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Long-term Risk of Heart Failure and Myocardial Dysfunction After Thoracic Radiotherapy: A Systematic Review


Nolan, MT and Russell, DJ and Marwick, TH, Long-term Risk of Heart Failure and Myocardial Dysfunction After Thoracic Radiotherapy: A Systematic Review, Canadian Journal of Cardiology, 32, (7) pp. 908-920. ISSN 0828-282X (2016) [Refereed Article]

Copyright Statement

2016 Canadian Cardiovascular Society. Published by Elsevier Inc. All rights reserved.

Official URL: 0.1 016/j.cjca.20 15.12.020

DOI: doi:10.1016/j.cjca.2015.12.020


BACKGROUND: Chest irradiation is a commonly used treatment for malignancy, with demonstrated symptomatic and survival benefit. The frequency and presentation of cardiovascular complications of radiotherapy remains unclear.

METHODS: We performed a systematic review to evaluate the prevalence and manifestations of myocardial dysfunction (asymptomatic and symptomatic) in long-term cancer survivors treated with radiotherapy.

RESULTS: Thoracic radiotherapy is associated with increased risk of heart failure in long-term follow-up, with hazard ratios ranging from 2.7 to 7.4 for Hodgkin lymphoma, and 1.5-2.4 for breast cancer. Although ejection fraction is often normal, systolic dysfunction has been more widely reported with modern techniques including 2-dimensional speckle strain and cardiac magnetic resonance. This might have implications for the selection of patients for cardioprotection. Despite common emphasis, diastolic functional abnormalities were infrequent in the long term. A limited amount of data suggest that right ventricular dysfunction is important in this population.

CONCLUSIONS: The reports were heterogeneous, used different treatments, end points, and definitions of myocardial dysfunction, and most studies on the cardiac consequences of radiotherapy involved small numbers of patients and were published decades ago, making it difficult to formulate definitive conclusions for the current era.

Item Details

Item Type:Refereed Article
Research Division:Biomedical and Clinical Sciences
Research Group:Cardiovascular medicine and haematology
Research Field:Cardiology (incl. cardiovascular diseases)
Objective Division:Health
Objective Group:Clinical health
Objective Field:Clinical health not elsewhere classified
UTAS Author:Nolan, MT (Mr Mark Nolan)
UTAS Author:Marwick, TH (Professor Tom Marwick)
ID Code:111675
Year Published:2016
Web of Science® Times Cited:22
Deposited By:Menzies Institute for Medical Research
Deposited On:2016-09-28
Last Modified:2022-08-25

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