Abstract
ObjectivesThe aim of this study was to investigate the impact of BMI on late gadolinium enhancement (LGE) of the coronary artery wall in identical monozygous twins discordant for BMI. Coronary LGE represents a useful parameter for the detection and quantification of atherosclerotic coronary vessel wall disease.MethodsThirteen monozygote female twin pairs (n = 26) with significantly different BMIs (>1.6 kg/m2) were recruited out of >10,000 twin pairs (TwinsUK Registry). A coronary 3D-T2prep-TFE MR angiogram and 3D-IR-TFE vessel wall scan were performed prior to and following the administration of 0.2 mmol/kg of Gd-DTPA on a 1.5 T MR scanner. The number of enhancing coronary segments and contrast to noise ratios (CNRs) of the coronary wall were quantified.ResultsAn increase in BMI was associated with an increased number of enhancing coronary segments (5.3 ± 1.5 vs. 3.5 ± 1.6, p < 0.0001) and increased coronary wall enhancement (6.1 ± 1.1 vs. 4.8 ± 0.9, p = 0.0027) compared to matched twins with lower BMI.ConclusionsThis study in monozygous twins indicates that acquired factors predisposing to obesity, including lifestyle and environmental factors, result in increased LGE of the coronary arteries, potentially reflecting an increase in coronary atherosclerosis in this female study population.Key points• BMI-discordant twins allow the investigation of the influence of lifestyle factors independent from genetic confounders.• Only thirteen obesity-discordant twins were identified underlining the strong genetic component of BMI.• In female twins, a BMI increase is associated with increased coronary late gadolinium enhancement.• Increased late gadolinium enhancement in the coronary vessel wall potentially reflects increased atherosclerosis.
Highlights
Obesity has been recognized as a major contributor to the global burden of chronic disease and disability [1,2,3].Eur Radiol (2017) 27:4612–4618Epidemiological, clinical, and preclinical studies conducted in the field of cardiovascular medicine have led to significant progress in our understanding of modifiable and nonmodifiable risk factors in cardiovascular disease
An increase in body mass index (BMI) was associated with an increased number of enhancing coronary segments (5.3 ± 1.5 vs. 3.5 ± 1.6, p < 0.0001) and increased coronary wall enhancement (6.1 ± 1.1 vs. 4.8 ± 0.9, p = 0.0027) compared to matched twins with lower BMI
This study in monozygous twins indicates that acquired factors predisposing to obesity, including lifestyle and environmental factors, result in increased late gadolinium enhancement (LGE) of the coronary arteries, potentially reflecting an increase in coronary atherosclerosis in this female study population
Summary
Obesity has been recognized as a major contributor to the global burden of chronic disease and disability [1,2,3].Eur Radiol (2017) 27:4612–4618Epidemiological, clinical, and preclinical studies conducted in the field of cardiovascular medicine have led to significant progress in our understanding of modifiable and nonmodifiable risk factors in cardiovascular disease. Despite the availability of cost-effective interventions to reduce risks, the World Health Report 2002 estimated 58 % of diabetes, 21 % of ischemic heart disease and 8–42 % of certain cancers globally were attributable to a body mass index (BMI) above 21 kg/m2. The BMI was shown to be associated with coronary atherosclerosis and the risk for cardiovascular events [4]. It is recognized that an increase in BMI is associated with an increase in cardiovascular events, this association is highly complex. It is not well investigated whether or to which extent this association is confounded by genetic factors [4]
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