Lee Young Shin, Yang Pil-Sung, Jang Eunsun, Kim Daehoon, Yu Hee Tae, Kim Tae-Hoon, Uhm Jae-Sun, Sung Jung-Hoon, Pak Hui-Nam, Lee Moon-Hyoung, Kim Jin-Bae, Joung Boyoung
Division of Cardiology Department of Internal Medicine Kyung Hee University Medical Center Seoul Korea.
Department of Cardiology CHA Bundang Medical Center CHA University Seongnam Republic of Korea.
J Am Heart Assoc. 2025 Mar 18;14(6):e038074. doi: 10.1161/JAHA.124.038074. Epub 2025 Mar 13.
Clinical and genetic predispositions are significant in predicting atrial fibrillation (AF); however, their role in patients with hypertrophic cardiomyopathy (HCM) remains unclear. This study aims to elucidate the impact of clinical and genetic risk factors on the development of AF in patients with and without HCM.
This retrospective analysis involved data from the UK Biobank cohort. Participants were divided into 3 groups based on their validated polygenic risk score for AF: the bottom 10% as low risk, the top 10% as high risk, and the rest as intermediate risk. We assessed the incidence of AF and cardiovascular complications and analyzed its predictors, including genetic risk. We examined 1180 patients with HCM (mean age, 61.1±7.1; 63.0% men) and 476 238 participants without HCM (mean age, 57.0±8.1; 45.3% men). During the 11.6-year follow-up period, the age- and sex-adjusted AF incidence rates for the low, intermediate, and high genetic risk groups were 2.4, 3.6, and 5.4 per 100 person-years in participants with HCM and 0.2, 0.5, and 1.0 per 100 person-years in participants without HCM, respectively. Genetic risk, evaluated as a continuous variable using polygenic risk score, was a less significant predictor of AF in the HCM group (hazard ratio [HR], 1.35 [95% CI, 1.21-1.49]) than in non-HCM group (HR, 1.57 [95% CI, 1.56-1.59]; =0.005 for interaction). A high genetic risk was significantly associated with the risk of cardiovascular complications in both groups.
Genetic predisposition is associated with the development of AF and cardiovascular complications in people with and without HCM; this association was weaker in the HCM group.
临床和遗传易感性在预测心房颤动（AF）方面具有重要意义；然而，它们在肥厚型心肌病（HCM）患者中的作用仍不明确。本研究旨在阐明临床和遗传危险因素对有无HCM患者发生AF的影响。
这项回顾性分析涉及英国生物银行队列的数据。参与者根据其经验证的AF多基因风险评分分为3组：最低的10%为低风险，最高的10%为高风险，其余为中等风险。我们评估了AF和心血管并发症的发生率，并分析了其预测因素，包括遗传风险。我们研究了1180例HCM患者（平均年龄61.1±7.1岁；63.0%为男性）和476238例无HCM参与者（平均年龄57.0±8.1岁；45.3%为男性）。在11.6年的随访期内，HCM参与者中低、中、高遗传风险组的年龄和性别调整后的AF发病率分别为每100人年2.4、3.6和5.4例，无HCM参与者分别为每100人年0.2、0.5和1.0例。使用多基因风险评分作为连续变量评估的遗传风险，在HCM组中对AF的预测作用（风险比[HR]，1.35[95%CI，1.21-1.49]）比非HCM组（HR，1.57[95%CI，1.56-1.59]；交互作用P=0.005）弱。高遗传风险与两组心血管并发症风险均显著相关。
遗传易感性与有无HCM人群的AF发生及心血管并发症相关；这种关联在HCM组中较弱。
