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Bodagh N, Williams MC, Vickneson K, Gharaviri A, Niederer S, Williams SE. State of the art paper: Cardiac computed tomography of the left atrium in atrial fibrillation. J Cardiovasc Comput Tomogr 2023; 17:166-176. [PMID: 36966040 PMCID: PMC10689253 DOI: 10.1016/j.jcct.2023.03.002] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/17/2022] [Revised: 02/06/2023] [Accepted: 03/11/2023] [Indexed: 03/27/2023]
Abstract
The clinical spectrum of atrial fibrillation means that a patient-individualized approach is required to ensure optimal treatment. Cardiac computed tomography can accurately delineate atrial structure and function and could contribute to a personalized care pathway for atrial fibrillation patients. The imaging modality offers excellent spatial resolution and has been utilised in pre-, peri- and post-procedural care for patients with atrial fibrillation. Advances in temporal resolution, acquisition times and analysis techniques suggest potential expanding roles for cardiac computed tomography in the future management of patients with atrial fibrillation. The aim of the current review is to discuss the use of cardiac computed tomography in atrial fibrillation in pre-, peri- and post-procedural settings. Potential future applications of cardiac computed tomography including atrial wall thickness assessment and epicardial fat volume quantification are discussed together with emerging analysis techniques including computational modelling and machine learning with attention paid to how these developments may contribute to a personalized approach to atrial fibrillation management.
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Affiliation(s)
- Neil Bodagh
- School of Biomedical Engineering and Imaging Sciences, King's College London, London, UK.
| | | | - Keeran Vickneson
- Centre for Cardiovascular Science, University of Edinburgh, Edinburgh, UK
| | - Ali Gharaviri
- Centre for Cardiovascular Science, University of Edinburgh, Edinburgh, UK
| | - Steven Niederer
- School of Biomedical Engineering and Imaging Sciences, King's College London, London, UK
| | - Steven E Williams
- School of Biomedical Engineering and Imaging Sciences, King's College London, London, UK; Centre for Cardiovascular Science, University of Edinburgh, Edinburgh, UK
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Drobni ZD, Kolossvary M, Karady J, Jermendy AL, Tarnoki AD, Tarnoki DL, Simon J, Szilveszter B, Littvay L, Voros S, Jermendy G, Merkely B, Maurovich-Horvat P. Heritability of Coronary Artery Disease: Insights From a Classical Twin Study. Circ Cardiovasc Imaging 2022; 15:e013348. [PMID: 35290075 PMCID: PMC8925867 DOI: 10.1161/circimaging.121.013348] [Citation(s) in RCA: 11] [Impact Index Per Article: 5.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/18/2022]
Abstract
BACKGROUND Genetics have a strong influence on calcified atherosclerotic plaques; however, data regarding the heritability of noncalcified plaque volume are scarce. We aimed to evaluate genetic versus environmental influences on calcium (coronary artery calcification) score, noncalcified and calcified plaque volumes by coronary computed tomography angiography in adult twin pairs without known coronary artery disease. METHODS In the prospective BUDAPEST-GLOBAL (Burden of Atherosclerotic Plaques Study in Twins-Genetic Loci and the Burden of Atherosclerotic Lesions) classical twin study, we analyzed twin pairs without known coronary artery disease. All twins underwent coronary computed tomography angiography to assess coronary atherosclerotic plaque volumes. Structural equation models were used to quantify the contribution of additive genetic, common environmental, and unique environmental components to plaque volumes adjusted for age, gender, or atherosclerotic cardiovascular disease risk estimate and statin use. RESULTS We included 196 twins (mean age±SD, 56±9 years, 63.3% females), 120 monozygotic and 76 same-gender dizygotic pairs. Using structural equation models, noncalcified plaque volume was predominantly determined by environmental factors (common environment, 63% [95% CI, 56%-67%], unique environment, 37% [95% CI, 33%-44%]), while coronary artery calcification score and calcified plaque volumes had a relatively strong genetic heritability (additive genetic, 58% [95% CI, 50%-66%]; unique environmental, 42% [95% CI, 34%-50%] and additive genetic, 78% [95% CI, 73%-80%]; unique environmental, 22% [95% CI, 20%-27%]), respectively. CONCLUSIONS Noncalcified plaque volume is mainly influenced by shared environmental factors, whereas coronary artery calcification score and calcified plaque volume are more determined by genetics. These findings emphasize the importance of early lifestyle interventions in preventing coronary plaque formation. REGISTRATION URL: https://www. CLINICALTRIALS gov; Unique identifier: NCT01738828.
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Affiliation(s)
- Zsofia D Drobni
- MTA-SE Cardiovascular Imaging Research Group, (Z.D.D., M.K., J.K., A.L.J., J.S., B.S., P.M.-H.), Semmelweis University, Budapest, Hungary
| | - Marton Kolossvary
- Cardiovascular Imaging Research Center, Department of Radiology, Massachusetts General Hospital, Harvard Medical School, Boston, MA, USA (M.K., J.K.)
| | - Julia Karady
- Cardiovascular Imaging Research Center, Department of Radiology, Massachusetts General Hospital, Harvard Medical School, Boston, MA, USA (M.K., J.K.)
| | - Adam L Jermendy
- MTA-SE Cardiovascular Imaging Research Group, (Z.D.D., M.K., J.K., A.L.J., J.S., B.S., P.M.-H.), Semmelweis University, Budapest, Hungary
| | - Adam D Tarnoki
- Department of Radiology, Medical Imaging Centre (A.D.T., D.L.T., P.M.-H.), Semmelweis University, Budapest, Hungary
| | - David L Tarnoki
- Department of Radiology, Medical Imaging Centre (A.D.T., D.L.T., P.M.-H.), Semmelweis University, Budapest, Hungary
| | - Judit Simon
- MTA-SE Cardiovascular Imaging Research Group, (Z.D.D., M.K., J.K., A.L.J., J.S., B.S., P.M.-H.), Semmelweis University, Budapest, Hungary
| | - Balint Szilveszter
- MTA-SE Cardiovascular Imaging Research Group, (Z.D.D., M.K., J.K., A.L.J., J.S., B.S., P.M.-H.), Semmelweis University, Budapest, Hungary
| | - Levente Littvay
- Department of Political Science, Central European University, Budapest, Hungary (L.L.)
