Background Hodgkin lymphoma (HL) patients have a good prognosis after adequate treatment. Previous treatment with mantle field irradiation has been accompanied by an increased long-term risk of cardiovascular disease (CVD). This study identified co-morbidity factors for the development of cardiovascular side effects and initiated an intervention study aimed to decrease morbidity and mortality of CVD in HL survivors. Design Hodgkin lymphoma patients aged ≤45 years diagnosed between 1965 and 1995 were invited to participate. In total, 453 patients completed a questionnaire that addressed co-morbidity factors and clinical symptoms. Of these, 319 accepted to participate in a structured clinical visit. The statistical analyses compared individuals with CVD with those with no CVD. Results Cardiovascular disease was reported by 27.9%. Radiotherapy (odds ratio [OR]: 3.27), hypertension and hypercholesterolemia were shown to be independent risk factors for the development of CVD. The OR for CVD and valve disease in patients who received radiotherapy towards mediastinum was 4.48 and 6.07, respectively. At clinical visits, 42% of the patients were referred for further investigation and 24% of these had a cardiac ultrasound performed due to previously unknown heart murmurs. Conclusion Radiotherapy towards mediastinum was an independent risk factor for CVD as well as hypercholesterolemia and hypertension. A reasonable approach as intervention for this cohort of patients is regular monitoring of hypertension and hypercholesterolemia and referral to adequate investigation when cardiac symptoms appear. Broad knowledge about the side effects from radiotherapy in the medical community and well-structured information regarding late side effects to the patients are all reasonable approaches as late effects can occur even 40 years after cancer treatment.

中文翻译：

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霍奇金淋巴瘤治疗后发生心血管副作用的风险很高-是否需要对长期幸存者进行干预？

背景霍奇金淋巴瘤（HL）患者经过充分治疗后预后良好。先前用地幔辐射治疗已经伴有心血管疾病（CVD）的长期风险增加。这项研究确定了心血管副作用发生的合并症因素，并发起了一项旨在降低HL幸存者CVD的发病率和死亡率的干预研究。1965年至1995年之间诊断为≤45岁的设计霍奇金淋巴瘤患者被邀请参加。总共453名患者完成了一份针对并发因素和临床症状的问卷。其中，319名患者接受了参加结构化临床访问。统计分析将患有CVD的个体与没有CVD的个体进行了比较。结果心血管疾病报告率为27.9％。放疗（优势比[OR]：3.27），高血压和高胆固醇血症被证明是发展CVD的独立危险因素。接受纵隔放疗的患者的CVD和瓣膜疾病的OR分别为4.48和6.07。在临床就诊时，有42％的患者被转诊接受进一步检查，其中24％的患者由于先前未知的心脏杂音而进行了心脏超声检查。结论纵隔放疗是CVD以及高胆固醇血症和高血压的独立危险因素。对该人群进行干预的一种合理方法是定期监测高血压和高胆固醇血症，并在出现心脏症状时转介适当的检查。