Damage to the Heart after Radiotherapy in Childhood

Česká verzia

Authors: K. Hudecová; B. Mladosievičová
Authors place of work: Ústav patologickej fyziológie, Lekárska fakulta Univerzity Komenského, Bratislava prednosta doc. MUDr. M. Bernadič, CSc., mim. prof.
Published in the journal: Čes-slov Pediat 2008; 63 (4): 194-200.
Category: Review

Summary

The treatment of the child suffering from cancer carries a lot of risk into the future. Radiotherapy involving the chest, cranial and abdominal area can lead to late cardiovascular complications. Mediastinal radiotherapy may induce the damage of pericardium, myocardium, or coronary vasculature and causes the endothelial dysfunction and fibrosis. Radiotherapy can significantly contribute to the development of pericardial effusion, constrictive pericarditis, ischemic heart disease, myocardial infarction, valvular disorders, arrhythmias and other complications. Mutual connection between individual organ systems results in late effects which encourage and influence each other. The metabolic syndrome as a risk factor of atherogenesis and cardiovascular diseases is currently often discussed as a late effect of anti-cancer treatment, especially of cranial radiotherapy.

The identification of pathophysiological mechanisms of radiation-induced damage as well as using of new diagnostic cardiologic methods in clinical practice would enable us to detect the late effects already at subclinical level. It is expected to prevent the risk of cardiovascular diseases even in patients without any symptoms by using appropriate prevention and therapeutic methods (ACE-inhibitors, anticoagulants, prophylactic measures of bacterial endocarditis).

Key words:
radiotherapy, Hodgkin’s disease, metabolic syndrome, cardiotoxicity, prevention

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