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Van Wagoner DR. Collagen type V, interstitial fibrosis and the substrate for atrial fibrillation. Int J Cardiol Heart Vasc 2024; 50:101356. [PMID: 38419609 PMCID: PMC10899731 DOI: 10.1016/j.ijcha.2024.101356] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/31/2024] [Accepted: 02/02/2024] [Indexed: 03/02/2024]
Affiliation(s)
- David R. Van Wagoner
- Department of Cardiovascular and Metabolic Sciences, Cleveland Clinic, M/S ND50, 9500 Euclid Avenue, Cleveland, OH 44195, USA
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2
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Joglar JA, Chung MK, Armbruster AL, Benjamin EJ, Chyou JY, Cronin EM, Deswal A, Eckhardt LL, Goldberger ZD, Gopinathannair R, Gorenek B, Hess PL, Hlatky M, Hogan G, Ibeh C, Indik JH, Kido K, Kusumoto F, Link MS, Linta KT, Marcus GM, McCarthy PM, Patel N, Patton KK, Perez MV, Piccini JP, Russo AM, Sanders P, Streur MM, Thomas KL, Times S, Tisdale JE, Valente AM, Van Wagoner DR. 2023 ACC/AHA/ACCP/HRS Guideline for the Diagnosis and Management of Atrial Fibrillation: A Report of the American College of Cardiology/American Heart Association Joint Committee on Clinical Practice Guidelines. Circulation 2024; 149:e1-e156. [PMID: 38033089 DOI: 10.1161/cir.0000000000001193] [Citation(s) in RCA: 30] [Impact Index Per Article: 30.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/02/2023]
Abstract
AIM The "2023 ACC/AHA/ACCP/HRS Guideline for the Diagnosis and Management of Atrial Fibrillation" provides recommendations to guide clinicians in the treatment of patients with atrial fibrillation. METHODS A comprehensive literature search was conducted from May 12, 2022, to November 3, 2022, encompassing studies, reviews, and other evidence conducted on human subjects that were published in English from PubMed, EMBASE, the Cochrane Library, the Agency for Healthcare Research and Quality, and other selected databases relevant to this guideline. Additional relevant studies, published through November 2022, during the guideline writing process, were also considered by the writing committee and added to the evidence tables, where appropriate. STRUCTURE Atrial fibrillation is the most sustained common arrhythmia, and its incidence and prevalence are increasing in the United States and globally. Recommendations from the "2014 AHA/ACC/HRS Guideline for the Management of Patients With Atrial Fibrillation" and the "2019 AHA/ACC/HRS Focused Update of the 2014 AHA/ACC/HRS Guideline for the Management of Patients With Atrial Fibrillation" have been updated with new evidence to guide clinicians. In addition, new recommendations addressing atrial fibrillation and thromboembolic risk assessment, anticoagulation, left atrial appendage occlusion, atrial fibrillation catheter or surgical ablation, and risk factor modification and atrial fibrillation prevention have been developed.
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Affiliation(s)
| | | | | | | | | | | | - Anita Deswal
- ACC/AHA Joint Committee on Clinical Practice Guidelines liaison
| | | | | | | | | | - Paul L Hess
- ACC/AHA Joint Committee on Performance Measures liaison
| | | | | | | | | | - Kazuhiko Kido
- American College of Clinical Pharmacy representative
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3
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Joglar JA, Chung MK, Armbruster AL, Benjamin EJ, Chyou JY, Cronin EM, Deswal A, Eckhardt LL, Goldberger ZD, Gopinathannair R, Gorenek B, Hess PL, Hlatky M, Hogan G, Ibeh C, Indik JH, Kido K, Kusumoto F, Link MS, Linta KT, Marcus GM, McCarthy PM, Patel N, Patton KK, Perez MV, Piccini JP, Russo AM, Sanders P, Streur MM, Thomas KL, Times S, Tisdale JE, Valente AM, Van Wagoner DR. 2023 ACC/AHA/ACCP/HRS Guideline for the Diagnosis and Management of Atrial Fibrillation: A Report of the American College of Cardiology/American Heart Association Joint Committee on Clinical Practice Guidelines. J Am Coll Cardiol 2024; 83:109-279. [PMID: 38043043 DOI: 10.1016/j.jacc.2023.08.017] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/04/2023]
Abstract
AIM The "2023 ACC/AHA/ACCP/HRS Guideline for the Diagnosis and Management of Patients With Atrial Fibrillation" provides recommendations to guide clinicians in the treatment of patients with atrial fibrillation. METHODS A comprehensive literature search was conducted from May 12, 2022, to November 3, 2022, encompassing studies, reviews, and other evidence conducted on human subjects that were published in English from PubMed, EMBASE, the Cochrane Library, the Agency for Healthcare Research and Quality, and other selected databases relevant to this guideline. Additional relevant studies, published through November 2022, during the guideline writing process, were also considered by the writing committee and added to the evidence tables, where appropriate. STRUCTURE Atrial fibrillation is the most sustained common arrhythmia, and its incidence and prevalence are increasing in the United States and globally. Recommendations from the "2014 AHA/ACC/HRS Guideline for the Management of Patients With Atrial Fibrillation" and the "2019 AHA/ACC/HRS Focused Update of the 2014 AHA/ACC/HRS Guideline for the Management of Patients With Atrial Fibrillation" have been updated with new evidence to guide clinicians. In addition, new recommendations addressing atrial fibrillation and thromboembolic risk assessment, anticoagulation, left atrial appendage occlusion, atrial fibrillation catheter or surgical ablation, and risk factor modification and atrial fibrillation prevention have been developed.
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Heinzinger CM, Thompson NR, Milinovich A, Diniz Araujo ML, Orbea CP, Foldvary‐Schaefer N, Haouzi P, Faulx M, Van Wagoner DR, Chung MK, Mehra R. Sleep-Disordered Breathing, Hypoxia, and Pulmonary Physiologic Influences in Atrial Fibrillation. J Am Heart Assoc 2023; 12:e031462. [PMID: 37947123 PMCID: PMC10727289 DOI: 10.1161/jaha.123.031462] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/19/2023] [Accepted: 09/07/2023] [Indexed: 11/12/2023]
Abstract
Background We leverage a large clinical cohort to elucidate sleep-disordered breathing and sleep-related hypoxia in incident atrial fibrillation (AF) development given the yet unclear contributions of sleep-related hypoxia and pulmonary physiology in sleep-disordered breathing and AF. Methods and Results Patients who underwent sleep studies at Cleveland Clinic January 2, 2000, to December 30, 2015, comprised this retrospective cohort. Cox proportional hazards models were used to examine apnea hypopnea index, percentage time oxygen saturation <90%, minimum and mean oxygen saturation, and maximum end-tidal carbon dioxide on incident AF adjusted for age, sex, race, body mass index, cardiopulmonary disease and risk factors, antiarrhythmic medications, and positive airway pressure. Those with spirometry were additionally adjusted for forced expiratory volume in 1 second, forced vital capacity, and forced expiratory volume in 1 second/forced vital capacity. This cohort (n=42 057) was 50.7±14.1 years, 51.3% men, 74.1% White individuals, had median body mass index 33.2 kg/m2, and 1947 (4.6%) developed AF over 5 years. A 10-unit apnea hypopnea index increase was associated with 2% higher AF risk (hazard ratio [HR], 1.02 [95% CI, 1.00-1.03]). A 10-unit increase in percentage time oxygen saturation <90% and 10-unit decreases in mean and minimum oxygen saturation were associated with 6% (HR, 1.06 [95% CI, 1.04-1.08]), 30% (HR, 1.30 [95% CI, 1.18-1.42]), and 9% (HR, 1.09 [95% CI, 1.03-1.15]) higher AF risk, respectively. After adjustment for spirometry (n=9683 with available data), only hypoxia remained significantly associated with incident AF, although all coefficients were stable. Conclusions Sleep-related hypoxia was associated with incident AF in this clinical cohort, consistent across 3 measures of hypoxia, persistent after adjustment for pulmonary physiologic impairment. Findings identify a strong role for sleep-related hypoxia in AF development without pulmonary physiologic interdependence.
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Affiliation(s)
| | - Nicolas R. Thompson
- Department of Quantitative Health SciencesCleveland ClinicClevelandOH
- Neurological Institute Center for Outcomes Research & EvaluationCleveland ClinicClevelandOH
| | - Alex Milinovich
- Department of Quantitative Health SciencesCleveland ClinicClevelandOH
| | | | - Cinthya Pena Orbea
- Sleep Disorders Center, Neurological InstituteCleveland ClinicClevelandOH
| | | | | | - Michael Faulx
- Heart, Vascular, and Thoracic InstituteCleveland ClinicClevelandOH
| | | | - Mina K. Chung
- Heart, Vascular, and Thoracic InstituteCleveland ClinicClevelandOH
- Lerner Research InstituteCleveland ClinicClevelandOH
| | - Reena Mehra
- Sleep Disorders Center, Neurological InstituteCleveland ClinicClevelandOH
- Respiratory InstituteCleveland ClinicClevelandOH
- Heart, Vascular, and Thoracic InstituteCleveland ClinicClevelandOH
- Lerner Research InstituteCleveland ClinicClevelandOH
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5
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Tchou G, Ponce-Balbuena D, Liu N, Gore-Panter S, Hsu J, Liu F, Opoku E, Brubaker G, Schumacher SM, Moravec CS, Barnard J, Van Wagoner DR, Chung MK, Smith JD. Decreased FAM13B Expression Increases Atrial Fibrillation Susceptibility by Regulating Sodium Current and Calcium Handling. JACC Basic Transl Sci 2023; 8:1357-1378. [PMID: 38094680 PMCID: PMC10714175 DOI: 10.1016/j.jacbts.2023.05.009] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/23/2023] [Revised: 05/16/2023] [Accepted: 05/16/2023] [Indexed: 04/17/2024]
Abstract
A specific genetic variant associated with atrial fibrillation risk, rs17171731, was identified as a regulatory variant responsible for controlling FAM13B expression. The atrial fibrillation risk allele decreases FAM13B expression, whose knockdown alters the expression of many genes in stem cell-derived cardiomyocytes, including SCN2B, and led to pro-arrhythmogenic changes in the late sodium current and Ca2+ cycling. Fam13b knockout mice had increased P-wave and QT interval duration and were more susceptible to pacing-induced arrhythmias vs control mice. FAM13B expression, its regulation, and downstream effects are potential targets for investigation of patient-specific therapeutics.
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Affiliation(s)
- Gregory Tchou
- Departments of Cardiovascular and Metabolic Sciences, Cleveland Clinic, Cleveland, Ohio, USA
| | | | - Nana Liu
- Departments of Cardiovascular and Metabolic Sciences, Cleveland Clinic, Cleveland, Ohio, USA
| | - Shamone Gore-Panter
- Departments of Cardiovascular and Metabolic Sciences, Cleveland Clinic, Cleveland, Ohio, USA
| | - Jeffrey Hsu
- Departments of Cardiovascular and Metabolic Sciences, Cleveland Clinic, Cleveland, Ohio, USA
| | - Fang Liu
- Departments of Cardiovascular and Metabolic Sciences, Cleveland Clinic, Cleveland, Ohio, USA
| | - Emmanuel Opoku
- Departments of Cardiovascular and Metabolic Sciences, Cleveland Clinic, Cleveland, Ohio, USA
| | - Gregory Brubaker
- Departments of Cardiovascular and Metabolic Sciences, Cleveland Clinic, Cleveland, Ohio, USA
| | - Sarah M. Schumacher
- Departments of Cardiovascular and Metabolic Sciences, Cleveland Clinic, Cleveland, Ohio, USA
| | - Christine S. Moravec
- Departments of Cardiovascular and Metabolic Sciences, Cleveland Clinic, Cleveland, Ohio, USA
- Department of Cardiovascular Medicine, Cleveland Clinic, Cleveland, Ohio, USA
| | - John Barnard
- Department of Quantitative Health Sciences, Cleveland Clinic, Cleveland, Ohio, USA
| | - David R. Van Wagoner
- Departments of Cardiovascular and Metabolic Sciences, Cleveland Clinic, Cleveland, Ohio, USA
- Department of Cardiovascular Medicine, Cleveland Clinic, Cleveland, Ohio, USA
| | - Mina K. Chung
- Departments of Cardiovascular and Metabolic Sciences, Cleveland Clinic, Cleveland, Ohio, USA
- Department of Cardiovascular Medicine, Cleveland Clinic, Cleveland, Ohio, USA
| | - Jonathan D. Smith
- Departments of Cardiovascular and Metabolic Sciences, Cleveland Clinic, Cleveland, Ohio, USA
- Department of Cardiovascular Medicine, Cleveland Clinic, Cleveland, Ohio, USA
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6
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Wass SY, Offerman EJ, Sun H, Hsu J, Rennison JH, Cantlay CC, McHale ML, Gillinov AM, Moravec C, Smith JD, Van Wagoner DR, Barnard J, Chung MK. Novel functional atrial fibrillation risk genes and pathways identified from coexpression analyses in human left atria. Heart Rhythm 2023; 20:1219-1226. [PMID: 37329937 PMCID: PMC10527093 DOI: 10.1016/j.hrthm.2023.05.035] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/08/2022] [Revised: 04/17/2023] [Accepted: 05/25/2023] [Indexed: 06/19/2023]
Abstract
BACKGROUND Genomewide association studies have associated >100 genetic loci with atrial fibrillation (AF), but establishing causal genes contributing to AF remains challenging. OBJECTIVE The purpose of this study was to determine candidate novel causal genes and mechanistic pathways associated with AF risk loci by incorporating gene expression and coexpression analyses and to provide a resource for functional studies and targeting of AF-associated genes. METHODS Cis-expression quantitative trait loci were identified for candidate genes near AF risk variants in human left atrial tissues. Coexpression partners were identified for each candidate gene. Weighted gene coexpression network analysis (WGCNA) identified modules and modules with overrepresentation of candidate AF genes. Ingenuity pathway analysis (IPA) was applied to the coexpression partners of each candidate gene. IPA and gene set over representation analysis were applied to each WGCNA module. RESULTS One hundred sixty-six AF-risk single nucleotide polymorphisms were located in 135 loci. Eighty-one novel genes not previously annotated as putative AF risk genes were identified. IPA identified mitochondrial dysfunction, oxidative stress, epithelial adherens junction signaling, and sirtuin signaling as the most frequent significant pathways. WGCNA characterized 64 modules (candidate AF genes overrepresented in 8), represented by cell injury, death, stress, developmental, metabolic/mitochondrial, transcription/translation, and immune activation/inflammation regulatory pathways. CONCLUSION Candidate gene coexpression analyses suggest significant roles for cellular stress and remodeling in AF, supporting a dual risk model for AF: Genetic susceptibility to AF may not manifest until later in life, when cellular stressors overwhelm adaptive responses. These analyses also provide a novel resource to guide functional studies on potential causal AF genes.
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Affiliation(s)
- Sojin Youn Wass
- Department of Cardiovascular and Metabolic Sciences, Lerner Research Institute, Cleveland Clinic, Cleveland, Ohio
| | - Erik J Offerman
- Cleveland Clinic Lerner College of Medicine of Case Western Reserve University, Cleveland Clinic, Cleveland, Ohio
| | - Han Sun
- Department of Quantitative Health Sciences, Lerner Research Institute, Cleveland Clinic, Cleveland, Ohio
| | - Jeffrey Hsu
- Department of Cardiovascular and Metabolic Sciences, Lerner Research Institute, Cleveland Clinic, Cleveland, Ohio
| | - Julie H Rennison
- Department of Cardiovascular and Metabolic Sciences, Lerner Research Institute, Cleveland Clinic, Cleveland, Ohio
| | - Catherine C Cantlay
- Department of Cardiovascular and Metabolic Sciences, Lerner Research Institute, Cleveland Clinic, Cleveland, Ohio
| | - Meghan L McHale
- Department of Cardiovascular and Metabolic Sciences, Lerner Research Institute, Cleveland Clinic, Cleveland, Ohio
| | - A Marc Gillinov
- Cleveland Clinic Lerner College of Medicine of Case Western Reserve University, Cleveland Clinic, Cleveland, Ohio; Department of Cardiothoracic Surgery, Heart, Vascular & Thoracic Institute, Cleveland Clinic, Cleveland, Ohio
| | - Christine Moravec
- Department of Cardiovascular and Metabolic Sciences, Lerner Research Institute, Cleveland Clinic, Cleveland, Ohio; Cleveland Clinic Lerner College of Medicine of Case Western Reserve University, Cleveland Clinic, Cleveland, Ohio
| | - Jonathan D Smith
- Department of Cardiovascular and Metabolic Sciences, Lerner Research Institute, Cleveland Clinic, Cleveland, Ohio; Cleveland Clinic Lerner College of Medicine of Case Western Reserve University, Cleveland Clinic, Cleveland, Ohio; Department of Cardiovascular Medicine, Heart, Vascular & Thoracic Institute, Cleveland Clinic, Cleveland, Ohio
| | - David R Van Wagoner
- Department of Cardiovascular and Metabolic Sciences, Lerner Research Institute, Cleveland Clinic, Cleveland, Ohio; Cleveland Clinic Lerner College of Medicine of Case Western Reserve University, Cleveland Clinic, Cleveland, Ohio
| | - John Barnard
- Department of Quantitative Health Sciences, Lerner Research Institute, Cleveland Clinic, Cleveland, Ohio
| | - Mina K Chung
- Department of Cardiovascular and Metabolic Sciences, Lerner Research Institute, Cleveland Clinic, Cleveland, Ohio; Cleveland Clinic Lerner College of Medicine of Case Western Reserve University, Cleveland Clinic, Cleveland, Ohio; Department of Cardiovascular Medicine, Heart, Vascular & Thoracic Institute, Cleveland Clinic, Cleveland, Ohio.
