Right Ventricle and Radiotherapy: More Questions than Answers.
Marijana TadicJohannes KerstenDominik BuckertWolfgang RottbauerCesare CuspidiPublished in: Diagnostics (Basel, Switzerland) (2023)
The injury of the left ventricle (LV) during anticancer therapy has long been recognized, and guidelines recommend a specific set of parameters for determination of LV impairment. The influence of anticancer therapy on the right ventricle (RV) has been insufficiently investigated, and there are only a few studies that have considered the effect of radiotherapy on RV remodeling. On the other hand, large number of patients with different types of cancers located in the chest are treated with radiotherapy, and the negative clinical effects of this treatment such as accelerated coronary artery disease, valve degeneration and heart failure have been documented. The anatomical position of the RV, which is in the front of the chest, is responsible for its large exposure during radiation treatment, particularly in patients with left-sided breast and lung cancers and mediastinal cancers (hematological malignancies, esophagus cancers, thymomas, etc.). For the same reason, but also due to its anatomical complexity, the RV remains under-investigated during echocardiographic examination, which remains the cornerstone of cardiac imaging in everyday practice. In the last decade many new echocardiographic imaging techniques that enable better evaluation of RV structure, function and mechanics appeared, and they have been used in detection of early and late signs of RV injuries in oncological patients. These investigations are related to some important restrictions that include limited numbers of patients, used parameters and imaging techniques. Many questions about the potential impact of these changes and possible predictions of adverse events remain to be evaluated in future large longitudinal studies. The current body of evidence indicates an important role of radiotherapy in RV remodeling, and therefore, the aim of this review is to summarize currently available data regarding RV changes in patients with various oncological conditions and help clinicians in the assessment of possible cardiac damage.
Keyphrases
- mycobacterium tuberculosis
- ejection fraction
- early stage
- mitral valve
- end stage renal disease
- heart failure
- left ventricular
- coronary artery disease
- high resolution
- pulmonary hypertension
- newly diagnosed
- radiation therapy
- pulmonary artery
- chronic kidney disease
- locally advanced
- aortic stenosis
- healthcare
- rectal cancer
- prognostic factors
- young adults
- squamous cell carcinoma
- oxidative stress
- type diabetes
- cardiovascular disease
- patient reported outcomes
- left atrial
- percutaneous coronary intervention
- acute coronary syndrome
- current status
- ultrasound guided
- mass spectrometry
- robot assisted
- risk assessment
- coronary artery bypass grafting
- fluorescence imaging
- congenital heart disease
- clinical practice
- childhood cancer
- acute heart failure
- artificial intelligence