Machbarkeit einer Studie zum strahlenbedingten Risiko von Herz-Kreislauferkrankungen auf Basis der kooperative Gesundheitsforschung in der Region Augsburg (KORA)

Radiation induced cardiovascular disease is a risk proven by many
studies in patients exposed with high-doses from a thoracal
radiotherapy. Since the theory of cardiovascular effects caused by
low-doses of ionising radiation amongst the A-bomb survivors has
been raised, much effort has been taken to get more information and
significant results. Currently there is still no clear evidence of
a threshold dose or a linear relation for doses below 0,5Gy (energy
dose. The aim of this work was to develop a design for a
feasability study, based on the German cohort study KORA
(’Kooperative Gesundheitsforschung in der Region Augsburg’), for
low dose radiation from diagnostic imaging and possibly induced
myocardial infarction. To this end a completely new dosimetric
system had to be set up to get the organ dose of the heart from
different radiological examinations. This was achieved using
conversion coefficients, calculated by Monte Carlo (MC) simulations
with the mathematical or voxel phantoms from the ’Helmholtz
Zentrum’ Munich (HMGU, former ’Gesellschaft für Strahlenforschung’
GSF), and a large benchmarking for the individual parameters
depending on the examinations and patients. The next step was to
create a sensible questionnaire for a retrospective radiation
anamnesis including data for confounding analysis. This
questionnaire combined with the retrospective dosimetry was
successfully tested in a pilot study. The setup was a case control
study based on actual patients suffering from myocardial infarction
who were included in the Augsburg KORA-Herzinfarktregister and an
age and gender stratified control group recruited from the
population-based KORA-cohort having no diagnoses of myocardial
infarction.