| | | | | | - Bela Merkely
- Heart and Vascular Center (B.M.), Massachusetts General Hospital, Harvard Medical School, Boston, MA, USA
| | - Pal Maurovich-Horvat
- Department of Radiology, Medical Imaging Centre (A.D.T., D.L.T., P.M.-H.), Semmelweis University, Budapest, Hungary
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3
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Molnár AÁ, Kolossváry M, Lakatos B, Tokodi M, Tárnoki ÁD, Tárnoki DL, Kovács A, Szilveszter B, Voros S, Jermendy G, Maurovich-Horvat P, Merkely B. Left Ventricular Systolic Function Has Strong Independent Genetic Background from Diastolic Function: A Classical Twin Study. MEDICINA-LITHUANIA 2021; 57:medicina57090935. [PMID: 34577858 PMCID: PMC8470958 DOI: 10.3390/medicina57090935] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 07/02/2021] [Revised: 08/30/2021] [Accepted: 08/31/2021] [Indexed: 11/16/2022]
Abstract
Background and Objectives: No data are available on whether the heritability of left ventricle (LV) systolic and diastolic parameters are independent of each other. Therefore, our aim was to assess the magnitude of common and independent genetic and environmental factors defining LV systolic and diastolic function. Materials and Methods: We analyzed 184 asymptomatic twins (65% female, mean age: 56 ± 9 years). Transthoracic echocardiography was performed to measure LV systolic (global longitudinal and circumferential strain; basal and apical rotation) and diastolic (early diastolic velocity of mitral inflow and lateral mitral annulus tissue; deceleration time and early diastolic strain rate) parameters using conventional and speckle-tracking echocardiography. Genetic structural equation models were evaluated to quantify the proportion of common and specific genetic (Ac, As) and environmental factors (Ec, Es) contributing to the phenotypes. Results: LV systolic parameters had no common genetic or environmental heritability (Ac range: 0-0%; Ec range: 0-0%; As range: 57-77%; Es range: 24-43%). Diastolic LV parameters were mainly determined by common genetic and environmental effects (Ac range: 9-40%; Ec range: 11-49%; As range: 0-29%; Es range: 0-51%). Systolic parameters had no common genetic or environmental factors (Ac = 0%; Ec = 0%) with diastolic metrics. Conclusions: Systolic LV parameters have a strong genetic predisposition to any impact. They share no common genetic or environmental factors with each other or with diastolic parameters, indicating that they may deteriorate specifically to given effects. However, diastolic functional parameters are mainly affected by common environmental influences, suggesting that pathological conditions may deteriorate them equally. Estimation of the genetic and environmental influence and interdependence on systolic and diastolic LV function may help the understanding of the pathomechanism of different heart failure classification types.
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Affiliation(s)
- Andrea Ágnes Molnár
- Heart and Vascular Center, Semmelweis University, 1122 Budapest, Hungary; (M.K.); (B.L.); (M.T.); (A.K.); (B.S.); (P.M.-H.); (B.M.)
- Correspondence: ; Tel.: +36-30-8285078
| | - Márton Kolossváry
- Heart and Vascular Center, Semmelweis University, 1122 Budapest, Hungary; (M.K.); (B.L.); (M.T.); (A.K.); (B.S.); (P.M.-H.); (B.M.)
| | - Bálint Lakatos
- Heart and Vascular Center, Semmelweis University, 1122 Budapest, Hungary; (M.K.); (B.L.); (M.T.); (A.K.); (B.S.); (P.M.-H.); (B.M.)
| | - Márton Tokodi
- Heart and Vascular Center, Semmelweis University, 1122 Budapest, Hungary; (M.K.); (B.L.); (M.T.); (A.K.); (B.S.); (P.M.-H.); (B.M.)
| | - Ádám Domonkos Tárnoki
- Medical Imaging Center, Semmelweis University, 1082 Budapest, Hungary; (Á.D.T.); (D.L.T.)
| | - Dávid László Tárnoki
- Medical Imaging Center, Semmelweis University, 1082 Budapest, Hungary; (Á.D.T.); (D.L.T.)
| | - Attila Kovács
- Heart and Vascular Center, Semmelweis University, 1122 Budapest, Hungary; (M.K.); (B.L.); (M.T.); (A.K.); (B.S.); (P.M.-H.); (B.M.)
| | - Bálint Szilveszter
- Heart and Vascular Center, Semmelweis University, 1122 Budapest, Hungary; (M.K.); (B.L.); (M.T.); (A.K.); (B.S.); (P.M.-H.); (B.M.)
| | - Szilard Voros
- Scientific Affairs, Global Institute for Research, LLC, Richmond, VA 23219, USA;
| | - György Jermendy
- 3rd Department of Internal Medicine, Bajcsy Zsilinszky Hospital, 1106 Budapest, Hungary;
| | - Pál Maurovich-Horvat
- Heart and Vascular Center, Semmelweis University, 1122 Budapest, Hungary; (M.K.); (B.L.); (M.T.); (A.K.); (B.S.); (P.M.-H.); (B.M.)
- Medical Imaging Center, Semmelweis University, 1082 Budapest, Hungary; (Á.D.T.); (D.L.T.)
| | - Béla Merkely
- Heart and Vascular Center, Semmelweis University, 1122 Budapest, Hungary; (M.K.); (B.L.); (M.T.); (A.K.); (B.S.); (P.M.-H.); (B.M.)
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Overlapping Genetic Background of Coronary Artery and Carotid/Femoral Atherosclerotic Calcification. ACTA ACUST UNITED AC 2021; 57:medicina57030252. [PMID: 33803199 PMCID: PMC7999274 DOI: 10.3390/medicina57030252] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/09/2021] [Revised: 02/16/2021] [Accepted: 03/04/2021] [Indexed: 12/01/2022]
Abstract
Background and objectives: Multivessel atherosclerosis and its genetic background are under-investigated, although atherosclerosis is seldom local and still causes high mortality. Alternative methods to assess coronary calcification (CAC) might incorporate genetic links between different arteries’ atherosclerotic involvement, however, co-occurrences of coronary calcification have not been investigated in twins yet. Materials and Methods: We assessed the heritability of radio morphologically distinct atherosclerotic plaque types in coronary (non-enhanced CT, Agatston score), carotid, and femoral arteries (B-mode ultrasound) in 190 twin subjects (60 monozygotic, 35 dizygotic pairs). Four-segment scores were derived in order to assess the dissemination of the distinct plaque types in the carotid and femoral arteries taking bilaterality into account. We calculated the genetic correlation between phenotypically correlating plaque types in these arteries. Results: CAC and dissemination of calcified plaques in the carotid and femoral arteries (4S_hyper) were moderately heritable (0.67 [95% CI: 0.37–1] and 0.69 [95% CI: 0.38–1], respectively) when adjusted for age and sex. Hypoechoic plaques in the carotid and femoral arteries showed no heritability, while mixed plaques showed intermediate heritability (0.50 [95% CI: 0–0.76]). Age and sex-adjusted phenotypic correlation between CAC and 4segm_hyper was 0.48 [95% CI: 0.30–0.63] and the underlying genetic correlation was 0.86 [95% CI: 0.42–1]. Conclusions: Calcification of atherosclerotic plaques is moderately heritable in all investigated arteries and significant overlapping genetic factors can be attributed to the phenotypical resemblance of coronary and carotid or femoral atherosclerotic calcification. Our findings support the idea of screening extracoronary arteries in asymptomatic individuals. We also propose a hypothesis about primarily carotid-coronary and femoral-coronary atherosclerosis as two distinct genetic predispositions to co-localization.
