Mediastinal radiation for Hodgkin's disease was associated with grade >1 aortic or mitral regurgitation in 24% of patients vs 0% of controls, with females at higher risk (OR 4.7).
Cohort (n=156)
Does mediastinal radiation for Hodgkin's disease increase the risk of late cardiac sequelae such as valve regurgitation in young adults?
Mediastinal radiation for Hodgkin's disease is associated with a significantly increased risk of late left-sided valve regurgitation, particularly in females, warranting echocardiographic screening.
Absolute Event Rate: 24% vs 0%
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 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 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.
Lund et al. (1996) conducted a cohort in Hodgkin's disease (n=156). Mediastinal radiation vs. Healthy controls was evaluated on Grade > 1 aortic and/or mitral valvar regurgitation. Mediastinal radiation for Hodgkin's disease was associated with grade >1 aortic or mitral regurgitation in 24% of patients vs 0% of controls, with females at higher risk (OR 4.7).