Göğüs Bölgesine Radyoterapi Alan Hastalarda Kardiyak Otonomik Fonksiyonların ve Nabız Dalga Hızının Değerlendirilmesi
Özet
Although the introduction of radiation therapy (RT) for the management of thoracic malignancies has led to a significant improvement in disease-specific survival, and this has resulted in the emergence of a new spectrum of cardiovascular disorders induced by radiation injury. Pulse wave velocity (PWV) and augmentation index (Aix) as arterial stiffness parameters and heart rate recovery as an indicator of autonomic funtions, are measured non-invasively and easily. These parameters have been shown to be predictors of adverse cardiovascular events. In the present study, we investigated the effects of mediastinal radiotherapy on arterial stiffness and HRR parameters. 21 patients were included in this study who were planned to recieve chest radiotherapy because of lymphoma or lung cancer. Arterial stiffness parameters were evaluated by arteriograph and HRR parameters were evaluated by treadmill exercise before and after radiotherapy. We have found an increase in augmentation index (Aix) (33±12,11 vs 38,3±11,66) and decrease in HRR parameters (26,05±12,54 vs 19,52±12,28 for HRR1, 39,1±16,15 vs 32,86±14,83 for HRR2, 42,81±17,66 vs 38,05±16,14 for HRR3). But these changes were not significant after adjustment for the confounding factors (p>0,05). The higher doses of mediastinal radiotherapy caused significant changes on augmentation index and HRR parameters. Augmentation index changed from 36,35±13,51 to 39,16±11,46 in low dose group and from 29,95±10,38 to 37,52±12,34 in high dose group (p<0,05). HRR1 changed from 25,70±15,12 to 22,00±14,38 in low dose group and from 26,36±10,41 to 17,27±10,10 in high dose group (p<0,05). Attenuation of HRR2 and HRR3 were also more evident in high mediastinal dose group (p<0,05). In conclusion, Aix was increased and HRR parameters were decreased especially in patients who were exposed to more intense mediastinal radiation.
