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(Circulation. 2000;101:e63.)
© 2000 American Heart Association, Inc.

Circulation Electronic Pages

Identical Atherosclerotic Lesions in Identical Twins

Grzegorz Kaua, MD; John M. Abukhalil, RT(R); Albert E. Raizner, MD

From The Methodist Hospital and Baylor College of Medicine, Houston, Tex.

Correspondence to Albert E. Raizner, MD, The Methodist Hospital, 6535 Fannin, MS F1034, Houston, TX 77030. E-mail araizner{at}msn.com

	Introduction

Top Introduction

 
In 1997, a 55-year-old man underwent percutaneous coronary angioplasty (PTCA) of a lesion in the middle segment of the left anterior descending coronary artery (LAD) (Figure, A). He subsequently informed his cardiologist that his twin brother had also been treated successfully with PTCA at another hospital for stenosis of the LAD. The cineangiographic film of the twin brother was retrieved (Jackson Heart Clinic, Jackson, Miss, courtesy Dr Jeff Fletcher) (Figure, B). Both brothers had long-standing hypercholesterolemia and had stopped smoking many years earlier.

View larger version (101K): [in this window] [in a new window]   Figure 1.

The LADs of both brothers were similar in anatomy, size, and branching pattern. Remarkably, each had developed a stenosis in essentially the same location, and of similar shape and configuration, in the LAD. The circumflex branch and right coronary artery (not shown) were also similar in size, distribution, and branching pattern for both twins and contained no angiographically apparent disease.

The finding of "twin" atherosclerotic lesions in a pair of identical twins is of great interest. It is tempting to speculate that atherosclerotic plaque formation may be congenitally determined or at least inherently defined by specific coronary anatomy and a certain coronary flow pattern. In either event, an individual may be "fated" to develop a specific lesion at a particular site. During life, this process may be modulated. A better understanding of the anatomic determinants of coronary flow and their impact on subsequent lesion formation might allow preventive interventional therapies.

The authors would like to encourage their colleagues who are aware of twin pairs having angiographically documented CAD to contact us at the e-mail address gkaluza@tmh.tmc.edu

	Footnotes

 
The editor of Images in Cardiovascular Medicine is Hugh A. McAllister, Jr, MD, Chief, Department of Pathology, St Luke’s Episcopal Hospital and Texas Heart Institute, and Clinical Professor of Pathology, University of Texas Medical School and Baylor College of Medicine.

Circulation encourages readers to submit cardiovascular images to Dr Hugh A. McAllister, Jr, St Luke’s Episcopal Hospital and Texas Heart Institute, 6720 Bertner Ave, MC1-267, Houston, TX 77030.

This Article Full Text (PDF) Alert me when this article is cited Alert me if a correction is posted Services Email this article to a friend Similar articles in this journal Similar articles in PubMed Alert me to new issues of the journal Download to citation manager Request Permissions Citing Articles Citing Articles via Google Scholar Google Scholar Articles by Kaluza, G. Articles by Raizner, A. E. Search for Related Content PubMed PubMed Citation Articles by Kaluza, G. Articles by Raizner, A. E. Related Collections Clinical genetics Chronic ischemic heart disease Coronary circulation Coronary imaging: angiography/ultrasound/Doppler/CC CV surgery: aortic and vascular disease