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7
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Rennison JH, Van Wagoner DR. Dysregulated Ca2+ cycling in atrial fibrillation. Eur Heart J 2023; 44:2495-2497. [PMID: 37012620 PMCID: PMC10344643 DOI: 10.1093/eurheartj/ehad099] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 04/05/2023] Open
Affiliation(s)
- Julie H Rennison
- Department of Cardiovascular & Metabolic Sciences, Cleveland Clinic, M/S ND-50, 9500 Euclid Avenue, Cleveland, OH 44195, USA
| | - David R Van Wagoner
- Department of Cardiovascular & Metabolic Sciences, Cleveland Clinic, M/S ND-50, 9500 Euclid Avenue, Cleveland, OH 44195, USA
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8
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Romano KA, Nemet I, Prasad Saha P, Haghikia A, Li XS, Mohan ML, Lovano B, Castel L, Witkowski M, Buffa JA, Sun Y, Li L, Menge CM, Demuth I, König M, Steinhagen-Thiessen E, DiDonato JA, Deb A, Bäckhed F, Tang WHW, Naga Prasad SV, Landmesser U, Van Wagoner DR, Hazen SL. Gut Microbiota-Generated Phenylacetylglutamine and Heart Failure. Circ Heart Fail 2023; 16:e009972. [PMID: 36524472 PMCID: PMC9851997 DOI: 10.1161/circheartfailure.122.009972] [Citation(s) in RCA: 29] [Impact Index Per Article: 29.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/20/2022] [Accepted: 09/20/2022] [Indexed: 12/23/2022]
Abstract
BACKGROUND The gut microbiota-dependent metabolite phenylacetylgutamine (PAGln) is both associated with atherothrombotic heart disease in humans, and mechanistically linked to cardiovascular disease pathogenesis in animal models via modulation of adrenergic receptor signaling. METHODS Here we examined both clinical and mechanistic relationships between PAGln and heart failure (HF). First, we examined associations among plasma levels of PAGln and HF, left ventricular ejection fraction, and N-terminal pro-B-type natriuretic peptide in 2 independent clinical cohorts of subjects undergoing coronary angiography in tertiary referral centers (an initial discovery US Cohort, n=3256; and a validation European Cohort, n=829). Then, the impact of PAGln on cardiovascular phenotypes relevant to HF in cultured cardiomyoblasts, and in vivo were also examined. RESULTS Circulating PAGln levels were dose-dependently associated with HF presence and indices of severity (reduced ventricular ejection fraction, elevated N-terminal pro-B-type natriuretic peptide) independent of traditional risk factors and renal function in both cohorts. Beyond these clinical associations, mechanistic studies showed both PAGln and its murine counterpart, phenylacetylglycine, directly fostered HF-relevant phenotypes, including decreased cardiomyocyte sarcomere contraction, and B-type natriuretic peptide gene expression in both cultured cardiomyoblasts and murine atrial tissue. CONCLUSIONS The present study reveals the gut microbial metabolite PAGln is clinically and mechanistically linked to HF presence and severity. Modulating the gut microbiome, in general, and PAGln production, in particular, may represent a potential therapeutic target for modulating HF. REGISTRATION URL: https://clinicaltrials.gov/; Unique identifier: NCT00590200 and URL: https://drks.de/drks_web/; Unique identifier: DRKS00020915.
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Affiliation(s)
- Kymberleigh A Romano
- Department of Cardiovascular and Metabolic Sciences, Lerner Research Institute, Cleveland Clinic, OH (K.A.R., I.N., P.P.S., A.H., X.S.L., M.L.M., B.L., L.C., M.W., J.A.B., Y.S., L.L., C.M.M., J.A.D., W.H.W.T., S.V.N.P., D.R.V.W., S.L.H.)
| | - Ina Nemet
- Department of Cardiovascular and Metabolic Sciences, Lerner Research Institute, Cleveland Clinic, OH (K.A.R., I.N., P.P.S., A.H., X.S.L., M.L.M., B.L., L.C., M.W., J.A.B., Y.S., L.L., C.M.M., J.A.D., W.H.W.T., S.V.N.P., D.R.V.W., S.L.H.)
| | - Prasenjit Prasad Saha
- Department of Cardiovascular and Metabolic Sciences, Lerner Research Institute, Cleveland Clinic, OH (K.A.R., I.N., P.P.S., A.H., X.S.L., M.L.M., B.L., L.C., M.W., J.A.B., Y.S., L.L., C.M.M., J.A.D., W.H.W.T., S.V.N.P., D.R.V.W., S.L.H.)
| | - Arash Haghikia
- Department of Cardiovascular and Metabolic Sciences, Lerner Research Institute, Cleveland Clinic, OH (K.A.R., I.N., P.P.S., A.H., X.S.L., M.L.M., B.L., L.C., M.W., J.A.B., Y.S., L.L., C.M.M., J.A.D., W.H.W.T., S.V.N.P., D.R.V.W., S.L.H.)
- Department of Cardiology, Charité-Universitätsmedizin Berlin, Campus Benjamin Franklin, Germany; German Center for Cardiovascular Research, Partner Site Berlin, Germany; and Berlin Institute of Health, Germany (A.H., U.L.)
| | - Xinmin S Li
- Department of Cardiovascular and Metabolic Sciences, Lerner Research Institute, Cleveland Clinic, OH (K.A.R., I.N., P.P.S., A.H., X.S.L., M.L.M., B.L., L.C., M.W., J.A.B., Y.S., L.L., C.M.M., J.A.D., W.H.W.T., S.V.N.P., D.R.V.W., S.L.H.)
| | - Maradumane L Mohan
- Department of Cardiovascular and Metabolic Sciences, Lerner Research Institute, Cleveland Clinic, OH (K.A.R., I.N., P.P.S., A.H., X.S.L., M.L.M., B.L., L.C., M.W., J.A.B., Y.S., L.L., C.M.M., J.A.D., W.H.W.T., S.V.N.P., D.R.V.W., S.L.H.)
| | - Beth Lovano
- Department of Cardiovascular and Metabolic Sciences, Lerner Research Institute, Cleveland Clinic, OH (K.A.R., I.N., P.P.S., A.H., X.S.L., M.L.M., B.L., L.C., M.W., J.A.B., Y.S., L.L., C.M.M., J.A.D., W.H.W.T., S.V.N.P., D.R.V.W., S.L.H.)
| | - Laurie Castel
- Department of Cardiovascular and Metabolic Sciences, Lerner Research Institute, Cleveland Clinic, OH (K.A.R., I.N., P.P.S., A.H., X.S.L., M.L.M., B.L., L.C., M.W., J.A.B., Y.S., L.L., C.M.M., J.A.D., W.H.W.T., S.V.N.P., D.R.V.W., S.L.H.)
| | - Marco Witkowski
- Department of Cardiovascular and Metabolic Sciences, Lerner Research Institute, Cleveland Clinic, OH (K.A.R., I.N., P.P.S., A.H., X.S.L., M.L.M., B.L., L.C., M.W., J.A.B., Y.S., L.L., C.M.M., J.A.D., W.H.W.T., S.V.N.P., D.R.V.W., S.L.H.)
| | - Jennifer A Buffa
- Department of Cardiovascular and Metabolic Sciences, Lerner Research Institute, Cleveland Clinic, OH (K.A.R., I.N., P.P.S., A.H., X.S.L., M.L.M., B.L., L.C., M.W., J.A.B., Y.S., L.L., C.M.M., J.A.D., W.H.W.T., S.V.N.P., D.R.V.W., S.L.H.)
| | - Yu Sun
- Department of Cardiovascular and Metabolic Sciences, Lerner Research Institute, Cleveland Clinic, OH (K.A.R., I.N., P.P.S., A.H., X.S.L., M.L.M., B.L., L.C., M.W., J.A.B., Y.S., L.L., C.M.M., J.A.D., W.H.W.T., S.V.N.P., D.R.V.W., S.L.H.)
| | - Lin Li
- Department of Cardiovascular and Metabolic Sciences, Lerner Research Institute, Cleveland Clinic, OH (K.A.R., I.N., P.P.S., A.H., X.S.L., M.L.M., B.L., L.C., M.W., J.A.B., Y.S., L.L., C.M.M., J.A.D., W.H.W.T., S.V.N.P., D.R.V.W., S.L.H.)
| | - Christopher M Menge
- Department of Cardiovascular and Metabolic Sciences, Lerner Research Institute, Cleveland Clinic, OH (K.A.R., I.N., P.P.S., A.H., X.S.L., M.L.M., B.L., L.C., M.W., J.A.B., Y.S., L.L., C.M.M., J.A.D., W.H.W.T., S.V.N.P., D.R.V.W., S.L.H.)
| | - Ilja Demuth
- Department of Endocrinology and Metabolism, Charité-Universitätsmedizin Berlin, Charitéplatz, Germany (I.D., M.K., E.S.-T.)
- Berlin Institute of Health Center for Regenerative Therapies, Germany (I.D.)
| | - Maximilian König
- Department of Endocrinology and Metabolism, Charité-Universitätsmedizin Berlin, Charitéplatz, Germany (I.D., M.K., E.S.-T.)
| | - Elisabeth Steinhagen-Thiessen
- Department of Endocrinology and Metabolism, Charité-Universitätsmedizin Berlin, Charitéplatz, Germany (I.D., M.K., E.S.-T.)
| | - Joseph A DiDonato
- Department of Cardiovascular and Metabolic Sciences, Lerner Research Institute, Cleveland Clinic, OH (K.A.R., I.N., P.P.S., A.H., X.S.L., M.L.M., B.L., L.C., M.W., J.A.B., Y.S., L.L., C.M.M., J.A.D., W.H.W.T., S.V.N.P., D.R.V.W., S.L.H.)
| | - Arjun Deb
- Division of Cardiology and Department of Medicine, David Geffen School of Medicine, University of California Los Angeles (A.D.)
| | - Fredrik Bäckhed
- Department of Molecular and Clinical Medicine, Wallenberg Laboratory, Institute of Medicine, University of Gothenburg, Sweden (F.B.)
| | - W H Wilson Tang
- Department of Cardiovascular and Metabolic Sciences, Lerner Research Institute, Cleveland Clinic, OH (K.A.R., I.N., P.P.S., A.H., X.S.L., M.L.M., B.L., L.C., M.W., J.A.B., Y.S., L.L., C.M.M., J.A.D., W.H.W.T., S.V.N.P., D.R.V.W., S.L.H.)
- Heart, Vascular and Thoracic Institute, Cleveland Clinic, OH (W.H.W.T., S.L.H.)
| | - Sathyamangla Venkata Naga Prasad
- Department of Cardiovascular and Metabolic Sciences, Lerner Research Institute, Cleveland Clinic, OH (K.A.R., I.N., P.P.S., A.H., X.S.L., M.L.M., B.L., L.C., M.W., J.A.B., Y.S., L.L., C.M.M., J.A.D., W.H.W.T., S.V.N.P., D.R.V.W., S.L.H.)
| | - Ulf Landmesser
- Department of Cardiology, Charité-Universitätsmedizin Berlin, Campus Benjamin Franklin, Germany; German Center for Cardiovascular Research, Partner Site Berlin, Germany; and Berlin Institute of Health, Germany (A.H., U.L.)
| | - David R Van Wagoner
- Department of Cardiovascular and Metabolic Sciences, Lerner Research Institute, Cleveland Clinic, OH (K.A.R., I.N., P.P.S., A.H., X.S.L., M.L.M., B.L., L.C., M.W., J.A.B., Y.S., L.L., C.M.M., J.A.D., W.H.W.T., S.V.N.P., D.R.V.W., S.L.H.)
| | - Stanley L Hazen
- Department of Cardiovascular and Metabolic Sciences, Lerner Research Institute, Cleveland Clinic, OH (K.A.R., I.N., P.P.S., A.H., X.S.L., M.L.M., B.L., L.C., M.W., J.A.B., Y.S., L.L., C.M.M., J.A.D., W.H.W.T., S.V.N.P., D.R.V.W., S.L.H.)
- Heart, Vascular and Thoracic Institute, Cleveland Clinic, OH (W.H.W.T., S.L.H.)
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9
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Kornej J, Qadan MA, Alotaibi M, Van Wagoner DR, Watrous JD, Trinquart L, Preis SR, Ko D, Jain M, Benjamin EJ, Cheng S, Lin H. The association between eicosanoids and incident atrial fibrillation in the Framingham Heart Study. Sci Rep 2022; 12:20218. [PMID: 36418854 PMCID: PMC9684401 DOI: 10.1038/s41598-022-21786-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/23/2022] [Accepted: 10/04/2022] [Indexed: 11/26/2022] Open
Abstract
Chronic inflammation is a continuous low-grade activation of the systemic immune response. Whereas downstream inflammatory markers are associated with atrial fibrillation (AF), upstream inflammatory effectors including eicosanoids are less studied. To examine the association between eicosanoids and incident AF. We used a liquid chromatography-mass spectrometry for the non-targeted measurement of 161 eicosanoids and eicosanoid-related metabolites in the Framingham Heart Study. The association of each eicosanoid and incident AF was assessed using Cox proportional hazards models and adjusted for AF risk factors, including age, sex, height, weight, systolic/diastolic blood pressure, current smoking, antihypertensive medication, diabetes, history of myocardial infarction and heart failure. False discovery rate (FDR) was used to adjust for multiple testing. Eicosanoids with FDR < 0.05 were considered significant. In total, 2676 AF-free individuals (mean age 66 ± 9 years, 56% females) were followed for mean 10.8 ± 3.4 years; 351 participants developed incident AF. Six eicosanoids were associated with incident AF after adjusting for multiple testing (FDR < 0.05). A joint score was built from the top eicosanoids weighted by their effect sizes, which was associated with incident AF (HR = 2.72, CI = 1.71-4.31, P = 2.1 × 10-5). In conclusion, six eicosanoids were associated with incident AF after adjusting for clinical risk factors for AF.