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Whitaker J, Karády J, Karim R, Tobon-Gomez C, Fastl T, Razeghi O, O'Neill L, Decroocq M, Williams S, Corrado C, Mukherjee RK, Sim I, O'Hare D, Kotadia I, Kolossváry M, Merkely B, Littvay L, Tarnoki AD, Tarnoki DL, Voros S, Razavi R, O'Neill M, Rajani R, Maurovich Horvat P, Niederer S. Standardised computed tomographic assessment of left atrial morphology and tissue thickness in humans. IJC HEART & VASCULATURE 2021; 32:100694. [PMID: 33392384 PMCID: PMC7772783 DOI: 10.1016/j.ijcha.2020.100694] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/20/2020] [Revised: 11/21/2020] [Accepted: 12/02/2020] [Indexed: 11/18/2022]
Abstract
AIMS Left atrial (LA) remodelling is a common feature of many cardiovascular pathologies and is a sensitive marker of adverse cardiovascular outcomes. The aim of this study was to establish normal ranges for LA parameters derived from coronary computed tomographic angiography (CCTA) imaging using a standardised image processing pipeline to establish normal ranges in a previously described cohort. METHODS CCTA imaging from 193 subjects recruited to the Budapest GLOBAL twin study was analysed. Indexed LA cavity volume (LACVi), LA surface area (LASAi), wall thickness and LA tissue volume (LATVi) were calculated. Wall thickness maps were combined into an atlas. Indexed LA parameters were compared with clinical variables to identify early markers of pathological remodelling. RESULTS LACVi is similar between sexes (31 ml/m2 v 30 ml/m2) and increased in hypertension (33 ml/m2 v 29 ml/m2, p = 0.009). LASAi is greater in females than males (47.8 ml/m2 v 45.8 ml/m2 male, p = 0.031). Median LAWT was 1.45 mm. LAWT was lowest at the inferior portion of the posterior LA wall (1.14 mm) and greatest in the septum (median = 2.0 mm) (p < 0.001). Conditions known to predispose to the development of AF were not associated with differences in tissue thickness. CONCLUSIONS The reported LACVi, LASAi, LATVi and tissue thickness derived from CCTA may serve as reference values for this age group and clinical characteristics for future studies. Increased LASAi in females in the absence of differences in LACVi or LATVi may indicate differential LA shape changes between the sexes. AF predisposing conditions, other than sex, were not associated with detectable changes in LAWT.Clinical trial registration:http://www.ClinicalTrials.gov/NCT01738828.
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Key Words
- AF, atrial fibrillation
- BSA, body surface area
- CCTA, cardiac computed tomography
- Computed tomography (CT)
- DZ, dizygotic
- LA, left atrium
- LAA, left atrial appendage
- LACV, left atrial cavity volume
- LASA, left atrial surface area
- LATV, left atrial tissue volume
- LAWT, left atrial wall thickness
- Left atrium
- MZ, monozygotic
- PV, pulmonary vein
- Tissue thickness
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Affiliation(s)
- John Whitaker
- School of Biomedical Engineering and Imaging Sciences, King’s College, London, UK
| | - Júlia Karády
- Cardiovascular Imaging Research Group, Semmelweis University, Budapest, Hungary
| | - Rashed Karim
- School of Biomedical Engineering and Imaging Sciences, King’s College, London, UK
| | - Catalina Tobon-Gomez
- School of Biomedical Engineering and Imaging Sciences, King’s College, London, UK
| | - Thomas Fastl
- School of Biomedical Engineering and Imaging Sciences, King’s College, London, UK
| | - Orod Razeghi
- School of Biomedical Engineering and Imaging Sciences, King’s College, London, UK
| | - Louisa O'Neill
- School of Biomedical Engineering and Imaging Sciences, King’s College, London, UK
| | - Marie Decroocq
- School of Biomedical Engineering and Imaging Sciences, King’s College, London, UK
| | - Steven Williams
- School of Biomedical Engineering and Imaging Sciences, King’s College, London, UK
- Guy’s and St Thomas’ NHS Foundation Trust, London, UK
| | - Cesare Corrado
- School of Biomedical Engineering and Imaging Sciences, King’s College, London, UK
| | - Rahul K. Mukherjee
- School of Biomedical Engineering and Imaging Sciences, King’s College, London, UK
| | - Iain Sim
- School of Biomedical Engineering and Imaging Sciences, King’s College, London, UK
| | - Daniel O'Hare
- School of Biomedical Engineering and Imaging Sciences, King’s College, London, UK
| | - Irum Kotadia
- School of Biomedical Engineering and Imaging Sciences, King’s College, London, UK
| | - Márton Kolossváry
- Cardiovascular Imaging Research Group, Semmelweis University, Budapest, Hungary
| | - Bela Merkely
- Cardiovascular Imaging Research Group, Semmelweis University, Budapest, Hungary
| | - Levente Littvay
- Cardiovascular Imaging Research Group, Semmelweis University, Budapest, Hungary
| | - Adam D. Tarnoki
- Department of Radiology, Semmelweis University, Budapest, Hungary
- Hungarian Twin Registry, Budapest, Hungary
| | - David L. Tarnoki
- Department of Radiology, Semmelweis University, Budapest, Hungary
- Hungarian Twin Registry, Budapest, Hungary
| | - Szilard Voros
- Cardiovascular Imaging Research Group, Semmelweis University, Budapest, Hungary
| | - Reza Razavi
- School of Biomedical Engineering and Imaging Sciences, King’s College, London, UK
| | - Mark O'Neill
- School of Biomedical Engineering and Imaging Sciences, King’s College, London, UK
- Guy’s and St Thomas’ NHS Foundation Trust, London, UK
| | - Ronak Rajani
- School of Biomedical Engineering and Imaging Sciences, King’s College, London, UK
- Guy’s and St Thomas’ NHS Foundation Trust, London, UK
| | | | - Steven Niederer
- School of Biomedical Engineering and Imaging Sciences, King’s College, London, UK
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Identical STEMI Pattern in Two Siblings with Different Risk Factors. JOURNAL OF CARDIOVASCULAR EMERGENCIES 2020. [DOI: 10.2478/jce-2020-0012] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
Abstract
Abstract
Environmental factors may have an important role in the development of coronary heart disease. However, it is not clearly understood yet how the genetic factors interplay with the environmental ones in the onset of acute myocardial infarction. The early onset of coronary artery disease in cases with a positive family history suggests a certain role of genetic predisposition, but the open question remains: could environmental differences contribute to this predisposition? This case report describes similar coronary angiographic findings of two brothers who developed acute myocardial infarction in their early 40s, after being exposed to different environmental risk factors.
