Posttraumatic Stress Disorder, Myocardial Perfusion, and Myocardial Blood Flow: A Longitudinal Twin Study.

Coronary Artery Disease Humans Microcirculation Myocardial Perfusion Imaging / methods Perfusion Positron-Emission Tomography Stress Disorders, Post-Traumatic / diagnostic imaging
Cardiovascular disease Epidemiology Myocardial ischemia Positron emission tomography Posttraumatic stress disorder Twins

Journal

Biological psychiatry
ISSN: 1873-2402
Titre abrégé: Biol Psychiatry
Pays: United States
ID NLM: 0213264

Informations de publication

Date de publication:
01 04 2022
Historique:
received: 17 06 2021
revised: 31 08 2021
accepted: 17 09 2021
pubmed: 7 12 2021
medline: 20 4 2022
entrez: 6 12 2021
Statut: ppublish

Résumé

The link between posttraumatic stress disorder (PTSD) and ischemic heart disease remains elusive owing to a shortage of longitudinal studies with a clinical diagnosis of PTSD and objective measures of cardiac compromise. We performed positron emission tomography in 275 twins who participated in two examinations approximately 12 years apart. At both visits, we obtained a clinical diagnosis of PTSD, which was classified as long-standing (both visit 1 and visit 2), late onset (only visit 2), and no PTSD (no PTSD at both visits). With positron emission tomography, we assessed myocardial flow reserve (MFR), which, in absence of significant coronary stenoses, indexes coronary microvascular function. We compared positron emission tomography data at visit 2 across the three categories of longitudinally assessed PTSD and examined changes between the two visits. Overall, 80% of the twins had no or minimal obstructive coronary disease. Yet, MFR was depressed in twins with PTSD and was progressively lower across groups with no PTSD (2.13), late-onset PTSD (1.97), and long-standing PTSD (1.93) (p = .01). A low MFR (a ratio <2.0) was present in 40% of the twins without PTSD, in 56% of those with late-onset PTSD, and in 72% of those with long-standing PTSD (p < .001). Associations persisted in multivariable analysis, when examining changes in MFR between visit 1 and visit 2, and within twin pairs. Results were similar by zygosity. Longitudinally, PTSD is associated with reduced coronary microcirculatory function and greater deterioration over time. The association is especially noted among twins with chronic, long-standing PTSD and is not confounded by shared environmental or genetic factors.

Sections du résumé

BACKGROUND
The link between posttraumatic stress disorder (PTSD) and ischemic heart disease remains elusive owing to a shortage of longitudinal studies with a clinical diagnosis of PTSD and objective measures of cardiac compromise.
METHODS
We performed positron emission tomography in 275 twins who participated in two examinations approximately 12 years apart. At both visits, we obtained a clinical diagnosis of PTSD, which was classified as long-standing (both visit 1 and visit 2), late onset (only visit 2), and no PTSD (no PTSD at both visits). With positron emission tomography, we assessed myocardial flow reserve (MFR), which, in absence of significant coronary stenoses, indexes coronary microvascular function. We compared positron emission tomography data at visit 2 across the three categories of longitudinally assessed PTSD and examined changes between the two visits.
RESULTS
Overall, 80% of the twins had no or minimal obstructive coronary disease. Yet, MFR was depressed in twins with PTSD and was progressively lower across groups with no PTSD (2.13), late-onset PTSD (1.97), and long-standing PTSD (1.93) (p = .01). A low MFR (a ratio <2.0) was present in 40% of the twins without PTSD, in 56% of those with late-onset PTSD, and in 72% of those with long-standing PTSD (p < .001). Associations persisted in multivariable analysis, when examining changes in MFR between visit 1 and visit 2, and within twin pairs. Results were similar by zygosity.
CONCLUSIONS
Longitudinally, PTSD is associated with reduced coronary microcirculatory function and greater deterioration over time. The association is especially noted among twins with chronic, long-standing PTSD and is not confounded by shared environmental or genetic factors.

Identifiants

DOI: 10.1016/j.biopsych.2021.09.016 PMID: 34865854 PMC: PMC8918004
pubmed: 34865854
pii: S0006-3223(21)01628-0
doi: 10.1016/j.biopsych.2021.09.016
pmc: PMC8918004
mid: NIHMS1761794
pii:
doi:

Types de publication

Journal Article Research Support, N.I.H., Extramural Twin Study

Langues

eng

Sous-ensembles de citation

IM

Pagination

615-625

Subventions

Organisme : RRD VA
ID : I01 RX003418
Pays : United States
Organisme : NIMH NIH HHS
ID : R01 MH056120
Pays : United States
Organisme : NHLBI NIH HHS
ID : K24 HL077506
Pays : United States
Organisme : NHLBI NIH HHS
ID : R01 HL125246
Pays : United States
Organisme : NCRR NIH HHS
ID : M01 RR000039
Pays : United States
Organisme : NIMH NIH HHS
ID : R01 MH120262
Pays : United States
Organisme : NHLBI NIH HHS
ID : T32 HL130025
Pays : United States
Organisme : NHLBI NIH HHS
ID : K23 HL127251
Pays : United States
Organisme : NHLBI NIH HHS
ID : R01 HL068630
Pays : United States
Organisme : NHLBI NIH HHS
ID : P01 HL101398
Pays : United States
Organisme : NIDA NIH HHS
ID : UG3 DA048502
Pays : United States
Organisme : NIA NIH HHS
ID : R01 AG026255
Pays : United States
Organisme : NHLBI NIH HHS
ID : R01 HL136205
Pays : United States
Organisme : NIMH NIH HHS
ID : K24 MH076955
Pays : United States
Organisme : NHLBI NIH HHS
ID : R01 HL088726
Pays : United States

Commentaires et corrections

Type : CommentIn

Informations de copyright

Copyright © 2021 Society of Biological Psychiatry. Published by Elsevier Inc. All rights reserved.

