Causal Effect of Atrial Fibrillation on Heart Failure Risk in East Asian Ancestry: A Bidirectional Mendelian Randomization Study Using Genome-wide Association Data.

IF 1.4 4区 医学 Q3 CARDIAC & CARDIOVASCULAR SYSTEMS
Yibin Mei, Fang Ye, Xiaofen Yin, Xianjun Wu
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Abstract

Background: Atrial fibrillation (AF) and heart failure (HF) are prevalent cardiovascular conditions in East Asia, with a complex interrelationship. The directionality of the causal impact of AF on HF risk remains uncertain. This study employs Mendelian randomization (MR) to investigate the potential causal effect of AF on HF.

Methods: Utilizing summary data from genome-wide association studies (GWAS) within the Medical Research Council Integrative Epidemiology Unit open GWAS database, we analyzed 8180 AF cases and 28 612 controls, alongside 9413 HF cases and 203 040 controls, all of East Asian descent. We conducted MR analysis using the inverse variance weighted (IVW) method, complemented by various sensitivity analyses, including bidirectional MR to assess causality in the reverse direction.

Results: Genetically predicted AF was found to be causally associated with an increased risk of HF in East Asian populations (odds ratio = 1.14, 95% CI: 1.10-1.19, P <.001) as per the IVW method. These findings were consistent across multiple MR methods. Sensitivity analyses revealed no significant heterogeneity or pleiotropy. Notably, bidirectional MR analysis showed no causal effect of HF on the risk of developing AF.

Conclusions: The MR analysis supports a unidirectional causal relationship between AF and increased HF risk in East Asian individuals. The absence of a reverse causal effect reinforces the importance of maintaining sinus rhythm to mitigate HF risk. Further research is warranted to corroborate these findings and to explore their clinical implications in depth.

心房颤动对东亚血统心力衰竭风险的因果效应:利用全基因组关联数据的双向孟德尔随机化研究
背景:心房颤动(AF)和心力衰竭(HF)是东亚地区普遍存在的心血管疾病,两者之间存在复杂的相互关系。心房颤动对心力衰竭风险的因果影响的方向性仍不确定。本研究采用孟德尔随机法(MR)研究心房颤动对高血压的潜在因果效应:利用医学研究委员会综合流行病学组开放式 GWAS 数据库中全基因组关联研究 (GWAS) 的汇总数据,我们分析了 8180 例心房颤动病例和 28 612 例对照,以及 9413 例心房颤动病例和 203 040 例对照(均为东亚后裔)。我们使用逆方差加权(IVW)方法进行了MR分析,并辅以各种敏感性分析,包括双向MR分析,以评估反向因果关系:结果:研究发现,遗传预测的房颤与东亚人群罹患心房颤动的风险增加存在因果关系(几率比=1.14,95% CI:1.10-1.19,P 结论:MR 分析支持单向的房颤与心房颤动之间的因果关系:磁共振分析支持东亚人心房颤动与心房颤动风险增加之间的单向因果关系。缺乏反向因果效应加强了保持窦性心律对降低高频风险的重要性。为证实这些发现并深入探讨其临床意义,还需要进一步的研究。
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来源期刊
Anatolian Journal of Cardiology
Anatolian Journal of Cardiology CARDIAC & CARDIOVASCULAR SYSTEMS-
CiteScore
2.30
自引率
7.70%
发文量
270
审稿时长
12 weeks
期刊介绍: The Anatolian Journal of Cardiology is an international monthly periodical on cardiology published on independent, unbiased, double-blinded and peer-review principles. The journal’s publication language is English. The Anatolian Journal of Cardiology aims to publish qualified and original clinical, experimental and basic research on cardiology at the international level. The journal’s scope also covers editorial comments, reviews of innovations in medical education and practice, case reports, original images, scientific letters, educational articles, letters to the editor, articles on publication ethics, diagnostic puzzles, and issues in social cardiology. The target readership includes academic members, specialists, residents, and general practitioners working in the fields of adult cardiology, pediatric cardiology, cardiovascular surgery and internal medicine.
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