ACE inhibition attenuates radiation-induced cardiopulmonary damage.

نویسندگان

  • Sonja J van der Veen
  • Ghazaleh Ghobadi
  • Rudolf A de Boer
  • Hette Faber
  • Megan V Cannon
  • Peter W Nagle
  • Sytze Brandenburg
  • Johannes A Langendijk
  • Peter van Luijk
  • Robert P Coppes
چکیده

BACKGROUND AND PURPOSE In thoracic irradiation, the maximum radiation dose is restricted by the risk of radiation-induced cardiopulmonary damage and dysfunction limiting tumor control. We showed that radiation-induced sub-clinical cardiac damage and lung damage in rats mutually interact and that combined irradiation intensifies cardiopulmonary toxicity. Unfortunately, current clinical practice does not include preventative measures to attenuate radiation-induced lung or cardiac toxicity. Here, we investigate the effects of the ACE inhibitor captopril on radiation-induced cardiopulmonary damage. MATERIAL AND METHODS After local irradiation of rat heart and/or lungs captopril was administered orally. Cardiopulmonary performance was assessed using biweekly breathing rate measurements. At 8 weeks post-irradiation, cardiac hemodynamics were measured, CT scans and histopathology were analyzed. RESULTS Captopril significantly improved breathing rate and cardiopulmonary density/structure, but only when the heart was included in the radiation field. Consistently, captopril reduced radiation-induced pleural and pericardial effusion and cardiac fibrosis, resulting in an improved left ventricular end-diastolic pressure only in the heart-irradiated groups. CONCLUSION Captopril improves cardiopulmonary morphology and function by reducing acute cardiac damage, a risk factor in the development of radiation-induced cardiopulmonary toxicity. ACE inhibition should be evaluated as a strategy to reduce cardiopulmonary complications induced by radiotherapy to the thoracic area.

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عنوان ژورنال:
  • Radiotherapy and oncology : journal of the European Society for Therapeutic Radiology and Oncology

دوره 114 1  شماره 

صفحات  -

تاریخ انتشار 2015