Abstract
Therapeutic mediastinal irradiation can induce heart disease with variable degree of cardiac engagement. Heart disease manifestations depend on the grade of involvement of the different cardiac structures. During the first two years following irradiation, pericarditis with or without pericardial effusion is the most common manifestation of toxicity related to radiation therapy. Later on, after a latency period of five to ten years, a constrictive pericarditis may develop. Other type of late cardiac toxicities due to irradiation are restrictive cardiomyopathy, multiple valvular disease, coronary artery disease and different atrioventricular conduction disturbances. The therapeutic approach to this kind of heart disease has to be focused on its progressive course and in the possibility of a global involvement of all the cardiac structures. Pericardiectomy is strongly recommended for recurrent pericardial effusion with cardiac tamponade. Cardiac surgery for myocardial revascularization or valvular disease can be performed with variable results; the presence of myocardial fibrosis can significantly affect perioperative management and long-term results. Cardiac transplantation is a promissory option for those patients with end-stage cardiac failure. Immunosuppressive regimens are not associated with recurrence of malignancy. (author) [Spanish] La radioterapia aplicada sobre el mediastino puede afectar las diferentes estructuras cardiacas. De la magnitud de ese compromiso
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Alvarez, Jose A.G.;
Leiva, Gustavo;
[1]
Schwartz, Laura;
D'Angiola, Marisa
[2]
- Hospital Britanico, Buenos Aires (Argentina).Servicio de Cardiologia
- Hospital de Ninos 'Dr. Ricardo Gutierrez', Buenos Aires (Argentina)
Citation Formats
Alvarez, Jose A.G., Leiva, Gustavo, Schwartz, Laura, and D'Angiola, Marisa.
Cardiovascular effects of radiation therapy; Efectos cardiovasculares de la radioterapia.
Argentina: N. p.,
2001.
Web.
Alvarez, Jose A.G., Leiva, Gustavo, Schwartz, Laura, & D'Angiola, Marisa.
Cardiovascular effects of radiation therapy; Efectos cardiovasculares de la radioterapia.
Argentina.
Alvarez, Jose A.G., Leiva, Gustavo, Schwartz, Laura, and D'Angiola, Marisa.
2001.
"Cardiovascular effects of radiation therapy; Efectos cardiovasculares de la radioterapia."
Argentina.
@misc{etde_20816055,
title = {Cardiovascular effects of radiation therapy; Efectos cardiovasculares de la radioterapia}
author = {Alvarez, Jose A.G., Leiva, Gustavo, Schwartz, Laura, and D'Angiola, Marisa}
abstractNote = {Therapeutic mediastinal irradiation can induce heart disease with variable degree of cardiac engagement. Heart disease manifestations depend on the grade of involvement of the different cardiac structures. During the first two years following irradiation, pericarditis with or without pericardial effusion is the most common manifestation of toxicity related to radiation therapy. Later on, after a latency period of five to ten years, a constrictive pericarditis may develop. Other type of late cardiac toxicities due to irradiation are restrictive cardiomyopathy, multiple valvular disease, coronary artery disease and different atrioventricular conduction disturbances. The therapeutic approach to this kind of heart disease has to be focused on its progressive course and in the possibility of a global involvement of all the cardiac structures. Pericardiectomy is strongly recommended for recurrent pericardial effusion with cardiac tamponade. Cardiac surgery for myocardial revascularization or valvular disease can be performed with variable results; the presence of myocardial fibrosis can significantly affect perioperative management and long-term results. Cardiac transplantation is a promissory option for those patients with end-stage cardiac failure. Immunosuppressive regimens are not associated with recurrence of malignancy. (author) [Spanish] La radioterapia aplicada sobre el mediastino puede afectar las diferentes estructuras cardiacas. De la magnitud de ese compromiso dependera la aparicion de diversas manifestaciones clinicas. La pericarditis, con derrame o sin el, es lo mas habitual en los dos primeros anios; algunas evolucionan hacia la cronicidad para desarrollar, cinco