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Jermendy G, Kolossváry M, Dudás I, Jermendy ÁL, Panajotu A, Suhai IF, Drobni ZD, Karády J, Tárnoki ÁD, Tárnoki DL, Voros S, Merkely B, Maurovich-Horvat P. Effect of genetic and environmental influences on hepatic steatosis: A classical twin study based on computed tomography. IMAGING 2020. [DOI: 10.1556/1647.2020.00006] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/19/2022] Open
Abstract
AbstractBackground and aimsNon-alcoholic fatty liver disease (NAFLD) increases cardiovascular morbidity and mortality, and carries poor long-term hepatic prognosis. Data about the role of genetic and environmental factors in the hepatic lipid accumulation are limited. The aim of the study was to evaluate the genetic and environmental impact on the hepatic lipid accumulation within a cohort of adult twin pairs.Patients and methodsWe investigated 182 twin subjects [monozygotic (MZ, n = 114) and dizygotic (DZ, n = 68) same-gender twins (age 56.0 ± 9.6 years; BMI 27.5 ± 5.0 kg/m2; females 65.9%)] who underwent computed tomography (CT) with a 256-slice scanner. Using non-enhanced CT-images, we calculated the average value of hepatic attenuation [expressed in Hounsfield unit (HU)] suggesting hepatic lipid content. Crude data were adjusted to age, sex, BMI and HbA1c values. Intra-pair correlations were established, and structural equation models were used for quantifying the contribution of additive genetic (A), common environmental (C) and unique environmental (E) components to the investigated phenotype.ResultsThe study cohort represented a moderately overweight, middle-aged Caucasian population. There was no significant difference between MZ and DZ twin subjects regarding hepatic CT-attenuation (57.9 ± 12.6 HU and 59.3 ± 11.7 HU, respectively; p = 0.747). Age, sex, BMI and HbA1c adjusted co-twin correlations between the siblings showed that MZ twins have stronger correlations of HU values than DZ twins (rMZ = 0.592, p < 0.001; rDZ = 0.047, p = 0.690, respectively). Using the structural equation model, a moderate additive genetic dependence (A: 38%, 95% CI 15–58%) and a greater unique environmental influence (E: 62%, 95% CI 42–85%) was found. Common environmental influence was not identified (C: 0%).ConclusionThe results of our classical CT-based twin study revealed moderate genetic and greater environmental influences on the phenotypic appearance of hepatic steatosis, commonly referred to as NAFLD. Favorable changes of modifiable environmental factors are of great importance in preventing or treating NAFLD.
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Affiliation(s)
- György Jermendy
- 1Bajcsy-Zsilinszky Hospital and Outpatient Department, Budapest, Hungary
| | - Márton Kolossváry
- 2MTA-SE Cardiovascular Imaging Research Group, Heart and Vascular Center, Semmelweis University, Budapest, Hungary
| | - Ibolya Dudás
- 2MTA-SE Cardiovascular Imaging Research Group, Heart and Vascular Center, Semmelweis University, Budapest, Hungary
| | - Ádám L. Jermendy
- 2MTA-SE Cardiovascular Imaging Research Group, Heart and Vascular Center, Semmelweis University, Budapest, Hungary
| | - Alexisz Panajotu
- 2MTA-SE Cardiovascular Imaging Research Group, Heart and Vascular Center, Semmelweis University, Budapest, Hungary
| | - Imre F. Suhai
- 3Department of Radiology, Medical Imaging Centre, Semmelweis University, Budapest, Hungary
| | - Zsófia D. Drobni
- 2MTA-SE Cardiovascular Imaging Research Group, Heart and Vascular Center, Semmelweis University, Budapest, Hungary
| | - Júlia Karády
- 2MTA-SE Cardiovascular Imaging Research Group, Heart and Vascular Center, Semmelweis University, Budapest, Hungary
- 4Cardiovascular Imaging Research Center, Massachusetts General Hospital, Harvard Medical School, Boston, MA, USA
| | - Ádám D. Tárnoki
- 3Department of Radiology, Medical Imaging Centre, Semmelweis University, Budapest, Hungary
| | - Dávid L. Tárnoki
- 3Department of Radiology, Medical Imaging Centre, Semmelweis University, Budapest, Hungary
| | | | - Béla Merkely
- 2MTA-SE Cardiovascular Imaging Research Group, Heart and Vascular Center, Semmelweis University, Budapest, Hungary
| | - Pál Maurovich-Horvat
- 2MTA-SE Cardiovascular Imaging Research Group, Heart and Vascular Center, Semmelweis University, Budapest, Hungary
- 3Department of Radiology, Medical Imaging Centre, Semmelweis University, Budapest, Hungary
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8
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Jermendy G, Kolossváry M, Drobni Z, Papp S, Jermendy ÁL, Panajotu A, Dudás I, Tárnoki ÁD, Tárnoki DL, Voros S, Merkely B, Maurovich-Horvat P. Environmental Factors Slightly Outweigh Genetic Influences in the Development of Pancreatic Lipid Accumulation: A Classical Twin Study. Metab Syndr Relat Disord 2020; 18:413-418. [PMID: 32721180 DOI: 10.1089/met.2020.0038] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/13/2022] Open
Abstract
Background: Several studies showed that lipid accumulation in the pancreas (NAFPD: nonalcoholic fatty pancreas disease) may lead to different pancreatic disorders, including beta-cell dysfunction. The role of genetic and environmental factors in pancreatic lipid accumulation is unclear. We evaluated the magnitude of genetic and environmental impact on pancreatic lipid content within a cohort of adult twin pairs. Patients and Methods: We investigated 136 twin subjects [monozygotic (MZ, n = 86) and dizygotic (DZ, n = 50) same-gender twins (age 57.7 ± 9.1 years; body mass index [BMI] 28.0 ± 4.4 kg/m2; females 64.7%)] with a 256-slice computed tomography (CT)-scanner. Using nonenhanced CT images, we calculated the average value of pancreatic attenuation expressed in Hounsfield unit (HU) suggesting pancreatic lipid content. Crude data were adjusted to age, sex, BMI, and hemoglobinA1c values. Intrapair correlations were established, and structural equation models were used for quantifying the contribution of additive genetic (A), common environmental (C), and unique environmental (E) components to the investigated phenotype. Results: The study cohort represented a moderately overweight, middle-aged Caucasian population. Average pancreatic attenuation was 48.9 ± 11.9 HU in MZ and 49.0 ± 13.0 HU in DZ twins (P = 0.934). The intrapair correlation between HU values was stronger in MZ compared to DZ twins (rMZ = 0.536, P < 0.001; rDZ = 0.115, P = 0.580). Using the structural equation model, a greater unique environmental influence [E: 54%, 95% confidence interval (CI) 19%-66%] and a moderate additive genetic dependence (A: 46%, 95% CI 34%-81%) were found. Conclusions: The results of our classical twin study indicate that environmental (lifestyle) influences slightly outweigh genetic effects on the phenotypic appearance of pancreatic lipid accumulation known as NAFPD.
