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Cardiac Loading using Passive Left Atrial Pressurization and Passive Afterload for Graft Assessment
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Valvular dysfunction and left ventricular changes in Hodgkin's lymphoma survivors. A longitudinal study
T Wethal1, M-B Lund, T Edvardsen
1Department of Cardiology, University of Oslo, Sognsvannsveien 20, Oslo 0027, Norway.
British Journal of Cancer
|July 23, 2009
Summary
Long-term survivors of Hodgkin's lymphoma (HLSs) treated with mediastinal radiotherapy face progressive valvular dysfunction and left ventricular remodelling. Lifelong cardiac monitoring is recommended for these patients.
Area of Science:
- Cardiology
- Oncology
- Radiotherapy
Background:
- Hodgkin's lymphoma survivors (HLSs) exhibit increased cardiovascular disease risk years post-treatment.
- Mediastinal radiotherapy and anthracyclines are known cardiotoxic agents in HLSs.
Purpose of the Study:
- To investigate the time-dependent development of valvular and myocardial function in HLSs.
- To assess the long-term cardiac effects of mediastinal radiotherapy and anthracyclines.
Main Methods:
- 116 HLSs underwent initial echocardiography (1993), median 10 years post-treatment.
- A follow-up echocardiography was performed in 51 patients (2005-2007), median 22 years post-treatment.
- Patients were selected based on pre-existing valvular regurgitation.
Main Results:
- 31% of HLSs had moderate valvular regurgitation initially; 39% developed mild-to-severe aortic stenosis over time.
- Anthracycline use predicted left ventricular remodelling, including increased end-systolic diameter and reduced wall thickness.
- Valvular dysfunction and left ventricular changes showed a progressive nature over 20-30 years post-treatment.
Conclusions:
- Valvular dysfunction and left ventricular remodelling are progressive in HLSs treated with mediastinal radiotherapy.
- Lifelong cardiological follow-up is crucial for HLSs treated with mediastinal radiotherapy due to progressive cardiac damage.
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