Interaction between systemic iron parameters and left ventricular structure and function in the preserved ejection fraction population: a two-sample bidirectional Mendelian randomization study.

IF 1.8 4区医学 Q3 CARDIAC & CARDIOVASCULAR SYSTEMS

Journal of Geriatric Cardiology Pub Date : 2024-01-28 DOI:10.26599/1671-5411.2024.01.006

Xiong-Bin Ma, Yong-Ming Liu, Yan-Lin Lv, Lin Qian

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引用次数: 0

Abstract

Background: Left ventricular (LV) remodeling and diastolic function in people with heart failure (HF) are correlated with iron status; however, the causality is uncertain. This Mendelian randomization (MR) study investigated the bidirectional causal relationship between systemic iron parameters and LV structure and function in a preserved ejection fraction population.

Methods: Transferrin saturation (TSAT), total iron binding capacity (TIBC), and serum iron and ferritin levels were extracted as instrumental variables for iron parameters from meta-analyses of public genome-wide association studies. Individuals without myocardial infarction history, HF, or LV ejection fraction (LVEF) < 50% (n = 16,923) in the UK Biobank Cardiovascular Magnetic Resonance Imaging Study constituted the outcome dataset. The dataset included LV end-diastolic volume, LV end-systolic volume, LV mass (LVM), and LVM-to-end-diastolic volume ratio (LVMVR). We used a two-sample bidirectional MR study with inverse variance weighting (IVW) as the primary analysis method and estimation methods using different algorithms to improve the robustness of the results.

Results: In the IVW analysis, one standard deviation (SD) increased in TSAT significantly correlated with decreased LVMVR (β = -0.1365; 95% confidence interval [CI]: -0.2092 to -0.0638; P = 0.0002) after Bonferroni adjustment. Conversely, no significant relationships were observed between other iron and LV parameters. After Bonferroni correction, reverse MR analysis showed that one SD increase in LVEF significantly correlated with decreased TSAT (β = -0.0699; 95% CI: -0.1087 to -0.0311; P = 0.0004). No heterogeneity or pleiotropic effects evidence was observed in the analysis.

Conclusions: We demonstrated a causal relationship between TSAT and LV remodeling and function in a preserved ejection fraction population.

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保留射血分数人群全身铁参数与左心室结构和功能之间的相互作用：一项双样本双向孟德尔随机研究。

背景：心力衰竭（HF）患者的左心室（LV）重塑和舒张功能与铁的状态相关，但因果关系尚不确定。这项孟德尔随机化（MR）研究调查了保留射血分数人群中全身铁参数与左心室结构和功能之间的双向因果关系：转铁蛋白饱和度（TSAT）、总铁结合能力（TIBC）以及血清铁和铁蛋白水平是从公开的全基因组关联研究荟萃分析中提取的铁参数工具变量。英国生物库心血管磁共振成像研究（UK Biobank Cardiovascular Magnetic Resonance Imaging Study）中无心肌梗死病史、高血压或左心室射血分数（LVEF）<50%的个体（n = 16,923）构成了结果数据集。数据集包括左心室舒张末期容积、左心室收缩末期容积、左心室质量（LVM）和左心室质量与舒张末期容积比（LVMVR）。我们采用了反方差加权（IVW）作为主要分析方法的双样本双向磁共振研究，并使用不同算法的估算方法来提高结果的稳健性：在 IVW 分析中，经 Bonferroni 调整后，TSAT 增加一个标准差（SD）与 LVMVR 下降显著相关（β = -0.1365；95% 置信区间 [CI]：-0.2092 至 -0.0638；P = 0.0002）。相反，在其他铁和左心室参数之间没有观察到明显的关系。经 Bonferroni 校正后，反向 MR 分析表明，LVEF 每增加 1 SD 与 TSAT 的降低显著相关（β = -0.0699; 95% CI: -0.1087 to -0.0311; P = 0.0004）。分析中未发现异质性或多效应证据：我们证明了在射血分数保留的人群中，TSAT与左心室重塑和功能之间存在因果关系。

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来源期刊

Journal of Geriatric Cardiology CARDIAC & CARDIOVASCULAR SYSTEMS-GERIATRICS & GERONTOLOGY

CiteScore

3.30

自引率

4.00%

发文量

1161

期刊介绍： JGC focuses on both basic research and clinical practice to the diagnosis and treatment of cardiovascular disease in the aged people, especially those with concomitant disease of other major organ-systems, such as the lungs, the kidneys, liver, central nervous system, gastrointestinal tract or endocrinology, etc.