Advances in radiation-induced heart disease diagnosis and treatment

Over the past decades, the survival rates of patients with cancer have significantly increased owing to advancements in cancer treatment strategies. Radiotherapy has become an indispensable treatment modality for thoracic tumors. While it offers benefits in treating or even potentially curing cancer, thoracic radiotherapy exposes neighboring heart tissues to ionizing radiation, elevating the risk of radiation-induced heart disease (RIHD). Despite improvements in radiotherapy techniques that have reduced the incidence of RIHD, complete avoidance of heart radiation exposure remains a challenge. Cohort studies involving atomic bomb survivors and individuals with occupational radiation exposure, even at relatively low doses, have reported a significant increase in RIHD risks. The pathological mechanisms underlying RIHD have been extensively reviewed. At present, imaging techniques and traditional cardiac biomarkers are the primary methods to diagnose RIHD, with ongoing efforts to explore additional promising markers for predicting and monitoring RIHD. Moreover, traditional and novel therapeutic strategies are being actively explored to prevent or alleviate RIHD. Insights gained from therapeutic advancements in other organ systems or heart diseases caused by different factors can provide valuable ideas for RIHD management. This review discusses the recent advancements in the diagnosis and treatment of RIHD.