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：

---

霍奇金淋巴瘤治疗后心血管副作用的高风险——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。以前的地幔场辐射治疗伴随着心血管疾病（CVD）的长期风险增加。本研究确定了心血管副作用发展的共病因素，并启动了一项旨在降低 HL 幸存者心血管疾病发病率和死亡率的干预研究。设计邀请 1965 年至 1995 年间诊断的年龄≤45 岁的霍奇金淋巴瘤患者参与。总共有 453 名患者完成了一份针对共病因素和临床症状的问卷调查。其中，319 人接受了结构化临床访问。统计分析将患有 CVD 的个体与没有 CVD 的个体进行比较。结果 心血管疾病的报告率为 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生 CVD 的独立危险因素。接受纵隔放疗的患者 CVD 和瓣膜疾病的 OR 分别为 4.48 和 6.07。在临床就诊时，42% 的患者被转诊进行进一步调查，其中 24% 的患者因先前未知的心脏杂音而进行了心脏超声检查。结论 纵隔放疗是心血管疾病以及高胆固醇血症和高血压的独立危险因素。对这类患者进行干预的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诊进行充分调查。