Sun Xiao-Ting, Pang Yu-Qiao, Li Hui, Liuhuo Wu-Sha, Tang Chao, Zhao Li-Zhi
Department of Cardiology, The Affiliated Traditional Chinese Medicine Hospital, Southwest Medical University, 646000 Luzhou, Sichuan, China.
Rev Cardiovasc Med. 2024 Oct 8;25(10):356. doi: 10.31083/j.rcm2510356. eCollection 2024 Oct.
The relationship between negative emotions and atrial fibrillation (AF) has garnered significant attention, yet observational studies have yielded contradictory findings regarding the causal associations between the two. Our study sought to provide genetic evidence for a causal relationship between negative emotions and AF through Mendelian randomization (MR) study.
Utilizing genetic variations associated with negative emotions and AF as instrumental variables (IVs), a two-sample MR study was implemented. The potential causality between the two was initially assessed by using negative emotions as exposure and AF as outcome. Subsequently, potential reverse causality was evaluated by using AF as exposure and negative emotions as outcome. The inverse variance weighted (IVW) method served as the primary analysis for the two-sample MR, supplemented by weighted median method, MR-Egger regression, Simple mode method, and Weighted mode method. Sensitivity analyses were performed using the MR pleiotropy residual sum and outlier test (MR-PRESSO), Cochran Q test, and leave-one-out analysis to ensure the robustness of the results.
The two-sample MR analyses revealed that genetic susceptibility to AF had no potential causal effect on negative emotions ( > 0.05). Conversely, genetic susceptibility to negative emotions was positively correlated with an increased relative risk of AF [odds ratio (OR), 1.173, 95% confidence interval (CI): 1.115-1.235, = 8.475 × 10]. Furthermore, neither horizontal pleiotropy nor heterogeneity was detected in the analysis.
Genetic evidence from the study supports a potential causal link between negative emotions and AF. The study suggests that negative emotions may elevate the risk of AF, and the escalation of negative emotions in AF patients is more likely attributable to modifiable factors rather than genetically related factors.
负面情绪与心房颤动（AF）之间的关系已引起广泛关注，但观察性研究在两者因果关联方面得出了相互矛盾的结果。我们的研究旨在通过孟德尔随机化（MR）研究为负面情绪与AF之间的因果关系提供遗传学证据。
利用与负面情绪和AF相关的基因变异作为工具变量（IVs），开展了一项两样本MR研究。首先以负面情绪为暴露因素、AF为结局评估两者之间的潜在因果关系。随后，以AF为暴露因素、负面情绪为结局评估潜在的反向因果关系。逆方差加权（IVW）方法作为两样本MR的主要分析方法，辅以加权中位数法、MR-Egger回归、简单模式法和加权模式法。使用MR多效性残差和离群值检验（MR-PRESSO）、Cochran Q检验和留一法分析进行敏感性分析，以确保结果的稳健性。
两样本MR分析显示，AF的遗传易感性对负面情绪无潜在因果效应（>0.05）。相反，负面情绪的遗传易感性与AF相对风险增加呈正相关[比值比（OR），1.173，95%置信区间（CI）：1.115 - 1.235， = 8.475×10]。此外，分析中未检测到水平多效性和异质性。
该研究的遗传学证据支持负面情绪与AF之间存在潜在因果联系。研究表明，负面情绪可能会增加AF风险，AF患者负面情绪的加剧更可能归因于可改变因素而非遗传相关因素。
