Assessment of Cardiac Autonomic Functions by Heart Rate Recovery Indices in Patients Receiving Chest Radiotherapy

Şefik Görkem  Fatihoğlu; Ergün Barış Kaya; Duygu Koçyiğit; Elvin Hosrovzade; Naresh Maharjan; Gözde Yazıcı; Mustafa Cengiz; Mehmet Levent Şahiner; Hikmet Yorgun; Ahmet Hakan Ateş; Kudret Aytemir

doi:10.54614/eurjther.2021.0088

Authors

Şefik Görkem Fatihoğlu Department of Cardiology, Akhisar Mustafa Kirazoglu State Hospital, Manisa, Turkey https://orcid.org/0000-0003-2154-2784
Ergün Barış Kaya Department of Cardiology, Hacettepe University, Faculty of Medicine, Ankara, Turkey https://orcid.org/0000-0002-4424-3704
Duygu Koçyiğit Department of Cardiology, Dinar State Hospital, Afyonkarahisar, Turkey https://orcid.org/0000-0001-5547-0235
Elvin Hosrovzade Department of Cardiology, Alanya Life Hospital, Antalya, Turkey https://orcid.org/0000-0002-8675-8087
Naresh Maharjan Department of Cardiology, Grande International Hospital, Kathmandu, Nepal https://orcid.org/0000-0002-1646-8623
Gözde Yazıcı Department of Radiation Oncology, Hacettepe University, Ankara, Turkey https://orcid.org/0000-0002-7430-6729
Mustafa Cengiz Department of Radiation Oncology, Hacettepe University, Ankara, Turkey https://orcid.org/0000-0003-3692-8532
Mehmet Levent Şahiner Department of Cardiology, Hacettepe University, Faculty of Medicine, Ankara, Turkey https://orcid.org/0000-0002-0985-3144
Hikmet Yorgun Department of Cardiology, Hacettepe University, Faculty of Medicine, Ankara, Turkey https://orcid.org/0000-0001-7673-229X
Ahmet Hakan Ateş Department of Cardiology, Hacettepe University, Faculty of Medicine, Ankara, Turkey https://orcid.org/0000-0001-5414-7268
Kudret Aytemir Department of Cardiology, Hacettepe University, Faculty of Medicine, Ankara, Turkey https://orcid.org/0000-0001-9279-8424

DOI:

https://doi.org/10.54614/eurjther.2021.0088

Keywords:

cardiac autonomic functions, heart rate recovery, lung cancer, lymphoma, Radiotherapy

Abstract

Objective: Although the introduction of radiation therapy for the management of thoracic malignancies has led to a significant improvement in disease-specific survival, this has resulted in the emergence of a new spectrum of cardiovascular disorders induced by radiation injury. Heart rate recovery, as a predictor of cardiovascular events and an indicator of autonomic functions, is measured non-invasively and easily. In the present study, we investigated the effects of mediastinal radiotherapy on heart rate recovery parameters.

Methods: Twenty-one patients were included in this study who were planned to receive chest radiotherapy because of lymphoma or lung cancer. Heart rate recovery parameters were evaluated by treadmill exercise before and after radiotherapy.

Results: We have found decrease in heart rate recovery parameters (26.05 ± 12.54 vs. 19.52 ± 12.28 for HRR1, 39.1 ± 16.15 vs. 32.86 ± 14.83 for HRR2, 42.81 ± 17.66 vs. 38.05 ± 16.14 for HRR3). The higher doses of mediastinal radiotherapy caused significant changes on heart rate recovery parameters. HRR1 changed from 25.70 ± 15.12 to 22.00 ± 14.38 in low dose group and from 26.36 ± 10.41 to 17.27 ± 10.10 in high-dose group (P < .05). Attenuation of HRR2 and HRR3 were also more evident in high mediastinal dose group (P < .05).

Conclusion: Heart rate recovery parameters were decreased especially in patients who were exposed to more intense mediastinal radiation.

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