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Affiliation(s)
- Jelena Kornej
- National Heart, Lung, and Blood Institute, Boston University's Framingham Heart Study, Framingham, MA, USA. .,Section of Cardiovascular Medicine, Department of Medicine, Boston Medical Center, Boston University School of Medicine, Boston, MA, USA.
| | - Maha A. Qadan
- grid.239578.20000 0001 0675 4725Department of Cardiovascular and Metabolic Sciences, Lerner Research Institute, Cleveland Clinic Foundation, Cleveland, OH USA
| | - Mona Alotaibi
- grid.266100.30000 0001 2107 4242Division of Pulmonary, Critical Care and Sleep Medicine, University of California San Diego, La Jolla, CA USA
| | - David R. Van Wagoner
- grid.239578.20000 0001 0675 4725Department of Cardiovascular and Metabolic Sciences, Lerner Research Institute, Cleveland Clinic Foundation, Cleveland, OH USA
| | - Jeramie D. Watrous
- grid.266100.30000 0001 2107 4242Department of Medicine, University of California, La Jolla, San Diego, CA USA
| | - Ludovic Trinquart
- grid.510954.c0000 0004 0444 3861National Heart, Lung, and Blood Institute, Boston University’s Framingham Heart Study, Framingham, MA USA ,grid.189504.10000 0004 1936 7558Department of Biostatistics, Boston University School of Public Health, Boston, MA USA
| | - Sarah R. Preis
- grid.510954.c0000 0004 0444 3861National Heart, Lung, and Blood Institute, Boston University’s Framingham Heart Study, Framingham, MA USA ,grid.189504.10000 0004 1936 7558Department of Biostatistics, Boston University School of Public Health, Boston, MA USA
| | - Darae Ko
- grid.510954.c0000 0004 0444 3861National Heart, Lung, and Blood Institute, Boston University’s Framingham Heart Study, Framingham, MA USA ,grid.189504.10000 0004 1936 7558Section of Cardiovascular Medicine, Department of Medicine, Boston Medical Center, Boston University School of Medicine, Boston, MA USA
| | - Mohit Jain
- grid.266100.30000 0001 2107 4242Department of Medicine, University of California, La Jolla, San Diego, CA USA
| | - Emelia J. Benjamin
- grid.510954.c0000 0004 0444 3861National Heart, Lung, and Blood Institute, Boston University’s Framingham Heart Study, Framingham, MA USA ,grid.189504.10000 0004 1936 7558Section of Cardiovascular Medicine, Department of Medicine, Boston Medical Center, Boston University School of Medicine, Boston, MA USA ,grid.189504.10000 0004 1936 7558Department of Epidemiology, Boston University School of Public Health, Boston, MA USA
| | - Susan Cheng
- grid.512369.aDepartment of Cardiology, Cedars-Sinai Medical Center, Smidt Heart Institute, Los Angeles, CA USA
| | - Honghuang Lin
- grid.510954.c0000 0004 0444 3861National Heart, Lung, and Blood Institute, Boston University’s Framingham Heart Study, Framingham, MA USA ,grid.168645.80000 0001 0742 0364Department of Medicine, University of Massachusetts Chan Medical School, Worcester, MA USA
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10
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Lal JC, Mao C, Zhou Y, Gore-Panter SR, Rennison JH, Lovano BS, Castel L, Shin J, Gillinov AM, Smith JD, Barnard J, Van Wagoner DR, Luo Y, Cheng F, Chung MK. Transcriptomics-based network medicine approach identifies metformin as a repurposable drug for atrial fibrillation. Cell Rep Med 2022; 3:100749. [PMID: 36223777 PMCID: PMC9588904 DOI: 10.1016/j.xcrm.2022.100749] [Citation(s) in RCA: 10] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/25/2022] [Revised: 05/25/2022] [Accepted: 08/26/2022] [Indexed: 11/24/2022]
Abstract
Effective drugs for atrial fibrillation (AF) are lacking, resulting in significant morbidity and mortality. This study demonstrates that network proximity analysis of differentially expressed genes from atrial tissue to drug targets can help prioritize repurposed drugs for AF. Using enrichment analysis of drug-gene signatures and functional testing in human inducible pluripotent stem cell (iPSC)-derived atrial-like cardiomyocytes, we identify metformin as a top repurposed drug candidate for AF. Using the active compactor, a new design analysis of large-scale longitudinal electronic health record (EHR) data, we determine that metformin use is significantly associated with a reduced risk of AF (odds ratio = 0.48, 95%, confidence interval [CI] 0.36-0.64, p < 0.001) compared with standard treatments for diabetes. This study utilizes network medicine methodologies to identify repurposed drugs for AF treatment and identifies metformin as a candidate drug.
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Affiliation(s)
- Jessica C. Lal
- Genomic Medicine Institute, Lerner Research Institute, Cleveland Clinic, 9500 Euclid Ave., NE5-305, Cleveland, OH 44195, USA,Department of Molecular Medicine, Cleveland Clinic Lerner College of Medicine, Case Western Reserve University, Cleveland, OH 44195, USA
| | - Chengsheng Mao
- Division of Health and Biomedical Informatics, Department of Preventive Medicine, Northwestern University, Chicago, IL 60611, USA
| | - Yadi Zhou
- Genomic Medicine Institute, Lerner Research Institute, Cleveland Clinic, 9500 Euclid Ave., NE5-305, Cleveland, OH 44195, USA
| | - Shamone R. Gore-Panter
- Cardiovascular and Metabolic Sciences, Lerner Research Institute, Cleveland Clinic, Cleveland, OH, USA,Department of Biological, Geological, and Environmental Sciences, Cleveland State University, Cleveland, OH 44115, USA
| | - Julie H. Rennison
- Cardiovascular and Metabolic Sciences, Lerner Research Institute, Cleveland Clinic, Cleveland, OH, USA
| | - Beth S. Lovano
- Cardiovascular and Metabolic Sciences, Lerner Research Institute, Cleveland Clinic, Cleveland, OH, USA
| | - Laurie Castel
- Cardiovascular and Metabolic Sciences, Lerner Research Institute, Cleveland Clinic, Cleveland, OH, USA
| | - Jiyoung Shin
- Division of Health and Biomedical Informatics, Department of Preventive Medicine, Northwestern University, Chicago, IL 60611, USA
| | - A. Marc Gillinov
- Thoracic and Cardiovascular Surgery, Cleveland Clinic, Cleveland, OH 44195, USA
| | - Jonathan D. Smith
- Department of Molecular Medicine, Cleveland Clinic Lerner College of Medicine, Case Western Reserve University, Cleveland, OH 44195, USA,Cardiovascular and Metabolic Sciences, Lerner Research Institute, Cleveland Clinic, Cleveland, OH, USA
| | - John Barnard
- Department of Quantitative Health Sciences, Cleveland Clinic, Cleveland, OH, USA
| | - David R. Van Wagoner
- Cardiovascular and Metabolic Sciences, Lerner Research Institute, Cleveland Clinic, Cleveland, OH, USA
| | - Yuan Luo
- Division of Health and Biomedical Informatics, Department of Preventive Medicine, Northwestern University, Chicago, IL 60611, USA,Corresponding author
| | - Feixiong Cheng
- Genomic Medicine Institute, Lerner Research Institute, Cleveland Clinic, 9500 Euclid Ave., NE5-305, Cleveland, OH 44195, USA,Department of Molecular Medicine, Cleveland Clinic Lerner College of Medicine, Case Western Reserve University, Cleveland, OH 44195, USA,Case Comprehensive Cancer Center, Case Western Reserve University School of Medicine, Cleveland, OH 44106, USA,Corresponding author
| | - Mina K. Chung
- Cardiovascular and Metabolic Sciences, Lerner Research Institute, Cleveland Clinic, Cleveland, OH, USA,Cardiovascular Medicine, Heart, Vascular, and Thoracic Institute, Cleveland Clinic, 9500 Euclid Ave., J2-2, OH 44195, USA,Corresponding author
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11
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Van Wagoner DR. What is the impact of endothelin receptor blockade on atrial remodeling in a hypertensive model? IJC Heart & Vasculature 2022; 42:101107. [PMID: 36042790 PMCID: PMC9420357 DOI: 10.1016/j.ijcha.2022.101107] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/06/2022] [Accepted: 08/10/2022] [Indexed: 11/24/2022]
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12
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Liu N, Barnard J, Mahajan G, Tchou G, SUN H, Van Wagoner DR, Chung MK, Smith JD. BS-515-03 ATRIAL FIBRILLATION ASSOCIATED COMMON INTRONIC RISK VARIANTS IN SYNE2 LEAD TO LOWER EXPRESSION OF NESPRIN-2A1, INCREASED NUCLEAR STIFFNESS AND EARLY AFTER DEPOLARIZATIONS IN CARDIOMYOCYTES. Heart Rhythm 2022. [DOI: 10.1016/j.hrthm.2022.03.685] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/04/2022]
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13
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Labarbera MA, Atta-Fosu T, Feeny AK, Firouznia M, Mchale M, Cantlay C, Roach T, Axtell A, Schoenhagen P, Barnard J, Smith JD, Van Wagoner DR, Madabhushi A, Chung MK. New Radiomic Markers of Pulmonary Vein Morphology Associated With Post-Ablation Recurrence of Atrial Fibrillation. IEEE J Transl Eng Health Med 2021; 10:1800209. [PMID: 34976444 PMCID: PMC8716081 DOI: 10.1109/jtehm.2021.3134160] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 04/13/2021] [Revised: 07/08/2021] [Accepted: 11/22/2021] [Indexed: 11/30/2022]
Abstract
Objective: To identify radiomic and clinical features associated with post-ablation recurrence of AF, given that cardiac morphologic changes are associated with persistent atrial fibrillation (AF), and initiating triggers of AF often arise from the pulmonary veins which are targeted in ablation. Methods: Subjects with pre-ablation contrast CT scans prior to first-time catheter ablation for AF between 2014-2016 were retrospectively identified. A training dataset (D1) was constructed from left atrial and pulmonary vein morphometric features extracted from equal numbers of consecutively included subjects with and without AF recurrence determined at 1 year. The top-performing combination of feature selection and classifier methods based on C-statistic was evaluated on a validation dataset (D2), composed of subjects retrospectively identified between 2005-2010. Clinical models ([Formula: see text]) were similarly evaluated and compared to radiomic ([Formula: see text]) and radiomic-clinical models ([Formula: see text]), each independently validated on D2. Results: Of 150 subjects in D1, 108 received radiofrequency ablation and 42 received cryoballoon. Radiomic features of recurrence included greater right carina angle, reduced anterior-posterior atrial diameter, greater atrial volume normalized to height, and steeper right inferior pulmonary vein angle. Clinical features predicting recurrence included older age, greater BMI, hypertension, and warfarin use; apixaban use was associated with reduced recurrence. AF recurrence was predicted with radio-frequency ablation models on D2 subjects with C-statistics of 0.68, 0.63, and 0.70 for radiomic, clinical, and combined feature models, though these were not prognostic in patients treated with cryoballoon. Conclusions: Pulmonary vein morphology associated with increased likelihood of AF recurrence within 1 year of catheter ablation was identified on cardiac CT. Significance: Radiomic and clinical features-based predictive models may assist in identifying atrial fibrillation ablation candidates with greatest likelihood of successful outcome.
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Affiliation(s)
- Michael A. Labarbera
- Cleveland Clinic Lerner College of MedicineCase Western Reserve UniversityClevelandOH44106USA
| | - Thomas Atta-Fosu
- Department of Biomedical EngineeringCase Western Reserve UniversityClevelandOH44106USA
| | - Albert K. Feeny
- Cleveland Clinic Lerner College of MedicineCase Western Reserve UniversityClevelandOH44106USA
| | - Marjan Firouznia
- Department of Biomedical EngineeringCase Western Reserve UniversityClevelandOH44106USA
| | - Meghan Mchale
- Department of Cardiovascular and Metabolic SciencesLerner Research Institute, Cleveland ClinicClevelandOH44106USA
| | - Catherine Cantlay
- Department of Cardiovascular and Metabolic SciencesLerner Research Institute, Cleveland ClinicClevelandOH44106USA
| | - Tyler Roach
- Department of Cardiovascular and Metabolic SciencesLerner Research Institute, Cleveland ClinicClevelandOH44106USA
| | - Alexis Axtell
- Department of Cardiovascular and Metabolic SciencesLerner Research Institute, Cleveland ClinicClevelandOH44106USA
| | - Paul Schoenhagen
- Department of Cardiovascular Medicine, Heart, VascularThoracic Institute, Cleveland ClinicClevelandOH44106USA
| | - John Barnard
- Department of Quantitative Health SciencesLerner Research Institute, Cleveland ClinicClevelandOH44106USA
| | - Jonathan D. Smith
- Department of Cardiovascular and Metabolic SciencesLerner Research Institute, Cleveland ClinicClevelandOH44106USA
| | - David R. Van Wagoner
- Department of Cardiovascular and Metabolic SciencesLerner Research Institute, Cleveland ClinicClevelandOH44106USA
| | - Anant Madabhushi
- Department of Biomedical EngineeringCase Western Reserve UniversityClevelandOH44106USA
- Louis Stokes Cleveland Veterans Administration Medical CenterClevelandOH44106USA
| | - Mina K. Chung
- Department of Cardiovascular and Metabolic SciencesLerner Research Institute, Cleveland ClinicClevelandOH44106USA
- Department of Cardiovascular Medicine, Heart, VascularThoracic Institute, Cleveland ClinicClevelandOH44106USA
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14
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Rennison JH, Wass SY, Lin CR, Sun H, Hsu J, Cantlay C, Castel L, Lovano B, McHale M, Gillinov AM, Moravec CS, Smith JD, Chung MK, Barnard J, Van Wagoner DR. Abstract P382: Transcriptomic Analysis Of Human Left Atrial Tissue Reveals Mitochondrial Gene Co-expression. Circ Res 2021. [DOI: 10.1161/res.129.suppl_1.p382] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
Atrial fibrillation (AF) risk is heritable. High rate electrical activity in AF requires increased energy. Atrial mitochondrial structure and function are altered in AF patients in an effort to generate adequate ATP through oxidative phosphorylation. Genomic studies have identified putative AF risk genes, but the association of AF risk genes with expression of mitochondrial genes is unclear. We tested the hypothesis that putative AF risk genes are co-expressed with mitochondrial genes that play a role in atrial energy production. RNA-seq was performed on left atrial appendage (LAA) tissues obtained from 251 cardiac surgery patients. RNA coexpression profiles were evaluated for 222 putative AF risk genes. Genes encoding proteins that localize to the mitochondria were identified using MitoCarta 2.0. Changes in metabolic pathways were detected using Ingenuity Pathway Analysis (IPA). Our analysis identified 128 AF risk genes that coexpressed with at least one mitochondrial gene. The highest level of mitochondrial gene coexpression was evident with PCCB, in which 30% (253 of 848) of coexpressed genes were mitochondrial. CASQ2 (24%, 104 of 431) and ASAH1 (20%, 37 of 182) also showed high levels of mitochondrial gene coexpression. The IPA Oxidative Phosphorylation Pathway was significantly altered (p<0.05) for 26 AF risk genes, with CASQ2 (9.42E-79), MYH6 (4.73E-78), YWHAE (4.96E-75), and TTN (4.30E-71) the most strongly associated (Table). Additionally, 12 AF risk genes coexpressed with genes encoded by mitochondrial DNA (mtDNA) (Table). ASAH1, CASQ2, MYH6, NACA, NUCKS1, PLN, TTN, and YWHAE coexpressed with all 13 mtDNA encoded components of the electron transport chain. Many AF risk genes show significant coexpression with mitochondrial genes. We propose that genetic risk scores based on these AF risk genes may identify a subset of AF patients that would benefit from AF therapies that enhance metabolic activity.
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Affiliation(s)
| | | | | | - Han Sun
- Cleveland Clinic, Cleveland, OH
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15
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Stavrakis S, Morris L, Takashima AD, Elkholey K, Van Wagoner DR, Ajijola OA. Circulating Neuropeptide Y as a Biomarker for Neuromodulation in Atrial Fibrillation. JACC Clin Electrophysiol 2021; 6:1575-1576. [PMID: 33213819 DOI: 10.1016/j.jacep.2020.08.025] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/15/2020] [Revised: 08/18/2020] [Accepted: 08/19/2020] [Indexed: 11/28/2022]
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16
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Benjamin EJ, Al-Khatib SM, Desvigne-Nickens P, Alonso A, Djoussé L, Forman DE, Gillis AM, Hendriks JML, Hills MT, Kirchhof P, Link MS, Marcus GM, Mehra R, Murray KT, Parkash R, Piña IL, Redline S, Rienstra M, Sanders P, Somers VK, Van Wagoner DR, Wang PJ, Cooper LS, Go AS. Research Priorities in the Secondary Prevention of Atrial Fibrillation: A National Heart, Lung, and Blood Institute Virtual Workshop Report. J Am Heart Assoc 2021; 10:e021566. [PMID: 34351783 PMCID: PMC8475065 DOI: 10.1161/jaha.121.021566] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/24/2022]
Abstract
There has been sustained focus on the secondary prevention of coronary heart disease and heart failure; yet, apart from stroke prevention, the evidence base for the secondary prevention of atrial fibrillation (AF) recurrence, AF progression, and AF‐related complications is modest. Although there are multiple observational studies, there are few large, robust, randomized trials providing definitive effective approaches for the secondary prevention of AF. Given the increasing incidence and prevalence of AF nationally and internationally, the AF field needs transformative research and a commitment to evidenced‐based secondary prevention strategies. We report on a National Heart, Lung, and Blood Institute virtual workshop directed at identifying knowledge gaps and research opportunities in the secondary prevention of AF. Once AF has been detected, lifestyle changes and novel models of care delivery may contribute to the prevention of AF recurrence, AF progression, and AF‐related complications. Although benefits seen in small subgroups, cohort studies, and selected randomized trials are impressive, the widespread effectiveness of AF secondary prevention strategies remains unknown, calling for development of scalable interventions suitable for diverse populations and for identification of subpopulations who may particularly benefit from intensive management. We identified critical research questions for 6 topics relevant to the secondary prevention of AF: (1) weight loss; (2) alcohol intake, smoking cessation, and diet; (3) cardiac rehabilitation; (4) approaches to sleep disorders; (5) integrated, team‐based care; and (6) nonanticoagulant pharmacotherapy. Our goal is to stimulate innovative research that will accelerate the generation of the evidence to effectively pursue the secondary prevention of AF.
