(Circulation. 2001;103:496.)
© 2001 American Heart Association, Inc.
Clinical Investigation and Reports |
High Prevalence of Myocardial Perfusion Abnormalities on Positron Emission Tomography in Asymptomatic Persons With a Parent or Sibling With Coronary Artery Disease
From the Department of Medicine, Division of Cardiology (S.S., D.P.), and The Weatherhead PET Center for Preventing and Reversing Atherosclerosis (K.L.G.), University of Texas Medical School at Houston; and the Memorial Hermann Health Care System and Hermann Hospital, Houston, Tex.
Correspondence to K. Lance Gould, MD, The Weatherhead PET Center, University of Texas Medical School, 6431 Fannin St, Room 4.256 MSB, Houston, TX 77030. E-mail gould{at}heart.med.uth.tmc.edu
Background—We hypothesized that asymptomatic persons with a parent or sibling with coronary artery disease (CAD) have myocardial perfusion defects on positron emission tomography (PET) as markers of early CAD.
Methods and
Results—After medical and family histories
were recorded, 90 subjects underwent rest-dipyridamole cardiac PET
perfusion imaging, including 18 index cases (a subject with CAD
documented by PET and arteriography), 32 asymptomatic adults without
known CAD who had a parent or sibling with CAD among these index cases,
30 asymptomatic subjects with comparable coronary risk factors without
CAD or a family history of CAD, and 10 volunteer control subjects with
no risk factors and no family history. PET perfusion images were
quantified with automated software for size of abnormalities as percent
of the cardiac image outside 95% CIs of normal controls and for
severity as the lowest quadrant average relative activity. Of
asymptomatic subjects with a parent or sibling with CAD (first-degree
relatives), 50% had dipyridamole-induced myocardial perfusion defects
that involved 
5% of the cardiac image outside normal 95% CIs with
or without other risk factors. The size of perfusion defects was larger
in first-degree relatives than in control subjects (11±13%
versus 1±1%, P=0.02) and
larger than in asymptomatic subjects with comparable risk factors but
no family history of CAD (11±13% versus 5±6%,
P=0.02).
Conclusions—This study documents the presence of quantitative, statistically significant, dipyridamole-induced myocardial perfusion abnormalities on PET in 50% of asymptomatic persons with a parent or sibling with CAD, independent of other risk factors, indicating preclinical coronary atherosclerosis.
Key Words: tomography • perfusion • genetics • risk factors • coronary disease
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