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Increased risk of heart valve regurgitation after mediastinal radiation for Hodgkin's disease: an echocardiographic study.
Heart 1996; 75(6):591-5H

Abstract

OBJECTIVE

To assess by echocardiography the occurrence and degree of late cardiac sequelae after treatment for Hodgkin's disease by radiation and chemotherapy.

PATIENTS AND METHODS

In Norway from 1980 to 1988, 129 patients < 50 years old with Hodgkin's disease had curative treatment with mediastinal radiation, with or without chemotherapy. 116 (90%) of these patients (mean (SD) age 37 (7) years, 67 males) were examined by echocardiography 5-13 years after treatment. 40 healthy individuals (mean (SD) age 40 (11), 20 males) were examined as controls. All those examined were in regular sinus rhythm.

RESULTS

Grade > 1 (scale 0-3) aortic and/or mitral valvar regurgitation was found in 24% of the patients (15% aortic, 7% mitral, and 2% aortic+mitral), affecting 46% of the females v 16% of the males (P < 0.001). Female gender was a significant risk factor for aortic and mitral regurgitation (odds ratio 4.7, 95% confidence interval 2.0 to 11.2), whereas age, period of follow up, radiation dose, and chemotherapy were not. Thickened pericardium was diagnosed in 15% of the patients. No risk factors were identified. No cases of pericardial thickening or valvar regurgitation grade > 1 were recorded in the control group. Mean values for measured and calculated indices of systolic and diastolic function were within the normal range for patients and controls. The patients had reduced E/A ratio compared with the healthy controls (E/A 1.1 v 2.0, P < 0.001).

CONCLUSIONS

Abnormal left sided valvar regurgitation was detected in one fourth of the patients, affecting the aortic valve in more than half of the cases. Females had an increased risk of valvar regurgitation. Echocardiographic screening after high-dose mediastinal radiation is recommended.

Authors+Show Affiliations

Department of Thoracic Medicine, National Hospital, University of Oslo, Norway.

Pub Type(s)

Journal Article

Language

eng

PubMed ID

8697163

Citation

Lund, M B., et al. "Increased Risk of Heart Valve Regurgitation After Mediastinal Radiation for Hodgkin's Disease: an Echocardiographic Study." Heart (British Cardiac Society), vol. 75, no. 6, 1996, pp. 591-5.
Lund MB, Ihlen H, Voss BM, et al. Increased risk of heart valve regurgitation after mediastinal radiation for Hodgkin's disease: an echocardiographic study. Heart. 1996;75(6):591-5.
Lund, M. B., Ihlen, H., Voss, B. M., Abrahamsen, A. F., Nome, O., Kongerud, J., ... Forfang, K. (1996). Increased risk of heart valve regurgitation after mediastinal radiation for Hodgkin's disease: an echocardiographic study. Heart (British Cardiac Society), 75(6), pp. 591-5.
Lund MB, et al. Increased Risk of Heart Valve Regurgitation After Mediastinal Radiation for Hodgkin's Disease: an Echocardiographic Study. Heart. 1996;75(6):591-5. PubMed PMID: 8697163.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Increased risk of heart valve regurgitation after mediastinal radiation for Hodgkin's disease: an echocardiographic study. AU - Lund,M B, AU - Ihlen,H, AU - Voss,B M, AU - Abrahamsen,A F, AU - Nome,O, AU - Kongerud,J, AU - Stugaard,M, AU - Forfang,K, PY - 1996/6/1/pubmed PY - 1996/6/1/medline PY - 1996/6/1/entrez SP - 591 EP - 5 JF - Heart (British Cardiac Society) JO - Heart VL - 75 IS - 6 N2 - OBJECTIVE: To assess by echocardiography the occurrence and degree of late cardiac sequelae after treatment for Hodgkin's disease by radiation and chemotherapy. PATIENTS AND METHODS: In Norway from 1980 to 1988, 129 patients < 50 years old with Hodgkin's disease had curative treatment with mediastinal radiation, with or without chemotherapy. 116 (90%) of these patients (mean (SD) age 37 (7) years, 67 males) were examined by echocardiography 5-13 years after treatment. 40 healthy individuals (mean (SD) age 40 (11), 20 males) were examined as controls. All those examined were in regular sinus rhythm. RESULTS: Grade > 1 (scale 0-3) aortic and/or mitral valvar regurgitation was found in 24% of the patients (15% aortic, 7% mitral, and 2% aortic+mitral), affecting 46% of the females v 16% of the males (P < 0.001). Female gender was a significant risk factor for aortic and mitral regurgitation (odds ratio 4.7, 95% confidence interval 2.0 to 11.2), whereas age, period of follow up, radiation dose, and chemotherapy were not. Thickened pericardium was diagnosed in 15% of the patients. No risk factors were identified. No cases of pericardial thickening or valvar regurgitation grade > 1 were recorded in the control group. Mean values for measured and calculated indices of systolic and diastolic function were within the normal range for patients and controls. The patients had reduced E/A ratio compared with the healthy controls (E/A 1.1 v 2.0, P < 0.001). CONCLUSIONS: Abnormal left sided valvar regurgitation was detected in one fourth of the patients, affecting the aortic valve in more than half of the cases. Females had an increased risk of valvar regurgitation. Echocardiographic screening after high-dose mediastinal radiation is recommended. SN - 1355-6037 UR - https://www.unboundmedicine.com/medline/citation/8697163/Increased_risk_of_heart_valve_regurgitation_after_mediastinal_radiation_for_Hodgkin's_disease:_an_echocardiographic_study_ L2 - http://heart.bmj.com/cgi/pmidlookup?view=long&amp;pmid=8697163 DB - PRIME DP - Unbound Medicine ER -