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Auteurs

Viola Vaccarino (V)

Department of Epidemiology, Rollins School of Public Health, Emory University, Atlanta, Georgia; Division of Cardiology, Department of Medicine, Emory University School of Medicine, Atlanta, Georgia. Electronic address: viola.vaccarino@emory.edu.

Amit J Shah (AJ)

Department of Epidemiology, Rollins School of Public Health, Emory University, Atlanta, Georgia; Division of Cardiology, Department of Medicine, Emory University School of Medicine, Atlanta, Georgia; Atlanta Veterans Affairs Health Care System, Decatur, Georgia.

Valeria Moncayo (V)

Department of Radiology and Imaging Sciences, Emory University School of Medicine, Atlanta, Georgia.

Jonathon Nye (J)

Department of Radiology and Imaging Sciences, Emory University School of Medicine, Atlanta, Georgia.

Marina Piccinelli (M)

Department of Radiology and Imaging Sciences, Emory University School of Medicine, Atlanta, Georgia.

Yi-An Ko (YA)

Department of Biostatistics and Bioinformatics, Rollins School of Public Health, Emory University, Atlanta, Georgia.

Xin Ma (X)

Department of Biostatistics and Bioinformatics, Rollins School of Public Health, Emory University, Atlanta, Georgia.

Nancy Murrah (N)

Department of Epidemiology, Rollins School of Public Health, Emory University, Atlanta, Georgia.

Lucy Shallenberger (L)

Department of Epidemiology, Rollins School of Public Health, Emory University, Atlanta, Georgia.

Emily Driggers (E)

Department of Epidemiology, Rollins School of Public Health, Emory University, Atlanta, Georgia.

Oleksiy M Levantsevych (OM)

Department of Epidemiology, Rollins School of Public Health, Emory University, Atlanta, Georgia.

Muhammad Hammadah (M)

Division of Cardiology, Department of Medicine, Emory University School of Medicine, Atlanta, Georgia.

Bruno B Lima (BB)

Division of Cardiology, Department of Medicine, Emory University School of Medicine, Atlanta, Georgia.

An Young (A)

Division of Cardiology, Department of Medicine, Emory University School of Medicine, Atlanta, Georgia.

Wesley O'Neal (W)

Division of Cardiology, Department of Medicine, Emory University School of Medicine, Atlanta, Georgia.

Mhmtjamil Alkhalaf (M)

Department of Epidemiology, Rollins School of Public Health, Emory University, Atlanta, Georgia.

Ammer Haffar (A)

Department of Epidemiology, Rollins School of Public Health, Emory University, Atlanta, Georgia.

Paolo Raggi (P)

Mazankowski Alberta Heart Institute, University of Alberta, Edmonton, Alberta, Canada.

Jack Goldberg (J)

Seattle Epidemiologic Research and Information Center, United States Department of Veterans Affairs Office of Research and Development, Seattle, Washington.

Nicholas L Smith (NL)

Seattle Epidemiologic Research and Information Center, United States Department of Veterans Affairs Office of Research and Development, Seattle, Washington; Department of Epidemiology, University of Washington, Seattle, Washington.

Ernest V Garcia (EV)

Department of Radiology and Imaging Sciences, Emory University School of Medicine, Atlanta, Georgia.

Arshed A Quyyumi (AA)

Division of Cardiology, Department of Medicine, Emory University School of Medicine, Atlanta, Georgia.

J Douglas Bremner (JD)

Department of Radiology and Imaging Sciences, Emory University School of Medicine, Atlanta, Georgia; Department of Psychiatry and Behavioral Sciences, Emory University School of Medicine, Atlanta, Georgia; Atlanta Veterans Affairs Health Care System, Decatur, Georgia.

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Classifications MeSH

questionsmedicales.fr › Maladies cardiovasculaires › Maladies vasculaires › Ischémie myocardique › Maladie coronarienne › Maladie des artères coronaires › Posttraumatic Stress Disorder, Myocardial...
questionsmedicales.fr › Eucaryotes › Animaux › Chordés › Vertébrés › Mammifères › Eutheria › Primates › Haplorhini › Catarrhini › Hominidae › Humains › Posttraumatic Stress Disorder, Myocardial...
questionsmedicales.fr › Phénomènes physiologiques respiratoires et circulatoires › Phénomènes physiologiques cardiovasculaires › Circulation sanguine › Microcirculation › Posttraumatic Stress Disorder, Myocardial...
questionsmedicales.fr › Diagnostic › Techniques et procédures diagnostiques › Techniques de diagnostic radioisotopique › Scintigraphie › Imagerie de perfusion › Imagerie de perfusion myocardique › Posttraumatic Stress Disorder, Myocardial...
questionsmedicales.fr › Techniques d'investigation › Perfusion › Posttraumatic Stress Disorder, Myocardial...
questionsmedicales.fr › Diagnostic › Techniques et procédures diagnostiques › Techniques de diagnostic radioisotopique › Scintigraphie › Tomoscintigraphie › Tomographie par émission de positons › Posttraumatic Stress Disorder, Myocardial...
questionsmedicales.fr › Troubles mentaux › Troubles liés aux traumatismes et au stress › Troubles de stress traumatique › Troubles de stress post-traumatique › Posttraumatic Stress Disorder, Myocardial...