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Histopathological Examination of an Explanted Heart in a Long-Term Responder to Cardiac Stereotactic Body Radiotherapy (STereotactic Arrhythmia Radioablation)

Cardiac stereotactic body radiotherapy is an emerging treatment method for recurrent ventricular tachycardia refractory to invasive treatment methods. The single-fraction delivery of 25 Gy was assumed to produce fibrosis, similar to a post-radiofrequency ablation scar. However, the dynamics of clini...

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Autores principales: Miszczyk, Marcin, Sajdok, Mateusz, Nożyński, Jerzy, Cybulska, Magdalena, Bednarek, Jacek, Jadczyk, Tomasz, Latusek, Tomasz, Kurzelowski, Radoslaw, Dolla, Łukasz, Wojakowski, Wojciech, Dyla, Agnieszka, Zembala, Michał, Drzewiecka, Anna, Kaminiów, Konrad, Kozub, Anna, Chmielik, Ewa, Grza̧dziel, Aleksandra, Bekman, Adam, Gołba, Krzysztof Stanisław, Blamek, Sławomir
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Frontiers Media S.A. 2022
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9302025/
https://www.ncbi.nlm.nih.gov/pubmed/35872906
http://dx.doi.org/10.3389/fcvm.2022.919823
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author Miszczyk, Marcin
Sajdok, Mateusz
Nożyński, Jerzy
Cybulska, Magdalena
Bednarek, Jacek
Jadczyk, Tomasz
Latusek, Tomasz
Kurzelowski, Radoslaw
Dolla, Łukasz
Wojakowski, Wojciech
Dyla, Agnieszka
Zembala, Michał
Drzewiecka, Anna
Kaminiów, Konrad
Kozub, Anna
Chmielik, Ewa
Grza̧dziel, Aleksandra
Bekman, Adam
Gołba, Krzysztof Stanisław
Blamek, Sławomir
author_facet Miszczyk, Marcin
Sajdok, Mateusz
Nożyński, Jerzy
Cybulska, Magdalena
Bednarek, Jacek
Jadczyk, Tomasz
Latusek, Tomasz
Kurzelowski, Radoslaw
Dolla, Łukasz
Wojakowski, Wojciech
Dyla, Agnieszka
Zembala, Michał
Drzewiecka, Anna
Kaminiów, Konrad
Kozub, Anna
Chmielik, Ewa
Grza̧dziel, Aleksandra
Bekman, Adam
Gołba, Krzysztof Stanisław
Blamek, Sławomir
author_sort Miszczyk, Marcin
collection PubMed
description Cardiac stereotactic body radiotherapy is an emerging treatment method for recurrent ventricular tachycardia refractory to invasive treatment methods. The single-fraction delivery of 25 Gy was assumed to produce fibrosis, similar to a post-radiofrequency ablation scar. However, the dynamics of clinical response and recent preclinical findings suggest a possible different mechanism. The data on histopathological presentation of post-radiotherapy hearts is scarce, and the authors provide significantly different conclusions. In this article, we present unique data on histopathological examination of a heart explanted from a patient who had a persistent anti-arrhythmic response that lasted almost a year, until a heart failure exacerbation caused a necessity of a heart transplant. Despite a complete treatment response, there was no homogenous transmural fibrosis in the irradiated region, and the overall presentation of the heart was similar to other transplanted hearts of patients with advanced heart failure. In conclusion, our findings support the theorem of functional changes as a source of the anti-arrhythmic mechanism of radiotherapy and show that durable treatment response can be achieved in absence of transmural fibrosis of the irradiated myocardium.
