Association between Radiation Exposure and Endothelium-Dependent Vasodilation: Results from Clinical and Experimental Studies

J Vasc Interv Radiol. 2020 Jan;31(1):42-48. doi: 10.1016/j.jvir.2019.09.017. Epub 2019 Dec 9.

Abstract

Purpose: The association between occupational radiation exposure and endothelium-dependent vasodilation (EDV) remains unclear. This study evaluated the association between radiation exposure and EDV among fluoroscopy-guided interventional procedure specialists and explored the possible mechanisms.

Materials and methods: Brachial flow-mediated dilation was compared in 21 interventional cardiologists (the radiation group) and 15 noninterventional cardiologists (the nonradiation group). Animal radiation experiments were also performed to observe the impact of radiation on EDV.

Results: Flow-mediated dilation in both the left (radiation group, 3.63% vs. nonradiation group, 6.77%; P < .001) and right brachial arteries (5.36% vs. 7.33%, respectively; P = .04) and serum nitric oxide (NO) level (343.69 vs. 427.09 μmol/L, respectively; P = .02) were significantly reduced in the radiation group compared to those in the nonradiation group. EDV was significantly impaired in acetylcholine concentrations of 3 × 10-6 mol/L and 10-5 mol/L (60.09% vs.74.79%, respectively; P = .03; and 62.73% vs. 80.56%, respectively; P = .002), and reactive oxygen species levels in the aorta intima and media layers were significantly increased in mice after a single x-ray exposure, which could be partly rescued by pretreatment with folic acid (P < .05).

Conclusions: Radiation exposure can lead to impairment of flow-mediated vasodilation in human or EDV in mice. In mice acutely exposed to radiation, folic acid alleviated radiation-induced EDV impairment by possible reduction of reactive oxidative species.

MeSH terms

  • Adult
  • Animals
  • Antioxidants / pharmacology
  • Aorta / drug effects
  • Aorta / metabolism
  • Aorta / physiopathology
  • Aorta / radiation effects*
  • Brachial Artery / metabolism
  • Brachial Artery / physiopathology
  • Brachial Artery / radiation effects*
  • Case-Control Studies
  • Female
  • Folic Acid / pharmacology
  • Humans
  • Male
  • Mice
  • Middle Aged
  • Nitric Oxide / metabolism
  • Occupational Exposure / adverse effects*
  • Occupational Health*
  • Oxidative Stress / drug effects
  • Radiation Dosage*
  • Radiation Exposure / adverse effects*
  • Radiography, Interventional / adverse effects*
  • Radiologists*
  • Reactive Oxygen Species / metabolism
  • Vasodilation / radiation effects*

Substances

  • Antioxidants
  • Reactive Oxygen Species
  • Nitric Oxide
  • Folic Acid