Incorporated cesium, and cardiovascular pathology
Y.I. Bandazhevsky and G. Bandazhevskaia
"Health effects of the Chernobyl accident : results of 15-years follow-up studies"
Abstract submitted for the plenary session, Tuesday, June 5th, 2001 :
Incidence of cardiovascular diseases, first cause of death in Belarus, increases since decades. Where radiocesium is omnipresent, new cardiac diseases appeared with hypertension, even in younger subjects.
Gomel Medical Institute's collaborators undertook experimental,
anatomo-pathological, and clinical studies on the pathogenesis of these
cardiovascular diseases.
1) Experimental trials :
The consequences of Cs137 cardiac accumulation were assessed in rats fed with contaminated cereals. 63.35Bq/kg/body-weight and 445.7Bq/kg/heart were measured after 10 days. Alkaline phosphatase and CPK decreased, whereas AST increased significantly, reflecting major cardiac metabolic dysfunction.
Histology showed destruction in cardiomyocytes, and other highly differentiated
cells, e.g. : kidney, thyroid. The electron microscopy shows the damages at the
mitochondrion level.
2) Patho-morphology and histology :
Autopsies were performed in
persons who lived and died in contaminated regions. Average Cs137 level was
26.1Bq/kg cardiac muscle in 285 subjects died from sudden-death. Cardiac
dilatation and congestive heart failure was commonly encountered in adults but
also in young children. Coronary obstruction with ischemic damage of the
myocardium was rare in this group.
Histology showed degenerative heart alterations in 98.6% of the 285 cases, with
atrophic or hypertrophic cardiomyocytes, loss of striation, myocytolysis,
pycnotic nuclei, cell death, with focal cellular accumulation, and generalised
interstitial oedema without infiltrations.
Other organs showed similar degenerative cellular distrophy, e.g. : kidney,
responsible for hypertension in several cases, thyroid which interfere also in
cardiac function.
3) Clinical findings :
School-children from villages from Grodno, Vetka, Minsk to Gomel areas, with
different levels of Cs137 contamination, had usually a satisfactory nutritional
status. However, many reacted to moderate physical efforts with tachycardia,
arrhythmia, unstable blood pressure, abnormal fatigue. Anorganic systolic
murmurs were frequent, in some cases the first cardiac sound was abnormally
soft, the second split. In such children, ECG showed e.g. atrio-ventricular
block and repolarisation anomalies. ECG changes were directly proportional to
the measured Cs137 incorporated in the organism.
In adults, Cs137 levels of over 20-30 Bq/kg body-weight, reduced the adaptative
cardiac response : functional impairment after moderate stress, such as physical
efforts, infectious diseases.
Conclusion :
Chronic Cs137 levels over 30
Bq/kg body-weight is often associated with serious cardiovascular diseases.
In children, these changes remain reversible, when uncontaminated food, holidays
in clean regions or pectine treatment are prescribed.