April 11, 2006European Heart Journal144 citationsOpen Access
View Full PaperCardiac catheterization and long-term chromosomal damage in children with congenital heart disease
Key Result
Cardiac ionizing procedures in children with congenital heart disease were associated with a higher frequency of chromosomal aberrations (2.8% vs 0.7%; P<0.0001) compared to healthy controls.
Study Design
Type
Observational (n=74)
PICO
P
Population
74 subjects including 32 children with congenital heart disease exposed to cardiac ionizing procedures, 32 healthy matched controls, and 10 non-exposed newborns.
E
Exposure / Comparator
Cardiac procedures employing ionizing radiation vs Healthy matched subjects and non-exposed newborns
O
Primary Outcome
Frequency of chromosomal aberrations (CA), p=<0.0001
Main Result
Absolute Event Rate: 2.8% vs 0.7%
p-value: p=<0.0001
Abstract
AIMS: Medical radiological exposure is associated with an additional risk of cancer. Children with repaired congenital heart disease (CHD) are theoretically at a relatively greater cancer risk as the radiological exposure can be intensive in these patients. Chromosomal aberrations test (CA) and micronucleus assay (MN) in peripheral blood lymphocytes are biomarkers of chromosomal damage and intermediate endpoints in carcinogenesis. METHODS AND RESULTS: The frequency of CA and MN was assessed in three groups of patients: Group I, 32 exposed patients (17 males, age=15.5+/-8.3 years) who underwent cardiac procedures employing ionizing radiation (mostly cardiac catheterization) for CHD between 1965 and 2000; Group II, 32 healthy age- and sex-matched subjects (17 males, age=14.1+/-12.3 years), and Group III, 10 newborn non-exposed patients (7 males) with CHD. Exposed patients of Group I had a mean value of 2.9+/-1.4 cardiac catheterization (range 1-5) procedures per person. The mean frequency of CA was higher in the exposed patients (Group I=2.8+/-1.9% vs. Group II=0.7+/-0.7%; vs. Group III=0.8+/-0.8%; P<0.0001). Similarly, the mean values of MN were higher in the exposed patients (Group I =12.3+/-5.1 per thousand vs. Group II=6.0+/-3.8 per thousand; vs. Group III=4.4+/-1.4 per thousand; P<0.0001). CONCLUSION: Cardiac ionizing procedures are associated with a long-lasting mark in the chromosomal damage of exposed children with CHD.