http://www.mdpi.com/journal/ijerph/special_issues/cardiac-imaging/ Medical radiation imaging is the major source of man-made irradiation in western countries. About 5 billion imaging examinations are performed worldwide each year, and cardiac imaging represent >50% of all ionizing radiation examinations, accounting for about two thirds of the total effective dose to patients Individual lifetime patient exposures may well reach values around a cumulative exposure of 100 mSv, corresponding to 5,000 chest x-rays by the execution—one after the other — of a Multislice Computed Tomography (MSCT) (15 mSv), a Thallium scan (20–25 mSv), a coronary angiography (6 mSv), a coronary stenting (15 mSv), a follow-up repeat MSCT (again 15 mSv) and Thallium scan (again 20–25 mSv). Unfortunately, physicians show little awareness of the dose of the exam they daily perform or request. The current status of this field of evidence is the subjects of this special issue. In particular, it will comprise manuscripts providing information on population impact, professional and patient exposure from radiation dose in cardiac imaging. In addition, the issue will include also a paper describing the findings of recent studies regarding the use of surrogate biomarker of susceptibility in the assessing long-term risk of heath effects, and the future perspectives of the molecular epidemiology. Based on these contributions, the issue will try to compose a balanced issue in order to increase awareness and knowledge about radiation exposure from cardiac imaging and implications for health risk. - free for readers, with low publishing fees paid by authors or their institutions Free publication for manuscripts submitted by end of 2008. Rapid publication: accepted papers are immediately published online (we started to publish papers quickly since September 2008). The printed edition will only be continued for the Proceedings of the yearly International Symposiums on Recent Advances in Environmental Health Research starting 2009. Submission The Int. J. Environ. Res. Public Health (ISSN 1660-4601) was launched in 2004 and is an Open Access journal, with the main Editorial Office located in Basel, Switzerland. It has been accepted for coverage in Science Citation Index Expanded, available as the Web of Science and in Current Contents/Agriculture, Biology, and Environmental Sciences. Coverage will begin with the 2009 issues. This journal is also abstracted and indexed very rapidly by Chemical Abstracts, MedLine/PubMed and EMBASE. The IJERPH maintains a rapid editorial procedure and a rigorous peer-review system. Well written papers have been peer-reviewed and published in less than 4 weeks from manuscript submission. All papers published in IJERPH have DOI numbers. All papers should be submitted to ijerph@mdpi.com with copy to the guest editor. To be published continuously until the deadline and papers will be listed together at this special issue website. Please visit the Instructions for Authors page before submitting a paper. Open Access publication fees are 300 CHF per paper. English correction fees (250 CHF) will be added in certain cases (550 CHF per paper for those papers that require extensive additional formatting and/or English corrections.). Free publication in open access format for manuscripts submitted in 2008. http://www.mdpi.com/1660-4601/6/6/1882/ Cardiac diagnostic or therapeutic testing is an essential tool for diagnosis and treatment of cardiovascular disease, but it also involves considerable exposure to ionizing radiation. Every exposure produces a corresponding increase in cancer risk, and risks are highest for radiation exposure during infancy and adolescence. Recent studies on chromosomal biomarkers corroborate the current radioprotection assumption showing that even modest radiation load due to cardiac catheter-based fluoroscopic procedures can damage the DNA of the cell. In this article, we review the biological and clinical risks of cardiac imaging employing ionizing radiation. We also discuss the perspectives offered by the use of molecular biomarkers in order to better assess the long-term development of health effects. http://www.mdpi.com/1660-4601/6/6/1882/ Fri, 19 Jun 2009 00:00:00 CEST International Journal of Environmental Research and Public Health 2009-06-19 6 6 Article 1882 1893 1660-4601 Health Risk and Biological Effects of Cardiac Ionising Imaging: From Epidemiology to Genes 2009-06-19 doi: 10.3390/ijerph6061882 Ilenia Foffa Monica Cresci Maria Grazia Andreassi http://www.mdpi.com/1660-4601/6/6/1778/ Since the introduction of Magnetic Resonance Imaging (MRI) as a diagnostic technique, the number of people exposed to electromagnetic fields (EMF) has increased dramatically. In this review, based on the results of a pioneer study showing in vitro and in vivo genotoxic effects of MRI scans, we report an updated survey about the effects of non-ionizing EMF employed in MRI, relevant for patients’ and workers’ safety. While the whole data does not confirm a risk hypothesis, it suggests a need for further studies and prudent use in order to avoid unnecessary examinations, according to the precautionary principle. http://www.mdpi.com/1660-4601/6/6/1778/ Wed, 10 Jun 2009 00:00:00 CEST International Journal of Environmental Research and Public Health 2009-06-10 6 6 Review 1778 1798 1660-4601 Biological Effects and Safety in Magnetic Resonance Imaging: A Review 2009-06-10 doi: 10.3390/ijerph6061778 Valentina Hartwig Giulio Giovannetti Nicola Vanello Massimo Lombardi Luigi Landini Silvana Simi http://www.mdpi.com/1660-4601/6/5/1649/ The immense clinical and scientific benefits of cardiovascular imaging are well-established, but are also true that 30 to 50% of all examinations are partially or totally inappropriate. Marketing messages, high patient demand and defensive medicine, lead to the vicious circle of the so-called Ulysses syndrome. Mr. Ulysses, a typical middle-aged “worried-well” asymptomatic subject with an A-type coronary personality, a heavy (opium) smoker, leading a stressful life, would be advised to have a cardiological check-up after 10 years of war. After a long journey across imaging laboratories, he will have stress echo, myocardial perfusion scintigraphy, PET-CT, 64-slice CT, and adenosine-MRI performed, with a cumulative cost of >100 times a simple exercise-electrocardiography test and a cumulative radiation dose of >4,000 chest x-rays, with a cancer risk of 1 in 100. Ulysses is tired of useless examinations, exorbitant costs. unaffordable even by the richest society, and unacceptable risks. http://www.mdpi.com/1660-4601/6/5/1649/ Thu, 14 May 2009 00:00:00 CEST International Journal of Environmental Research and Public Health 2009-05-14 6 5 Article 1649 1664 1660-4601 The Risks of Inappropriateness in Cardiac Imaging 2009-05-14 doi: 10.3390/ijerph6051649 Eugenio Picano