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评估高血压对左心房和左心室结构及功能的因果作用:一项两样本孟德尔随机化研究。

Assessing the causal role of hypertension on left atrial and left ventricular structure and function: A two-sample Mendelian randomization study.

作者信息

Sun Yancui, Zhang Ying, Xu Nan, Bi Cheng, Liu Xiaojie, Song Wei, Jiang Yinong

机构信息

Department of Cardiology, First Affiliated Hospital of Dalian Medical University, Dalian, Liaoning, China.

School of Basic Medical Sciences, Henan University, Kaifeng, Henan, China.

出版信息

Front Cardiovasc Med. 2022 Nov 2;9:1006380. doi: 10.3389/fcvm.2022.1006380. eCollection 2022.

Abstract

AIM

The aim of this study was to investigate whether hypertension may be causally linked to left atrial (LA) and left ventricular (LV) structure and function.

METHODS AND RESULTS

We performed a two-Mendelian randomization (MR) analysis implementing the results from the FinnGen large-scale, genome-wide association study for hypertension ( = 218,754), and LV ( = 16,923) and LA studies ( = 35,648) by the UK Biobank to identify genetic instruments. The MR analysis was implemented using an inverse-variance weighted (IVW) approach. We identified a positive potential causal relationship between hypertension and indices for the LA maximum (LAmax with causal estimates of 0.126 [95% CI, (0.093 to 0.160)]); LA minimum (LAmin with causal estimates of 0.122 [95% CI, (0.089 to 0.156)]); LV function (causal estimates are LV end-diastolic volume (LVEDV), 0.078 [95% CI, (0.003 to 0.153)]; LV end-systolic volume (LVESV), 0.102 [95% CI, (0.030 to 0.173)]; LV mass (LVM), 0.171 [95% CI, (0.108 to 0.233)]; and LV mass to end-diastolic volume ratio (LVMVR at 0.098 [95% CI, (0.048 to 0.149)], respectively), which was directionally concordant with other robust MR methods. Other than this, we observed a significantly negative causal relationship between hypertension and the LA active emptying fraction (LAAEF), the LA passive emptying fraction (LAPEF), and the LA total emptying fraction (LATEF).

CONCLUSION

Our genetic analyses demonstrated a potential causal relationship between hypertension and the left atrium and left ventricle's structures and functions.

摘要

目的

本研究旨在调查高血压是否可能与左心房(LA)和左心室(LV)的结构及功能存在因果关系。

方法与结果

我们进行了一项双孟德尔随机化(MR)分析,利用芬兰基因库大规模全基因组关联研究中关于高血压(n = 218,754)、左心室(n = 16,923)和左心房(n = 35,648)研究的结果,通过英国生物银行来确定遗传工具。MR分析采用逆方差加权(IVW)方法进行。我们确定了高血压与左心房最大内径指标(LAmax,因果估计值为0.126 [95%可信区间,(0.093至0.160)])、左心房最小内径指标(LAmin,因果估计值为0.122 [95%可信区间,(0.089至0.156)])、左心室功能指标(因果估计值分别为左心室舒张末期容积(LVEDV),0.078 [95%可信区间,(0.003至0.153)];左心室收缩末期容积(LVESV),0.102 [95%可信区间,(0.030至0.173)];左心室质量(LVM),0.171 [95%可信区间,(0.108至0.233)];以及左心室质量与舒张末期容积比值(LVMVR,为0.098 [95%可信区间,(0.048至0.149)])之间存在正的潜在因果关系,这与其他可靠的MR方法方向一致。除此之外,我们观察到高血压与左心房主动排空分数(LAAEF)、左心房被动排空分数(LAPEF)和左心房总排空分数(LATEF)之间存在显著的负因果关系。

结论

我们的遗传分析表明高血压与左心房和左心室的结构及功能之间存在潜在的因果关系。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/9982/9666890/27fadba58952/fcvm-09-1006380-g001.jpg

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