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Affiliation(s)
- György Jermendy
- Bajcsy-Zsilinszky Hospital and Outpatient Department, Budapest, Hungary
| | - Márton Kolossváry
- MTA-SE Cardiovascular Imaging Research Group, Heart and Vascular Center, Semmelweis University, Budapest, Hungary
| | - Zsófia Drobni
- MTA-SE Cardiovascular Imaging Research Group, Heart and Vascular Center, Semmelweis University, Budapest, Hungary
| | - Sára Papp
- MTA-SE Cardiovascular Imaging Research Group, Heart and Vascular Center, Semmelweis University, Budapest, Hungary
| | - Ádám L Jermendy
- MTA-SE Cardiovascular Imaging Research Group, Heart and Vascular Center, Semmelweis University, Budapest, Hungary
| | - Alexisz Panajotu
- MTA-SE Cardiovascular Imaging Research Group, Heart and Vascular Center, Semmelweis University, Budapest, Hungary
| | - Ibolya Dudás
- Department of Radiology, Medical Imaging Centre, Semmelweis University, Budapest, Hungary
| | - Ádám D Tárnoki
- Department of Radiology, Medical Imaging Centre, Semmelweis University, Budapest, Hungary
| | - Dávid L Tárnoki
- Department of Radiology, Medical Imaging Centre, Semmelweis University, Budapest, Hungary
| | | | - Béla Merkely
- MTA-SE Cardiovascular Imaging Research Group, Heart and Vascular Center, Semmelweis University, Budapest, Hungary
| | - Pál Maurovich-Horvat
- MTA-SE Cardiovascular Imaging Research Group, Heart and Vascular Center, Semmelweis University, Budapest, Hungary.,Department of Radiology, Medical Imaging Centre, Semmelweis University, Budapest, Hungary
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The Hungarian Twin Registry Update: Turning From a Voluntary to a Population-Based Registry. Twin Res Hum Genet 2020; 22:561-566. [PMID: 31907087 DOI: 10.1017/thg.2019.100] [Citation(s) in RCA: 16] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/13/2022]
Abstract
Since our last report on the voluntary Hungarian Twin Registry (HTR) in 2012, the number of pairs or multiplets included increased from 310 to 1044. Efforts to turn the registry into a population-based one are on the way. Nearly 128,000 twins living in Hungary (98,500 adults) will be mailed information on how to register on the new HTR website. Twins will be asked to invite their spouses and immediate family members. Meanwhile, strong cooperation through exchange programs has been developed with other foreign twin registries. Current research focuses on radiogenomics, musculoskeletal, cardiovascular and respiratory diseases, gut microbiome as well as basic molecular research and yielded new awards and further publications.
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10
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Bikov A, Kolossváry M, Jermendy AL, Drobni ZD, Tarnoki AD, Tarnoki DL, Forgó B, Kovacs DT, Losonczy G, Kunos L, Voros S, Merkely B, Maurovich-Horvat P. Comprehensive coronary plaque assessment in patients with obstructive sleep apnea. J Sleep Res 2019; 28:e12828. [PMID: 30724416 DOI: 10.1111/jsr.12828] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/22/2018] [Revised: 11/20/2018] [Accepted: 12/27/2018] [Indexed: 12/26/2022]
Abstract
Obstructive sleep apnea (OSA) is associated with an increased risk of cardiovascular disease. Previous studies have assessed the relationship between OSA and coronary artery disease (CAD) using coronary artery calcium score (CAC) measurements. However, limited data are available regarding the association of OSA with non-calcified plaque burden. We therefore aimed to assess the relationship between CAD severity as assessed by coronary computed tomography angiography (CTA) and OSA. Forty-one adult subjects (59 ± 9 years, 15 men) underwent a 256-slice coronary CTA, which was followed by a diagnostic attended cardiorespiratory polygraphy (n = 13) or polysomnography (n = 28). Segment involvement score (SIS), segment stenosis score (SSS) and CAC were used to quantify total CAD burden. Correlation analysis was used to assess potential associations between CAD and OSA. Twenty-two patients were diagnosed with OSA. SIS and SSS were elevated in OSA (2.90 ± 2.78 versus 1.79 ± 2.39 and 4.91 ± 5.94 versus 1.79 ± 4.54, OSA versus controls, SIS and SSS respectively, both p < 0.01) and correlated with OSA severity as measured by the apnea-hypopnea index (AHI, r = 0.41 and 0.43, p < 0.01) and oxygen desaturation index (ODI, r = 0.45 and 0.46, p < 0.01). However, no significant correlation was observed between CAC and OSA. Compared to CAC, SIS and SSS provide additional information on coronary plaque burden in OSA, which shows a significant association with OSA.
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Affiliation(s)
- Andras Bikov
- Department of Pulmonology, Semmelweis University, Budapest, Hungary
| | - Márton Kolossváry
- Cardiovascular Imaging Research Group, Heart and Vascular Center, Semmelweis University, Budapest, Hungary
| | - Adam L Jermendy
- Cardiovascular Imaging Research Group, Heart and Vascular Center, Semmelweis University, Budapest, Hungary
| | - Zsofia D Drobni
- Cardiovascular Imaging Research Group, Heart and Vascular Center, Semmelweis University, Budapest, Hungary
| | - Adam D Tarnoki
- Department of Radiology, Semmelweis University, Budapest, Hungary
| | - David L Tarnoki
- Department of Radiology, Semmelweis University, Budapest, Hungary
| | - Bianka Forgó
- Department of Radiology, Semmelweis University, Budapest, Hungary
| | - Daniel T Kovacs
- Department of Radiology, Semmelweis University, Budapest, Hungary
| | - Gyorgy Losonczy
- Department of Pulmonology, Semmelweis University, Budapest, Hungary
| | - Laszlo Kunos
- Department of Pulmonology, Semmelweis University, Budapest, Hungary
| | | | - Bela Merkely
- Cardiovascular Imaging Research Group, Heart and Vascular Center, Semmelweis University, Budapest, Hungary
| | - Pal Maurovich-Horvat
- Cardiovascular Imaging Research Group, Heart and Vascular Center, Semmelweis University, Budapest, Hungary
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11
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Kovács A, Molnár AÁ, Kolossváry M, Szilveszter B, Panajotu A, Lakatos BK, Littvay L, Tárnoki ÁD, Tárnoki DL, Voros S, Jermendy G, Sengupta PP, Merkely B, Maurovich-Horvat P. Genetically determined pattern of left ventricular function in normal and hypertensive hearts. J Clin Hypertens (Greenwich) 2018; 20:949-958. [PMID: 29741807 DOI: 10.1111/jch.13271] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/02/2018] [Revised: 02/20/2018] [Accepted: 02/28/2018] [Indexed: 01/08/2023]
Abstract
We sought to assess the inheritance of left ventricular (LV) function using speckle-tracking echocardiography and the impact of hypertension on modifying the genetically determined pattern of contraction in a population of twins. We recruited 92 Caucasian twin pairs, including 74 hypertensive (HTN) siblings. Beyond standard echocardiographic protocol, a speckle-tracking analysis was performed, including global longitudinal strain (GLS). Systolic function, as assessed by ejection fraction, showed moderate heritability (61%); however, GLS showed higher and dominant heritability (75%). Heterogeneity models revealed that there were no differences between the HTN and non-HTN subjects regarding the heritability of GLS. However, the heritability estimates of diastolic function parameters, including early diastolic strain rate, were low. LV systolic biomechanics is highly heritable. GLS shows dominant heritability, despite the presence of early-stage hypertensive heart disease. Early diastolic parameters are rather determined by environmental factors. These findings suggest the presence of a genetic framework that conserves systolic function despite the expression of diastolic dysfunction and may underlie the phenotypic progression towards heart failure with preserved ejection fraction.
