胸部恶性瘤中与辐射疗法暴露相关的心血管结果:使用国家住院患者数据库的洞察研究
Mahir Yilmaz1, Ekrem Turk1, Muhammad K Sana1
1Internal Medicine, John H. Stroger, Jr. Hospital of Cook County, Chicago, USA.
Cureus
|November 29, 2023
概括
胸部癌症的放射治疗增加了患各种心脏病的风险,包括心周炎,心力衰竭和冠状动脉疾病. 接受胸部放射治疗 (RT) 的患者应对长期心血管并发症进行监测.
科学领域:
- 心脏病学 心脏病学
- 在瘤学瘤学.
- 放射学 放射学是一门学科.
背景情况:
- 胸部辐射是一种常见的癌症治疗方法,但存在心血管风险.
- 短期影响包括心周疾病; 长期影响如心力衰竭和冠状动脉疾病在几十年内表现出来.
- 预测和确定辐射暴露与长期心脏问题之间的联系是具有挑战性的.
研究的目的:
- 调查胸部辐射疗法 (RT) 与患有胸部恶性瘤的成年患者中各种心脏结局的患病率之间的联系.
- 为了比较接受RT的患者与没有接受RT的患者,以及与一般人群之间的心脏结果.
主要方法:
- 使用国家住院样本 (NIS) 数据库 (2016-2019) 的回顾性观察性研究.
- 确定了患有原发性胸部恶性瘤的成年患者,他们接受了RT.
- 不包括二次恶性瘤和其他RT可治疗的癌症.
- 使用多变量逻辑和线性回归分析了心力衰竭,冠状动脉疾病,心肌病,导电障碍,心周疾病和膜性心脏病的患病率.
主要成果:
- 与一般人群相比,接受RT治疗的患有胸部恶性瘤的成年人患慢性心膜炎 (aOR=2.0),急性心膜炎 (aOR=2.3),收缩性心膜炎 (aOR=2.8),导电障碍 (aOR=1.3),冠状动脉疾病 (aOR=1.24),心力衰竭 (aOR=1.44) 和心病 (aOR=1.37) 的几率明显更高.
- 与没有接受RT的胸癌患者相比,接受RT的患者患急性心肌梗塞 (aOR=1.14),慢性心膜炎 (aOR=1.3),急性心膜炎 (aOR=1.6),收缩性心膜炎 (aOR=2.2),导电障碍 (aOR=1.1),冠状动脉疾病 (aOR=1.14),心力衰竭 (aOR=1.2) 和膜性心脏病 (aOR=1.3) 的几率更高.
- 在RT患者和一般人群之间没有观察到心脏骤停几率的显著差异 (aOR=1.0),但与非RT癌症患者相比,观察到略有增加 (aOR=0.86).
结论:
- 胸部辐射疗法 (RT) 与患慢性心膜炎,急性心膜炎,收缩性心膜炎,导电障碍,冠状动脉疾病,心力衰竭和膜性心脏病的几率增加有关.
- 虽然心脏骤停和急性心肌梗塞的风险与一般人群相比没有显著增加,但RT患者与非RT胸部癌症患者相比,急性心肌梗塞的几率增加.
- 对于接受胸部放射治疗的患者来说,长期的心血管监测至关重要.
相关概念视频
Biological Effects of Radiation
15.5K
All radioactive nuclides emit high-energy particles or electromagnetic waves. When this radiation encounters living cells, it can cause heating, break chemical bonds, or ionize molecules. The most serious biological damage results when these radioactive emissions fragment or ionize molecules. For example, α and β particles emitted from nuclear decay reactions possess much higher energies than ordinary chemical bond energies. When these particles strike and penetrate matter, they...
15.5K
Radiological Investigation III: Pulmonary Angiogram and PET Scan
95
Radiological investigations are paramount in the diagnosis and management of various pulmonary diseases. Two essential investigations are the Pulmonary Angiogram and the Positron Emission Tomography (PET) Scan.
Pulmonary Angiogram
A Pulmonary Angiogram is an invasive procedure involving injecting a contrast medium through a catheter threaded into the pulmonary artery or the right side of the heart to visualize the pulmonary vasculature. Computed Tomography (CT) scans have mainly replaced this...
Pulmonary Angiogram
A Pulmonary Angiogram is an invasive procedure involving injecting a contrast medium through a catheter threaded into the pulmonary artery or the right side of the heart to visualize the pulmonary vasculature. Computed Tomography (CT) scans have mainly replaced this...
95
Imaging Studies for Cardiovascular System III: X-Ray
191
The most common cardiovascular diagnostic test is an X-ray. It produces images of the heart, blood vessels, and adjacent structures.
Definition and Purpose
An X-ray, or radiograph, is a non-invasive method that uses ionizing radiation to take images of internal structures. It is mainly used in cardiac imaging to examine the heart, lungs, and major blood vessels, aiming to identify abnormalities in the heart's size, shape, and position, such as heart failure, congenital defects, and vascular...
Definition and Purpose
An X-ray, or radiograph, is a non-invasive method that uses ionizing radiation to take images of internal structures. It is mainly used in cardiac imaging to examine the heart, lungs, and major blood vessels, aiming to identify abnormalities in the heart's size, shape, and position, such as heart failure, congenital defects, and vascular...
191
Cancer Survival Analysis
356
Cancer survival analysis focuses on quantifying and interpreting the time from a key starting point, such as diagnosis or the initiation of treatment, to a specific endpoint, such as remission or death. This analysis provides critical insights into treatment effectiveness and factors that influence patient outcomes, helping to shape clinical decisions and guide prognostic evaluations. A cornerstone of oncology research, survival analysis tackles the challenges of skewed, non-normally...
356


