Hypoxia in aged and atherosclerotic coronary arteries significantly reduces radiosensitivity to both high- and low-LET irradiation, impacting cardiovascular disease risk estimates for radiation exposure.
Hypoxia may lower radiation damage estimates in atherosclerotic arteries; leaves open prospective validation for CVD risk models in exposed patients.
PURPOSE: The aim is to study the implications of the decrease in oxygen concentration in the coronary artery walls with age and atherosclerosis, particularly with regard to an associated reduction in the radiosensitivity to high-and low-linear-energy-transfer (LET) irradiation. MATERIALS AND METHODS: In accompanying papers, the age-dependent morphology and composition for the wall layers of normal and diseased coronary arteries were developed in Part A from published data. In Part B, the oxygen concentration in the coronary artery walls was evaluated taking account the diffusion of oxygen from blood and the solubility of oxygen in tissues. In this part the oxygen effect was evaluated using published experimental data. RESULTS: Based on simulation results from the one-dimensional diffusion model, the oxygen enhancement ratio (OER) is lower in the hypoxic vessel walls of aged and atherosclerotic arteries. Consequently the high-LET radiation damage arising from both the radon ((222)Rn) and thoron ((220)Rn) decay chains to the intimal layer of highly diseased arteries was estimated to be reduced by approximately 37% due to hypoxia. A greater reduction in radiosensitivity (51%) due to hypoxia was determined for low-LET irradiation. CONCLUSION: These results imply that the oxygen effect, and other radiation biological factors, have a significant influence on radiation biological effects and risk of cardiovascular disease (CVD) to Japanese atomic bomb (A-bomb) survivors and patients receiving radiotherapy of the mediastinum.
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Richard B. Richardson (2008) studied this question.
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