Evidence map›Paper›PMID 26210695›Full record

ArticleJACC. Cardiovascular imaging2015

Assessment of the Radiation Effects of Cardiac CT Angiography Using Protein and Genetic Biomarkers.

Patricia K Nguyen, Won Hee Lee, Yong Fuga Li, Wan Xing Hong, Shijun Hu, Charles Chan, Grace Liang, Ivy Nguyen, Sang-Ging Ong, Jared Churko and 4 more

Erratum issuedAbstract read
PubMed Full text at PMC Publisher
In one paragraph

Article in JACC. Cardiovascular imaging, 2015. The graph could read no effect estimate from its abstract, so it casts no vote on the map. An erratum has been issued. Cited by 43 papers.

0numbers the graph read from it
0cells of the map it votes in
43citing papers in PubMed
9.5field-weighted citation impact, top 2% of its field
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

43 citing papers in PubMed, 74 citations in OpenAlex.

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  14. 3D iterative reconstruction can do so much more than reduce dose.Journal of nuclear cardiology : official publication of the American Society of Nuclear Cardiology · 2021
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4 · The record

Corrections and comments

5 · Who and what money

Authors and funding

14 authors at 2 institutions in 1 country.

Patricia K NguyenStanford Cardiovascular Institute, Stanford University School of Medicine, Stanford, California; Veterans Administration Palo Alto, Palo Alto, California; Department of Medicine, Division of Cardiology, Stanford University School of Medicine, Stanford, California. Electronic address: pknguyen@stanford.edu.
Won Hee LeeStanford Cardiovascular Institute, Stanford University School of Medicine, Stanford, California; Department of Medicine, Division of Cardiology, Stanford University School of Medicine, Stanford, California.
Yong Fuga LiDepartment of Genetics, Stanford University School of Medicine, Stanford, California.
Wan Xing HongStanford Cardiovascular Institute, Stanford University School of Medicine, Stanford, California; Department of Medicine, Division of Cardiology, Stanford University School of Medicine, Stanford, California.
Shijun HuStanford Cardiovascular Institute, Stanford University School of Medicine, Stanford, California; Department of Medicine, Division of Cardiology, Stanford University School of Medicine, Stanford, California.
Charles ChanDepartment of Surgery, Stanford University School of Medicine, Stanford, California.
Grace LiangStanford Cardiovascular Institute, Stanford University School of Medicine, Stanford, California.
Ivy NguyenStanford Cardiovascular Institute, Stanford University School of Medicine, Stanford, California.
Sang-Ging OngStanford Cardiovascular Institute, Stanford University School of Medicine, Stanford, California; Department of Medicine, Division of Cardiology, Stanford University School of Medicine, Stanford, California.
Jared ChurkoStanford Cardiovascular Institute, Stanford University School of Medicine, Stanford, California; Department of Medicine, Division of Cardiology, Stanford University School of Medicine, Stanford, California.
Jia WangEnvironmental Health and Safety, Stanford University School of Medicine, Stanford, California.
Russ B AltmanDepartment of Genetics, Stanford University School of Medicine, Stanford, California.
Dominik FleischmannStanford Cardiovascular Institute, Stanford University School of Medicine, Stanford, California; Department of Radiology, Stanford University School of Medicine, Stanford, California.
Joseph C WuStanford Cardiovascular Institute, Stanford University School of Medicine, Stanford, California; Department of Medicine, Division of Cardiology, Stanford University School of Medicine, Stanford, California; Department of Radiology, Stanford University School of Medicine, Stanford, California. Electronic address: joewu@stanford.edu.
Cardiovascular Institute of the South · USStanford University · US

Funding

Molecular Imaging of Targeted Cardiac Gene TherapyR01HL093172 · NHLBI · STANFORD UNIVERSITY · PI WU, JOSEPH C. · 2009 to 2015
$2.7M
Integrated Strategies for Novel Treatment of Myocardial IschemiaR01HL095571 · NHLBI · STANFORD UNIVERSITY · PI WU, JOSEPH C. · 2010 to 2014
$2.0M
NHLBI NIH HHS HL093172NHLBI NIH HHS HL09551NHLBI NIH HHS R01 HL093172NHLBI NIH HHS R01 HL095571
6 · The paper itself

Abstract

objectivesThe purpose of this study was to evaluate whether radiation exposure from cardiac computed tomographic angiography (CTA) is associated with deoxyribonucleic acid (DNA) damage and whether damage leads to programmed cell death and activation of genes involved in apoptosis and DNA repair.

backgroundExposure to radiation from medical imaging has become a public health concern, but whether it causes significant cell damage remains unclear.

methodsWe conducted a prospective cohort study in 67 patients undergoing cardiac CTA between January 2012 and December 2013 in 2 U.S. medical centers. Median blood radiation exposure was estimated using phantom dosimetry. Biomarkers of DNA damage and apoptosis were measured by flow cytometry, whole genome sequencing, and single cell polymerase chain reaction.

resultsThe median dose length product was 1,535.3 mGy·cm (969.7 to 2,674.0 mGy·cm). The median radiation dose to the blood was 29.8 mSv (18.8 to 48.8 mSv). Median DNA damage increased 3.39% (1.29% to 8.04%, p < 0.0001) and median apoptosis increased 3.1-fold (interquartile range [IQR]: 1.4- to 5.1-fold, p < 0.0001) post-radiation. Whole genome sequencing revealed changes in the expression of 39 transcription factors involved in the regulation of apoptosis, cell cycle, and DNA repair. Genes involved in mediating apoptosis and DNA repair were significantly changed post-radiation, including DDB2 (1.9-fold [IQR: 1.5- to 3.0-fold], p < 0.001), XRCC4 (3.0-fold [IQR: 1.1- to 5.4-fold], p = 0.005), and BAX (1.6-fold [IQR: 0.9- to 2.6-fold], p < 0.001). Exposure to radiation was associated with DNA damage (odds ratio [OR]: 1.8 [1.2 to 2.6], p = 0.003). DNA damage was associated with apoptosis (OR: 1.9 [1.2 to 5.1], p < 0.0001) and gene activation (OR: 2.8 [1.2 to 6.2], p = 0.002).

conclusionsPatients exposed to >7.5 mSv of radiation from cardiac CTA had evidence of DNA damage, which was associated with programmed cell death and activation of genes involved in apoptosis and DNA repair.

Indexed as

ApoptosisDNA DamageAgedAged, 80 and overAnnexin A5Ataxia Telangiectasia Mutated Proteinsbcl-2-Associated X ProteinBiomarkersCohort StudiesCoronary AngiographyDNA-Binding ProteinsDNA RepairFemaleFlow CytometryHeartHistonesAnnexin A5Ataxia Telangiectasia Mutated ProteinsATR protein, humanbcl-2-Associated X ProteinBiomarkersDNA-Binding ProteinsH2AX protein, humanHistonesPDRG1 protein, humanCT/MRIgene expressiongene regulationimaging

Identifiers

PMID26210695
PMCPMC5019957
OpenAlexW1004913847

What OpenQuestion holds

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Registered trials

None linked

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.