Research progress of radiation-induced heart disease: from epidemiology to clinical management
10.12025/j.issn.1008-6358.2026.20260468
- VernacularTitle:放射性心脏损伤的研究进展：从流行病学到临床管理
- Author:
Siyu ZHU
1
;
Yihui SHEN
2
;
Leilei CHENG
3
Author Information
1. Shanghai Institute of Cardiovascular Diseases, Shanghai 200032, China;State Key Laboratory of Cardiology, Shanghai 200032, China;School of Basic Medical Sciences, Fudan University, Shanghai 200433, China;National Clinical Research Center for Interventional Medicine, Shanghai 200032, China.
2. Department of Radiation Oncology, Zhongshan Hospital, Fudan University, Shanghai 200032, China.
3. Shanghai Institute of Cardiovascular Diseases, Shanghai 200032, China;State Key Laboratory of Cardiology, Shanghai 200032, China;National Clinical Research Center for Interventional Medicine, Shanghai 200032, China;Department of Echocardiography, Zhongshan Hospital, Fudan University, Shanghai 200032, China.
- Publication Type:Review
- Keywords:
radiation-induced heart disease;
cardiotoxicity;
immunotherapy;
cardio-oncology
- From:
Chinese Journal of Clinical Medicine
2026;33(4):694-702
- CountryChina
- Language:Chinese
-
Abstract:
Radiation-induced heart disease (RIHD) is a form of cardiotoxicity caused by radioactive substances or radiotherapy, and represents a common long-term complication after thoracic malignancy radiotherapy. RIHD onset is insidious, progression is slow, and significantly affects patients’ long-term quality of life. The pathophysiological mechanisms of RIHD involve multiple pathways, including endothelial cell injury, oxidative stress, inflammatory response, and myocardial fibrosis, ultimately leading to pericarditis, coronary artery disease, valvular heart disease, cardiac dysfunction, and conduction abnormalities, etc. Widespread use of immune checkpoint inhibitors (ICIs) in thoracic tumors, especially the combination of radiotherapy and ICIs, has introduced new changes in cardiac risk. This article reviews the epidemiological characteristics of RIHD, potential molecular targets, clinical manifestations, and treatment options. It also summarizes the value of imaging, electrocardiography, and biomarkers in RIHD monitoring, as well as the cardiac risks associated with combined radiotherapy and immunotherapy. Furthermore, multidisciplinary management strategies and preventive approaches are discussed, aiming to provide a reference for individualized management of RIHD patients in clinical practice.
