Asymptomatic cardiac disease following mediastinal irradiation
Paul A. Heidenreich, MD, FACC* ,*,
Steven L. Hancock, MD ,
Byron K. Lee, MD, FACC,
Carol S. Mariscal, RN and
Ingela Schnittger, MD, FACC
* Palo Alto Veterans Affairs Health Care System, Stanford, California, USA
Department of Medicine, Stanford University, Stanford, California, USA
Department of Radiation Oncology, Stanford University, Stanford, California, USA.
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Figure 1 Prevalence of mild or greater aortic regurgitation stratified by age and time following irradiation. The prevalence of aortic regurgitation increases markedly with both age and time following irradiation. Open bars = age <40 years; lined bars = age 40 to 50 years; solid bars = age >50 years.
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Figure 2 Mean left ventricular mass adjusted for body height and stratified by age and time following irradiation. As previously described for the general population, left ventricular mass increases with age. However, for any age group, mass decreases as time following irradiation increases. Open bars = age <40 years; lined bars = age 40 to 50 years; solid bars = age >50 years.
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Figure 3 Survival free from cardiac events (death, heart failure, symptomatic coronary artery disease, valve replacement) is displayed for patients grouped by time following irradiation. The event rate increases with increasing time following irradiation, which persists after adjustment for age, gender, and radiation dose. Solid line = 2 to 10 years; line with circles = 11 to 20 years; dashed line = >20 years.
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