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Affiliation(s)
- Emelia J Benjamin
- Cardiovascular Medicine Department of Medicine Boston University School of Medicine Boston MA.,Department of Epidemiology Boston University School of Public Health Boston MA
| | - Sana M Al-Khatib
- Division of Cardiology and Duke Clinical Research Institute Duke University Medical Center Durham NC
| | - Patrice Desvigne-Nickens
- Division of Cardiovascular Sciences National Heart, Lung, and Blood InstituteNational Institutes of Health Bethesda MD
| | - Alvaro Alonso
- Department of Epidemiology Rollins School of Public Health Emory University Atlanta GA
| | - Luc Djoussé
- Division of Aging Department of Medicine Brigham and Women's Hospital and Harvard Medical School Boston MA
| | - Daniel E Forman
- Divisions of Geriatrics and Cardiology University of Pittsburgh Medical CenterAging InstituteUniversity of PittsburghVA Pittsburgh Healthcare System Pittsburgh PA
| | - Anne M Gillis
- Libin Cardiovascular Institute of AlbertaUniversity of Calgary Alberta Canada
| | - Jeroen M L Hendriks
- Centre for Heart Rhythm Disorders University of Adelaide, and Royal Adelaide Hospital Adelaide Australia.,Caring Futures Institute College of Nursing and Health Sciences Flinders University Adelaide Australia
| | | | - Paulus Kirchhof
- Department of Cardiology University Heart and Vascular Center UKE Hamburg Hamburg Germany.,Institute of Cardiovascular Science University of Birmingham United Kingdom.,German Center for Cardiovascular Research, Partner Site Hamburg/Kiel/Lübeck Berlin Germany.,AFNET Münster Germany
| | - Mark S Link
- Division of Cardiology Department of Medicine UT Southwestern Medical Center Dallas TX
| | - Gregory M Marcus
- Division of Cardiology University of California, San Francisco San Francisco CA
| | - Reena Mehra
- Sleep Disorders Center Neurologic Institute Respiratory Institute Heart and Vascular Institute, and Molecular Cardiology Department of the Lerner Research Institute Cleveland Clinic Cleveland OH
| | | | - Ratika Parkash
- Division of Cardiology QEII Health Sciences Center/Dalhousie University Halifax Nova Scotia Canada
| | - Ileana L Piña
- Wayne State University Detroit MI.,Central Michigan University Mt Pleasant MI.,FDAOPEQCenter for Devices and Radiological Health Silver Spring MD
| | - Susan Redline
- Department of Medicine Brigham and Women's Hospital Boston MA
| | - Michiel Rienstra
- Department of Cardiology University of GroningenUniversity Medical Center Groningen Groningen the Netherlands
| | - Prashanthan Sanders
- Centre for Heart Rhythm Disorders University of Adelaide, and Royal Adelaide Hospital Adelaide Australia
| | - Virend K Somers
- Department of Cardiovascular Medicine Mayo Clinic Rochester MN
| | | | - Paul J Wang
- Stanford University School of Medicine Palo Alto CA
| | - Lawton S Cooper
- Division of Cardiovascular Sciences National Heart, Lung, and Blood InstituteNational Institutes of Health Bethesda MD
| | - Alan S Go
- Division of Research Kaiser Permanente Northern California Oakland CA.,Department of Health System Science Kaiser Permanente Bernard J. Tyson School of Medicine Pasadena CA.,Departments of Epidemiology, Biostatistics and Medicine University of California, San Francisco San Francisco CA.,Departments of Medicine Health Research and Policy Stanford University Stanford CA
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17
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Van Wagoner DR. Right atrial blood supply and complexity of induced atrial fibrillation: What's left? Int J Cardiol Heart Vasc 2021; 34:100816. [PMID: 34169141 PMCID: PMC8207232 DOI: 10.1016/j.ijcha.2021.100816] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/30/2021] [Accepted: 05/31/2021] [Indexed: 11/30/2022]
Affiliation(s)
- David R Van Wagoner
- Department of Cardiovascular & Metabolic Sciences, Cleveland Clinic, 9500 Euclid Avenue, M/S ND-50, Cleveland, OH 44195, USA
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18
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Yamaguchi N, Xiao J, Narke D, Shaheen D, Lin X, Offerman E, Khodadadi-Jamayran A, Shekhar A, Choy A, Wass SY, Van Wagoner DR, Chung MK, Park DS. Cardiac Pressure Overload Decreases ETV1 Expression in the Left Atrium, Contributing to Atrial Electrical and Structural Remodeling. Circulation 2021; 143:805-820. [PMID: 33225722 PMCID: PMC8449308 DOI: 10.1161/circulationaha.120.048121] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
BACKGROUND Elevated intracardiac pressure attributable to heart failure induces electrical and structural remodeling in the left atrium (LA) that begets atrial myopathy and arrhythmias. The underlying molecular pathways that drive atrial remodeling during cardiac pressure overload are poorly defined. The purpose of this study is to characterize the response of the ETV1 (ETS translocation variant 1) signaling axis in the LA during cardiac pressure overload in humans and mouse models and explore the role of ETV1 in atrial electrical and structural remodeling. METHODS We performed gene expression profiling in 265 left atrial samples from patients who underwent cardiac surgery. Comparative gene expression profiling was performed between 2 murine models of cardiac pressure overload, transverse aortic constriction banding and angiotensin II infusion, and a genetic model of Etv1 cardiomyocyte-selective knockout (Etv1f/fMlc2aCre/+). RESULTS Using the Cleveland Clinic biobank of human LA specimens, we found that ETV1 expression is decreased in patients with reduced ejection fraction. Consistent with its role as an important mediator of the NRG1 (Neuregulin 1) signaling pathway and activator of rapid conduction gene programming, we identified a direct correlation between ETV1 expression level and NRG1, ERBB4, SCN5A, and GJA5 levels in human LA samples. In a similar fashion to patients with heart failure, we showed that left atrial ETV1 expression is downregulated at the RNA and protein levels in murine pressure overload models. Comparative analysis of LA RNA sequencing datasets from transverse aortic constriction and angiotensin II-treated mice showed a high Pearson correlation, reflecting a highly ordered process by which the LA undergoes electrical and structural remodeling. Cardiac pressure overload produced a consistent downregulation of ErbB4, Etv1, Scn5a, and Gja5 and upregulation of profibrotic gene programming, which includes Tgfbr1/2, Igf1, and numerous collagen genes. Etv1f/fMlc2aCre/+ mice displayed atrial conduction disease and arrhythmias. Correspondingly, the LA from Etv1f/fMlc2aCre/+ mice showed downregulation of rapid conduction genes and upregulation of profibrotic gene programming, whereas analysis of a gain-of-function ETV1 RNA sequencing dataset from neonatal rat ventricular myocytes transduced with Etv1 showed reciprocal changes. CONCLUSIONS ETV1 is downregulated in the LA during cardiac pressure overload, contributing to both electrical and structural remodeling.
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Affiliation(s)
- Naoko Yamaguchi
- The Leon H. Charney Division of Cardiology, New York University Grossman School of Medicine, 435 E 30 Street, Science Building 723, New York, New York 10016, USA
| | - Junhua Xiao
- The Leon H. Charney Division of Cardiology, New York University Grossman School of Medicine, 435 E 30 Street, Science Building 723, New York, New York 10016, USA
| | - Deven Narke
- The Leon H. Charney Division of Cardiology, New York University Grossman School of Medicine, 435 E 30 Street, Science Building 723, New York, New York 10016, USA
| | - Devin Shaheen
- The Leon H. Charney Division of Cardiology, New York University Grossman School of Medicine, 435 E 30 Street, Science Building 723, New York, New York 10016, USA
| | - Xianming Lin
- The Leon H. Charney Division of Cardiology, New York University Grossman School of Medicine, 435 E 30 Street, Science Building 723, New York, New York 10016, USA
| | - Erik Offerman
- The Leon H. Charney Division of Cardiology, New York University Grossman School of Medicine, 435 E 30 Street, Science Building 723, New York, New York 10016, USA
| | - Alireza Khodadadi-Jamayran
- NYU Applied Bioinformatics Labs, New York University Grossman School of Medicine, 227 E 30 Street, TRB-745, New York, New York 10016, USA
| | - Akshay Shekhar
- Regeneron Pharmaceuticals, Inc. Biotechnology, 777 Old Saw Mill River Road, Tarrytown, NY, 10591 USA
| | - Alex Choy
- Icahn Medical Institute at Mount Sinai, 1 Gustave L. Levy Place, New York, NY 10029, USA
| | - Sojin Y. Wass
- Department of Cardiovascular & Metabolic Sciences; Department of Cardiovascular Medicine, Cleveland Clinic, 9500 Euclid Avenue, Cleveland, OH 44195, USA
| | - David R. Van Wagoner
- Department of Cardiovascular & Metabolic Sciences; Department of Cardiovascular Medicine, Cleveland Clinic, 9500 Euclid Avenue, Cleveland, OH 44195, USA
| | - Mina K. Chung
- Department of Cardiovascular & Metabolic Sciences; Department of Cardiovascular Medicine, Cleveland Clinic, 9500 Euclid Avenue, Cleveland, OH 44195, USA
| | - David S. Park
- The Leon H. Charney Division of Cardiology, New York University Grossman School of Medicine, 435 E 30 Street, Science Building 723, New York, New York 10016, USA
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19
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Van Wagoner DR. Atrial fibrillation risk: Can we see it now? Trends Cardiovasc Med 2021; 32:32-33. [PMID: 33516821 DOI: 10.1016/j.tcm.2021.01.005] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/21/2021] [Accepted: 01/23/2021] [Indexed: 11/26/2022]
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20
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May AM, Wang L, Kwon DH, Van Wagoner DR, Chung MK, Dalton JE, Mehra R. Sleep apnea screening instrument evaluation and novel model development and validation in the paroxysmal atrial fibrillation population. Int J Cardiol Heart Vasc 2020; 31:100624. [PMID: 33364332 PMCID: PMC7752750 DOI: 10.1016/j.ijcha.2020.100624] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/11/2020] [Revised: 08/12/2020] [Accepted: 08/19/2020] [Indexed: 12/27/2022]
Abstract
Standard sleep apnea (SA) screening instruments perform suboptimally in the atrial fibrillation (AF) population. We evaluated and optimized common OSA screening tools in the AF population. Participants of the Sleep Apnea and Atrial Fibrillation Biomarkers and Electrophysiologic Atrial Triggers (SAFEBEAT, NCT02576587) age (±5 years)-, sex-, body mass index (BMI ± 5 kg/m2)-matched case control study (n = 150 each group) completed concurrent questionnaires and overnight polysomnography. Models based on STOP, STOP-BANG, Berlin, NoSAS and Epworth Sleepiness Scale and also models with STOP-BANG predictors with resting heart rate or left atrial volume were constructed. “Best subset” analysis was used to select a predictor subset for evaluation. We assessed test performance for two outcome thresholds: apnea-hypopnea index (AHI) ≥ 5 and AHI ≥ 15. Paroxysmal AF participants were: 61.3 ± 12.1 years, BMI = 31.2 ± 6.6 kg/m2 with median AHI = 11.8(IQR: 3.8, 24.5); 65 (43.3%) with AHI ≥ 15. Only STOP and STOP-BANG did not perform worse in AF relative to controls. For AHI ≥ 15, STOP-BANG (AUC 0.71, 95%CI:0.55–0.85) did not perform as well as NABS – a composite of neck circumference, age, and BMI as continuous variables and snoring (AUC 0.88, 95%CI:0.76–0.96). Optimal model for AHI ≥ 15 was NABS (sensitivity = 45%, specificity = 97%). For AHI ≥ 5, NABS was also the best performing (AUC 0.82, 95%CI:0.68–0.92, sensitivity = 78%, specificity = 67%). We identify a novel, short-item SA screening instrument for use in paroxysmal AF, i.e. NABS, with improved discriminative ability compared to commonly-used instruments. Further validation studies are needed to assess utility in other AF subtypes. Trial registration: clinicaltrials.gov NCT02576587.
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Affiliation(s)
- Anna M May
- Sleep Medicine Section, VA Northeast Ohio Healthcare System, Cleveland, OH, United States.,Research Section, VA Northeast Ohio Healthcare System, Cleveland, OH, United States.,Division of Pulmonary, Critical Care, & Sleep Medicine. University Hospitals Cleveland Medical Center, Cleveland, OH, United States.,Case Western Reserve University School of Medicine, Cleveland, OH, United States
| | - Lu Wang
- Department of Quantitative Heath Sciences, Lerner Research Institute, Cleveland Clinic, Cleveland, OH, United States
| | - Deborah H Kwon
- Department of Cardiovascular Medicine, Cleveland Clinic Lerner College of Medicine of Case Western Reserve University, Cleveland, OH, United States
| | - David R Van Wagoner
- Department of Cardiovascular & Metabolic Science, Lerner Research Institute, Cleveland Clinic Lerner College of Medicine of Case Western Reserve University, Cleveland, OH, United States
| | - Mina K Chung
- Department of Cardiovascular Medicine, Cleveland Clinic Lerner College of Medicine of Case Western Reserve University, Cleveland, OH, United States.,Department of Cardiovascular & Metabolic Science, Lerner Research Institute, Cleveland Clinic Lerner College of Medicine of Case Western Reserve University, Cleveland, OH, United States
| | - Jarrod E Dalton
- Department of Quantitative Heath Sciences, Lerner Research Institute, Cleveland Clinic, Cleveland, OH, United States
| | - Reena Mehra
- Sleep Disorders Center, Neurologic Institute, Cleveland Clinic Lerner College of Medicine of Case Western Reserve University, Cleveland, OH, United States
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21
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Harwood SJ, Barnard J, Sun H, McCurry KR, Okamoto T, SMITH JD, Van Wagoner DR, Chung MK. Abstract 262: Regional Transcriptomics of Left Atrial Cardiac Tissue in a Patient With Atrial Fibrillation. Circ Res 2020. [DOI: 10.1161/res.127.suppl_1.262] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
Background:
Common genetic variants and inflammatory factors are associated with atrial fibrillation (AF) risk. Although the top AF risk locus is near
PITX2
(associated with pulmonary vein (PV) development), regional differential expression (DE) of AF risk genes in the left atrium (LA) and PVs is not well studied. While LAA and PV gene expression have been compared, transcriptome mapping of the entire LA has not been done. We tested the hypothesis that there is significant regional DE in LA structures.
Methods:
RNAseq was performed in 25 regions within the PVs (n=12), LA body (LAB) (n=10), and LA appendage (LAA) (n=3) from a 75 year old male with hypertension and AF who died of a stroke. DE analysis of regional clusters (R 3.6
Limma
package) and gene set enrichment analysis (GSEA) (Broad Institute) were performed.
Results:
In full transcriptome (n=20664) sequencing, 118 genes were significantly (q < 0.05) upregulated in the LAA, including
FOSB
(fold change [FC] 67.0),
IL6
(FC 15.4),
TNF
(FC 2.4) and
NLRP3
(FC 2.4), and 56 downregulated, including developmental genes such as
SHOX2
(FC -12.9) and
HOXA4
(FC -4.1). LAA GSEA showed enrichment (FDR < 0.05) of inflammatory response genes and TNF-α, IL-2, IL-6, and IgG signaling pathways. 2454 genes were significantly upregulated and 3737 downregulated in the PVs while 4021 genes were upregulated and 2998 were downregulated in the LAB. In an AF implicated gene set (n=190), 28 genes were upregulated in the PVs, including
SIRT1
(FC 1.7), and 31 downregulated, including
PMNT
(FC -2.1) and
CGA
(FC -3.2).
NEURL1
was significantly upregulated in the inferior PV (n=4) compared to the superior PV (n=8) (FC 3.6). In the LAB, 33 genes were upregulated, including
MYH7
(FC 2.2)
and PMNT
(FC 2.1)
,
and 38 downregulated including
SIRT1
(FC -1.9).
PITX2
did not show any significant DE in any gene set.
Conclusions:
This data shows that genes involved in AF pathogenesis can have substantial regional expression difference, particularly when comparing the LA body, PVs, and LAA. Inflammatory activation in the LAA may contribute to increased stroke risk.