a diez anios mas tarde, una pericarditis constrictiva. Otras manifestaciones tardias inducidas por la radioterapia pueden ser miocardiopatia restrictiva por fibrosis intersticial, disfunciones valvulares multiples, enfermedad obstructiva coronaria y trastornos en el sistema de conduccion auriculoventricular. En el manejo terapeutico de esta cardiopatia debe considerarse el caracter progresivo de la afeccion y la posibilidad de que el compromiso afecte en mayor o menor medida todas las estructuras cardiacas. La pericardiectomia debe hacerse precozmente en casos de derrame recidivante o taponamiento. La cirugia para revascularizacion miocardica, reemplazo o plastica valvular puede realizarse con resultados variables pues la presencia de fibrosis miocardica puede complicar el manejo perioperatorio y la evolucion alejada. El trasplante cardiaco es una opcion terapeutica valida para casos de insuficiencia cardiaca terminal; el tratamiento con inmunosupresores no parece que aumente la tasa de recurrencia del tumor original ni que favorezca la aparicion de nuevas neoplasias.}
journal = []
issue = {2}
volume = {69}
place = {Argentina}
year = {2001}
month = {Mar}
}
title = {Cardiovascular effects of radiation therapy; Efectos cardiovasculares de la radioterapia}
author = {Alvarez, Jose A.G., Leiva, Gustavo, Schwartz, Laura, and D'Angiola, Marisa}
abstractNote = {Therapeutic mediastinal irradiation can induce heart disease with variable degree of cardiac engagement. Heart disease manifestations depend on the grade of involvement of the different cardiac structures. During the first two years following irradiation, pericarditis with or without pericardial effusion is the most common manifestation of toxicity related to radiation therapy. Later on, after a latency period of five to ten years, a constrictive pericarditis may develop. Other type of late cardiac toxicities due to irradiation are restrictive cardiomyopathy, multiple valvular disease, coronary artery disease and different atrioventricular conduction disturbances. The therapeutic approach to this kind of heart disease has to be focused on its progressive course and in the possibility of a global involvement of all the cardiac structures. Pericardiectomy is strongly recommended for recurrent pericardial effusion with cardiac tamponade. Cardiac surgery for myocardial revascularization or valvular disease can be performed with variable results; the presence of myocardial fibrosis can significantly affect perioperative management and long-term results. Cardiac transplantation is a promissory option for those patients with end-stage cardiac failure. Immunosuppressive regimens are not associated with recurrence of malignancy. (author) [Spanish] La radioterapia aplicada sobre el mediastino puede afectar las diferentes estructuras cardiacas. De la magnitud de ese compromiso dependera la aparicion de diversas manifestaciones clinicas. La pericarditis, con derrame o sin el, es lo mas habitual en los dos primeros anios; algunas evolucionan hacia la cronicidad para desarrollar, cinco a diez anios mas tarde, una pericarditis constrictiva. Otras manifestaciones tardias inducidas por la radioterapia pueden ser miocardiopatia restrictiva por fibrosis intersticial, disfunciones valvulares multiples, enfermedad obstructiva coronaria y trastornos en el sistema de conduccion auriculoventricular. En el manejo terapeutico de esta cardiopatia debe considerarse el caracter progresivo de la afeccion y la posibilidad de que el compromiso afecte en mayor o menor medida todas las estructuras cardiacas. La pericardiectomia debe hacerse precozmente en casos de derrame recidivante o taponamiento. La cirugia para revascularizacion miocardica, reemplazo o plastica valvular puede realizarse con resultados variables pues la presencia de fibrosis miocardica puede complicar el manejo perioperatorio y la evolucion alejada. El trasplante cardiaco es una opcion terapeutica valida para casos de insuficiencia cardiaca terminal; el tratamiento con inmunosupresores no parece que aumente la tasa de recurrencia del tumor original ni que favorezca la aparicion de nuevas neoplasias.}
journal = []
issue = {2}
volume = {69}
place = {Argentina}
year = {2001}
month = {Mar}
}