Cardiovascular diseases induced by radiotherapy. Case report

Cover Page

Cite item

Full Text

Abstract

The article presents the current understanding of the problem of radiation therapy (RT)-induced heart diseases. The paper is based on a clinical case of restrictive cardiomyopathy in a female previously cured of Hodgkin's lymphoma with RT. The importance of using modern imaging technologies aimed at verifying pathomorphological changes in the myocardium that cause the development of heart failure with preserved left ventricular ejection fraction is reflected. The given clinical case shows the combination of visceral complications arising in the long term after RT in oncohematological patients.

About the authors

Anton V. Barsukov

CardioClinic; Kirov Military Medical Academy

Author for correspondence.
Email: avbarsukov@yandex.ru
ORCID iD: 0000-0002-1943-9545

D. Sci. (Med.), Prof.

Russian Federation, Saint Petersburg; Saint Petersburg

Ekaterina V. Borisova

CardioClinic

Email: avbarsukov@yandex.ru
ORCID iD: 0000-0002-0960-9627

D. Sci. (Med.)

Russian Federation, Saint Petersburg

Dmitrii V. Glukhovskoi

Kirov Military Medical Academy

Email: avbarsukov@yandex.ru
ORCID iD: 0000-0002-5920-9074

Cand. Sci. (Med.)

Russian Federation, Saint Petersburg

Svetlana A. Glebova

CardioClinic

Email: avbarsukov@yandex.ru
ORCID iD: 0000-0003-1627-587X

Cand. Sci. (Med.)

Russian Federation, Saint Petersburg

Sergey D. Rud

Kirov Military Medical Academy

Email: avbarsukov@yandex.ru
ORCID iD: 0000-0002-3585-9793

Cand. Sci. (Med.), Assoc. Prof.

Russian Federation, Saint Petersburg

Ilgam M. Akhmetshin

Kirov Military Medical Academy

Email: avbarsukov@yandex.ru
ORCID iD: 0000-0002-7794-5809

Cand. Sci. (Med.)

Russian Federation, Saint Petersburg

Tatiana S. Sveklina

Kirov Military Medical Academy

Email: avbarsukov@yandex.ru
ORCID iD: 0000-0001-9546-7049

Cand. Sci. (Med.), Assoc. Prof.

Russian Federation, Saint Petersburg

Boris A. Chumak

Kirov Military Medical Academy

Email: avbarsukov@yandex.ru
ORCID iD: 0000-0002-5010-7661

Cand. Sci. (Med.), Assoc. Prof.

