Cardiovascular calcifications after radiation therapy for Hodgkin lymphoma: Computed tomography detection and clinical correlation

Sara Apter, Joseph Shemesh, Pia Raanani, Orith Portnoy, Michael Thaler, Rivka Zissin, David Ezra, Judith Rozenman, Raphael Pfeffer, Marjorie Hertz

Research output: Contribution to journalArticlepeer-review

Abstract

OBJECTIVE: To study cardiovascular calcifications, detected by computed tomography, in patients following mediastinal radiation for Hodgkin lymphoma, and correlate them with clinical findings. MATERIALS AND METHODS: Fifteen patients, ≤55 years, with computed tomography detected cardiovascular calcifications after mediastinal radiotherapy for Hodgkin lymphoma were identified during a 10-year period. Calcifications were evaluated for site and extent and were correlated with clinical data including symptoms and signs of heart disease, angiographic and surgical findings. RESULTS: Accelerated calcifications were detected in the coronary arteries (n=11), in the aorta (n=11), and in the aortic valve and the mitral apparatus (n=8). Calcifications were more extensive when radiation was given at a young age. Clinical evidence of cardiovascular disease included coronary events in three patients, valvular dysfunction in two, pericarditis in two and complete atrioventricular block in one. Seven patients had no cardiac symptoms. CONCLUSION: Early cardiovascular calcifications can be radiation associated. Such calcifications may represent radiation-induced atherosclerosis and can be detected by computed tomography even in asymptomatic patients. The implication of our findings is that spiral computed tomography may serve as a non-invasive modality to detect accelerated cardiovascular calcifications in high-risk asymptomatic patients who survived Hodgkin lymphoma.

Original languageEnglish
Pages (from-to)145-151
Number of pages7
JournalCoronary Artery Disease
Volume17
Issue number2
DOIs
StatePublished - Mar 2006
Externally publishedYes

Keywords

  • Cardiovascular calcifications
  • Computed tomography
  • Hodgkin lymphoma
  • Mediastinal radiotherapy
  • Radiation-induced heart disease

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