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Affiliation(s)
- Attila Kovács
- MTA-SE Cardiovascular Imaging Research Group, Heart and Vascular Center, Semmelweis University, Budapest, Hungary
| | - Andrea Ágnes Molnár
- MTA-SE Cardiovascular Imaging Research Group, Heart and Vascular Center, Semmelweis University, Budapest, Hungary
| | - Márton Kolossváry
- MTA-SE Cardiovascular Imaging Research Group, Heart and Vascular Center, Semmelweis University, Budapest, Hungary
| | - Bálint Szilveszter
- MTA-SE Cardiovascular Imaging Research Group, Heart and Vascular Center, Semmelweis University, Budapest, Hungary
| | - Alexisz Panajotu
- MTA-SE Cardiovascular Imaging Research Group, Heart and Vascular Center, Semmelweis University, Budapest, Hungary
| | - Bálint Károly Lakatos
- MTA-SE Cardiovascular Imaging Research Group, Heart and Vascular Center, Semmelweis University, Budapest, Hungary
| | | | - Ádám Domonkos Tárnoki
- Hungarian Twin Registry, Budapest, Hungary.,Department of Radiology and Oncotherapy, Semmelweis University, Budapest, Hungary
| | - Dávid László Tárnoki
- Hungarian Twin Registry, Budapest, Hungary.,Department of Radiology and Oncotherapy, Semmelweis University, Budapest, Hungary
| | | | - György Jermendy
- III. Department of Internal Medicine, Bajcsy-Zsilinszky Hospital, Budapest, Hungary
| | | | - Béla Merkely
- MTA-SE Cardiovascular Imaging Research Group, Heart and Vascular Center, Semmelweis University, Budapest, Hungary
| | - Pál Maurovich-Horvat
- MTA-SE Cardiovascular Imaging Research Group, Heart and Vascular Center, Semmelweis University, Budapest, Hungary
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12
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Lucatelli P, Fagnani C, Tarnoki AD, Tarnoki DL, Sacconi B, Fejer B, Stazi MA, Salemi M, Cirelli C, d'Adamo A, Fanelli F, Catalano C, Maurovich-Horvat P, Jermendy AL, Jermendy G, Merkely B, Molnar AA, Pucci G, Schillaci G, Farina F, Meneghetti G, Baracchini C, Medda E. Genetic influence on femoral plaque and its relationship with carotid plaque: an international twin study. Int J Cardiovasc Imaging 2017; 34:531-541. [PMID: 29022127 DOI: 10.1007/s10554-017-1256-2] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/17/2017] [Accepted: 10/06/2017] [Indexed: 01/26/2023]
Abstract
To disentangle genetic and environmental influences on the development of femoral plaques using a population of adult twins. To evaluate the potential role of shared genetic and environmental factors in the co-occurrence of femoral and carotid plaques. The sample included 566 twins belonging to 164 monozygotic (MZ) and 119 dizygotic (DZ) twin pairs, who underwent peripheral arterial assessment by B-mode ultrasound in different centers. The variance in femoral plaques onset was due to genetic factors and the remaining 50% was explained by common (15%) and unique (35%) environmental factors. Findings on sidedness and number of femoral plaques indicated that also these traits were mainly under genetic control. No effect of common environment was found on plaques composition, and variability of this trait was explained by genetics (64%) and unique environment (36%). Covariation between the liabilities to carotid and femoral plaques was mainly attributed to shared genes (77%), with the remaining 23% explained by individual-specific environmental factors shared by the two districts. Inter-individual differences in plaque onset as well as in their number, sidedness and composition are mainly genetic in origin. The results on the cooccurrence of carotid and femoral plaque underline the genetic role in atherogenesis.
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Affiliation(s)
- Pierleone Lucatelli
- Vascular and Interventional Radiology Unit, Department of Radiology, Oncology and Anatomic Pathology, Policlinico Umberto I, "Sapienza" University of Rome, Rome, Italy.
| | - Corrado Fagnani
- Centre for Behavioural Sciences and Mental Health, Istituto Superiore di Sanità, Rome, Italy
| | - Adam Domonkos Tarnoki
- Department of Radiology, Semmelweis University, Budapest, Hungary.,Hungarian Twin Registry, Budapest, Hungary
| | - David Laszlo Tarnoki
- Department of Radiology, Semmelweis University, Budapest, Hungary.,Hungarian Twin Registry, Budapest, Hungary
| | - Beatrice Sacconi
- Vascular and Interventional Radiology Unit, Department of Radiology, Oncology and Anatomic Pathology, Policlinico Umberto I, "Sapienza" University of Rome, Rome, Italy
| | - Bence Fejer
- Department of Radiology, Semmelweis University, Budapest, Hungary
| | - Maria Antonietta Stazi
- Centre for Behavioural Sciences and Mental Health, Istituto Superiore di Sanità, Rome, Italy
| | - Miriam Salemi
- Centre for Behavioural Sciences and Mental Health, Istituto Superiore di Sanità, Rome, Italy
| | - Carlo Cirelli
- Vascular and Interventional Radiology Unit, Department of Radiology, Oncology and Anatomic Pathology, Policlinico Umberto I, "Sapienza" University of Rome, Rome, Italy
| | - Alessandro d'Adamo
- Vascular and Endovascular Surgery Division, Department of Surgery "Paride Stefanini", Policlinico Umberto I, "Sapienza" University of Rome, Rome, Italy
| | - Fabrizio Fanelli
- Vascular and Interventional Radiology Unit, Department of Radiology, Oncology and Anatomic Pathology, Policlinico Umberto I, "Sapienza" University of Rome, Rome, Italy
| | - Carlo Catalano
- Vascular and Interventional Radiology Unit, Department of Radiology, Oncology and Anatomic Pathology, Policlinico Umberto I, "Sapienza" University of Rome, Rome, Italy
| | - Pal Maurovich-Horvat
- MTA-SE Cardiovascular Imaging Research Group, Heart and Vascular Center, Semmelweis University, Budapest, Hungary
| | - Adam L Jermendy
- MTA-SE Cardiovascular Imaging Research Group, Heart and Vascular Center, Semmelweis University, Budapest, Hungary
| | - Gyorgy Jermendy
- 3rd Department of Internal Medicine, Bajcsy Zsilinszky Hospital, Budapest, Hungary
| | - Bela Merkely
- MTA-SE Cardiovascular Imaging Research Group, Heart and Vascular Center, Semmelweis University, Budapest, Hungary
| | - Andrea A Molnar
- MTA-SE Cardiovascular Imaging Research Group, Heart and Vascular Center, Semmelweis University, Budapest, Hungary
| | - Giacomo Pucci
- Unità di Medicina Interna, Ospedale 'S. Maria', Università di Perugia, Terni, Italy
| | - Giuseppe Schillaci
- Unità di Medicina Interna, Ospedale 'S. Maria', Università di Perugia, Terni, Italy
| | - Filippo Farina
