Cardiovascular sequel of neck irradiation in head and neck cancer patients
Cardiovascular sequel of neck irradiation in head and neck cancer patients
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DOI：
10.1080/09553002.2017.1303217
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发表时间：
2017-01-01
影响因子：
2.6
通讯作者：
Bhatt, Madan Lal
中科院分区：
文献类型：
--
作者：
Goyal, Manish;Shukla, Pragya;Bhatt, Madan Lal
目的：压力感受性反射是控制植物神经功能的重要传入机制。由于传入神经经过颈部，它们容易受到头颈癌患者颈部照射的损伤。随着头颈部肿瘤治疗方法的改进，患者生存率的提高，其心血管疾病的发病率和死亡率也越来越明显，这是临床关注的问题。颈部放疗后压力感受性反射衰竭的病例报道很少。目的：本研究评价颈部放疗患者心脏自主神经张力和姿势性心血管反射的变化。方法：采用5min心电图时域分析法，对15例接受颈部放疗的头颈部肿瘤患者和15例健康对照者进行心率变异性分析。姿势性心血管反射与血压和心率的变化进行了研究，在说谎站立test.Results：我们的研究结果表明，有一个整体的时间域措施的心率变异性和颈部照射patients.Conclusion：颈部照射患者的心率变异性降低反映了心血管疾病的独立风险。早期发现这些患者的心血管损伤可能有助于医疗保健专业人员提供更好的护理。此外，应监测和限制输送到颈动脉窦的剂量。
Purpose: The baroreflex is an important afferent mechanism controlling autonomic functions. As afferent nerves course through the neck, they are susceptible to damage by neck irradiation in head and neck cancer patients. With increased survival of head and neck cancer patients because of improved therapy, the cardiovascular morbidity and mortality in them have become apparent and this is of clinical concern. There are few case reports of baroreflex failure as a chronic sequel to neck irradiation.Objectives: The present study evaluated the changes in cardio-autonomic tone and postural cardiovascular reflex in neck-irradiated patients.Methods: Head and neck cancer patients who had received neck irradiation (n=15) and healthy controls (n=15) were evaluated for heart rate variability with time domain analysis of 5min ECG recording. Postural cardiovascular reflexes were studied with changes in blood pressure and heart rate in the lying to standing test.Results: Our results suggest that there is a reduction in overall time domain measures of heart rate variability and weakened postural reflexes in neck-irradiated patients.Conclusion: Decreased heart rate variability in neck-irradiated patients reflects an independent risk of cardiovascular morbidity. The early detection of cardiovascular impairment in such patients may help healthcare professionals in providing better care. Furthermore, the dose delivered to the carotid sinus should be monitored and restricted.