Radiation as a Risk Factor for Cardiovascular Disease

Abstract

Humans are continually exposed to ionizing radiation from terrestrial sources. The two major contributors to radiation exposure of the U.S. population are ubiquitous background radiation and medical exposure of patients. From the early 1980s to 2006, the average dose per individual in the United States for all sources of radiation increased by a factor of 1.7-6.2 mSv, with this increase due to the growth of medical imaging procedures. Radiation can place individuals at an increased risk of developing cardiovascular disease. Excess risk of cardiovascular disease occurs a long time after exposure to lower doses of radiation as demonstrated in Japanese atomic bomb survivors. This review examines sources of radiation (atomic bombs, radiation accidents, radiological terrorism, cancer treatment, space exploration, radiosurgery for cardiac arrhythmia, and computed tomography) and the risk for developing cardiovascular disease. The evidence presented suggests an association between cardiovascular disease and exposure to low-to-moderate levels of radiation, as well as the well-known association at high doses. Studies are needed to define the extent that diagnostic and therapeutic radiation results in increased risk factors for cardiovascular disease, to understand the mechanisms involved, and to develop strategies to mitigate or treat radiation-induced cardiovascular disease. Antioxid. Redox Signal. 15, 1945Signal. 15, -1956

Late Effects of Total-Body Gamma Irradiation on Cardiac Structure and Function in Male Rhesus Macaques

“…Currently, the risk of dying from CVD exceeds the risk of dying from initial or recurrent cancer for many cancer survivors ( 15 – 17 ). The relative risk values generally reported in Hodgkin’s disease survivors range from 2 to 5 for cardiovascular morbidity ( 18 – 20 ), with one study reporting a relative risk of 7.2 ( 21 ). A recent population-based case-control study in women who received radiotherapy for breast cancer between 1958 and 2001 in Denmark and Sweden showed that the rate of major coronary events increased by 7.4% per Gy of incidental exposure to the heart with no apparent threshold for increased risk ( 22 ).…”

Transcriptomic profiling suggests a role for IGFBP5 in premature senescence of endothelial cells after chronic low dose rate irradiation

“…Th e endothelium, which constitutes the inner lining of the cardiovascular system, is considered to be a critical target for radiation-related CVD (Baker et al 2011). Endothelial cells are involved in processes such as coagulation, fi brinolysis, vascular tone regulation and infl ammation, and are considered safeguards for normal vascular functioning (Michiels 2003).…”

2013 Dade W. Moeller Lecture

“…Such mitigation was first demonstrated in 1988 using a rat model of lung injury (Ward et al 1988); (Moulder et al 1993, Cohen et al 1997, Moulder et al 1997) a more recent study of mitigation of radiation-induced lung injury is shown in Fig 5. Subsequently, the ACEIs were also shown to mitigate experimental radiation-induced renal (Fig 5), brain (Fig 6), and cardiac (Baker et al 2011) injuries. The ACEI’s have now made the transition from bench-to-bedside (Fig 7), and have shown promise for mitigation of radiation-induced renal (Cohen et al 2012) and lung (Jenkins and Watts 2011, Cohen et al 2012, Kharofa et al 2012) injury in humans.…”

“…2), and might also cause cognitive impairment (Raber et al 2004, Acevedo et al 2008). (Baker et al 2011) Lower-body doses this high would result in severe prodromal emesis and diarrhea (Anno et al 1995, Otterson et al 1996), but would probably not cause acute gastrointestinal lethality (Fig 2). However, lower-body doses this high would exceed renal tolerance (Fig.…”