Radiation-Induced Cardiovascular Disease: Mechanisms, Prevention, and Treatment

Curr Oncol Rep. 2022 May;24(5):543-553. doi: 10.1007/s11912-022-01238-8. Epub 2022 Feb 22.

Abstract

Purpose of review: Despite the advancements of modern radiotherapy, radiation-induced cardiovascular disease (RICVD) remains a common cause of morbidity and mortality among cancer survivors.

Recent findings: Proposed pathogenetic mechanisms of RICVD include endothelial cell damage with accelerated atherosclerosis, pro-thrombotic alterations in the coagulation pathway as well as inflammation and fibrosis of the myocardial, pericardial, valvular, and conduction tissues. Prevention of RICVD can be achieved by minimizing the exposure of the cardiovascular system to radiation, by treatment of underlying cardiovascular risk factors and cardiovascular disease, and possibly by prophylactic pharmacotherapy post exposure. Herein we summarize current knowledge on the mechanisms underlying the pathogenesis of RICVD and propose prevention and treatment strategies.

Keywords: Cardiotoxicity; Mechanisms; Prevention; Radiation therapy; Radiation-induced cardiovascular disease; Radiotherapy; Treatment.

Publication types

  • Review
  • Research Support, N.I.H., Extramural
  • Research Support, Non-U.S. Gov't

MeSH terms

  • Cardiotoxicity / etiology
  • Cardiovascular Diseases* / etiology
  • Cardiovascular Diseases* / prevention & control
  • Heart
  • Humans
  • Neoplasms* / complications
  • Neoplasms* / radiotherapy
  • Radiation Injuries* / etiology
  • Radiation Injuries* / prevention & control