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. 2009 Oct 12;169(18):1668-76.
doi: 10.1001/archinternmed.2009.330.

Major depression and coronary flow reserve detected by positron emission tomography

Viola Vaccarino  1 , John Votaw, Tracy Faber, Emir Veledar, Nancy V Murrah, Linda R Jones, Jinying Zhao, Shaoyong Su, Jack Goldberg, J Paolo Raggi, Arshed A Quyyumi, David S Sheps, J Douglas Bremner
Affiliations

Major depression and coronary flow reserve detected by positron emission tomography

Viola Vaccarino et al. Arch Intern Med. .

Abstract

Background: Major depressive disorder (MDD) is associated with coronary heart disease (CHD), but the mechanisms are unclear. The presence of MDD may increase CHD risk by affecting microvascular circulation. It is also plausible that genetic factors influencing MDD may overlap with those for CHD. We sought to examine the relationship between MDD and coronary flow reserve (CFR), the ratio of maximum flow during stress to flow at rest measured in milliliters per minute per gram of tissue.

Methods: We examined 289 male middle-aged twins, including 106 twins (53 twin pairs) discordant for a lifetime history of MDD and 183 control twins (unrelated to any twins in the experimental group) without MDD. To calculate CFR, we used positron emission tomography with nitrogen 13 ((13)N) ammonia to evaluate myocardial blood flow at rest and after adenosine stress. A standard perfusion defect score was also used to assess myocardial ischemia.

Results: There was no difference in myocardial ischemia between twins with and without MDD. Among the dizygotic twin pairs discordant for MDD, the CFR was 14% lower in the twins with MDD than in their brothers without MDD (2.36 vs 2.74) (P = .03). This association was not present in the monozygotic discordant pairs who were genetically matched (2.86 vs 2.64) (P = .19). The zygosity-MDD interaction after adjustment was significant (P = .006). The CFR in the dizygotic twins with MDD was also lower than in the control twins.

Conclusions: Our results provide evidence for a shared genetic pathway between MDD and microvascular dysfunction. Common pathophysiologic processes may link MDD and early atherosclerosis.

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Figures

Figure 1
Figure 1
Within-pair major depressive disorder (MDD)-discordant twin comparisons of myocardial blood flow (MBF), averaged over the entire left ventricle. A, Dizygotic hyperemia (after adenosine infusion); B, dizygotic at rest; C, monozygotic hyperemia; and D, monozygotic at rest. Each colored line represents a twin pair. The mean (SEM) within-pair differences are reported for each condition.
Figure 2
Figure 2
Myocardial blood flow (MBF), averaged over the entire left ventricle, at rest (basal) and after adenosine infusion in major depressive disorder (MDD)-discordant and control twin pairs. Each colored line represents a twin pair. The mean (SD) within-pair differences are reported for each condition.
See this image and copyright information in PMC

References

    1. Nicholson A, Kuper H, Hemingway H. Depression as an aetiologic and prognostic factor in coronary heart disease: a meta-analysis of 6362 events among 146 538 participants in 54 observational studies. Eur Heart J. 2006;27(23):2763–2774. - PubMed
    1. Rugulies R. Depression as a predictor for coronary heart disease: a review and meta-analysis. Am J Prev Med. 2002;23(1):51–61. - PubMed
    1. Vaccarino V, Johnson BD, Sheps DS, et al. National Heart, Lung, and Blood Institute Depression, inflammation, and incident cardiovascular disease in women with suspected coronary ischemia: the National Heart, Lung, and Blood Institute-sponsored WISE study. J Am Coll Cardiol. 2007;50(21):2044–2050. - PubMed
    1. Lespérance F, Frasure-Smith N, Theroux P, Irwin M. The association between major depression and levels of soluble intercellular adhesion molecule 1, interleukin-6, and C-reactive protein in patients with recent acute coronary syndromes. Am J Psychiatry. 2004;161(2):271–277. - PubMed
    1. Barefoot JC, Helms MJ, Mark DB, et al. Depression and long-term mortality risk in patients with coronary artery disease. Am J Cardiol. 1996;78(6):613–617. - PubMed

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