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European Heart Journal Advance Access originally published online on April 30, 2009
European Heart Journal 2009 30(13):1643-1647; doi:10.1093/eurheartj/ehp142
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Published on behalf of the European Society of Cardiology. All rights reserved. © The Author 2009. For permissions please email: journals.permissions@oxfordjournals.org

Heritability of left ventricular and papillary muscle heart size: a twin study with cardiac magnetic resonance imaging

Christoph A. Busjahn1,2,*, Jeanette Schulz-Menger1, Hassan Abdel-Aty1, Andre Rudolph1, Jens Jordan3, Friedrich C. Luft1 and Andreas Busjahn4

1 Medical Faculty of the Charité, Franz-Volhard Clinic, HELIOS Klinikum-Berlin, Experimental and Clinical Research Center and Max Delbrueck Center for Molecular Medicine, Berlin, Germany
2 Klinik fuer Anaesthesiologie und Intensivmedizin, MediClin Mueritz-Klinikum GmbH Waren, Waren, Germany
3 Institut für Klinische Pharmakologie Medizinische Hochschule Hannover, Hannover, Germany
4 HealthTwiSt GmbH, Lindenberger Weg 80, Berlin 13125, Germany

Received 16 October 2008; revised 12 February 2009; accepted 13 March 2009; online publish-ahead-of-print 30 April 2009.

* Corresponding author. Tel: +49 30 9417 1271, Fax: +49 30 9417 1260, Email: busjahn{at}healthtwist.de

Aims: Earlier studies in monozygotic (MZ) and dizygotic (DZ) twins showed genetic variance on echocardiographically determined heart size. However, cardiovascular magnetic resonance (CMR) is more precise and reproducible. We performed a twin study relying on CMR, focusing on left ventricular (LV) mass and papillary muscle, since there are no genetic reports on this structure.

Methods and results: We measured left heart dimensions of 25 healthy twin pairs with a 1.5T MR scanner, analysed with the mass©, Medis Software. We performed heritability analysis and tests for genetic influences shared between cardiac structures. We found that CMR-based heritability estimates (h2 = 84%) substantially exceeded estimates based on echocardiography. We also found significant genetic influence on papillary muscle mass (h2 = 82%). Bivariate analysis of papillary and LV muscle mass revealed significant genetic influences shared by both phenotypes (genetic correlation 0.59) and suggested an additional genetic component specific to papillary muscle. We observed correlations between body mass index, surface area, and systolic blood pressure with cardiac dimensions, even in this small study. Environmental influences were relevant as well, indicating reciprocal influences on papillary vs. LV muscle mass.

Conclusion: Cardiovascular magnetic resonance, even with few subjects, allows a genetic assessment of cardiac structures that cannot be attained with echocardiography. Hitherto fore unappreciated relationships can be uncovered by this method.

Key Words: Genetics • Heart • Twins • Magnetic resonance imaging • Heredity


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