European Heart Journal Advance Access originally published online on May 22, 2006
European Heart Journal 2006 27(22):2703-2708; doi:10.1093/eurheartj/ehl014
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Cardiac catheterization and long-term chromosomal damage in children with congenital heart disease
1 CNR, Institute of Clinical Physiology, Pisa, Italy
2 Scuola Superiore S. Anna, Pisa, Italy
3 Clinica Cardiologica MonteVergine, Mercogliano, Avellino, Italy
Received 18 October 2005; revised 23 March 2006; accepted 13 April 2006; online publish-ahead-of-print 22 May 2006.
* Corresponding author. Tel: +39 0585 493646; fax: +39 0585 493601E-mail address: andreas{at}ifc.cnr.it
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
vs. Group II=6.0±3.8; vs. Group III=4.4±1.4; P<0.0001).
Conclusion Cardiac ionizing procedures are associated with a long-lasting mark in the chromosomal damage of exposed children with CHD.
Key Words: Congenital heart disease • Cardiac catheterization • Ionizing radiation • Chromosomal damage • Cancer risk
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