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Affiliation(s)
| | | | - Han Sun
- Cleveland Clinic, Cleveland, OH
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22
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Van Wagoner DR. Pitfalls and potential for the use of computational modelling to guide the treatment of atrial fibrillation. J Physiol 2020; 598:3541-3542. [PMID: 32589261 DOI: 10.1113/jp280261] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/15/2020] [Accepted: 06/17/2020] [Indexed: 11/08/2022] Open
Affiliation(s)
- David R Van Wagoner
- Department of Cardiovascular & Metabolic Sciences, Lerner Research Institute, Cleveland Clinic, 9500 Euclid Avenue, Cleveland, OH, 44195
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23
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Van Wagoner DR. Paracrine Signals Modulate Atrial Epicardial Progenitor Cells and Development of Subepicardial Adiposity and Fibrosis Implications for Atrial Fibrillation. Circ Res 2020; 126:1343-1345. [PMID: 32379572 DOI: 10.1161/circresaha.120.317007] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/29/2022]
Affiliation(s)
- David R Van Wagoner
- From the Department of Cardiovascular and Metabolic Sciences, Cleveland Clinic, OH
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24
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Shoemaker MB, Husser D, Roselli C, Al Jazairi M, Chrispin J, Kühne M, Neumann B, Knight S, Sun H, Mohanty S, Shaffer C, Thériault S, Rinke LL, Siland JE, Crawford DM, Ueberham L, Zardkoohi O, Büttner P, Geelhoed B, Blum S, Aeschbacher S, Smith JD, Van Wagoner DR, Freudling R, Müller-Nurasyid M, Montgomery J, Yoneda Z, Wells Q, Issa T, Weeke P, Jacobs V, Van Gelder IC, Hindricks G, Barnard J, Calkins H, Darbar D, Michaud G, Kääb S, Ellinor P, Natale A, Chung M, Nazarian S, Cutler MJ, Sinner MF, Conen D, Rienstra M, Bollmann A, Roden DM, Lubitz S. Genetic Susceptibility for Atrial Fibrillation in Patients Undergoing Atrial Fibrillation Ablation. Circ Arrhythm Electrophysiol 2020; 13:e007676. [PMID: 32078373 DOI: 10.1161/circep.119.007676] [Citation(s) in RCA: 13] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
BACKGROUND Ablation is a widely used therapy for atrial fibrillation (AF); however, arrhythmia recurrence and repeat procedures are common. Studies examining surrogate markers of genetic susceptibility to AF, such as family history and individual AF susceptibility alleles, suggest these may be associated with recurrence outcomes. Accordingly, the aim of this study was to test the association between AF genetic susceptibility and recurrence after ablation using a comprehensive polygenic risk score for AF. METHODS Ten centers from the AF Genetics Consortium identified patients who had undergone de novo AF ablation. AF genetic susceptibility was measured using a previously described polygenic risk score (N=929 single-nucleotide polymorphisms) and tested for an association with clinical characteristics and time-to-recurrence with a 3 month blanking period. Recurrence was defined as >30 seconds of AF, atrial flutter, or atrial tachycardia. Multivariable analysis adjusted for age, sex, height, body mass index, persistent AF, hypertension, coronary disease, left atrial size, left ventricular ejection fraction, and year of ablation. RESULTS Four thousand two hundred seventy-six patients were eligible for analysis of baseline characteristics and 3259 for recurrence outcomes. The overall arrhythmia recurrence rate between 3 and 12 months was 44% (1443/3259). Patients with higher AF genetic susceptibility were younger (P<0.001) and had fewer clinical risk factors for AF (P=0.001). Persistent AF (hazard ratio [HR], 1.39 [95% CI, 1.22-1.58]; P<0.001), left atrial size (per cm: HR, 1.32 [95% CI, 1.19-1.46]; P<0.001), and left ventricular ejection fraction (per 10%: HR, 0.88 [95% CI, 0.80-0.97]; P=0.008) were associated with increased risk of recurrence. In univariate analysis, higher AF genetic susceptibility trended towards a higher risk of recurrence (HR, 1.08 [95% CI, 0.99-1.18]; P=0.07), which became less significant in multivariable analysis (HR, 1.06 [95% CI, 0.98-1.15]; P=0.13). CONCLUSIONS Higher AF genetic susceptibility was associated with younger age and fewer clinical risk factors but not recurrence. Arrhythmia recurrence after AF ablation may represent a genetically different phenotype compared to AF susceptibility.
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Affiliation(s)
- M Benjamin Shoemaker
- Department of Medicine, Vanderbilt University Medical Center, Nashville, TN (M.B.S., C.S., L.L.R., D.M.C., J.M., Z.Y., Q.W., T.I., P.W., G.M.)
| | - Daniela Husser
- Heart Center Leipzig, Department of Electrophysiology, Leipzig Heart Institute, University of Leipzig, Germany (D.H., L.U., P.B., G.H., A.B.)
| | - Carolina Roselli
- Program in Medical and Population Genetics, The Broad Institute of MIT and Harvard, Program in Medical and Population Genetics, Cambridge, MA (C.R., P.E., S.L.)
| | - Meelad Al Jazairi
- Department of Cardiology, University of Groningen, University Medical Center Groningen, the Netherlands (M.A.J., J.E.S., B.G., I.C.V.G., M.R.)
| | - Jonathan Chrispin
- Division of Cardiology, Department of Medicine, Johns Hopkins University School of Medicine, Baltimore, MD (J.C., H.C.)
| | - Michael Kühne
- University Hospital Basel, Switzerland (M.K., S.B., S.A., D.C.).,Cardiovascular Research Institute Basel, University Hospital Basel, Switzerland (M.K., S.B., S.A., D.C.)
| | - Benjamin Neumann
- Department of Medicine, University Hospital Munich, Ludwig Maximilians University of Munich, Germany (B.N., R.F., S. Kääb, M.F.S.)
| | - Stacey Knight
- Intermountain Heart Institute, Intermountain Medical Center, Murray (S. Knight, V.J.).,Department of Medicine, University of Utah, Salt Lake City (S. Knight)
| | - Han Sun
- Department of Quantitative Health Sciences (H.S., J.B.), Lerner Research Institute, Cleveland Clinic, OH
| | - Sanghamitra Mohanty
- Texas Cardiac Arrhythmia Institute, Austin, TX (S.M., A.N.).,Department of Internal Medicine, Dell Medical School, Austin, TX (S.M., A.N.)
| | - Christian Shaffer
- Department of Medicine, Vanderbilt University Medical Center, Nashville, TN (M.B.S., C.S., L.L.R., D.M.C., J.M., Z.Y., Q.W., T.I., P.W., G.M.)
| | - Sébastien Thériault
- Population Health Research Institute, McMaster University, Hamilton, ON, Canada (S.T., D.C.).,Department of Molecular Biology, Medical Biochemistry and Pathology, Laval University, Quebec City, Canada (S.T.)
| | - Lauren Lee Rinke
- Department of Medicine, Vanderbilt University Medical Center, Nashville, TN (M.B.S., C.S., L.L.R., D.M.C., J.M., Z.Y., Q.W., T.I., P.W., G.M.)
| | - Joylene E Siland
- Department of Cardiology, University of Groningen, University Medical Center Groningen, the Netherlands (M.A.J., J.E.S., B.G., I.C.V.G., M.R.)
| | - Diane M Crawford
- Department of Medicine, Vanderbilt University Medical Center, Nashville, TN (M.B.S., C.S., L.L.R., D.M.C., J.M., Z.Y., Q.W., T.I., P.W., G.M.)
| | - Laura Ueberham
- Heart Center Leipzig, Department of Electrophysiology, Leipzig Heart Institute, University of Leipzig, Germany (D.H., L.U., P.B., G.H., A.B.)
| | - Omeed Zardkoohi
- Departments of Cardiovascular Medicine and Molecular Cardiology, Heart and Vascular Institute (O.Z., M.C.), Lerner Research Institute, Cleveland Clinic, OH
| | - Petra Büttner
- Heart Center Leipzig, Department of Electrophysiology, Leipzig Heart Institute, University of Leipzig, Germany (D.H., L.U., P.B., G.H., A.B.)
| | - Bastiaan Geelhoed
- Department of Cardiology, University of Groningen, University Medical Center Groningen, the Netherlands (M.A.J., J.E.S., B.G., I.C.V.G., M.R.)
| | - Steffen Blum
- University Hospital Basel, Switzerland (M.K., S.B., S.A., D.C.).,Cardiovascular Research Institute Basel, University Hospital Basel, Switzerland (M.K., S.B., S.A., D.C.)
| | - Stefanie Aeschbacher
- University Hospital Basel, Switzerland (M.K., S.B., S.A., D.C.).,Cardiovascular Research Institute Basel, University Hospital Basel, Switzerland (M.K., S.B., S.A., D.C.)
| | - Jonathan D Smith
- Department of Cellular and Molecular Medicine (J.D.S.), Lerner Research Institute, Cleveland Clinic, OH
| | - David R Van Wagoner
- Department of Molecular Cardiology (D.R.V.W.), Lerner Research Institute, Cleveland Clinic, OH
| | - Rebecca Freudling
- Department of Medicine, University Hospital Munich, Ludwig Maximilians University of Munich, Germany (B.N., R.F., S. Kääb, M.F.S.).,Institute of Genetic Epidemiology, Helmholtz Zentrum München, Neuherberg (R.F., M.M.-N.)
| | - Martina Müller-Nurasyid
- Institute of Genetic Epidemiology, Helmholtz Zentrum München, Neuherberg (R.F., M.M.-N.).,German Centre for Cardiovascular Research (DZHK), partner site: Munich Heart Alliance, Germany (M.M.-N., S. Kääb, M.F.S.)
| | - Jay Montgomery
- Department of Medicine, Vanderbilt University Medical Center, Nashville, TN (M.B.S., C.S., L.L.R., D.M.C., J.M., Z.Y., Q.W., T.I., P.W., G.M.)
| | - Zachary Yoneda
- Department of Medicine, Vanderbilt University Medical Center, Nashville, TN (M.B.S., C.S., L.L.R., D.M.C., J.M., Z.Y., Q.W., T.I., P.W., G.M.)
| | - Quinn Wells
- Department of Medicine, Vanderbilt University Medical Center, Nashville, TN (M.B.S., C.S., L.L.R., D.M.C., J.M., Z.Y., Q.W., T.I., P.W., G.M.)
| | - Tariq Issa
- Department of Medicine, Vanderbilt University Medical Center, Nashville, TN (M.B.S., C.S., L.L.R., D.M.C., J.M., Z.Y., Q.W., T.I., P.W., G.M.)
| | - Peter Weeke
- Department of Medicine, Vanderbilt University Medical Center, Nashville, TN (M.B.S., C.S., L.L.R., D.M.C., J.M., Z.Y., Q.W., T.I., P.W., G.M.)
| | - Victoria Jacobs
- Intermountain Heart Institute, Intermountain Medical Center, Murray (S. Knight, V.J.)
| | - Isabelle C Van Gelder
- Department of Cardiology, University of Groningen, University Medical Center Groningen, the Netherlands (M.A.J., J.E.S., B.G., I.C.V.G., M.R.)
| | - Gerhard Hindricks
- Heart Center Leipzig, Department of Electrophysiology, Leipzig Heart Institute, University of Leipzig, Germany (D.H., L.U., P.B., G.H., A.B.)
| | - John Barnard
- Department of Quantitative Health Sciences (H.S., J.B.), Lerner Research Institute, Cleveland Clinic, OH
| | - Hugh Calkins
- Division of Cardiology, Department of Medicine, Johns Hopkins University School of Medicine, Baltimore, MD (J.C., H.C.)
| | - Dawood Darbar
- Division of Cardiology, Department of Medicine, University of Illinois Health, Chicago (D.D.)
| | - Greg Michaud
- Department of Medicine, Vanderbilt University Medical Center, Nashville, TN (M.B.S., C.S., L.L.R., D.M.C., J.M., Z.Y., Q.W., T.I., P.W., G.M.)
| | - Stefan Kääb
- Department of Medicine, University Hospital Munich, Ludwig Maximilians University of Munich, Germany (B.N., R.F., S. Kääb, M.F.S.).,German Centre for Cardiovascular Research (DZHK), partner site: Munich Heart Alliance, Germany (M.M.-N., S. Kääb, M.F.S.)
| | - Patrick Ellinor
- Program in Medical and Population Genetics, The Broad Institute of MIT and Harvard, Program in Medical and Population Genetics, Cambridge, MA (C.R., P.E., S.L.).,Massachusetts General Hospital, Cardiac Arrhythmia Service, Boston (P.E., S.L.)
| | - Andrea Natale
- Texas Cardiac Arrhythmia Institute, Austin, TX (S.M., A.N.).,Department of Internal Medicine, Dell Medical School, Austin, TX (S.M., A.N.).,Scripps Clinic, Interventional Electrophysiology, San Diego, CA (A.N.).,Division of Cardiology, Stanford University, Palo Alto, CA (A.N.).,Case Western University, Cleveland, OH (A.N.)
| | - Mina Chung
- Departments of Cardiovascular Medicine and Molecular Cardiology, Heart and Vascular Institute (O.Z., M.C.), Lerner Research Institute, Cleveland Clinic, OH
| | - Saman Nazarian
- Division of Cardiology, University of Pennsylvania Perelman School of Medicine, Philadelphia (S.N.)
| | - Michael J Cutler
- Intermountain Heart Institute, Intermountain Medical Center, Murray, UT (M.J.C.)
| | - Moritz F Sinner
- Department of Medicine, University Hospital Munich, Ludwig Maximilians University of Munich, Germany (B.N., R.F., S. Kääb, M.F.S.).,German Centre for Cardiovascular Research (DZHK), partner site: Munich Heart Alliance, Germany (M.M.-N., S. Kääb, M.F.S.)
| | - David Conen
- University Hospital Basel, Switzerland (M.K., S.B., S.A., D.C.).,Cardiovascular Research Institute Basel, University Hospital Basel, Switzerland (M.K., S.B., S.A., D.C.).,Population Health Research Institute, McMaster University, Hamilton, ON, Canada (S.T., D.C.)
| | - Michiel Rienstra
- Department of Cardiology, University of Groningen, University Medical Center Groningen, the Netherlands (M.A.J., J.E.S., B.G., I.C.V.G., M.R.)
| | - Andreas Bollmann
- Heart Center Leipzig, Department of Electrophysiology, Leipzig Heart Institute, University of Leipzig, Germany (D.H., L.U., P.B., G.H., A.B.)
| | - Dan M Roden
- Animal, Dairy, and Veterinary Sciences, Utah State University, Logan (D.M.R.)
| | - Steven Lubitz
- Program in Medical and Population Genetics, The Broad Institute of MIT and Harvard, Program in Medical and Population Genetics, Cambridge, MA (C.R., P.E., S.L.).,Massachusetts General Hospital, Cardiac Arrhythmia Service, Boston (P.E., S.L.)
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25
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Gore-Panter SR, Van Wagoner DR. Editorial commentary: A CRISPR approach to the study and treatment of cardiovascular disease. Trends Cardiovasc Med 2020; 30:102-103. [PMID: 31097387 PMCID: PMC8439345 DOI: 10.1016/j.tcm.2019.04.008] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/21/2019] [Accepted: 04/23/2019] [Indexed: 11/17/2022]
Affiliation(s)
- Shamone R Gore-Panter
- Dept. Biological, Geological and Environmental Sciences, Cleveland State University, 2121 Euclid Avenue, SI230, Cleveland, OH, United States.
| | - David R Van Wagoner
- Department of Cardiovascular & Metabolic Sciences, Cleveland Clinic, 9500 Euclid Avenue, M/S ND50, Cleveland, OH 44195, United States.
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26
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Affiliation(s)
- David R Van Wagoner
- Departments of Molecular Cardiology, Lerner Research Institute (D.R.V.W., M.K.C.), Cleveland Clinic, OH
| | - Mina K Chung
- Departments of Molecular Cardiology, Lerner Research Institute (D.R.V.W., M.K.C.), Cleveland Clinic, OH.,Cardiovascular Medicine, Heart and Vascular Institute (M.K.C.), Cleveland Clinic, OH
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27
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Macri V, Brody JA, Arking DE, Hucker WJ, Yin X, Lin H, Mills RW, Sinner MF, Lubitz SA, Liu CT, Morrison AC, Alonso A, Li N, Fedorov VV, Janssen PM, Bis JC, Heckbert SR, Dolmatova EV, Lumley T, Sitlani CM, Cupples LA, Pulit SL, Newton-Cheh C, Barnard J, Smith JD, Van Wagoner DR, Chung MK, Vlahakes GJ, O'Donnell CJ, Rotter JI, Margulies KB, Morley MP, Cappola TP, Benjamin EJ, Muzny D, Gibbs RA, Jackson RD, Magnani JW, Herndon CN, Rich SS, Psaty BM, Milan DJ, Boerwinkle E, Mohler PJ, Sotoodehnia N, Ellinor PT. Common Coding Variants in SCN10A Are Associated With the Nav1.8 Late Current and Cardiac Conduction. Circ Genom Precis Med 2019; 11:e001663. [PMID: 29752399 DOI: 10.1161/circgen.116.001663] [Citation(s) in RCA: 22] [Impact Index Per Article: 4.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/17/2016] [Accepted: 03/02/2018] [Indexed: 12/20/2022]
Abstract
BACKGROUND Genetic variants at the SCN5A/SCN10A locus are strongly associated with electrocardiographic PR and QRS intervals. While SCN5A is the canonical cardiac sodium channel gene, the role of SCN10A in cardiac conduction is less well characterized. METHODS We sequenced the SCN10A locus in 3699 European-ancestry individuals to identify variants associated with cardiac conduction, and replicated our findings in 21,000 individuals of European ancestry. We examined association with expression in human atrial tissue. We explored the biophysical effect of variation on channel function using cellular electrophysiology. RESULTS We identified 2 intronic single nucleotide polymorphisms in high linkage disequilibrium (r 2=0.86) with each other to be the strongest signals for PR (rs10428132, β=-4.74, P=1.52×10-14) and QRS intervals (rs6599251, QRS β=-0.73; P=1.2×10-4), respectively. Although these variants were not associated with SCN5A or SCN10A expression in human atrial tissue (n=490), they were in high linkage disequilibrium (r 2≥0.72) with a common SCN10A missense variant, rs6795970 (V1073A). In total, we identified 7 missense variants, 4 of which (I962V, P1045T, V1073A, and L1092P) were associated with cardiac conduction. These 4 missense variants cluster in the cytoplasmic linker of the second and third domains of the SCN10A protein and together form 6 common haplotypes. Using cellular electrophysiology, we found that haplotypes associated with shorter PR intervals had a significantly larger percentage of late current compared with wild-type (I962V+V1073A+L1092P, 20.2±3.3%, P=0.03, and I962V+V1073A, 22.4±0.8%, P=0.0004 versus wild-type 11.7±1.6%), and the haplotype associated with the longest PR interval had a significantly smaller late current percentage (P1045T, 6.4±1.2%, P=0.03). CONCLUSIONS Our findings suggest an association between genetic variation in SCN10A, the late sodium current, and alterations in cardiac conduction.
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Affiliation(s)
- Vincenzo Macri
- Cardiovascular Research Center, Massachusetts General Hospital, Charlestown (V.M., W.J.H., R.W.M., S.A.L., E.V.D., S.L.P., C.N.-C., D.J.M., P.T.E.)
| | - Jennifer A Brody
- Cardiovascular Health Research Unit, Department of Medicine (J.A.B., J.C.B., S.R.H., C.M.S., N.S.)
| | - Dan E Arking
- University of Washington, Seattle. McKusick-Nathans Institute of Genetic Medicine, Johns Hopkins University School of Medicine, Baltimore, MD (D.E.A.)
| | - William J Hucker
- Cardiovascular Research Center, Massachusetts General Hospital, Charlestown (V.M., W.J.H., R.W.M., S.A.L., E.V.D., S.L.P., C.N.-C., D.J.M., P.T.E.).,Cardiac Arrhythmia Service (W.J.H., S.A.L., D.J.M., P.T.E.)
| | - Xiaoyan Yin
- Massachusetts General Hospital, Boston. NHLBI's & Boston University's Framingham Heart Study, MA (X.Y., H.L., L.A.C.).,Department of Biostatistics (X.Y., L.A.C., C.-T.L.)
| | - Honghuang Lin
- Massachusetts General Hospital, Boston. NHLBI's & Boston University's Framingham Heart Study, MA (X.Y., H.L., L.A.C.).,School of Public Health, Boston University, MA. Computational Biomedicine Section (H.L.)
| | - Robert W Mills
- Cardiovascular Research Center, Massachusetts General Hospital, Charlestown (V.M., W.J.H., R.W.M., S.A.L., E.V.D., S.L.P., C.N.-C., D.J.M., P.T.E.)
| | - Moritz F Sinner
- Department of Medicine, Boston University School of Medicine, MA. German Centre for Cardiovascular Research (DZHK), partner site: Munich Heart Alliance, Germany and Department of Medicine I, University Hospital Munich, Ludwig-Maximilian's University, Munich, Germany (M.F.S.)
| | - Steven A Lubitz
- Cardiovascular Research Center, Massachusetts General Hospital, Charlestown (V.M., W.J.H., R.W.M., S.A.L., E.V.D., S.L.P., C.N.-C., D.J.M., P.T.E.).,Cardiac Arrhythmia Service (W.J.H., S.A.L., D.J.M., P.T.E.)
| | - Ching-Ti Liu
- Department of Biostatistics (X.Y., L.A.C., C.-T.L.)
| | - Alanna C Morrison
- Human Genetics Center, University of Texas Health Science Center at Houston (A.C.M., E.B.)
| | - Alvaro Alonso
- Department of Epidemiology, Rollins School of Public Health, Emory University, Atlanta, GA (A.A.)
| | - Ning Li
- Department of Physiology & Cell Biology and Davis Heart & Lung Research Institute, The Ohio State University Wexner Medical Center, Columbus (N.L., V.V.F., P.M.J., P.J.M.)
| | - Vadim V Fedorov
- Department of Physiology & Cell Biology and Davis Heart & Lung Research Institute, The Ohio State University Wexner Medical Center, Columbus (N.L., V.V.F., P.M.J., P.J.M.)
| | - Paul M Janssen
- Department of Physiology & Cell Biology and Davis Heart & Lung Research Institute, The Ohio State University Wexner Medical Center, Columbus (N.L., V.V.F., P.M.J., P.J.M.)
| | - Joshua C Bis
- Cardiovascular Health Research Unit, Department of Medicine (J.A.B., J.C.B., S.R.H., C.M.S., N.S.)
| | - Susan R Heckbert
- Cardiovascular Health Research Unit, Department of Medicine (J.A.B., J.C.B., S.R.H., C.M.S., N.S.).,Department of Epidemiology (S.R.H., T.L.)
| | - Elena V Dolmatova
- Cardiovascular Research Center, Massachusetts General Hospital, Charlestown (V.M., W.J.H., R.W.M., S.A.L., E.V.D., S.L.P., C.N.-C., D.J.M., P.T.E.)
| | | | - Colleen M Sitlani
- Cardiovascular Health Research Unit, Department of Medicine (J.A.B., J.C.B., S.R.H., C.M.S., N.S.)
| | - L Adrienne Cupples
- Massachusetts General Hospital, Boston. NHLBI's & Boston University's Framingham Heart Study, MA (X.Y., H.L., L.A.C.).,Department of Biostatistics (X.Y., L.A.C., C.-T.L.)
| | - Sara L Pulit
- Cardiovascular Research Center, Massachusetts General Hospital, Charlestown (V.M., W.J.H., R.W.M., S.A.L., E.V.D., S.L.P., C.N.-C., D.J.M., P.T.E.).,Department of Statistics, University of Auckland, New Zealand (S.L.P.)
| | - Christopher Newton-Cheh
- Cardiovascular Research Center, Massachusetts General Hospital, Charlestown (V.M., W.J.H., R.W.M., S.A.L., E.V.D., S.L.P., C.N.-C., D.J.M., P.T.E.).,Center for Genomic Medicine (C.N.-C.).,Program in Medical and Population Genetics, Broad Institute of Harvard and MIT, Cambridge, MA (C.N.-C.)
| | - John Barnard
- Department of Quantitative Health Sciences, Lerner Research Institute (J.B.)
| | - Jonathan D Smith
- Department of Cardiovascular Medicine, Heart and Vascular Institute (J.D.S., D.R.V.W., M.K.C.).,Department of Cellular and Molecular Medicine Biology, Lerner Research Institute (J.D.S.)
| | - David R Van Wagoner
- Department of Cardiovascular Medicine, Heart and Vascular Institute (J.D.S., D.R.V.W., M.K.C.).,Department of Molecular Cardiology, Lerner Research Institute (D.R.V.W., M.K.C.)
| | - Mina K Chung
- Department of Cardiovascular Medicine, Heart and Vascular Institute (J.D.S., D.R.V.W., M.K.C.).,Department of Molecular Cardiology, Lerner Research Institute (D.R.V.W., M.K.C.)
| | | | | | - Jerome I Rotter
- Cleveland Clinic, OH. Institute for Translational Genomics and Population Sciences, Los Angeles BioMedical Research Institute & Department of Pediatrics, Harbor-UCLA Medical Center, Torrance (J.I.R.)
| | - Kenneth B Margulies
- Penn Cardiovascular Institute, Perelman School of Medicine (K.B.M., M.P.M., T.P.C.).,Department of Medicine, Perelman School of Medicine (K.B.M., M.P.M., T.P.C.)
| | - Michael P Morley
- Penn Cardiovascular Institute, Perelman School of Medicine (K.B.M., M.P.M., T.P.C.).,Department of Medicine, Perelman School of Medicine (K.B.M., M.P.M., T.P.C.)
| | - Thomas P Cappola
- Penn Cardiovascular Institute, Perelman School of Medicine (K.B.M., M.P.M., T.P.C.).,Department of Medicine, Perelman School of Medicine (K.B.M., M.P.M., T.P.C.)
| | - Emelia J Benjamin
- Department of Epidemiology (E.J.B.).,Preventive Medicine Section (E.J.B.).,Cardiology Section (E.J.B.)
| | - Donna Muzny
- University of Pennsylvania, Philadelphia. Human Genome Sequencing Center, Baylor College of Medicine, Houston, TX (D.M.M., R.A.G., E.B.)
| | - Richard A Gibbs
- University of Pennsylvania, Philadelphia. Human Genome Sequencing Center, Baylor College of Medicine, Houston, TX (D.M.M., R.A.G., E.B.)
| | - Rebecca D Jackson
- Division of Endocrinology, Diabetes and Metabolism, College of Medicine, The Ohio State University, Columbus (R.D.J.)
| | - Jared W Magnani
- Division of Cardiology, Department of Medicine, UPMC Heart and Vascular Institute (J.W.M.)
| | - Caroline N Herndon
- Program in Medical and Population Genetics, Broad Institute, Cambridge, MA (C.N.H., P.T.E.)
| | - Stephen S Rich
- Center for Public Health Genomics, University of Virginia, Charlottesville (S.S.R.)
| | - Bruce M Psaty
- Cardiovascular Health Research Unit, Departments of Medicine, Epidemiology and Health Services, University of Washington, Seattle; and Kaiser Permanente Washington Health Research Institute, Seattle, WA. (B.M.P.)
| | - David J Milan
- Cardiovascular Research Center, Massachusetts General Hospital, Charlestown (V.M., W.J.H., R.W.M., S.A.L., E.V.D., S.L.P., C.N.-C., D.J.M., P.T.E.).,Cardiac Arrhythmia Service (W.J.H., S.A.L., D.J.M., P.T.E.)
| | - Eric Boerwinkle
- Human Genetics Center, University of Texas Health Science Center at Houston (A.C.M., E.B.).,University of Pennsylvania, Philadelphia. Human Genome Sequencing Center, Baylor College of Medicine, Houston, TX (D.M.M., R.A.G., E.B.)
| | - Peter J Mohler
- Department of Physiology & Cell Biology and Davis Heart & Lung Research Institute, The Ohio State University Wexner Medical Center, Columbus (N.L., V.V.F., P.M.J., P.J.M.)
| | - Nona Sotoodehnia
- Cardiovascular Health Research Unit, Department of Medicine (J.A.B., J.C.B., S.R.H., C.M.S., N.S.) .,Division of Cardiology (N.S.)
| | - Patrick T Ellinor
- Cardiovascular Research Center, Massachusetts General Hospital, Charlestown (V.M., W.J.H., R.W.M., S.A.L., E.V.D., S.L.P., C.N.-C., D.J.M., P.T.E.).,Cardiac Arrhythmia Service (W.J.H., S.A.L., D.J.M., P.T.E.).,Program in Medical and Population Genetics, Broad Institute, Cambridge, MA (C.N.H., P.T.E.)
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28
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Choi SH, Lu-Chen W, Roselli C, Lin H, Haggerty CM, Shoemaker MB, Barnard J, Arking DE, Chasman DI, Albert CM, Chaffin M, Tucker NR, Smith JD, Gupta N, Gabriel S, Margolin L, Shea MA, Shaffer CM, Yoneda ZT, Boerwinkle E, Smith NL, Silverman EK, Redline S, Vasan RS, Burchard EG, Gogarten SM, Laurie C, Blackwell TW, Abecasis G, Carey DJ, Fornwalt BK, Smelser DT, Baras A, Dewey FE, Jaquish CE, Papanicolaou GJ, Sotoodehnia N, Van Wagoner DR, Psaty BM, Kathiresan S, Darbar D, Alonso A, Heckbert SR, Chung MK, Roden DM, Benjamin EJ, Murray MF, Lunetta KL, Lubitz SA, Ellinor PT. Association Between Titin Loss-of-Function Variants and Early-Onset Atrial Fibrillation. JAMA 2018; 320:2354-2364. [PMID: 30535219 PMCID: PMC6436530 DOI: 10.1001/jama.2018.18179] [Citation(s) in RCA: 132] [Impact Index Per Article: 22.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/16/2022]
Abstract
IMPORTANCE Atrial fibrillation (AF) is the most common arrhythmia affecting 1% of the population. Young individuals with AF have a strong genetic association with the disease, but the mechanisms remain incompletely understood. OBJECTIVE To perform large-scale whole-genome sequencing to identify genetic variants related to AF. DESIGN, SETTING, AND PARTICIPANTS The National Heart, Lung, and Blood Institute's Trans-Omics for Precision Medicine Program includes longitudinal and cohort studies that underwent high-depth whole-genome sequencing between 2014 and 2017 in 18 526 individuals from the United States, Mexico, Puerto Rico, Costa Rica, Barbados, and Samoa. This case-control study included 2781 patients with early-onset AF from 9 studies and identified 4959 controls of European ancestry from the remaining participants. Results were replicated in the UK Biobank (346 546 participants) and the MyCode Study (42 782 participants). EXPOSURES Loss-of-function (LOF) variants in genes at AF loci and common genetic variation across the whole genome. MAIN OUTCOMES AND MEASURES Early-onset AF (defined as AF onset in persons <66 years of age). Due to multiple testing, the significance threshold for the rare variant analysis was P = 4.55 × 10-3. RESULTS Among 2781 participants with early-onset AF (the case group), 72.1% were men, and the mean (SD) age of AF onset was 48.7 (10.2) years. Participants underwent whole-genome sequencing at a mean depth of 37.8 fold and mean genome coverage of 99.1%. At least 1 LOF variant in TTN, the gene encoding the sarcomeric protein titin, was present in 2.1% of case participants compared with 1.1% in control participants (odds ratio [OR], 1.76 [95% CI, 1.04-2.97]). The proportion of individuals with early-onset AF who carried a LOF variant in TTN increased with an earlier age of AF onset (P value for trend, 4.92 × 10-4), and 6.5% of individuals with AF onset prior to age 30 carried a TTN LOF variant (OR, 5.94 [95% CI, 2.64-13.35]; P = 1.65 × 10-5). The association between TTN LOF variants and AF was replicated in an independent study of 1582 patients with early-onset AF (cases) and 41 200 control participants (OR, 2.16 [95% CI, 1.19-3.92]; P = .01). CONCLUSIONS AND RELEVANCE In a case-control study, there was a statistically significant association between an LOF variant in the TTN gene and early-onset AF, with the variant present in a small percentage of participants with early-onset AF (the case group). Further research is necessary to understand whether this is a causal relationship.
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Affiliation(s)
- Seung Hoan Choi
- Program in Medical and Population Genetics, The Broad Institute of MIT and Harvard, Cambridge, MA, USA
| | - Weng Lu-Chen
- Program in Medical and Population Genetics, The Broad Institute of MIT and Harvard, Cambridge, MA, USA
- Cardiovascular Research Center, Massachusetts General Hospital, Boston, MA, USA
| | - Carolina Roselli
- Program in Medical and Population Genetics, The Broad Institute of MIT and Harvard, Cambridge, MA, USA
| | - Honghuang Lin
- NHLBI and Boston University’s Framingham Heart Study, Framingham, MA, USA
- Section of Computational Biomedicine, Department of Medicine, Boston University School of Medicine, Boston, MA, USA
| | | | - M. Benjamin Shoemaker
- Departments of Medicine, Pharmacology, and Biomedical Informatics, Vanderbilt University Medical Center, Nashville, TN, USA
| | - John Barnard
- Departments of Quantitative Health Sciences, Cleveland Clinic, Cleveland, OH, USA
| | - Dan E. Arking
- McKusick-Nathans Institute of Genetic Medicine, Johns Hopkins University School of Medicine, Baltimore, MD, USA
| | - Daniel I. Chasman
- Program in Medical and Population Genetics, The Broad Institute of MIT and Harvard, Cambridge, MA, USA
- Divisions of Preventive Medicine and Genetics, Brigham and Women’s Hospital & Harvard Medical School, Boston, MA, USA
| | - Christine M. Albert
- Divisions of Preventive and Cardiovascular Medicine, Brigham and Women’s Hospital & Harvard Medical School, Boston, MA, USA
| | - Mark Chaffin
- Program in Medical and Population Genetics, The Broad Institute of MIT and Harvard, Cambridge, MA, USA
| | - Nathan R. Tucker
- Program in Medical and Population Genetics, The Broad Institute of MIT and Harvard, Cambridge, MA, USA
- Cardiovascular Research Center, Massachusetts General Hospital, Boston, MA, USA
| | - Jonathan D. Smith
- Departments of Cellular and Molecular Medicine, Cleveland Clinic, Cleveland, OH, USA
| | - Namrata Gupta
- Program in Medical and Population Genetics, The Broad Institute of MIT and Harvard, Cambridge, MA, USA
| | - Stacey Gabriel
- Program in Medical and Population Genetics, The Broad Institute of MIT and Harvard, Cambridge, MA, USA
| | - Lauren Margolin
- Program in Medical and Population Genetics, The Broad Institute of MIT and Harvard, Cambridge, MA, USA
| | - Marisa A. Shea
- Cardiovascular Research Center, Massachusetts General Hospital, Boston, MA, USA
| | - Christian M. Shaffer
- Departments of Medicine, Pharmacology, and Biomedical Informatics, Vanderbilt University Medical Center, Nashville, TN, USA
| | - Zachary T. Yoneda
- Departments of Medicine, Pharmacology, and Biomedical Informatics, Vanderbilt University Medical Center, Nashville, TN, USA
| | - Eric Boerwinkle
- Human Genetics Center, Department of Epidemiology, Human Genetics and Environmental Sciences, School of Public Health, The University of Texas Health Science Center at Houston, Houston, TX, USA
| | - Nicholas L. Smith
- Department of Epidemiology and Cardiovascular Health Research Unit, University of Washington, Seattle, WA, USA
| | - Edwin K. Silverman
- Channing Division of Network Medicine, Brigham and Women’s Hospital, Harvard Medical School, Boston, MA, USA
| | - Susan Redline
- Division of Sleep and Circadian Disorders, Departments of Medicine and Neurology, Brigham and Women’s Hospital, Boston, MA, USA
| | | | - Esteban G. Burchard
- Department of Bioengineering, School of Pharmacy, University of California, San Francisco, CA, USA
| | | | - Cecelia Laurie
- Department of Biostatistics, University of Washington, Seattle, WA, USA
| | - Thomas W. Blackwell
- Center for Statistical Genetics, Department of Biostatistics, University of Michigan School of Public Health, Ann Arbor, MI, USA
| | - Gonçalo Abecasis
- Center for Statistical Genetics, Department of Biostatistics, University of Michigan School of Public Health, Ann Arbor, MI, USA
| | - David J. Carey
- Department of Molecular and Functional Genomics, Geisinger, Danville, PA, USA
| | | | - Diane T. Smelser
- Department of Molecular and Functional Genomics, Geisinger, Danville, PA, USA
| | - Aris Baras
- Regeneron Genetics Center, Tarrytown, NY, USA
| | | | - Cashell E. Jaquish
- Division of Cardiovascular Sciences, National Heart, Lung, and Blood Institute, National Institutes of Health, Bethesda, MD, USA
| | - George J. Papanicolaou
- Division of Cardiovascular Sciences, National Heart, Lung, and Blood Institute, National Institutes of Health, Bethesda, MD, USA
| | - Nona Sotoodehnia
- Cardiovascular Health Research Unit, Department of Medicine, University of Washington, Seattle, WA, USA
| | | | - Bruce M. Psaty
- Department of Epidemiology and Cardiovascular Health Research Unit, University of Washington, Seattle, WA, USA
- Cardiovascular Health Research Unit, Department of Medicine, University of Washington, Seattle, WA, USA
- Kaiser Permanente Washington Health Research Institute, Seattle, WA, USA
- Department of Health Services, University of Washington, Seattle, WA, USA
| | - Sekar Kathiresan
- Program in Medical and Population Genetics, The Broad Institute of MIT and Harvard, Cambridge, MA, USA
| | - Dawood Darbar
- Division of Cardiology, Department of Medicine, University of Illinois, Chicago, IL, USA
| | - Alvaro Alonso
- Department of Epidemiology, Rollins School of Public Health, Emory University, Atlanta, GA, USA
| | - Susan R. Heckbert
- Department of Epidemiology and Cardiovascular Health Research Unit, University of Washington, Seattle, WA, USA
- Kaiser Permanente Washington Health Research Institute, Seattle, WA, USA
| | - Mina K. Chung
- Departments of Cardiovascular Medicine, Cleveland Clinic, Cleveland, OH, USA
| | - Dan M. Roden
- Departments of Medicine, Pharmacology, and Biomedical Informatics, Vanderbilt University Medical Center, Nashville, TN, USA
| | - Emelia J. Benjamin
- NHLBI and Boston University’s Framingham Heart Study, Framingham, MA, USA
- Department of Medicine, Boston University School of Medicine, Boston, MA, USA
- Department of Epidemiology, Boston University School of Public Health, Boston, MA, USA
| | | | - Kathryn L. Lunetta
- NHLBI and Boston University’s Framingham Heart Study, Framingham, MA, USA
- Department of Biostatistics, Boston University School of Public Health, Boston, MA, USA
| | - Steven A. Lubitz
- Program in Medical and Population Genetics, The Broad Institute of MIT and Harvard, Cambridge, MA, USA
- Cardiovascular Research Center, Massachusetts General Hospital, Boston, MA, USA
- Cardiac Arrhythmia Service, Massachusetts General Hospital, Boston, MA, USA
| | - Patrick T. Ellinor
- Program in Medical and Population Genetics, The Broad Institute of MIT and Harvard, Cambridge, MA, USA
- Cardiovascular Research Center, Massachusetts General Hospital, Boston, MA, USA
- Cardiac Arrhythmia Service, Massachusetts General Hospital, Boston, MA, USA
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29
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Gorenek B, Pelliccia A, Benjamin EJ, Boriani G, Crijns HJ, Fogel RI, Van Gelder IC, Halle M, Kudaiberdieva G, Lane DA, Larsen TB, Lip GYH, Løchen ML, Marín F, Niebauer J, Sanders P, Tokgozoglu L, Vos MA, Van Wagoner DR, Fauchier L, Savelieva I, Goette A, Agewall S, Chiang CE, Figueiredo M, Stiles M, Dickfeld T, Patton K, Piepoli M, Corra U, Marques-Vidal PM, Faggiano P, Schmid JP, Abreu A. European Heart Rhythm Association (EHRA)/European Association of Cardiovascular Prevention and Rehabilitation (EACPR) position paper on how to prevent atrial fibrillation endorsed by the Heart Rhythm Society (HRS) and Asia Pacific Heart Rhythm Society (APHRS). Europace 2018; 19:190-225. [PMID: 28175283 DOI: 10.1093/europace/euw242] [Citation(s) in RCA: 38] [Impact Index Per Article: 6.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/18/2022] Open
Affiliation(s)
| | | | | | | | - Harry J Crijns
- Maastricht University Medical Centre, Maastricht, The Netherlands
| | | | | | - Martin Halle
- Prevention and Sports Medicine, Technical University Munich, München, Germany
| | | | | | | | | | - Maja-Lisa Løchen
- University of Birmingham, Birmingham, UK.,Aalborg University Hospital, Aalborg, Denmark
| | | | - Josef Niebauer
- Paracelsus Medical University Salzburg, Salzburg, Austria
| | | | | | | | | | | | | | | | | | | | | | | | | | | | | | - Ugo Corra
- Irccs Rehabilitation Medical Center, Veruno, Italy
| | | | | | | | - Ana Abreu
- Hospital de Santa Marta, Lisboa, Portugal
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30
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van Setten J, Brody JA, Jamshidi Y, Swenson BR, Butler AM, Campbell H, Del Greco FM, Evans DS, Gibson Q, Gudbjartsson DF, Kerr KF, Krijthe BP, Lyytikäinen LP, Müller C, Müller-Nurasyid M, Nolte IM, Padmanabhan S, Ritchie MD, Robino A, Smith AV, Steri M, Tanaka T, Teumer A, Trompet S, Ulivi S, Verweij N, Yin X, Arnar DO, Asselbergs FW, Bader JS, Barnard J, Bis J, Blankenberg S, Boerwinkle E, Bradford Y, Buckley BM, Chung MK, Crawford D, den Hoed M, Denny JC, Dominiczak AF, Ehret GB, Eijgelsheim M, Ellinor PT, Felix SB, Franco OH, Franke L, Harris TB, Holm H, Ilaria G, Iorio A, Kähönen M, Kolcic I, Kors JA, Lakatta EG, Launer LJ, Lin H, Lin HJ, Loos RJF, Lubitz SA, Macfarlane PW, Magnani JW, Leach IM, Meitinger T, Mitchell BD, Munzel T, Papanicolaou GJ, Peters A, Pfeufer A, Pramstaller PP, Raitakari OT, Rotter JI, Rudan I, Samani NJ, Schlessinger D, Silva Aldana CT, Sinner MF, Smith JD, Snieder H, Soliman EZ, Spector TD, Stott DJ, Strauch K, Tarasov KV, Thorsteinsdottir U, Uitterlinden AG, Van Wagoner DR, Völker U, Völzke H, Waldenberger M, Jan Westra H, Wild PS, Zeller T, Alonso A, Avery CL, Bandinelli S, Benjamin EJ, Cucca F, Dörr M, Ferrucci L, Gasparini P, Gudnason V, Hayward C, Heckbert SR, Hicks AA, Jukema JW, Kääb S, Lehtimäki T, Liu Y, Munroe PB, Parsa A, Polasek O, Psaty BM, Roden DM, Schnabel RB, Sinagra G, Stefansson K, Stricker BH, van der Harst P, van Duijn CM, Wilson JF, Gharib SA, de Bakker PIW, Isaacs A, Arking DE, Sotoodehnia N. PR interval genome-wide association meta-analysis identifies 50 loci associated with atrial and atrioventricular electrical activity. Nat Commun 2018; 9:2904. [PMID: 30046033 PMCID: PMC6060178 DOI: 10.1038/s41467-018-04766-9] [Citation(s) in RCA: 56] [Impact Index Per Article: 9.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/31/2017] [Accepted: 05/21/2018] [Indexed: 12/24/2022] Open
Abstract
Electrocardiographic PR interval measures atrio-ventricular depolarization and conduction, and abnormal PR interval is a risk factor for atrial fibrillation and heart block. Our genome-wide association study of over 92,000 European-descent individuals identifies 44 PR interval loci (34 novel). Examination of these loci reveals known and previously not-yet-reported biological processes involved in cardiac atrial electrical activity. Genes in these loci are over-represented in cardiac disease processes including heart block and atrial fibrillation. Variants in over half of the 44 loci were associated with atrial or blood transcript expression levels, or were in high linkage disequilibrium with missense variants. Six additional loci were identified either by meta-analysis of ~105,000 African and European-descent individuals and/or by pleiotropic analyses combining PR interval with heart rate, QRS interval, and atrial fibrillation. These findings implicate developmental pathways, and identify transcription factors, ion-channel genes, and cell-junction/cell-signaling proteins in atrio-ventricular conduction, identifying potential targets for drug development.
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Affiliation(s)
- Jessica van Setten
- Department of Cardiology, University Medical Center Utrecht, University of Utrecht, Utrecht, 3584CX, The Netherlands.
| | - Jennifer A Brody
- Department of Medicine, Cardiovascular Health Research Unit, University of Washington, Seattle, 98195, WA, USA
| | - Yalda Jamshidi
- Cardiogenetics Lab, Molecular and Clinical Sciences Research Institute, St George's University of London, London, SW17 0RE, UK
| | - Brenton R Swenson
- Department of Medicine, Cardiovascular Health Research Unit, University of Washington, Seattle, 98195, WA, USA
- Institute for Public Health Genetics, School of Public Health, University of Washington, Seattle, 98195, WA, USA
| | - Anne M Butler
- Division of Infectious Diseases, Washington University School of Medicine, St. Louis, 63110, MO, USA
| | - Harry Campbell
- Centre for Global Health Research, Usher Institute of Population Health Sciences and Informatics, University of Edinburgh, Edinburgh, EH8 9YL, UK
| | - Fabiola M Del Greco
- Institute for Biomedicine, Eurac Research, Affiliated Institute of the University of Lübeck, Bolzano, 39100, Italy
| | - Daniel S Evans
- California Pacific Medical Center Research Institute, San Francisco, 94107, CA, USA
| | - Quince Gibson
- Department of Surgery, University of Alabama Birmingham Hospital, Birmingham, 35233, AL, USA
| | - Daniel F Gudbjartsson
- deCODE genetics/Amgen, Inc., Reykjavik, IS-101, Iceland
- School of Engineering and Natural Sciences, University of Iceland, Reykjavik, 101, Iceland
| | - Kathleen F Kerr
- Department of Biostatistics, School of Public Health, University of Washington, Seattle, 98195, WA, USA
| | - Bouwe P Krijthe
- Department of Epidemiology, Erasmus Medical Center, Rotterdam, 3015GD, The Netherlands
| | - Leo-Pekka Lyytikäinen
- Department of Clinical Chemistry, Fimlab Laboratories, Tampere, 33520, Finland
- Department of Clinical Chemistry, Finnish Cardiovascular Research Center-Tampere, Faculty of Medicine and Life Sciences, University of Tampere, Tampere, 33014, Finland
| | - Christian Müller
- Department of General and Interventional Cardiology, University Heart Center Hamburg-Eppendorf, Hamburg, 20251, Germany
- DZHK (German Center for Cardiovascular Research) Partner Site, Hamburg/Kiel/Lübeck, Germany
| | - Martina Müller-Nurasyid
- Institute of Genetic Epidemiology, Helmholtz Zentrum München-German Research Center for Environmental Health, Neuherberg, D-85764, Germany
- Department of Internal Medicine I (Cardiology), Hospital of the Ludwig-Maximilians-University (LMU) Munich, Munich, 81377, Germany
- DZHK (German Centre for Cardiovascular Research), Partner Site Munich Heart Alliance, Munich, 80802, Germany
- Department of Epidemiology, University of Groningen, University Medical Center Groningen, Groningen, 9713GZ, The Netherlands
| | - Ilja M Nolte
- Department of Epidemiology, University of Groningen, University Medical Center Groningen, Groningen, 9713GZ, The Netherlands
| | - Sandosh Padmanabhan
- Institute of Cardiovascular and Medical Sciences, College of Medical, Veterinary and Life Sciences, University of Glasgow, Glasgow, G12 8TA, Scotland, UK
| | - Marylyn D Ritchie
- Department of Genetics, University of Pennsylvania, Philadelphia, PA 19104, PA, USA
| | - Antonietta Robino
- Institute for Maternal and Child Health-IRCCS "Burlo Garofolo", Trieste, 34137, Italy
| | - Albert V Smith
- Icelandic Heart Association, Kopavogur, IS-201, Iceland
- Faculty of Medicine, University of Iceland, Reykjavik, 101, Iceland
- Department of Biostatistics, University of Michigan, Ann Arbor, 48109, MI, USA
| | - Maristella Steri
- Istituto di Ricerca Genetica e Biomedica, Consiglio Nazionale delle Ricerche (CNR), Monserrato, 00185, Cagliari, Italy
| | - Toshiko Tanaka
- Translational Gerontology Branch, NIA, Baltimore, 20892, MD, USA
| | - Alexander Teumer
- Institute for Community Medicine, University Medicine Greifswald, Greifswald, 17489, Germany
- DZHK (German Centre for Cardiovascular Research), Partner Site Greifswald, 17475, Greifswald, Germany
| | - Stella Trompet
- Department of Cardiology, Leiden University Medical Center, Leiden, 2300RC, The Netherlands
- Department of Gerontology and Geriatrics, Leiden University Medical Center, Leiden, 2300RC, The Netherlands
| | - Sheila Ulivi
- Institute for Maternal and Child Health-IRCCS "Burlo Garofolo", Trieste, 34137, Italy
| | - Niek Verweij
- Department of Cardiology, University Medical Center Groningen, University of Groningen, Groningen, 7913GZ, The Netherlands
| | - Xiaoyan Yin
- Department of Medicine, Boston University School of Medicine, Boston, 02118, MA, USA
| | - David O Arnar
- deCODE genetics/Amgen, Inc., Reykjavik, IS-101, Iceland
- Faculty of Medicine, University of Iceland, Reykjavik, 101, Iceland