- Department of Neurosciences, University of Padua School of Medicine, Padua, Italy
| | - Giorgio Meneghetti
- Department of Neurosciences, University of Padua School of Medicine, Padua, Italy
| | - Claudio Baracchini
- Department of Neurosciences, University of Padua School of Medicine, Padua, Italy
| | - Emanuela Medda
- Centre for Behavioural Sciences and Mental Health, Istituto Superiore di Sanità, Rome, Italy
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13
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Assessing genetic and environmental influences on epicardial and abdominal adipose tissue quantities: a classical twin study. Int J Obes (Lond) 2017; 42:163-168. [PMID: 28852208 DOI: 10.1038/ijo.2017.212] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/03/2017] [Revised: 06/30/2017] [Accepted: 08/16/2017] [Indexed: 12/19/2022]
Abstract
BACKGROUND/OBJECTIVES Various adipose tissue compartments play an important role in the development of cardiometabolic diseases. The quantity of different fat compartments is influenced by genetic and environmental factors. The aim of our study was to evaluate the magnitude of genetic and environmental effects on epicardial, subcutaneous and visceral adipose tissue (EAT, SAT and VAT) quantities in a cohort of adult twin pairs. SUBJECTS/METHODS In this cross-sectional study we investigated adult twins (57 monozygotic (MZ) and 33 dizygotic (DZ) same-gender twin pairs; 180 twin subjects). We measured EAT volume using electrocardiogram-gated native computed tomography (CT) scan of the heart, and abdominal SAT and VAT areas were quantified between the third and fourth lumbar vertebra on native CT images. We calculated genetic and environmental impact on the size of various adipose tissue compartments by analyzing co-twin correlations in MZ and DZ pairs separately, and furthermore by using genetic structural equation models. RESULTS In co-twin analysis, MZ twins had stronger correlations than DZ twins for EAT (rMZ=0.81, rDZ=0.32), similar to SAT and VAT quantities (rMZ=0.80, rDZ=0.68 and rMZ=0.79, rDZ=0.48, respectively). In multi-trait model fitting analysis, the overall contribution of genetic factors to EAT, SAT and VAT volumes were 80%, 78% and 70%, whereas environmental factors were 20%, 22% and 30%, respectively. Common pathway model analyses indicated that none of the EAT, SAT and VAT phenotypes was independent of the other two. CONCLUSIONS Genetic factors have substantial influence, while environmental factors have only a modest impact on EAT volume, abdominal SAT and VAT quantities. There is a considerable amount of common genetic background influencing the quantities of all three adipose tissue compartments.
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14
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Nagy E, Jermendy AL, Merkely B, Maurovich-Horvat P. Clinical importance of epicardial adipose tissue. Arch Med Sci 2017; 13:864-874. [PMID: 28721155 PMCID: PMC5507110 DOI: 10.5114/aoms.2016.63259] [Citation(s) in RCA: 80] [Impact Index Per Article: 11.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/04/2016] [Accepted: 08/23/2016] [Indexed: 12/12/2022] Open
Abstract
Different visceral fat compartments have several systemic effects and may play a role in the development of both insulin resistance and cardiovascular diseases. In the last couple of years special attention has been paid to the epicardial adipose tissue (EAT), which can be quantified by non-invasive cardiac imaging techniques. The epicardial fat is a unique fat compartment between the myocardium and the visceral pericardium sharing a common embryologic origin with the visceral fat depot. Epicardial adipose tissue has several specific roles, and its local effects on cardiac function are incorporated in the complex pathomechanism of coronary artery disease. Importantly, EAT may produce several adipocytokines and chemokines that may influence - through paracrine and vasocrine effects - the development and progression of coronary atherosclerosis. Epicardial adipose tissue volume has a relatively strong genetic dependence, similarly to other visceral fat depots. In this article, the anatomical and physiological as well as pathophysiological characteristics of the epicardial fat compartment are reviewed.
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Affiliation(s)
- Eszter Nagy
- MTA-SE Cardiovascular Imaging Research Group, Budapest, Hungary
| | - Adam L Jermendy
- MTA-SE Cardiovascular Imaging Research Group, Budapest, Hungary
| | - Bela Merkely
- MTA-SE Cardiovascular Imaging Research Group, Budapest, Hungary
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15
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Fejer B, Tarnoki AD, Tarnoki DL, Lucatelli P, Littvay L, Maurovich-Horvat P, Jermendy AL, Kovacs A, Godor E, Fagnani C, Stazi MA, Molnar AA, Fanelli F, Cirelli C, Farina F, Baracchini C, Meneghetti G, Pucci G, Jermendy G, Merkely B, Schillaci G, Medda E. Heritability of the femoral intima media thickness. Eur J Intern Med 2017; 41:44-48. [PMID: 28237540 DOI: 10.1016/j.ejim.2017.02.019] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/18/2016] [Revised: 02/17/2017] [Accepted: 02/20/2017] [Indexed: 11/29/2022]
Abstract
BACKGROUND The measurement of femoral intima-media thickness (IMT) is underutilized in the clinical practice, although it is a surrogate marker of cardiovascular disease. MATERIALS AND METHODS 388 Hungarian and Italian twins (121 monozygotic, 73 dizygotic pairs) underwent bilateral B-mode sonography of femoral arteries. IMT was measured by semiautomated software, where available, or by calipers. RESULTS Within-pair correlation in monozygotic twins was higher than in dizygotics for each parameter. Age-, sex- and country-adjusted genetic effect accounted for 43.9% (95% confidence interval, CI 21.3%-65.2%) and 47.2% (95% CI, 31.4%-62.6%) of the variance of common and superficial femoral artery IMT, respectively, and unshared environmental effect for 56.1% (95% CI 34.6%-78.5%) and 52.8% (95% CI, 37.2%-68.5%). These results did not change significantly after correcting for body mass index or central systolic blood pressure. CONCLUSIONS Genetic factors have a moderate role in the determination of common and superficial femoral IMT; however, the influence of environmental (lifestyle) factors remains still relevant. Environmental factors may have a role in influencing the genetic predisposition for femoral vascular hypertrophy.
