Major depression and coronary flow reserve detected by positron emission tomography

Viola Vaccarino, 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

Research output: Contribution to journalArticle

36 Citations (Scopus)

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: Weexamined 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 (13N) 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.

Original languageEnglish (US)
Pages (from-to)1668-1676
Number of pages9
JournalArchives of Internal Medicine
Volume169
Issue number18
DOIs
StatePublished - Oct 12 2009
Externally publishedYes

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Major Depressive Disorder
Positron-Emission Tomography
Depression
Coronary Disease
Dizygotic Twins
Myocardial Ischemia
Social Adjustment
Ammonia
Adenosine
Siblings
Atherosclerosis
Nitrogen
Perfusion

ASJC Scopus subject areas

  • Internal Medicine

Cite this

Vaccarino, V., Votaw, J., Faber, T., Veledar, E., Murrah, N. V., Jones, L. R., ... Bremner, J. D. (2009). Major depression and coronary flow reserve detected by positron emission tomography. Archives of Internal Medicine, 169(18), 1668-1676. https://doi.org/10.1001/archinternmed.2009.330

Major depression and coronary flow reserve detected by positron emission tomography. / Vaccarino, Viola; Votaw, John; Faber, Tracy; Veledar, Emir; Murrah, Nancy V.; Jones, Linda R.; Zhao, Jinying; Su, Shaoyong; Goldberg, Jack; Raggi, J. Paolo; Quyyumi, Arshed A.; Sheps, David S.; Bremner, J. Douglas.

In: Archives of Internal Medicine, Vol. 169, No. 18, 12.10.2009, p. 1668-1676.

Research output: Contribution to journalArticle

Vaccarino, V, Votaw, J, Faber, T, Veledar, E, Murrah, NV, Jones, LR, Zhao, J, Su, S, Goldberg, J, Raggi, JP, Quyyumi, AA, Sheps, DS & Bremner, JD 2009, 'Major depression and coronary flow reserve detected by positron emission tomography', Archives of Internal Medicine, vol. 169, no. 18, pp. 1668-1676. https://doi.org/10.1001/archinternmed.2009.330
Vaccarino, Viola ; Votaw, John ; Faber, Tracy ; Veledar, Emir ; Murrah, Nancy V. ; Jones, Linda R. ; Zhao, Jinying ; Su, Shaoyong ; Goldberg, Jack ; Raggi, J. Paolo ; Quyyumi, Arshed A. ; Sheps, David S. ; Bremner, J. Douglas. / Major depression and coronary flow reserve detected by positron emission tomography. In: Archives of Internal Medicine. 2009 ; Vol. 169, No. 18. pp. 1668-1676.
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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: Weexamined 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 (13N) 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.",
author = "Viola Vaccarino and John Votaw and Tracy Faber and Emir Veledar and Murrah, {Nancy V.} and Jones, {Linda R.} and Jinying Zhao and Shaoyong Su and Jack Goldberg and Raggi, {J. Paolo} and Quyyumi, {Arshed A.} and Sheps, {David S.} and Bremner, {J. Douglas}",
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T1 - Major depression and coronary flow reserve detected by positron emission tomography

AU - Vaccarino, Viola

AU - Votaw, John

AU - Faber, Tracy

AU - Veledar, Emir

AU - Murrah, Nancy V.

AU - Jones, Linda R.

AU - Zhao, Jinying

AU - Su, Shaoyong

AU - Goldberg, Jack

AU - Raggi, J. Paolo

AU - Quyyumi, Arshed A.

AU - Sheps, David S.

AU - Bremner, J. Douglas

PY - 2009/10/12

Y1 - 2009/10/12

N2 - 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: Weexamined 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 (13N) 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.

AB - 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: Weexamined 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 (13N) 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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U2 - 10.1001/archinternmed.2009.330

DO - 10.1001/archinternmed.2009.330

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JO - JAMA Internal Medicine

JF - JAMA Internal Medicine

SN - 2168-6106

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