Guo Xiaobo, Zhang Kui, Sun Yiping, Dong Ran
Department of Cardiac Surgery, Beijing Anzhen Hospital, Capital Medical University, 100029 Beijing, China.
Rev Cardiovasc Med. 2024 Oct 8;25(10):357. doi: 10.31083/j.rcm2510357. eCollection 2024 Oct.
The causal relationship between chronic venous insufficiency (CVI) and cardiovascular diseases (CVDs) has yet to be elucidated. Herein, we implement Mendelian randomization (MR) analysis to investigate the causal association.
A two-sample MR approach using genetic data from FinnGen and genome-wide association studies (GWAS) Catalog was applied to investigate the causal relationship between CVI and CVDs. This study assessed 77 single nucleotide polymorphisms (SNPs) as instrumental variables, employing random-effect inverse-variance-weighted MR, weighted median, Egger regression, Mendelian Randomization Pleiotropy RESidual Sum and Outlier (MR-PRESSO), and Robust Adjusted Profile Score (RAPS) methods. Multivariable MR (MVMR) considered confounding factors.
Genetically predicted CVI was associated with reduced heart failure risk (odds ratio (OR) = 0.96, 95% confidence interval (95% CI): 0.93-0.99, = 0.025) and increased atrial fibrillation risk (OR = 1.06, 95% CI: 1.03-1.09, = 0.0002). MVMR, adjusting for venous thromboembolism (VTE), lower limb ulceration, obesity, smoking, and alcohol, attenuated these associations. No significant links were found with hypertension, aortic aneurysm, coronary artery disease, myocardial infarction, valvular heart disease, or stroke.
This MR study supports an association between CVI and CVDs, which may imply CVI should be monitored during the treatment of heart failure and atrial fibrillation.
慢性静脉功能不全（CVI）与心血管疾病（CVD）之间的因果关系尚未阐明。在此，我们进行孟德尔随机化（MR）分析以研究因果关联。
采用来自芬兰基因研究（FinnGen）和全基因组关联研究（GWAS）目录的遗传数据，运用两样本MR方法来研究CVI与CVD之间的因果关系。本研究评估了77个单核苷酸多态性（SNP）作为工具变量，采用随机效应逆方差加权MR、加权中位数、Egger回归、孟德尔随机化多效性残差和离群值（MR-PRESSO）以及稳健调整轮廓得分（RAPS）方法。多变量MR（MVMR）考虑了混杂因素。
基因预测的CVI与心力衰竭风险降低相关（优势比（OR）=0.96，95%置信区间（95%CI）：0.93 - 0.99，P = 0.025），与心房颤动风险增加相关（OR = 1.06，95%CI：1.03 - 1.09，P = 0.0002）。在对静脉血栓栓塞（VTE）、下肢溃疡、肥胖、吸烟和饮酒进行调整的MVMR中，这些关联减弱。未发现与高血压、主动脉瘤、冠状动脉疾病、心肌梗死、心脏瓣膜病或中风有显著关联。
这项MR研究支持CVI与CVD之间存在关联，这可能意味着在心力衰竭和心房颤动的治疗过程中应监测CVI。
