Vaccarino V, Shah AJ, Moncayo V, et al. - Posttraumatic stress disorder (PTSD) is longitudinally linked with reduced coronary microcirculatory function and greater deterioration over time. Twins with chronic, longstanding PTSD particularly exhibit the association and shared environmental or genetic factors did not confound the association.

• A total of 275 twins underwent positron emission tomography during two examinations performed approximately 12 years apart.

• A clinical diagnosis of PTSD was determined during examinations which was classified as longstanding (both visit 1 and visit 2), late onset (only visit 2) and no PTSD (no PTSD at both visits).

• No or minimal obstructive coronary disease was recorded in overall 80% of twins.

• Yet, twins with PTSD showed decreased myocardial flow reserve (MFR); progressively lower MFR was recorded across groups of no PTSD (2.13), late-onset PTSD (1.97), and longstanding PTSD (1.93).

• Forty percent of twins without PTSD, 56% of twins with late-onset PTSD, and 72% of twins with longstanding PTSD had presence of a low MFR .

• There were similar results by zygosity.