The stage-by-stage treatment of critical aortic stenosis and progressive atherosclerosis of the coronary arteries that occurred three decades after radiation therapy for Hodgkin’s lymphoma. Clinical case
https://doi.org/10.17650/2782-3202-2024-4-3-99-103
Abstract
Modern treatment programs for Hodgkin’s lymphoma include both drug antitumor therapy and radiation exposure. When conducting remote radiation therapy on the mediastinal lymph nodes, damage to the heart, thoracic aorta and lungs is possible. Such late cardiovascular complications as damage to the valvular apparatus and progressive atherosclerosis of the coronary arteries, leading to obstruction with the subsequent development of coronary heart disease, more often occurred after the use of extended radiation fields and high total focal doses. The article presents a clinical case of a 64-year-old patient with Hodgkin’s lymphoma, who successfully underwent staged cardiac surgery for severe aortic stenosis and progressive atherosclerosis with calcification of the coronary arteries due to radiation exposure.
Keywords
About the Authors
K. A. VilizhinskayaRussian Federation
Kristina Alexandrovna Vilizhinskaya
119991; GSP-1; 2 Abrikosovsky Ln.; Moscow
E. P. Evseev
Russian Federation
119991; GSP-1; 2 Abrikosovsky Ln.; Moscow
Ya. A. Aidamirov
Russian Federation
119991; GSP-1; 2 Abrikosovsky Ln.; Moscow
E. V. Balakin
Russian Federation
119991; GSP-1; 2 Abrikosovsky Ln.; Moscow
M. A. Fomin
Russian Federation
119991; GSP-1; 2 Abrikosovsky Ln.; Moscow
V. A. Ivanov
Russian Federation
119991; GSP-1; 2 Abrikosovsky Ln.; Moscow
B. A. Rudenko
Russian Federation
111024; Bld. 25, 2 2st Kabelnaya St.; Moscow
Yu. V. Frolova
Russian Federation
119991; GSP-1; 2 Abrikosovsky Ln.; Moscow
References
1. De Vries S., Haaksma M.L., Jóźwiak K. et al. Development and validation of risk prediction models for coronary heart disease and heart failure after treatment for Hodgkin lymphoma. J Clin Oncol 2023;41(1):86–95. DOI: 10.1200/JCO.21.02613
2. Nkomo V.T., El-Am E.A. The complex treatment of postradiation valvular heart disease. JACC Case Rep 2022;8:101652. DOI: 10.1016/j.jaccas.2022.09.019
3. Ellahham S., Khalouf A., Elkhazendar M. et al. An overview of radiation-induced heart disease. Radiat Oncol J 2022;40(2):89–102. DOI: 10.3857/roj.2021.00766
4. Menezes K.M., Wang H., Hada M., Saganti P.B. Radiation matters of the heart : a mini review. Front Cardiovasc Med 2018;5:83. DOI: 10.3389/fcvm.2018.00083
5. Bergom C., Bradley J.A., Ng A.K. et al. Past, present, and future of radiation-induced cardiotoxicity: refinements in targeting, surveillance, and risk stratification. JACC CardioOncol 2021;3(3):343–59. DOI: 10.1016/j.jaccao.2021.06.007
6. Patil S., Pingle S.R., Shalaby K., Kim А.S. Mediastinal irradiation and valvular heart disease. Cardiooncology 2022;8(1):7. DOI: 10.1186/s40959-022-00133-2
7. Narowska G., Gandhi S., Tzeng A., Hamad E.A. Cardiovascular toxicities of radiation therapy and recommended screening and surveillance. J Cardiovasc Dev Dis 2023;10(11):447. DOI: 10.3390/jcdd10110447
8. Kirresh A., White L., Mitchell A. et al. Radiation-induced coronary artery disease: a difficult clinical conundrum. Clin Med (Lond) 2022;22(3):251–6. DOI: 10.7861/clinmed.2021-0600
9. Báez-Ferrer N., Izquierdo-Gómez M.M., Beyello-Belkasem C. et al. Long-term radiotherapy-induced cardiac complications: a case report. Am J Case Rep 2019;20:1182–8. DOI: 10.12659/AJCR.917224
10. Zou B., Schuster J.P., Niu K. et al. Radiotherapy-induced heart disease : a review of the literature. Precis Clin Med 2019;2(4):270–82. DOI: 10.1093/pcmedi/pbz025
11. Lancellotti P., Nkomo V.T., Badano L.P. et al. Expert consensus for multi-modality imaging evaluation of cardiovascular complications of radiotherapy in adults: a report from the European Association of Cardiovascular Imaging and the American Society of Echocardiography. Eur Heart J Cardiovasc Imaging 2013;14(8):721–40. DOI: 10.1093/ehjci/jet123
12. Quintero-Martinez J.A., Cordova-Madera S.N., Villarraga H.R. Radiation-induced heart disease. J Clin Med. 2021;11(1):146. DOI: 10.3390/jcm11010146
13. Badescu M.C., Badulescu O.V., Scripcariu D.V. et al. Myocardial ischemia related to common cancer therapy-prevention insights. Life (Basel) 2022;12(7):1034. DOI: 10.3390/life12071034
14. Dolmaci O.B., Farag E.S., Boekholdt S.M. et al. Outcomes cardiac surgery after mediastinalradiationtherapy: a single-center experience. J Card Surg 2020;35(3):612–9. DOI: 10.1111/jocs.14427
15. Suh E., Stratton K.L., Leisenring W.M. et al. Late mortality and chronic health conditions in long-term survivors of early-adolescent and young adult cancers: a retrospective cohort analysis from the Childhood Cancer Survivor Study. Lancet Oncol 2020;21(3):421–35. DOI: 10.1016/S1470-2045(19)30800-9
16. Yang E.H., Marmagkiolis K., Balanescu D.V. et al. Radiation-induced vascular disease – a state-of-the-art review. Front Cardiovasc Med 2021;8:652761. DOI: 10.3389/fcvm.2021.652761
17. Khalid Y., Fradley M., Dasu N. et al. Gender disparity in cardiovascular mortality following radiation therapy for Hodgkinʼs lymphoma : a systematic review. Cardiooncology 2020;6:12. DOI: 10.1186/s40959-020-00067-7
Review
For citations:
Vilizhinskaya K.A., Evseev E.P., Aidamirov Ya.A., Balakin E.V., Fomin M.A., Ivanov V.A., Rudenko B.A., Frolova Yu.V. The stage-by-stage treatment of critical aortic stenosis and progressive atherosclerosis of the coronary arteries that occurred three decades after radiation therapy for Hodgkin’s lymphoma. Clinical case. MD-Onco. 2024;4(3):99-103. (In Russ.) https://doi.org/10.17650/2782-3202-2024-4-3-99-103