Russian Federation, Saint Petersburg

References

  1. Cuomo JR, Sharma GK, Conger PD, Weintraub NL. Novel concepts in radiation-induced cardiovascular disease. World J Cardiol. 2016;8(9):504-19. doi: 10.4330/wjc.v8.i9.504
  2. Donnellan E, Phelan D, McCarthy CP, et al. Radiation-induced heart disease: A practical guide to diagnosis and management. Cleve Clin J Med. 2016;83(12):914-22. doi: 10.3949/ccjm.83a.15104
  3. Wang H, Wei J, Zheng Q, et al. Radiation-induced heart disease: a review of classification, mechanism and prevention. Int J Biol Sci. 2019;15(10):2128-38. doi: 10.7150/ijbs.35460
  4. Aleman BMP, van den Belt-Dusebout AW, De Bruin ML, et al. Late cardiotoxicity after treatment for Hodgkin lymphoma. Blood. 2007;109(5):1878-86. doi: 10.1182/blood-2006-07-034405
  5. Heidenreich PA, Schnittger I, Strauss HW, et al. Screening for coronary artery disease after mediastinal irradiation for Hodgkin's disease. J Clin Oncol. 2007;25(1):43-9. doi: 10.1200/JCO.2006.07.0805
  6. Heidenreich PA, Hancock SL, Vagelos RH, et al. Diastolic dysfunction after mediastinal irradiation. Am Heart J. 2005;150(5):977-82. doi: 10.1016/j.ahj.2004.12.026
  7. Redfield MM. Heart failure with preserved ejection fraction. N Engl J Med. 2016;375(19):1868-77. doi: 10.1056/NEJMcp1511175
  8. McDonagh TA, Metra M, Adamo M, et al. 2021 ESC Guidelines for the diagnosis and treatment of acute and chronic heart failure. Eur Heart J. 2021;42(36):3599-726. doi: 10.1093/eurheartj/ehab368
  9. Michaelson EM, Chen YH, Silver B, et al. Thyroid malignancies in survivors of Hodgkin’s lymphoma. Int J Radiation Oncol Biol Phys. 2014;88(3):636-41. doi: 10.1016/j.ijrobp.2013.11.237
  10. Richardson P, McKenna W, Bristow M, et al. Report of the 1995 World Health Organization/International Society and Federation of Cardiology Task Force on the Definition and Classification of cardiomyopathies. Circulation. 1996;93(5):841-2. doi: 10.1161/01.cir.93.5.841
  11. Maron BJ, Towbin J, Thiene G, et al. Contemporary definitions and classification of the cardiomyopathies. Circulation. 2006;113(14):1807-16. doi: 10.1161/CIRCULATIONAHA.106.174287
  12. Elliott P, Andersson B, Arbustini E, et al. Classification of the cardiomyopathies: a position statement from the European Society of Cardiology Working Group on Myocardial and Pericardial Diseases. Eur Heart J. 2008;29(2):270-6. doi: 10.1093/eurheartj/ehm342
  13. Constine L, Schwartz R, Savage D, et al. Cardiac function, perfusion, and morbidity in irradiated long-term survivors of Hodgkin’s disease. Int J Radiat Oncol Biol Phys. 1997;39(4):897-906. doi: 10.1016/s0360-3016(97)00467-7
  14. Nagueh S, Smiseth O, Appleton C, et al. Recommendations for the Evaluation of Left Ventricular Diastolic Function by Echocardiography: An Update from the American Society of Echocardiography and the European Association of Cardiovascular Imaging. J Am Soc Echocardiogr. 2016;29(4):277-314. doi: 10.1016/j.echo.2016.01.011
  15. Habib G, Bucciarelli-Ducci C, Caforio ALP, et al. Multimodality Imaging in Restrictive Cardiomyopathies: An EACVI expert consensus document In collaboration with the «Working Group on myocardial and pericardial diseases» of the European Society of Cardiology Endorsed by The Indian Academy of Echocardiography. Eur Heart J Cardiovasc Imaging. 2017;18(10):1090-1. doi: 10.1093/ehjci/jex034
  16. Rammos A, Meladinis V, Vovas G, Patsouras D. Restrictive cardiomyopathies: the importance of noninvasive cardiac imaging modalities in diagnosis and treatment-a systematic review. Radiol Res Pract. 2017;2017:e2874902. doi: 10.1155/2017/2874902
  17. Luis SA, Pellikka PA. Is speckle tracking imaging ready for prime time in current echo clinical practice? Prog Cardiovasc Dis. 2018;61(5-6):437-45. doi: 10.1016/j.pcad.2018.11.001
  18. Гриценко О.В., Чумакова Г.А., Трубина Е.В. Возможности speckle tracking-эхокардиографии для диагностики дисфункции миокарда. CardioСоматика. 2021;12(1):5-10 [Gritsenko OV, Chumakova GA, Trubina EV. Features of speckle tracking echocardiography for diagnosis of myocardial dysfunction. CardioSomatics. 2021;12(1):5-10 (in Russian)]. doi: 10.26442/22217185.2021.1.200756
  19. Никифоров В.С., Никищенкова Ю.В. Cовременные возможности speckle tracking эхокардиографии в клинической практике. Рациональная фармакотерапия в кардиологии. 2017;13(2):248-55 [Nikiforov VS, Nikishchenkova IV. Modern possibilities of speckle tracking echocardiography in clinical practice. Rational Pharmacotherapy in Cardiology. 2017;13(2):248-55 (in Russian)]. doi: 10.20996/1819-6446-2017-13-2-248-255

Supplementary files

Supplementary Files
Action
1. JATS XML
Download
2. Fig. 1. Tissue dopplerography of the mitral valve annulus. Fragments a and b showed a decrease in septal and lateral myocardial velocities of the mitral valve ring to 6,7 and 8,79 cm/s, respectively.

Download (177KB)
Indexing metadata
3. Fig. 2. Dopplerography of the transmitral and transtricuspid blood flow: a – the acceleration of the wave E of the transmitral blood flow up to 1,38 m/s and the ratio E/A<2; b – an increase in the speed of tricuspid regurgitation up to 323 cm/s.

Download (199KB)
Indexing metadata
4. Fig. 3. Ultrasound assessment of longitudinal systolic deformation of the myocardium: a – topographical presentation of data from longitudinal analysis of deformation in segments of the LV myocardium (bull's eye - target); b – longitudinal strain time plot of all septal and lateral segments.

Download (232KB)
Indexing metadata
5. Fig. 4. MRI data of the heart of patient B. Fragments show phase-selective images of “late” accumulation of the contrast agent, obtained 10 min after intravenous administration of gadolinium: a – the image along the short axis of the heart; b – the image in the four-chamber position. The arrows indicate the areas of contrast agent accumulation by the LV myocardium (a) and the atrial myocardium (b).

Download (198KB)
Indexing metadata

Copyright (c) 2022 Eco-Vector

Creative Commons License
This work is licensed under a Creative Commons Attribution-NonCommercial-ShareAlike 4.0 International License.

This website uses cookies

You consent to our cookies if you continue to use our website.

About Cookies