Cardiac catheterization procedures in children with congenital heart disease: Increased chromosomal aberrations in peripheral lymphocytes

Gao, Yu; Wang, Ping; Su, Yinping; Wang, Zhaonan; Han, Lin; Li, Jie; Fu, Yinghua; Zhao, Fen; Sun, Qiang; Lyu, Yumin

doi:10.1016/j.mrgentox.2020.503163

Cited by 6 publications

(4 citation statements)

References 23 publications

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“…We have found that both methods detect DNA damage in MNCs in patients undergoing single CT scanning, which indicates that these methods are highly sensitive with regard to detecting DNA damage induced by low-dose radiation. 7) Previous studies have reported in- creases in DNA damage after cardiac catheterization or other interventional radiology mainly in pediatric patients; [17][18][19][20][21][22] however, to our knowledge, this study is the first to evaluate DNA damage induced by radiation exposure from cardiac catheterization by both proteomic and cytogenetic methods. The increase in γH2AX significantly correlated with the DAP, which suggests that the DNA damage response immediately after DSBs itself depends on the radiation dose.…”

Section: Discussionmentioning

confidence: 91%

DNA Damage Induced by Radiation Exposure from Cardiac Catheterization

et al. 2022

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Almost 40% of medical radiation exposure is related to cardiac imaging or intervention. However, the biological effects of low-dose radiation from medical imaging remain largely unknown. This study aimed to evaluate the effects of ionized radiation from cardiac catheterization on genomic DNA integrity and inflammatory cytokines in patients and operators.Peripheral mononuclear cells (MNCs) were isolated from patients (n = 51) and operators (n = 35) before and after coronary angiography and/or percutaneous coronary intervention. The expression of γH2AX, a marker for DNA double-strand breaks, was measured by immunofluorescence. Dicentric chromosomes (DICs), a form of chromosome aberrations, were assayed using a fluorescent in situ hybridization technique.In the patient MNCs, the numbers of γH2AX foci and DICs increased after cardiac catheterization by 4.5 ± 9.4-fold and 71 ± 122%, respectively (P < 0.05 for both). The mRNA expressions of interleukin (IL)-1α, IL-1β, leukemia inhibitory factor, and caspase-1 were significantly increased by radiation exposure from cardiac catheterization. The increase in IL-1β was significantly correlated with that of γH2AX, but not with the dose area product. In the operators, neither γH2AX foci nor the DIC level was changed, but IL-1β mRNA was significantly increased. The protein expression of IκBα was significantly decreased in both groups.DNA damage was increased in the MNCs of patients, but not of operators, who underwent cardiac catheterization. Inflammatory cytokines were increased in both the patients and operators, presumably through NF-κB activation. Further efforts to reduce radiation exposure from cardiac catheterization are necessary for both patients and operators.

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Section: Discussionmentioning

confidence: 91%

DNA Damage Induced by Radiation Exposure from Cardiac Catheterization

et al. 2022

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“…Interestingly, a pioneering study conducted in 1978 showed a significant increase in CAs after cardiac catheterization in children as compared to the baseline value [ 48 ]. In more recent years, several studies reported that cardiac catheterization procedures increased acute [ 29 ] and long-term chromosomal aberrations in peripheral lymphocytes [ 49 , 50 ]. Importantly, the mean levels of CA frequencies were also significantly higher in exposed patients compared to both healthy age- and sex-matched subjects and newborns with similar heart defects without any radiation exposure [ 49 ].…”

Section: Molecular Epidemiology and Biomarkers For An Early Biologica...mentioning

confidence: 99%

Congenital Heart Disease and the Risk of Cancer: An Update on the Genetic Etiology, Radiation Exposure Damage, and Future Research Strategies

Campolo

Annoni

Giaccardi³

et al. 2022

JCDD

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Epidemiological studies have shown an increased prevalence of cancer in patients with congenital heart disease (CHD) as compared with the general population. The underlying risk factors for the acquired cancer risk remain poorly understood, and shared genetic anomalies and cumulative radiation exposure from repeated imaging and catheterization procedures may be contributing factors. In the present review, we provide an update on the most recent literature regarding the associations between CHD and cancer, with a particular focus on genetic etiology and radiation exposure from medical procedures. The current evidence indicates that children with CHD may be a high-risk population, already having the first genetic “hit”, and, consequently, may have increased sensitivity to ionizing radiation from birth or earlier. Future research strategies integrating biological and molecular measures are also discussed in this article.

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“…The development of cardiac devices and imaging gives a great range of options other than surgery, and they could even postpone or replace surgery. [ 3 4 ] However, reports from the perioperative cardiac Arrest registry in Pediatric found that about one-third of cardiac arrests occurred in children with CHDs, 17% of them occurred during cardiac catheterization. [ 5 ] Thus, the anesthesiologist in the catheterization lab should be familiar with CHDs and the specific limitations of this environment.…”

Section: Introductionmentioning

confidence: 99%

Recovery profile of sugammadex versus neostigmine in pediatric patients undergoing cardiac catheterization: A randomized double-blind study

et al. 2021

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Background: Sugammadex is a selective reversal agent which has the ability to reverse deep neuromuscular blockade. However, there are still controversial results as regard sugammadex effects on the quality of recovery. We hypothesized that Sugammadex may have better recovery profile compared to neostigmine in pediatric patients with congenital heart diseases undergoing cardiac catheterization. Patients and Methods: This prospective randomized double-blind study included 50 pediatric patients aged <2 years who were divided into two groups according to the reversal agent used; Group S (Sugammadex) and Group N (Neostigmine). Both groups received the same anesthetic technique during cardiac catheterization, and basic hemodynamic monitoring was ensured in both groups. After the procedure, reversal was done using 4 mg.kg ‒1 sugammadex or 0.04 mg. kg ‒1 neostigmine plus 0.02 mg. kg ‒1 atropine according to the group allocation. Recovery time and side effects were recorded. Results: The two groups showed comparable findings regarding demographics. Nonetheless, the total time of anesthesia had mean values of 91.06 and 101.25 min in the two groups, respectively ( P = 0.003), while recovery time had mean values of 1.61 and 9.23 min in the same groups, respectively ( P < 0.001). Hemodynamic profile (heart rate and mean arterial pressure) was better after reversal with sugammadex. Blood sugar levels and side effects showed no significant difference between both groups. Conclusion: Sugammadex can be a more rapid and effective alternative to neostigmine for reversal of rocuronium-induced neuromuscular blockade in pediatric patients undergoing cardiac catheterization.

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Cardiac catheterization procedures in children with congenital heart disease: Increased chromosomal aberrations in peripheral lymphocytes

Cited by 6 publications

References 23 publications

DNA Damage Induced by Radiation Exposure from Cardiac Catheterization

DNA Damage Induced by Radiation Exposure from Cardiac Catheterization

Congenital Heart Disease and the Risk of Cancer: An Update on the Genetic Etiology, Radiation Exposure Damage, and Future Research Strategies

Recovery profile of sugammadex versus neostigmine in pediatric patients undergoing cardiac catheterization: A randomized double-blind study

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