Ionizing radiation is widely used in various industrial and medical applications, resulting in increased exposure for certain populations. Lessons from radiation accidents and occupational exposure have highlighted the cardiovascular and cerebrovascular risks associated with radiation exposure. In addition, radiation therapy for cancer has been linked to numerous cardiovascular complications, depending on the distribution of the dose by volume in the heart and other relevant target tissues in the circulatory system. The manifestation of symptoms is influenced by numerous factors, and distinct cardiac complications have previously been observed in different groups of patients with cancer undergoing radiation therapy. However, in contemporary radiation therapy, advances in treatment planning with conformal radiation delivery have markedly reduced the mean heart dose and volume of exposure, and these variables are therefore no longer sole surrogates for predicting the risk of specific types of heart disease. Nevertheless, certain cardiac substructures remain vulnerable to radiation exposure, necessitating close monitoring. In this Review, we provide a comprehensive overview of the consequences of radiation exposure on the cardiovascular system, drawing insights from various cohorts exposed to uniform, whole-body radiation or to partial-body irradiation, and identify potential risk modifiers in the development of radiation-associated cardiovascular disease.

电离辐射广泛用于各种工业和医疗应用，导致某些人群的暴露量增加。辐射事故和职业暴露的教训突出了与辐射暴露相关的心脑血管风险。此外，癌症放射治疗与许多心血管并发症有关，具体取决于剂量在心脏和循环系统中其他相关靶组织中的体积分布。症状的表现受多种因素的影响，以前在接受放射治疗的不同癌症患者群体中观察到不同的心脏并发症。然而，在当代放射治疗中，适形放射治疗计划的进步显着降低了平均心脏剂量和暴露量，因此这些变量不再是预测特定类型心脏病风险的唯一替代指标。然而，某些心脏亚结构仍然容易受到辐射暴露，需要密切监测。在本综述中，我们全面概述了辐射暴露对心血管系统的影响，从暴露于均匀全身辐射或部分全身照射的各个队列中汲取见解，并确定了辐射相关心血管疾病发展中的潜在风险调节因素。