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Measurement of heritability of myocardial blood flow by positron emission tomography: the Twins Heart Study
  1. Shaoyong Su1,2,
  2. John Votaw3,
  3. Tracy Faber3,
  4. Durreshahwar Khan4,
  5. J Douglas Bremner5,
  6. Jack Goldberg6,
  7. Ken Nichols7,
  8. Andrew Van Tosh8,
  9. Viola Vaccarino2,9
  1. 1Georgia Prevention Institute, Department of Pediatrics, Georgia Health Sciences University, School of Medicine, Augusta, Georgia, USA
  2. 2Department of Epidemiology, Emory University, School of Public Health, Atlanta, Georgia, USA
  3. 3Department of Radiology, Emory University, School of Medicine, Atlanta, Georgia, USA
  4. 4Department of Medicine, Pennsylvania State University, State College, Pennsylvania, USA
  5. 5Department of Psychiatry and Behavioral Sciences, Emory University, School of Medicine, Atlanta, Georgia, USA
  6. 6Department of Epidemiology, University of Washington, School of Public Health, Seattle, Washington, USA
  7. 7Division of Nuclear Medicine and Molecular Imaging, North Shore–Long Island Jewish Health System, New Hyde Park, New York, USA
  8. 8Nuclear Cardiology, St Francis Hospital, Roslyn, New York, USA
  9. 9Department of Medicine, Emory University, School of Medicine, Atlanta, Georgia, USA
  1. Correspondence to Dr Viola Vaccarino, Department of Epidemiology, Emory University School of Public Health, 1518 Clifton Rd NE, Room 3011, Atlanta, GA 30322, USA; viola.vaccarino{at}


Objective To estimate the heritability of myocardial blood flow (MBF) and coronary flow reserve (CFR) measured with positron emission tomography (PET).

Design Cross-sectional twin study.

Setting General clinical research centre of a university hospital at Atlanta, USA.

Patients A sample of 180 middle-aged (mean±SD 55±2.9 years) male twins, including 107 monozygotic and 73 dizygotic twins.

Main outcome measures All twins underwent imaging of MBF with PET 13NH3 at rest and after adenosine stress during a single imaging session. Structural equation modelling was used to estimate the heritability of MBF at rest and during adenosine stress, as well as of CFR.

Results The basal MBF (mean±SD) was 0.69±0.20 ml/min/g, and the MBF during adenosine stress was 1.70±0.49 ml/min/g; the CFR was 2.62±0.99. There was substantial heritability for MBF both at rest (0.48, 95% CI 0.29 to 0.64) and during adenosine stress (0.51, 95% CI 0.29 to 0.68), as well as CFR (0.48, 95% CI 0.26 to 0.65).

Conclusions For the first time, a substantial genetic contribution to the interindividual variation in MBF and CFR measured with PET in middle-aged men has been demonstrated. The data suggest that a fruitful direction for future work would be the identification of genetic variants for early atherosclerotic stages assessed by PET imaging.

  • Coronary flow reserve
  • heritability
  • myocardial blood flow
  • positron emission tomography
  • twin study
  • depression
  • cytokines
  • atherosclerosis
  • genetics

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  • Funding This study was supported by K24HL077506, R01 HL68630 and R01 AG026255 from the National Institutes of Health, and by grants 0245115N, 0725513B and 09SDG2140117 from the American Heart Association and MO1-RR00039 from the Emory University General Clinical Research Center. The funding sources had no involvement in the design, analysis and interpretation of the data presented in this paper.

  • Competing interests None.

  • Patient consent Obtained.

  • Ethics approval This study was conducted with the approval of the institutional review board at Emory University.

  • Provenance and peer review Not commissioned; externally peer reviewed.