| Autor: |
Georgiev, K. N. |
| Předmět: |
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| Zdroj: |
Neurosonology & Cerebral Hemodynamics; 2024, Vol. 20 Issue 2, p224-225, 2p |
| Abstrakt: |
Radiotherapy is the first-line treatment for patients with head and neck cancer (HNC). Lorenz et al. (2007) demonstrated that a 0.1 mm increase in intima-media (IM) thickness leads to a 10-15% increase in the risk of myocardial infarction and a 13-18% increase in the risk of stroke. Currently, the AHA/ASA/ACCF American Heart Association/American Stroke Association/American College of Cardiology Foundation (AHA/ASA/ACCF) have no recommendations for IMT screening in asymptomatic patients, while the European Society of Cardiology (ESC) endorses ultrasound evaluation of carotid IMT and carotid plaque for primary and secondary prevention of cardiovascular disease. A series of studies of patients with HNC after radiotherapy showed a statistically significant thickening of the carotid intima-media by 0.1-0.2 mm, persisting up to 7 years after irradiation and associated with a significantly increased risk of stroke. Evidence is presented to support the need for timely carotid B-mode ultrasonography in addition to the Framingham Risk Score to improve prediction of strokes. The hypothesis of radiation-induced vascular endothelial injury during radiotherapy is substantiated. The significance of carotid B-mode ultrasonography as an effective non-invasive measurement of IMT associated with increased risk of vascular events is emphasized. Screening of this patient cohort would improve detection of asymptomatic at-risk patients in need of preventive treatment and long-term followup. Identification of changes in carotid IMT after radiotherapy may be a marker of atherosclerosis and a predictor of future ischemic strokes. [ABSTRACT FROM AUTHOR] |
| Databáze: |
Complementary Index |
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