TY - JOUR
T1 - Sparing of the heart facilitates recovery from cardiopulmonary side effects after thoracic irradiation
AU - Wiedemann, Julia
AU - Paruchuru, Sai K
AU - den Boef, Lisette E
AU - Brouwer, Uilke
AU - Silljé, Herman H W
AU - Schouten, Elisabeth M
AU - Dickinson, Michael G
AU - van Goethem, Marc-Jan
AU - Coppes, Robert P
AU - van Luijk, Peter
N1 - Copyright © 2024. Published by Elsevier Inc.
PY - 2025/1
Y1 - 2025/1
N2 - INTRODUCTION: When irradiating thoracic tumors, dose to the heart or lung has been associated with survival. We previously showed in a rat model that in addition to known side-effects such as pericarditis, pneumonitis and fibrosis, heart and/or lung irradiation also impaired diastolic function and increased pulmonary artery pressure. Simultaneous irradiation of both organs strongly intensified these effects. However, the long-term consequences of this interactions are not yet known. Therefore, here we investigate the long-term effects of combined heart and lung irradiation.MATERIAL AND METHODS: Different regions of the rat thorax containing the heart and/or 50% of the lungs were irradiated with protons. Respiratory rate (RR) was measured bi-weekly as an overall parameter for cardiopulmonary function. Echocardiography of the heart was performed at 8, 26 and 42 weeks after irradiation. Tissue remodeling and vascular changes were assessed using Masson Trichrome and Verhoeff-stained lung and LV tissue collected at 8 and 42 weeks after irradiation.RESULTS: During the entire experimental period RR was consistently increased after combined heart/lung irradiation. This coincided with persistent effects on lung vasculature and reduced right ventricle contraction. In contrast, recovery of RR, pulmonary remodeling and right ventricle contraction was observed after sparing of the heart. These corresponding temporal patterns suggest that the reduction of right ventricle (RV) function is related to vascular remodeling in the lung.CONCLUSION: Combined irradiation of lung and heart leads to an intensified, persistent reduction of cardiopulmonary function. Recovery of the pulmonary vasculature and right ventricle function requires heart-sparing.
AB - INTRODUCTION: When irradiating thoracic tumors, dose to the heart or lung has been associated with survival. We previously showed in a rat model that in addition to known side-effects such as pericarditis, pneumonitis and fibrosis, heart and/or lung irradiation also impaired diastolic function and increased pulmonary artery pressure. Simultaneous irradiation of both organs strongly intensified these effects. However, the long-term consequences of this interactions are not yet known. Therefore, here we investigate the long-term effects of combined heart and lung irradiation.MATERIAL AND METHODS: Different regions of the rat thorax containing the heart and/or 50% of the lungs were irradiated with protons. Respiratory rate (RR) was measured bi-weekly as an overall parameter for cardiopulmonary function. Echocardiography of the heart was performed at 8, 26 and 42 weeks after irradiation. Tissue remodeling and vascular changes were assessed using Masson Trichrome and Verhoeff-stained lung and LV tissue collected at 8 and 42 weeks after irradiation.RESULTS: During the entire experimental period RR was consistently increased after combined heart/lung irradiation. This coincided with persistent effects on lung vasculature and reduced right ventricle contraction. In contrast, recovery of RR, pulmonary remodeling and right ventricle contraction was observed after sparing of the heart. These corresponding temporal patterns suggest that the reduction of right ventricle (RV) function is related to vascular remodeling in the lung.CONCLUSION: Combined irradiation of lung and heart leads to an intensified, persistent reduction of cardiopulmonary function. Recovery of the pulmonary vasculature and right ventricle function requires heart-sparing.
U2 - 10.1016/j.ijrobp.2024.07.2330
DO - 10.1016/j.ijrobp.2024.07.2330
M3 - Article
C2 - 39151832
SN - 0360-3016
VL - 121
SP - 191
EP - 201
JO - International Journal of Radiation Oncology, Biology, Physics
JF - International Journal of Radiation Oncology, Biology, Physics
IS - 1
ER -