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Coronary Artery Disease
Apter, S., Department of Diagnostic Imaging, Sheba Medical Center, Tel-Hashomer, Israel, Department of Diagnostic Imaging, Sheba Medical Center, Tel-Hashomer 52621, Israel
Shemesh, J., Cardiac Rehabilitation Institute, Sheba Medical Center, Tel-Hashomer, Israel
Raanani, P., Institute of Hematology, Sheba Medical Center, Tel-Hashomer, Israel
Portnoy, O., Department of Diagnostic Imaging, Sheba Medical Center, Tel-Hashomer, Israel
Thaler, M., Department of Medicine, Sheba Medical Center, Tel-Hashomer, Israel
Zissin, R., Department of Diagnostic Imaging, Sapir Medical Center, Kfar Saba, Israel
Ezra, D., Department of Medicine, Sheba Medical Center, Tel-Hashomer, Israel
Rozenman, J., Department of Diagnostic Imaging, Sheba Medical Center, Tel-Hashomer, Israel
Pfeffer, R., Institute of Oncology, Sheba Medical Center, Tel-Hashomer, Israel
Hertz, M., Department of Diagnostic Imaging, Sheba Medical Center, Tel-Hashomer, Israel
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. © 2006 Lippincott Williams & Wilkins.
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Cardiovascular calcifications after radiation therapy for Hodgkin lymphoma: Computed tomography detection and clinical correlation
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Apter, S., Department of Diagnostic Imaging, Sheba Medical Center, Tel-Hashomer, Israel, Department of Diagnostic Imaging, Sheba Medical Center, Tel-Hashomer 52621, Israel
Shemesh, J., Cardiac Rehabilitation Institute, Sheba Medical Center, Tel-Hashomer, Israel
Raanani, P., Institute of Hematology, Sheba Medical Center, Tel-Hashomer, Israel
Portnoy, O., Department of Diagnostic Imaging, Sheba Medical Center, Tel-Hashomer, Israel
Thaler, M., Department of Medicine, Sheba Medical Center, Tel-Hashomer, Israel
Zissin, R., Department of Diagnostic Imaging, Sapir Medical Center, Kfar Saba, Israel
Ezra, D., Department of Medicine, Sheba Medical Center, Tel-Hashomer, Israel
Rozenman, J., Department of Diagnostic Imaging, Sheba Medical Center, Tel-Hashomer, Israel
Pfeffer, R., Institute of Oncology, Sheba Medical Center, Tel-Hashomer, Israel
Hertz, M., Department of Diagnostic Imaging, Sheba Medical Center, Tel-Hashomer, Israel
Cardiovascular calcifications after radiation therapy for Hodgkin lymphoma: Computed tomography detection and clinical correlation
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. © 2006 Lippincott Williams & Wilkins.
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