healthmedicinet

Cancer patients who receive chest radiation should be screened for heart disease every 5-10 years, according to the European Association of Cardiovascular Imaging (EACVI) of the European Society of Cardiology (ESC) and the American Society of Echocardiography (ASE).

Their recommendations are outlined in the first expert consensus statement on screening for radiation-induced heart disease (RIHD), published today in European Heart Journal – Cardiovascular Imaging.1

Professor Patrizio Lancellotti, chair of the expert task force and president of the EACVI, said: “The prevalence of radiation-induced heart disease is increasing because the rate of cancer survival has improved. It’s a long term risk, and RIHD manifests 5-20 years after the radiation dose.”

He added: “Survivors of Hodgkin’s lymphoma and breast cancer received high doses of radiation on their chest under the old treatment regimes. Over time these patients can develop RIHD in the heart valves, myocardium, vessels including the aorta, the pericardium, and the coronary arteries. Their risk of death from coronary artery disease, myocardial ischemia and myocardial infarction is increased.”

Professor Lancellotti continued: “Radiotherapy is now given in lower doses but patients are still at increased risk of RIHD, particularly when the heart is in the radiation field. This applies to patients treated for lymphoma, breast cancer and oesophageal cancer. Patients who receive radiotherapy for neck cancer are also at risk because lesions can develop on the carotid artery and increase the risk of stroke.”

RIHD is estimated to occur in 10-30% of patients who receive chest radiotherapy within 5-10 years post-treatment. Cardiac structural and functional changes after radiation can be detected early using echocardiography, cardiac computed tomography (CT), cardiac magnetic resonance (CMR) and nuclear cardiology. But screening for RIHD is not routine practice.

In the report the expert group recommends: