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Van Gelder IC, Rienstra M, Bunting KV, Casado-Arroyo R, Caso V, Crijns HJGM, De Potter TJR, Dwight J, Guasti L, Hanke T, Jaarsma T, Lettino M, Løchen ML, Lumbers RT, Maesen B, Mølgaard I, Rosano GMC, Sanders P, Schnabel RB, Suwalski P, Svennberg E, Tamargo J, Tica O, Traykov V, Tzeis S, Kotecha D. 2024 ESC Guidelines for the management of atrial fibrillation developed in collaboration with the European Association for Cardio-Thoracic Surgery (EACTS). Eur Heart J 2024:ehae176. [PMID: 39210723 DOI: 10.1093/eurheartj/ehae176] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 09/04/2024] Open
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Wu G, Zhang Q, Zhang J, Zhu J, Zheng D, Wang Y, Wu L. Exploring the impact of electrocardiographic parameters on the risk of common arrhythmias: a two-sample Mendelian randomization study. J Thorac Dis 2024; 16:4553-4566. [PMID: 39144314 PMCID: PMC11320266 DOI: 10.21037/jtd-24-814] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/16/2024] [Accepted: 07/12/2024] [Indexed: 08/16/2024]
Abstract
Background Observational studies have shown that heart rate (HR), heart rate variability (HRV), P-wave terminal force, P-wave duration, T-wave amplitude and PR interval are associated with risk factors for atrial fibrillation (AF) or bradycardia. Arrhythmias are associated with many causes of hospitalization. However, observational studies are susceptible to confounding factors that have not yet been identified. The objective of this study was to clarify the causal relationships by Mendelian randomization analysis. Methods We conducted a two-sample and multivariate Mendelian randomization (MVMR) analysis using genome-wide association study (GWAS) data from a European population to assess the total and direct causal effects of HR, three HRV traits, P-wave terminal force, P-wave duration, T-wave top amplitude in five-lead modes, and the PR interval on the risk of AF (N=191,205), bradycardia (N=463,010), and supraventricular tachycardia (SVT) (N=463,010). Results The results of the univariate MR analysis revealed the following significant causal effects: the higher the genetically predicted PR interval, the lower the risk of AF; the higher the HR and T-wave top amplitude (aVR leads and V3 + V4 + aVL leads), the lower the risk of bradycardia; and the higher HR and the lower PR interval, the higher the risk of SVT. The multivariate MR results indicated that the HRV_standard deviation of the normal-to-normal (SDNN) interval had an independent causal effect on the risk of AF [odds ratio (OR): 0.515; 95% confidence interval (CI): 0.278-0.954; P=0.03], and the T-wave top amplitude in the aVR leads (OR: 0.998; 95% CI: 0.996-0.999; P<0.001) and the HRV_SDNN (OR: 0.988; 95% CI: 0.976-1.000; P=0.045) had independent causal effects on the risk of bradycardia. Conclusions The HRV_SDNN had an independent causal effect on AF, while the HRV_SDNN and T-wave top amplitude in the aVR leads had independent causal effects on bradycardia, which suggests that some of the electrocardiographic parameters have preventive effects on the incidence of AF and bradycardia.
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Affiliation(s)
- Guangheng Wu
- Beijing Key Laboratory of Clinical Epidemiology, School of Public Health, Capital Medical University, Beijing, China
| | - Qiaoyun Zhang
- Department of Anesthesiology, Beijing Anzhen Hospital, Capital Medical University, Beijing, China
| | - Jie Zhang
- Beijing Key Laboratory of Clinical Epidemiology, School of Public Health, Capital Medical University, Beijing, China
| | - Jinqi Zhu
- Beijing Key Laboratory of Clinical Epidemiology, School of Public Health, Capital Medical University, Beijing, China
| | - Deqiang Zheng
- Beijing Key Laboratory of Clinical Epidemiology, School of Public Health, Capital Medical University, Beijing, China
| | - Youxin Wang
- Beijing Key Laboratory of Clinical Epidemiology, School of Public Health, Capital Medical University, Beijing, China
- School of Public Health, North China University of Science and Technology, Tangshan, China
- Centre for Precision Medicine, Edith Cowan University, Perth, Australia
| | - Lijuan Wu
- Beijing Key Laboratory of Clinical Epidemiology, School of Public Health, Capital Medical University, Beijing, China
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Luo X, Wang R, Zhou Y, Xie W. The relationship between emotional disorders and heart rate variability: A Mendelian randomization study. PLoS One 2024; 19:e0298998. [PMID: 38451975 PMCID: PMC10919610 DOI: 10.1371/journal.pone.0298998] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/23/2023] [Accepted: 02/04/2024] [Indexed: 03/09/2024] Open
Abstract
OBJECTIVE Previous studies have shown that emotional disorders are negatively associated with heart rate variability (HRV), but the potential causal relationship between genetic susceptibility to emotional disorders and HRV remains unclear. We aimed to perform a Mendelian randomization (MR) study to investigate the potential association between emotional disorders and HRV. METHODS The data used for this study were obtained from publicly available genome-wide association study datasets. Five models, including the inverse variance weighted model (IVW), the weighted median estimation model (WME), the weighted model-based method (WM), the simple model (SM) and the MR-Egger regression model (MER), were utilized for MR. The leave-one-out sensitivity test, MR pleiotropy residual sum and outlier test (MR-PRESSO) and Cochran's Q test were used to confirm heterogeneity and pleiotropy. RESULTS MR analysis revealed that genetic susceptibility to broad depression was negatively correlated with HRV (pvRSA/HF) (OR = 0.380, 95% CI 0.146-0.992; p = 0.048). However, genetic susceptibility to irritability was positively correlated with HRV (pvRSA/HF, SDNN) (OR = 2.017, 95% CI 1.152-3.534, p = 0.008) (OR = 1.154, 95% CI 1.000-1.331, p = 0.044). Genetic susceptibility to anxiety was positively correlated with HRV (RMSSD) (OR = 2.106, 95% CI 1.032-4.299; p = 0.041). No significant directional pleiotropy or heterogeneity was detected. The accuracy and robustness of these findings were confirmed through a sensitivity analysis. CONCLUSIONS Our MR study provides genetic support for the causal effects of broad depression, irritable mood, and anxiety on HRV.
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Affiliation(s)
- Xu Luo
- College of Clinical Medicine, University of Traditional Chinese Medicine, Chengdu, Sichuan, China
| | - Rui Wang
- College of Clinical Medicine, University of Traditional Chinese Medicine, Chengdu, Sichuan, China
| | - YunXiang Zhou
- College of Clinical Medicine, University of Traditional Chinese Medicine, Chengdu, Sichuan, China
| | - Wen Xie
- College of Clinical Medicine, University of Traditional Chinese Medicine, Chengdu, Sichuan, China
- Department of Cardiology, Hospital of Chengdu University of Traditional Chinese Medicine, Chengdu, Sichuan, China
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Ikram MA, Kieboom BCT, Brouwer WP, Brusselle G, Chaker L, Ghanbari M, Goedegebure A, Ikram MK, Kavousi M, de Knegt RJ, Luik AI, van Meurs J, Pardo LM, Rivadeneira F, van Rooij FJA, Vernooij MW, Voortman T, Terzikhan N. The Rotterdam Study. Design update and major findings between 2020 and 2024. Eur J Epidemiol 2024; 39:183-206. [PMID: 38324224 DOI: 10.1007/s10654-023-01094-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/21/2023] [Accepted: 12/14/2023] [Indexed: 02/08/2024]
Abstract
The Rotterdam Study is a population-based cohort study, started in 1990 in the district of Ommoord in the city of Rotterdam, the Netherlands, with the aim to describe the prevalence and incidence, unravel the etiology, and identify targets for prediction, prevention or intervention of multifactorial diseases in mid-life and elderly. The study currently includes 17,931 participants (overall response rate 65%), aged 40 years and over, who are examined in-person every 3 to 5 years in a dedicated research facility, and who are followed-up continuously through automated linkage with health care providers, both regionally and nationally. Research within the Rotterdam Study is carried out along two axes. First, research lines are oriented around diseases and clinical conditions, which are reflective of medical specializations. Second, cross-cutting research lines transverse these clinical demarcations allowing for inter- and multidisciplinary research. These research lines generally reflect subdomains within epidemiology. This paper describes recent methodological updates and main findings from each of these research lines. Also, future perspective for coming years highlighted.
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Affiliation(s)
- M Arfan Ikram
- Department of Epidemiology, Erasmus MC University Medical Center, Rotterdam, Netherlands.
| | - Brenda C T Kieboom
- Department of Epidemiology, Erasmus MC University Medical Center, Rotterdam, Netherlands
| | - Willem Pieter Brouwer
- Department of Hepatology, Erasmus MC University Medical Center, Rotterdam, Netherlands
| | - Guy Brusselle
- Department of Epidemiology, Erasmus MC University Medical Center, Rotterdam, Netherlands
- Department of Pulmonology, University Hospital Ghent, Ghent, Belgium
| | - Layal Chaker
- Department of Epidemiology, and Department of Internal Medicine, Erasmus MC University Medical Center, Rotterdam, Netherlands
| | - Mohsen Ghanbari
- Department of Epidemiology, Erasmus MC University Medical Center, Rotterdam, Netherlands
| | - André Goedegebure
- Department of Otorhinolaryngology and Head & Neck Surgery, Erasmus MC University Medical Center, Rotterdam, Netherlands
| | - M Kamran Ikram
- Department of Epidemiology, and Department of Neurology, Erasmus MC University Medical Center, Rotterdam, Netherlands
| | - Maryam Kavousi
- Department of Epidemiology, Erasmus MC University Medical Center, Rotterdam, Netherlands
| | - Rob J de Knegt
- Department of Hepatology, Erasmus MC University Medical Center, Rotterdam, Netherlands
| | - Annemarie I Luik
- Department of Epidemiology, Erasmus MC University Medical Center, Rotterdam, Netherlands
| | - Joyce van Meurs
- Department of Internal Medicine, Erasmus MC University Medical Center, Rotterdam, Netherlands
| | - Luba M Pardo
- Department of Dermatology, Erasmus MC University Medical Center, Rotterdam, Netherlands
| | - Fernando Rivadeneira
- Department of Medicine, and Department of Oral & Maxillofacial Surgery, Erasmus MC University Medical Center, Rotterdam, Netherlands
| | - Frank J A van Rooij
- Department of Epidemiology, Erasmus MC University Medical Center, Rotterdam, Netherlands
| | - Meike W Vernooij
- Department of Epidemiology, and Department of Radiology & Nuclear Medicine, Erasmus MC University Medical Center, Rotterdam, Netherlands
| | - Trudy Voortman
- Department of Epidemiology, Erasmus MC University Medical Center, Rotterdam, Netherlands
| | - Natalie Terzikhan
- Department of Epidemiology, Erasmus MC University Medical Center, Rotterdam, Netherlands
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Zhao Y, Yu H, Gong A, Zhang S, Xiao B. Heart rate variability and cardiovascular diseases: A Mendelian randomization study. Eur J Clin Invest 2024; 54:e14085. [PMID: 37641564 DOI: 10.1111/eci.14085] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/03/2023] [Revised: 06/23/2023] [Accepted: 08/01/2023] [Indexed: 08/31/2023]
Abstract
BACKGROUND The causal relationship between heart rate variability and cardiovascular diseases and the associated events is still unclear, and the conclusions of current studies are inconsistent. We aimed to explore the relationship between heart rate variability and cardiovascular diseases and the associated events with the Mendelian randomization study. METHODS We selected normal-to-normal inter-beat intervals (SDNN), root mean square of the successive differences of inter-beat intervals (RMSSD) and peak-valley respiratory sinus arrhythmia or high-frequency power (pvRSA/HF) as the three sets of instrumental variables for heart rate variability. The outcome for cardiovascular diseases included essential hypertension, heart failure, angina pectoris, myocardial infarction, nonischemic cardiomyopathy and arrhythmia. Cardiac arrest, cardiac death and major coronary heart disease event were defined as the related events of cardiovascular diseases. The data for exposures and outcomes were derived from publicly available genome-wide association studies. Inverse variance weighted was used for the main causal estimation. Analyses of heterogeneity and pleiotropy were conducted using the Cochran Q test of Inverse variance weighted and MR-Egger, leave-one-out analysis, and MR-Pleiotropy Residual Sum and Outlier methods. RESULTS The Inverse variance weighted method indicated that genetically predicted pvRSA/HF was associated with the increased risk of cardiac arrest (odds ratio 2.02, 95% confidence interval 1.25-3.28, p = .004). The results were free of heterogeneity and pleiotropy. There were no outliers and the leave-one-out analysis proved that the results were reliable. CONCLUSIONS This study provides genetic evidence that pvRSA/HF is causally related to cardiac arrest.
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Affiliation(s)
- Yan Zhao
- Department of Cardiology, The Second Hospital of Hebei Medical University, Shijiazhuang, China
| | - Hangtian Yu
- Department of Cardiology, The Second Hospital of Hebei Medical University, Shijiazhuang, China
| | - Angwei Gong
- Department of Cardiology, The Second Hospital of Hebei Medical University, Shijiazhuang, China
| | - Shuaidan Zhang
- Department of Cardiology, The Second Hospital of Hebei Medical University, Shijiazhuang, China
| | - Bing Xiao
- Department of Cardiology, The Second Hospital of Hebei Medical University, Shijiazhuang, China
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Akkoca A, Büyükakıllı B, Ballı E, Gültekin B, Özbay E, Oruç Demirbağ H, Türkseven ÇH. Protective effect of MitoTEMPO against cardiac dysfunction caused by ischemia-reperfusion: MCAO stroke model study. Int J Neurosci 2023:1-12. [PMID: 37862003 DOI: 10.1080/00207454.2023.2273768] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/16/2023] [Accepted: 10/17/2023] [Indexed: 10/21/2023]
Abstract
PURPOSE Neurological impairments are the leading cause of post-stroke mortality, while stroke-related cardiovascular diseases rank second in significance. This study investigates the potential protective effects of MitoTEMPO (2,2,6,6-tetramethyl-4-[[2-(triphenylphosphonio) acetyl] amino]-1-piperidinyloxy, monochloride, monohydrate), a mitochondria-specific antioxidant, against cardiac and neurological complications following stroke. The objective is to assess whether MitoTEMPO can be utilized as a protective agent for individuals with a high risk of stroke. MATERIALS AND METHODS Seventeen-week-old male Wistar Albino rats were randomly assigned to three groups: SHAM, ischemia-reperfusion and MitoTEMPO + ischemia-reperfusion (MitoTEMPO injection 0.7 mg/kg/day for 14 days). The SHAM group underwent a sham operation, while the ischemia-reperfusion group underwent 1-h middle cerebral artery occlusion followed by three days of reperfusion. Afterwards, noninvasive thoracic electrical bioimpedance and electrocardiography measurements were taken, and sample collection was performed for histological and biochemical examinations. RESULTS Our thoracic electrical bioimpedance and electrocardiography findings demonstrated that MitoTEMPO exhibited a protective effect on most parameters affected by ischemia-reperfusion compared to the SHAM group. Furthermore, our biochemical and histological data revealed a significant protective effect of MitoTEMPO against oxidative damage. CONCLUSIONS The findings suggest that both ischemia-reperfusion-induced cardiovascular abnormalities and the protective effect of MitoTEMPO may involve G-protein coupled receptor-mediated signaling mechanisms. This study was conducted with limitations including a single gender, a uniform age group, a specific stroke model limited to middle cerebral artery, and pre-scheduled only one ischemia-reperfusion period. In future studies, addressing these limitations may enable the implementation of preventive measures for individuals at high risk of stroke.
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Affiliation(s)
- Ahmet Akkoca
- Department of Occupational Health and Safety, Taşkent Vocational School, Selcuk University, Konya, Türkiye
| | - Belgin Büyükakıllı
- Department of Biophysics, Faculty of Medicine, Mersin University, Mersin, Türkiye
| | - Ebru Ballı
- Department of Histology and Embryology, Faculty of Medicine, Mersin University, Mersin, Türkiye
| | - Burcu Gültekin
- Department of Histology and Embryology, Faculty of Medicine, Necmettin Erbakan University, Konya, Türkiye
| | - Erkan Özbay
- Department of Medical Services and Techniques, Health Services Vocational School, Karamanoğlu Mehmetbey University, Karaman, Türkiye
| | - Hatice Oruç Demirbağ
- Department of Histology and Embryology, Faculty of Medicine, Mersin University, Mersin, Türkiye
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