Health Risk and Biological Effects of Cardiac Ionising Imaging: From Epidemiology to Genes

Abstract

Cardiac diagnostic or therapeutic testing is an essential tool for diagnosis and treatment of cardiovascular disease, but it also involves considerable exposure to ionizing radiation. Every exposure produces a corresponding increase in cancer risk, and risks are highest for radiation exposure during infancy and adolescence. Recent studies on chromosomal biomarkers corroborate the current radioprotection assumption showing that even modest radiation load due to cardiac catheter-based fluoroscopic procedures can damage the DNA of the cell. In this article, we review the biological and clinical risks of cardiac imaging employing ionizing radiation. We also discuss the perspectives offered by the use of molecular biomarkers in order to better assess the long-term development of health effects.

Application of dosimetry systems and cytogenetic status of the child population exposed to diagnostic X‐rays by use of the cytokinesis‐block micronucleus cytome assay

“…Those results suggest that, even after diagnostic X‐ray examination, some damaging effect to the cell chromosome structure can be induced, even though the dose for that type of procedure is low. Our results are in good agreement with previous results engaged in biomonitoring of children exposed to IR either from radioactive contamination (Bilban and Vaupoti, 2001; Pelevina et al ., 2004; Tsai et al ., 2001) and accidents (da Cruz et al ., 1994; Fenech et al ., 1997; Livingston et al ., 1997; Wuttke et al ., 1998; Zotti‐Martelli et al ., 1999) or from radiological procedures (Andreassi et al ., 2006; Foffa et al ., 2009; Nordenson et al ., 1980), which proves the usefulness of CBMN Cyt assay as reliable biomarker of radiation exposure and cancer susceptibility.…”

“…This risk is given by children's anatomical features and their longer life expectancy in which to express that risk (Fučić et al ., 2008; Neri et al ., 2003; Preston et al ., 2008; Ron, 2003; Wakeford 2008). Risks of radiation‐related cancer are greatest for those exposed early in life, and these risks appear to persist throughout life (Foffa et al ., 2009; Gilbert, 2009; Linet et al ., 2009; Shore et al ., 2002).…”

The Risk of Ionizing Radiation in Electrophysiology Studies and Ablations

“…March 2011 261 the risk of cancer from exposure to radiation of 10 mSv or less. 10 Moreover, individual differences in genetic susceptibility to radiation injury and various polymorphisms in the genes responsible for DNA injury would make population estimates highly inaccurate for assessing the risk for an individual patient. 11 Biomarkers of radiation injury may allow for more accurate assessments of risk on an individual basis.…”

“…Unfortunately, epidemiological studies may not be able to accurately estimate the risk of low‐dose radiation due to the background incidence of cancer and numerous confounding factors. It has been estimated that it would require five million people in order to accurately quantify the risk of cancer from exposure to radiation of 10 mSv or less 10 . Moreover, individual differences in genetic susceptibility to radiation injury and various polymorphisms in the genes responsible for DNA injury would make population estimates highly inaccurate for assessing the risk for an individual patient 11 …”

Referral Physicians’ Knowledge of Radiation Dose: A Cross-sectional Study

“…The probability of inducing the effect, but not the severity, will increase in relation to the dose and could be different between individuals. For example, a low dose of IR <50 mSv will not directly damage any organ in the body, but repeated exposures will increase cancer risk over the lifetime of the individual [8]. This risk can be mitigated by physicians ordering fewer unnecessary radiological examination procedures.…”