当照射胸部肿瘤时，心脏或肺部的剂量与生存相关。我们之前在大鼠模型中表明，除了已知的副作用（例如心包炎、肺炎和纤维化）之外，心脏和/或肺照射还会损害舒张功能并增加肺动脉压力。对两个器官的同时照射强烈增强了这些效应。然而，这种相互作用的长期后果尚不清楚。因此，在这里我们研究心肺联合照射的长期影响。用质子照射大鼠胸腔的不同区域，包括心脏和/或 50% 的肺。每两周测量一次呼吸频率（RR），作为心肺功能的总体参数。照射后第8、26和42周进行心脏超声心动图检查。使用照射后 8 周和 42 周收集的 Masson Trichrome 和 Verhoeff 染色的肺和左心室组织评估组织重塑和血管变化。在整个实验期间，心/肺联合照射后 RR 持续增加。这与对肺血管系统的持续影响和右心室收缩减少相一致。相反，在保留心脏后观察到 RR、肺重构和右心室收缩的恢复。这些相应的时间模式表明，右心室（RV）功能的下降与肺部血管重塑有关。肺和心脏的联合照射会导致心肺功能的加剧、持续下降。肺血管系统和右心室功能的恢复需要保留心脏。版权所有 © 2024。由 Elsevier Inc. 出版。

When irradiating thoracic tumors, dose to the heart or lung has been associated with survival. We previously showed in a rat model that in addition to known side-effects such as pericarditis, pneumonitis and fibrosis, heart and/or lung irradiation also impaired diastolic function and increased pulmonary artery pressure. Simultaneous irradiation of both organs strongly intensified these effects. However, the long-term consequences of this interactions are not yet known. Therefore, here we investigate the long-term effects of combined heart and lung irradiation.Different regions of the rat thorax containing the heart and/or 50% of the lungs were irradiated with protons. Respiratory rate (RR) was measured bi-weekly as an overall parameter for cardiopulmonary function. Echocardiography of the heart was performed at 8, 26 and 42 weeks after irradiation. Tissue remodeling and vascular changes were assessed using Masson Trichrome and Verhoeff-stained lung and LV tissue collected at 8 and 42 weeks after irradiation.During the entire experimental period RR was consistently increased after combined heart/lung irradiation. This coincided with persistent effects on lung vasculature and reduced right ventricle contraction. In contrast, recovery of RR, pulmonary remodeling and right ventricle contraction was observed after sparing of the heart. These corresponding temporal patterns suggest that the reduction of right ventricle (RV) function is related to vascular remodeling in the lung.Combined irradiation of lung and heart leads to an intensified, persistent reduction of cardiopulmonary function. Recovery of the pulmonary vasculature and right ventricle function requires heart-sparing.Copyright © 2024. Published by Elsevier Inc.