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spelling pubmed-93020252022-07-22 Histopathological Examination of an Explanted Heart in a Long-Term Responder to Cardiac Stereotactic Body Radiotherapy (STereotactic Arrhythmia Radioablation) Miszczyk, Marcin Sajdok, Mateusz Nożyński, Jerzy Cybulska, Magdalena Bednarek, Jacek Jadczyk, Tomasz Latusek, Tomasz Kurzelowski, Radoslaw Dolla, Łukasz Wojakowski, Wojciech Dyla, Agnieszka Zembala, Michał Drzewiecka, Anna Kaminiów, Konrad Kozub, Anna Chmielik, Ewa Grza̧dziel, Aleksandra Bekman, Adam Gołba, Krzysztof Stanisław Blamek, Sławomir Front Cardiovasc Med Cardiovascular Medicine Cardiac stereotactic body radiotherapy is an emerging treatment method for recurrent ventricular tachycardia refractory to invasive treatment methods. The single-fraction delivery of 25 Gy was assumed to produce fibrosis, similar to a post-radiofrequency ablation scar. However, the dynamics of clinical response and recent preclinical findings suggest a possible different mechanism. The data on histopathological presentation of post-radiotherapy hearts is scarce, and the authors provide significantly different conclusions. In this article, we present unique data on histopathological examination of a heart explanted from a patient who had a persistent anti-arrhythmic response that lasted almost a year, until a heart failure exacerbation caused a necessity of a heart transplant. Despite a complete treatment response, there was no homogenous transmural fibrosis in the irradiated region, and the overall presentation of the heart was similar to other transplanted hearts of patients with advanced heart failure. In conclusion, our findings support the theorem of functional changes as a source of the anti-arrhythmic mechanism of radiotherapy and show that durable treatment response can be achieved in absence of transmural fibrosis of the irradiated myocardium. Frontiers Media S.A. 2022-07-07 /pmc/articles/PMC9302025/ /pubmed/35872906 http://dx.doi.org/10.3389/fcvm.2022.919823 Text en Copyright © 2022 Miszczyk, Sajdok, Nożyński, Cybulska, Bednarek, Jadczyk, Latusek, Kurzelowski, Dolla, Wojakowski, Dyla, Zembala, Drzewiecka, Kaminiów, Kozub, Chmielik, Grza̧dziel, Bekman, Gołba and Blamek. https://creativecommons.org/licenses/by/4.0/This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY). The use, distribution or reproduction in other forums is permitted, provided the original author(s) and the copyright owner(s) are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms.
spellingShingle Cardiovascular Medicine
Miszczyk, Marcin
Sajdok, Mateusz
Nożyński, Jerzy
Cybulska, Magdalena
Bednarek, Jacek
Jadczyk, Tomasz
Latusek, Tomasz
Kurzelowski, Radoslaw
Dolla, Łukasz
Wojakowski, Wojciech
Dyla, Agnieszka
Zembala, Michał
Drzewiecka, Anna
Kaminiów, Konrad
Kozub, Anna
Chmielik, Ewa
Grza̧dziel, Aleksandra
Bekman, Adam
Gołba, Krzysztof Stanisław
Blamek, Sławomir
Histopathological Examination of an Explanted Heart in a Long-Term Responder to Cardiac Stereotactic Body Radiotherapy (STereotactic Arrhythmia Radioablation)
title Histopathological Examination of an Explanted Heart in a Long-Term Responder to Cardiac Stereotactic Body Radiotherapy (STereotactic Arrhythmia Radioablation)
title_full Histopathological Examination of an Explanted Heart in a Long-Term Responder to Cardiac Stereotactic Body Radiotherapy (STereotactic Arrhythmia Radioablation)
title_fullStr Histopathological Examination of an Explanted Heart in a Long-Term Responder to Cardiac Stereotactic Body Radiotherapy (STereotactic Arrhythmia Radioablation)
title_full_unstemmed Histopathological Examination of an Explanted Heart in a Long-Term Responder to Cardiac Stereotactic Body Radiotherapy (STereotactic Arrhythmia Radioablation)
title_short Histopathological Examination of an Explanted Heart in a Long-Term Responder to Cardiac Stereotactic Body Radiotherapy (STereotactic Arrhythmia Radioablation)
title_sort histopathological examination of an explanted heart in a long-term responder to cardiac stereotactic body radiotherapy (stereotactic arrhythmia radioablation)
topic Cardiovascular Medicine
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9302025/
https://www.ncbi.nlm.nih.gov/pubmed/35872906
http://dx.doi.org/10.3389/fcvm.2022.919823
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