RADIATION-ASSOCIATED VALVULAR DISEASE

被引:143
作者
CARLSON, RG
MAYFIELD, WR
NORMANN, S
ALEXANDER, JA
机构
关键词
D O I
10.1378/chest.99.3.538
中图分类号
R4 [临床医学];
学科分类号
1002 ; 100602 ;
摘要
The prevalence of radiation-associated cardiac disease is increasing due to prolonged survival following mediastinal irradiation. Side effects of radiation include pericarditis, accelerated coronary artery disease, myocardial fibrosis and valvular injury. We evaluated the cases of three young patients with evidence of significant valvular disease following mediastinal irradiation. One patient underwent the first reported successful aortic and mitral valve replacement for radiation-associated valvular disease (RAVD) as well as concurrent coronary artery revascularization. A review of the literature revealed 35 reported cases of RAVD, with only one successful case of valve replacement that was limited to the aortic valve. Asymptomatic RAVD is diagnosed 11.5 years after mediastinal irradiation compared with 16.5 years for symptomatic patients, emphasizing that long-term follow-up is important for patients receiving mediastinal irradiation. This study defines a continuum of valvular disease following radiation that begins with mild asymptomatic valvular thickening and progresses to severe valvular fibrosis with hemodynamic compromise requiring surgical intervention.
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页码:538 / 545
页数:8
相关论文
共 35 条
[1]   THE SYNERGISM OF X-IRRADIATION AND CHOLESTEROL-FAT FEEDING ON THE DEVELOPMENT OF CORONARY ARTERY LESIONS [J].
AMROMIN, GD ;
GILDENHORN, HL ;
SOLOMON, RD ;
NADKARNI, BB ;
JACOBS, ML .
JOURNAL OF ATHEROSCLEROSIS RESEARCH, 1964, 4 (04) :325-334
[2]  
ANNEST LS, 1983, J THORAC CARDIOV SUR, V85, P257
[3]   CARDIAC DISEASE AFTER RADIATION-THERAPY FOR HODGKINS-DISEASE - ANALYSIS OF 48 PATIENTS [J].
APPLEFELD, MM ;
WIERNIK, PH .
AMERICAN JOURNAL OF CARDIOLOGY, 1983, 51 (10) :1679-1681
[4]  
APPLEFELD MM, 1982, CANCER TREAT REP, V66, P1003
[5]   RADIATION HEART-DISEASE - ANALYSIS OF 16 YOUNG (AGED 15 TO 33 YEARS) NECROPSY PATIENTS WHO RECEIVED OVER 3,500 RADS TO THE HEART [J].
BROSIUS, FC ;
WALLER, BF ;
ROBERTS, WC .
AMERICAN JOURNAL OF MEDICINE, 1981, 70 (03) :519-530
[6]   EFFECTS OF RADIATION ON HUMAN HEART - AN ELECTRON MICROSCOPIC STUDY [J].
BURCH, GE ;
SOHAL, RS ;
SUN, SC ;
MILLER, GC ;
COLCOLOUGH, HL .
ARCHIVES OF INTERNAL MEDICINE, 1968, 121 (03) :230-+
[7]  
CASSADY JR, 1975, CANCER, V36, P946, DOI 10.1002/1097-0142(197509)36:3<946::AID-CNCR2820360316>3.0.CO
[8]  
2-5
[9]   TWO-DIMENSIONAL ECHOCARDIOGRAPHIC ASSESSMENT OF RADIATION-INDUCED VALVULAR HEART-DISEASE [J].
DETRANO, RC ;
YIANNIKAS, J ;
SALCEDO, EE .
AMERICAN HEART JOURNAL, 1984, 107 (03) :584-585
[10]   RADIATION-INDUCED CORONARY-ARTERY DISEASE [J].
DUNSMORE, LD ;
LOPONTE, MA ;
DUNSMORE, RA .
JOURNAL OF THE AMERICAN COLLEGE OF CARDIOLOGY, 1986, 8 (01) :239-244