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Affiliation(s)
- Bence Fejer
- Department of Radiology, Semmelweis University, 78/A Üllői Street, Budapest 1082, Hungary.
| | - Adam D Tarnoki
- Department of Radiology, Semmelweis University, 78/A Üllői Street, Budapest 1082, Hungary; Hungarian Twin Registry, 29 Erdélyi Street, Budapest 1212, Hungary.
| | - David L Tarnoki
- Department of Radiology, Semmelweis University, 78/A Üllői Street, Budapest 1082, Hungary; Hungarian Twin Registry, 29 Erdélyi Street, Budapest 1212, Hungary.
| | - Pierleone Lucatelli
- Vascular and Interventional Radiology Unit, Department of Radiological, Oncological and Anatomo-Pathological Sciences, Sapienza University of Rome, Viale Regina Elena 324, 00161 Rome, Italy.
| | - Levente Littvay
- Central European University, 9 Nador Street, Budapest 1051, Hungary.
| | - Pal Maurovich-Horvat
- MTA-SE Cardiovascular Imaging Research Group, Heart and Vascular Center, Semmelweis University, 18 Hataror Street, Budapest 1122, Hungary.
| | - Adam L Jermendy
- MTA-SE Cardiovascular Imaging Research Group, Heart and Vascular Center, Semmelweis University, 18 Hataror Street, Budapest 1122, Hungary.
| | - Attila Kovacs
- MTA-SE Cardiovascular Imaging Research Group, Heart and Vascular Center, Semmelweis University, 18 Hataror Street, Budapest 1122, Hungary.
| | - Erika Godor
- Department of Radiology, Semmelweis University, 78/A Üllői Street, Budapest 1082, Hungary.
| | - Corrado Fagnani
- Genetic Epidemiology Unit, National Centre of Epidemiology, Surveillance and Health Promotion; Istituto Superiore di Sanità, Viale Regina Elena 299, 00161 Rome, Italy.
| | - Maria A Stazi
- Genetic Epidemiology Unit, National Centre of Epidemiology, Surveillance and Health Promotion; Istituto Superiore di Sanità, Viale Regina Elena 299, 00161 Rome, Italy.
| | - Andrea A Molnar
- MTA-SE Cardiovascular Imaging Research Group, Heart and Vascular Center, Semmelweis University, 18 Hataror Street, Budapest 1122, Hungary; Research Group for Inflammation Biology and Immunogenomics of Hungarian Academy of Sciences, Semmelweis University, 44 Róbert Károly Krt., Budapest 1134, Hungary; Department of Cardiology, Military Hospital, 44 Róbert Károly Krt.., Budapest 1134, Hungary.
| | - Fabrizio Fanelli
- Vascular and Interventional Radiology Unit, Department of Radiological, Oncological and Anatomo-Pathological Sciences, Sapienza University of Rome, Viale Regina Elena 324, 00161 Rome, Italy.
| | - Carlo Cirelli
- Vascular and Interventional Radiology Unit, Department of Radiological, Oncological and Anatomo-Pathological Sciences, Sapienza University of Rome, Viale Regina Elena 324, 00161 Rome, Italy.
| | - Filippo Farina
- Department of Neurosciences, University of Padua School of Medicine, via Giustiniani 5, 35128 Padova, Italy.
| | - Claudio Baracchini
- Department of Neurosciences, University of Padua School of Medicine, via Giustiniani 5, 35128 Padova, Italy.
| | - Giorgio Meneghetti
- Department of Neurosciences, University of Padua School of Medicine, via Giustiniani 5, 35128 Padova, Italy.
| | - Giacomo Pucci
- Università di Perugia, Unità di Medicina Interna, Ospedale "S. Maria", Viale Tristano di Joannuccio, 1, 05100 Terni, Italy.
| | - Gyorgy Jermendy
- 3rd Department of Internal Medicine, Bajcsy Zsilinszky Hospital, 89-91 Maglódi Street, Budapest 1106, Hungary.
| | - Bela Merkely
- MTA-SE Cardiovascular Imaging Research Group, Heart and Vascular Center, Semmelweis University, 18 Hataror Street, Budapest 1122, Hungary.
| | - Giuseppe Schillaci
- Università di Perugia, Unità di Medicina Interna, Ospedale "S. Maria", Viale Tristano di Joannuccio, 1, 05100 Terni, Italy.
| | - Emanuela Medda
- Genetic Epidemiology Unit, National Centre of Epidemiology, Surveillance and Health Promotion; Istituto Superiore di Sanità, Viale Regina Elena 299, 00161 Rome, Italy.
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Aortic root dimensions are predominantly determined by genetic factors: a classical twin study. Eur Radiol 2016; 27:2419-2425. [PMID: 27659700 DOI: 10.1007/s00330-016-4590-1] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/22/2016] [Revised: 07/22/2016] [Accepted: 08/29/2016] [Indexed: 10/21/2022]
Abstract
OBJECTIVES Previous studies using transthoracic echocardiography (TTE) observed moderate heritability of aortic root dimensions. Computed tomography angiography (CTA) might provide more accurate heritability estimates. Our primary aim was to assess the heritability of the aortic root with CTA. Our secondary aim was to derive TTE-based heritability and compare this with the CTA-based results. METHODS In the BUDAPEST-GLOBAL study 198 twin subjects (118 monozygotic, 80 dizygotic; age 56.1 ± 9.4 years; 126 female) underwent CTA and TTE. We assessed the diameter of the left ventricular outflow tract (LVOT), annulus, sinus of Valsalva, sinotubular junction and ascending aorta. Heritability was assessed using ACDE model (A additive genetic, C common environmental, D dominant genetic, E unique environmental factors). RESULTS Based on CTA, additive genetic effects were dominant (LVOT: A = 0.67, E = 0.33; annulus: A = 0.76, E = 0.24; sinus of Valsalva: A = 0.83, E = 0.17; sinotubular junction: A = 0.82, E = 0.18; ascending aorta: A = 0.75, E = 0.25). TTE-derived measurements showed moderate to no genetic influence (LVOT: A = 0.38, E = 0.62; annulus: C = 0.47, E = 0.53; sinus of Valsalva: C = 0.63, E = 0.37; sinotubular junction: C = 0.45, E = 0.55; ascending aorta: A = 0.67, E = 0.33). CONCLUSION CTA-based assessment suggests that aortic root dimensions are predominantly determined by genetic factors. TTE-based measurements showed moderate to no genetic influence. The choice of measurement method has substantial impact on heritability estimates. KEY POINTS • Aortic root dimensions are determined by genetic and environmental effects. • Transthoracic echocardiography (TTE) demonstrated moderate to no genetic effects on aortic root dimensions. • Computed tomography angiography might provide more accurate heritability estimates compared to TTE. • Three-dimensional imaging techniques are needed to reliably quantify aortic root dimensions.
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