y, Sun L, Zhao S, Mingyan E, You Q. RhNRG-1β protects the myocardium against irradiation-induced damage via the ErbB2-ERK-SIRT1 signaling pathway. PLoS One. 2015;10:e0137337.CrossRefPubMedPubMedCentral
28.
GHARAGOZLOO F, CLEMENTS IP, MULLANY CJ. Use of the internal mammary artery for myocardial revascularization in a patient with radiation-induced coronary artery disease. Mayo Clin Proc. 1992;67(11):1081–4.CrossRefPubMed
29.
•• Wu W, Masri A, Popovic ZB, et al. Long-term survival of patients with radiation heart disease undergoing cardiac surgery: a cohort study. Circulation. 2013;127:1476–84 Highlighted the high risk nature of open heart surgery in patients with radiation heart disease.CrossRefPubMed
30.
Desai MY, Cremer PC, Schoenhagen P. Thoracic aortic calcification: diagnostic, prognostic, and management considerations. JACC Cardiovasc Imaging. 2018;11:1012–26.CrossRefPubMed
31.
Crestanello JA, McGregor CGA, Danielson GK, et al. Mitral and tricuspid valve repair in patients with previous mediastinal radiation therapy. Ann Thorac Surg. 2004;78:826–31.CrossRefPubMed
32.
Wu W, Masri A, Popovic ZB, Smedira NG, Lytle BW, Marwick TH, et al. Long-term survival of patients with radiation heart disease undergoing cardiac surgery: a cohort study. Circulation. 2013;127:1476–85.CrossRefPubMed
33.
• Donnellan E, Alashi A, Johnston DR, et al. Outcomes of patients with mediastinal radiation-associated mitral valve disease undergoing cardiac surgery. Circulation. 2019;140:1288–90 The first study to investigate outcomes of mitral valve interventions in these patients.CrossRefPubMed
34.
Donnellan E, Masri A, Johnston DR, et al. Long-term outcomes of patients with mediastinal radiation-associated severe aortic stenosis and subsequent surgical aortic valve replacement: a matched cohort study. J Am Heart Assoc. 2017;6:e005396.CrossRefPubMedPubMedCentral
35.
Donnellan E, Griffin BP, Johnston DR, Popovic ZB, Alashi A, Kapadia SR, et al. Rate of progression of aortic stenosis and its impact on outcomes in patients with radiation-associated cardiac disease: a matched cohort study. JACC Cardiovasc Imaging. 2018;11:1072–80.CrossRefPubMed
36.
Donnellan E, Krishnaswamy A, Hutt-Centeno E, Johnston DR, Aguilera J, Kapadia SR, et al. Outcomes of patients with mediastinal radiation-associated severe aortic stenosis undergoing transcatheter aortic valve replacement. Circulation. 2018;138(16):1752–4.CrossRefPubMed
37.
Zhang D, Guo W, Al-Hijji MA, et al. Outcomes of patients with severe symptomatic aortic valve stenosis after chest radiation: transcatheter versus surgical aortic valve replacement. J Am Heart Assoc. 2019;8:e012110.PubMedPubMedCentral
38.
Baumgartner H, Falk V, Bax JJ, De Bonis M, Hamm C, Holm PJ, et al. ESC/EACTS guidelines for the management of valvular heart disease. Eur Heart J. 2017;2017(38):2739–91.CrossRef
Metadaten
Titel
Radiation-Associated Valvular Disease
verfasst von
Samantha Xu
Eoin Donnellan
Milind Y. Desai
Publikationsdatum
01.12.2020
Verlag
Springer US
Erschienen in
Current Cardiology Reports / Ausgabe 12/2020
Print ISSN: 1523-3782
Elektronische ISSN: 1534-3170
DOI
https://doi.org/10.1007/s11886-020-01411-0

Weitere Artikel der Ausgabe 12/2020

Current Cardiology Reports 12/2020 Zur Ausgabe

Psychological Aspects of Cardiovascular Diseases (A Steptoe, Section Editor)

Shock to the Heart: Psychosocial Implications and Applications of Sudden Cardiac Death in the Young

Management of Acute Coronary Syndromes (H Jneid, Section Editor)

Management of Patients with Acute Coronary Syndrome and Cancer

Public Health Policy (E Klodas, Section Editor)

Strategies for Improving Nutrition in Inner-City Populations

Congenital Heart Disease (RA Krasuski and G Fleming, Section Editors)

The Future of Paediatric Heart Interventions: Where Will We Be in 2030?

Cardiac PET, CT, and MRI (P Schoenhagen and P-H Chen, Section Editors)

Machine Learning in Electrocardiography and Echocardiography: Technological Advances in Clinical Cardiology

Cardio-Oncology (T Neilan, Section Editor)

COVID-19 and Cardiovascular Health Among Patients with Cancer

Neu im Fachgebiet Kardiologie

Nach Herzinfarkt mit Typ-1-Diabetes schlechtere Karten als mit Typ 2?

29.05.2024 Herzinfarkt Nachrichten

Bei Menschen mit Typ-2-Diabetes sind die Chancen, einen Myokardinfarkt zu überleben, in den letzten 15 Jahren deutlich gestiegen – nicht jedoch bei Betroffenen mit Typ 1.

Erhöhtes Risiko fürs Herz unter Checkpointhemmer-Therapie

28.05.2024 Nebenwirkungen der Krebstherapie Nachrichten

Kardiotoxische Nebenwirkungen einer Therapie mit Immuncheckpointhemmern mögen selten sein – wenn sie aber auftreten, wird es für Patienten oft lebensgefährlich. Voruntersuchung und Monitoring sind daher obligat.

GLP-1-Agonisten können Fortschreiten diabetischer Retinopathie begünstigen

24.05.2024 Diabetische Retinopathie Nachrichten

Möglicherweise hängt es von der Art der Diabetesmedikamente ab, wie hoch das Risiko der Betroffenen ist, dass sich sehkraftgefährdende Komplikationen verschlimmern.

TAVI versus Klappenchirurgie: Neue Vergleichsstudie sorgt für Erstaunen

21.05.2024 TAVI Nachrichten

Bei schwerer Aortenstenose und obstruktiver KHK empfehlen die Leitlinien derzeit eine chirurgische Kombi-Behandlung aus Klappenersatz plus Bypass-OP. Diese Empfehlung wird allerdings jetzt durch eine aktuelle Studie infrage gestellt – mit überraschender Deutlichkeit.

Update Kardiologie

Bestellen Sie unseren Fach-Newsletter und bleiben Sie gut informiert.

Newsletter bestellen