- Department of Medicine, Landspitali University Hospital, Reykjavik, 101, Iceland
| | - Folkert W Asselbergs
- Department of Cardiology, University Medical Center Utrecht, University of Utrecht, Utrecht, 3584CX, The Netherlands
- Durrer Center for Cardiogenetic Research, Netherlands Heart Institute, Utrecht, The Netherlands
- Institute of Cardiovascular Science, Faculty of Population Health Sciences, University College London, London, WC1E 6BT, UK
- Farr Institute of Health Informatics Research and Institute of Health Informatics, University College London, London, WC1E 6BT, London, United Kingdom
| | - Joel S Bader
- Department of Biomedical Engineering, Johns Hopkins University, Baltimore, 21218, MD, USA
| | - John Barnard
- Department of Quantitative Health Sciences, Lerner Research Institute, Cleveland Clinic, Cleveland, 44195, OH, USA
| | - Josh Bis
- Department of General and Interventional Cardiology, University Heart Center Hamburg-Eppendorf, Hamburg, 20251, Germany
- DZHK (German Center for Cardiovascular Research) Partner Site, Hamburg/Kiel/Lübeck, Germany
| | - Stefan Blankenberg
- DZHK (German Center for Cardiovascular Research) Partner Site, Hamburg/Kiel/Lübeck, Germany
- Institute of Genetic Epidemiology, Helmholtz Zentrum München-German Research Center for Environmental Health, Neuherberg, D-85764, Germany
| | - Eric Boerwinkle
- Human Genetics Center, University of Texas Health Science Center at Houston, Houston, 77030, TX, USA
| | - Yuki Bradford
- Department of Genetics, University of Pennsylvania, Philadelphia, PA 19104, PA, USA
| | - Brendan M Buckley
- Department of Pharmacology and Therapeutics, University College Cork, Cork, T12 K8AF, Ireland
| | - Mina K Chung
- Department of Cardiovascular Medicine, Heart and Vascular Institute, Cleveland Clinic, Cleveland, 44195, OH, USA
- Department of Molecular Cardiology, Lerner Research Institute, Cleveland Clinic, Cleveland, 44195, OH, USA
| | - Dana Crawford
- Institute for Computational Biology, Department of Population and Quantitative Health Sciences, Case Western Reserve University, Cleveland, 44106, OH, USA
| | - Marcel den Hoed
- Department of Immunology, Genetics and Pathology, Uppsala University, Uppsala, SE-751 05, Sweden
- Science for Life Laboratory, Uppsala University, Uppsala, SE-751 05, Sweden
| | - Josh C Denny
- Biomedical Informatics and Medicine, Vanderbilt University, Nashville, 37235, TN, USA
| | - Anna F Dominiczak
- Institute of Cardiovascular and Medical Sciences, College of Medical, Veterinary and Life Sciences, University of Glasgow, Glasgow, G12 8TA, Scotland, UK
| | - Georg B Ehret
- Center for Complex Disease Genomics, McKusick-Nathans Institute of Genetic Medicine, Johns Hopkins University School of Medicine, Baltimore, 21287, MD, USA
| | - Mark Eijgelsheim
- Department of Epidemiology, Erasmus Medical Center, Rotterdam, 3015GD, The Netherlands
- Department of Nephrology, University Medical Center Groningen, Groningen, 7913GZ, The Netherlands
| | - Patrick T Ellinor
- Program in Medical and Population Genetics, The Broad Institute of MIT and Harvard, Cambridge, 02142, MA, USA
- Cardiovascular Research Center, Massachusetts General Hospital, Boston, 02114, MA, USA
- Cardiac Arrhythmia Service, Massachusetts General Hospital, Boston, 02114, MA, USA
| | - Stephan B Felix
- DZHK (German Centre for Cardiovascular Research), Partner Site Greifswald, 17475, Greifswald, Germany
- Department of Internal Medicine B, University Medicine Greifswald, Greifswald, 17489, Germany
| | - Oscar H Franco
- Department of Epidemiology, Erasmus Medical Center, Rotterdam, 3015GD, The Netherlands
| | - Lude Franke
- Department of Genetics, University of Groningen, University Medical Center Groningen, Groningen, 7913GZ, The Netherlands
| | - Tamara B Harris
- Laboratory of Epidemiology and Population Sciences, National Institute on Aging, Intramural Research Program, National Institutes of Health, Bethesda, 20892, MD, USA
| | - Hilma Holm
- deCODE genetics/Amgen, Inc., Reykjavik, IS-101, Iceland
| | - Gandin Ilaria
- Department of Medical Sciences, University of Trieste, Trieste, 34127, Italy
| | - Annamaria Iorio
- Cardiovascular Department, "Ospedali Riuniti and University of Trieste", Trieste, 34124, Italy
| | - Mika Kähönen
- Department of Clinical Physiology, Tampere University Hospital, Tampere, 33521, Finland
- Department of Clinical Physiology, Finnish Cardiovascular Research Center-Tampere, Faculty of Medicine and Life Sciences, University of Tampere, Tampere, 33014, Finland
| | - Ivana Kolcic
- Faculty of Medicine, University of Split, Split, 21000, Croatia
| | - Jan A Kors
- Department of Medical Informatics, Erasmus University Medical Center, Rotterdam, 3015GD, The Netherlands
| | - Edward G Lakatta
- Laboratory of Cardiovascular Science, National Institute on Aging, National Institutes of Health, Baltimore, 20892, MD, USA
| | - Lenore J Launer
- Laboratory of Epidemiology and Population Sciences, National Institute on Aging, Intramural Research Program, National Institutes of Health, Bethesda, 20892, MD, USA
| | - Honghuang Lin
- Department of Medicine, Boston University School of Medicine, Boston, 02118, MA, USA
| | - Henry J Lin
- The Institute for Translational Genomics and Population Sciences, Department of Pediatrics, Los Angeles Biomedical Research Institute at Harbor-UCLA Medical Center, Torrance, 90502, CA, USA
| | - Ruth J F Loos
- The Charles Bronfman Institute for Personalized Medicine, Icahn School of Medicine at Mount Sinai, New York, 10029, NY, USA
- The Mindich Child health and Development Institute, Icahn School of Medicine at Mount Sinai, New York, 10029, NY, USA
| | - Steven A Lubitz
- Program in Medical and Population Genetics, The Broad Institute of MIT and Harvard, Cambridge, 02142, MA, USA
- Cardiovascular Research Center, Massachusetts General Hospital, Boston, 02114, MA, USA
- Cardiac Arrhythmia Service, Massachusetts General Hospital, Boston, 02114, MA, USA
| | - Peter W Macfarlane
- Institute of Health and Wellbeing, College of Medical, Veterinary and Life Sciences, University of Glasgow, Glasgow, G12 8QQ, UK
| | - Jared W Magnani
- Department of Medicine, Division of Cardiology, University of Pittsburgh Medical Center Heart and Vascular Institute, University of Pittsburgh, Pittsburgh, 15260, PA, USA
| | - Irene Mateo Leach
- Department of Cardiology, University Medical Center Groningen, University of Groningen, Groningen, 7913GZ, The Netherlands
| | - Thomas Meitinger
- DZHK (German Centre for Cardiovascular Research), Partner Site Munich Heart Alliance, Munich, 80802, Germany
- Institute of Human Genetics, Helmholtz Zentrum München-German Research Center for Environmental Health, Neuherberg, 85764, Germany
- Institute of Human Genetics, Klinikum rechts der Isar, Technische Universität München, Munich, 81675, Germany
| | - Braxton D Mitchell
- Department of Medicine, University of Maryland School of Medicine, Geriatrics Research and Education Clinical Center, Baltimore VA Medical Center, Baltimore, 21201, MD, USA
| | - Thomas Munzel
- Center for Cardiology, University Medical Center of the Johannes Gutenberg-University Mainz, Mainz, 55131, Germany
- DZHK (German Center for Cardiovascular Research), Partner Site Rhine-Main, Mainz, 55131, Germany
- Center for Translational Vascular Biology (CTVB), University Medical Center of the Johannes Gutenberg-University Mainz, Mainz, 55131, Germany
| | - George J Papanicolaou
- Division of Cardiovascular Sciences, National Heart, Lung, and Blood Institute, NIH, Bethesda, 20892, MD, USA
| | - Annette Peters
- DZHK (German Centre for Cardiovascular Research), Partner Site Munich Heart Alliance, Munich, 80802, Germany
- Institute of Epidemiology, Helmholtz Zentrum München-German Research Center for Environmental Health, Neuherberg, 85764, Germany
- German Center for Diabetes Research, Neuherberg, 85764, Germany
| | - Arne Pfeufer
- MVZ für Molekulardiagnostik, Munich, 81543, Germany
| | - Peter P Pramstaller
- Institute for Biomedicine, Eurac Research, Affiliated Institute of the University of Lübeck, Bolzano, 39100, Italy
- Department of Neurology, Central Hospital, Bolzano, 39100, Italy
| | - Olli T Raitakari
- Department of Clinical Physiology and Nuclear Medicine, Turku University Hospital, Turku, 20521, Finland
- Research Centre of Applied and Preventive Cardiovascular Medicine, University of Turku, Turku, 20014, Finland
| | - Jerome I Rotter
- Departments of Medicine and Pediatrics, The Institute for Translational Genomics and Population Sciences, Los Angeles Biomedical Research Institute at Harbor-UCLA Medical Center, Torrance, 90502, CA, USA
| | - Igor Rudan
- Centre for Global Health Research, Usher Institute of Population Health Sciences and Informatics, University of Edinburgh, Edinburgh, EH8 9YL, UK
| | - Nilesh J Samani
- Department of Cardiovascular Sciences, University of Leicester, Leicester, LE1 7RH, UK
- NIHR Leicester Biomedical Research Centre, Leicester, LE3 9QD, UK
| | - David Schlessinger
- Laboratory of Genetics and Genomics, National Institute on Aging, National Institute of Health, Baltimore, 20892, MD, USA
| | - Claudia T Silva Aldana
- Genetic Epidemiology Unit, Department of Epidemiology, Erasmus University Medical Center, Rotterdam, 3015GD, The Netherlands
- Institute of Translational Medicine-IMT, Center For Research in Genetics and Genomics-CIGGUR, GENIUROS Research Group, School of Medicine and Health Sciences, Universidad del Rosario, Bogotá, Cl. 12c #6-25, Colombia
| | - Moritz F Sinner
- Department of Internal Medicine I (Cardiology), Hospital of the Ludwig-Maximilians-University (LMU) Munich, Munich, 81377, Germany
- DZHK (German Centre for Cardiovascular Research), Partner Site Munich Heart Alliance, Munich, 80802, Germany
| | - Jonathan D Smith
- Department of Cardiovascular Medicine, Heart and Vascular Institute, Cleveland Clinic, Cleveland, 44195, OH, USA
- Department of Cellular and Molecular Medicine Biology, Lerner Research Institute, Cleveland Clinic, Cleveland, 44195, OH, USA
| | - Harold Snieder
- Department of Epidemiology, University of Groningen, University Medical Center Groningen, Groningen, 9713GZ, The Netherlands
| | - Elsayed Z Soliman
- Epidemiological Cardiology Research Center, Wake Forest School of Medicine, Winston-Salem, 27101, NC, USA
| | - Timothy D Spector
- Department of Twin Research and Genetic Epidemiology, St Thomas Hospital, King's College London, London, WC2R 2LS, UK
| | - David J Stott
- Institute of Cardiovascular and Medical Sciences, College of Medical, Veterinary and Life Sciences, University of Glasgow, Glasgow, G12 8TA, Scotland, UK
| | - Konstantin Strauch
- Institute of Genetic Epidemiology, Helmholtz Zentrum München-German Research Center for Environmental Health, Neuherberg, D-85764, Germany
- Chair of Genetic Epidemiology, IBE, Faculty of Medicine, LMU Munich, Munich, 81377, Germany
| | - Kirill V Tarasov
- Laboratory of Cardiovascular Science, National Institute on Aging, National Institutes of Health, Baltimore, 20892, MD, USA
| | - Unnur Thorsteinsdottir
- deCODE genetics/Amgen, Inc., Reykjavik, IS-101, Iceland
- Faculty of Medicine, University of Iceland, Reykjavik, 101, Iceland
| | - Andre G Uitterlinden
- Department of Internal Medicine, Erasmus Medical Center, Rotterdam, 3015GD, The Netherlands
| | - David R Van Wagoner
- Department of Cardiovascular Medicine, Heart and Vascular Institute, Cleveland Clinic, Cleveland, 44195, OH, USA
- Department of Molecular Cardiology, Lerner Research Institute, Cleveland Clinic, Cleveland, 44195, OH, USA
| | - Uwe Völker
- DZHK (German Centre for Cardiovascular Research), Partner Site Greifswald, 17475, Greifswald, Germany
- Interfaculty Institute for Genetics and Functional Genomics, University Medicine Greifswald, Greifswald, 17489, Germany
| | - Henry Völzke
- Institute for Community Medicine, University Medicine Greifswald, Greifswald, 17489, Germany
- DZHK (German Centre for Cardiovascular Research), Partner Site Greifswald, 17475, Greifswald, Germany
| | - Melanie Waldenberger
- DZHK (German Centre for Cardiovascular Research), Partner Site Munich Heart Alliance, Munich, 80802, Germany
- Institute of Epidemiology, Helmholtz Zentrum München-German Research Center for Environmental Health, Neuherberg, 85764, Germany
- Research Unit of Molecular Epidemiology, Helmholtz Zentrum München-German Research Center for Environmental Health, Neuherberg, 85764, Germany
| | - Harm Jan Westra
- Department of Genetics, University of Groningen, University Medical Center Groningen, Groningen, 7913GZ, The Netherlands
| | - Philipp S Wild
- DZHK (German Center for Cardiovascular Research), Partner Site Rhine-Main, Mainz, 55131, Germany
- Center for Translational Vascular Biology (CTVB), University Medical Center of the Johannes Gutenberg-University Mainz, Mainz, 55131, Germany
- Preventive Cardiology and Preventive Medicine, Center for Cardiology, University Medical Center of the Johannes Gutenberg-University Mainz, Mainz, 55131, Germany
- Center for Thrombosis and Hemostasis, University Medical Center of the Johannes Gutenberg-University Mainz, Mainz, 55131, Germany
| | - Tanja Zeller
- Department of General and Interventional Cardiology, University Heart Center Hamburg-Eppendorf, Hamburg, 20251, Germany
- DZHK (German Center for Cardiovascular Research) Partner Site, Hamburg/Kiel/Lübeck, Germany
| | - Alvaro Alonso
- Department of Epidemiology, Rollins School of Public Health, Emory University, Atlanta, 30322, GA, USA
| | - Christy L Avery
- Department of Epidemiology and Carolina Population Center, University of North Carolina at Chapel Hill, Chapel Hill, NC, 27514, USA
| | | | - Emelia J Benjamin
- Durrer Center for Cardiogenetic Research, Netherlands Heart Institute, Utrecht, The Netherlands
| | - Francesco Cucca
- Istituto di Ricerca Genetica e Biomedica, Consiglio Nazionale delle Ricerche (CNR), Monserrato, 00185, Cagliari, Italy
| | - Marcus Dörr
- DZHK (German Centre for Cardiovascular Research), Partner Site Greifswald, 17475, Greifswald, Germany
- Department of Internal Medicine B, University Medicine Greifswald, Greifswald, 17489, Germany
| | - Luigi Ferrucci
- Translational Gerontology Branch, NIA, Baltimore, 20892, MD, USA
| | - Paolo Gasparini
- Institute for Maternal and Child Health-IRCCS "Burlo Garofolo", Trieste, 34137, Italy
- Department of Medical Sciences, University of Trieste, Trieste, 34127, Italy
| | - Vilmundur Gudnason
- Icelandic Heart Association, Kopavogur, IS-201, Iceland
- Faculty of Medicine, University of Iceland, Reykjavik, 101, Iceland
| | - Caroline Hayward
- Medical Research Council Human Genetics Unit, Institute of Genetics and Molecular Medicine, University of Edinburgh, Edinburgh, EH8 9YL, UK
| | - Susan R Heckbert
- Cardiovascular Health Research Unit and the Department of Epidemiology, University of Washington, Seattle, 98195, WA, USA
| | - Andrew A Hicks
- Institute for Biomedicine, Eurac Research, Affiliated Institute of the University of Lübeck, Bolzano, 39100, Italy
| | - J Wouter Jukema
- Department of Cardiology, Leiden University Medical Center, Leiden, 2300RC, The Netherlands
- Einthoven Laboratory for Experimental Vascular Medicine, Leiden University Medical Center, Leiden, 2300RC, The Netherlands
- Interuniversity Cardiology Institute of the Netherlands, Utrecht, 3511EP, The Netherlands
| | - Stefan Kääb
- Department of Internal Medicine I (Cardiology), Hospital of the Ludwig-Maximilians-University (LMU) Munich, Munich, 81377, Germany
- DZHK (German Centre for Cardiovascular Research), Partner Site Munich Heart Alliance, Munich, 80802, Germany
| | - Terho Lehtimäki
- Department of Clinical Chemistry, Fimlab Laboratories, Tampere, 33520, Finland
- Department of Clinical Chemistry, Finnish Cardiovascular Research Center-Tampere, Faculty of Medicine and Life Sciences, University of Tampere, Tampere, 33014, Finland
| | - Yongmei Liu
- Department of Epidemiology and Prevention, Division of Public Health Sciences, Wake Forest University, Winston-Salem, 27101, NC, USA
| | - Patricia B Munroe
- Clinical Pharmacology, William Harvey Research Institute, Queen Mary University of London, London, E1 4NS, UK
- NIHR Biomedical Research Centre at Barts, Barts Health NHS Trust and Queen Mary University of London, London, E1 4NS, UK
| | - Afshin Parsa
- Department of Medicine, University of Maryland School of Medicine and Baltimore VA Medical Center, Baltimore, 21201, MD, USA
| | - Ozren Polasek
- Faculty of Medicine, University of Split, Split, 21000, Croatia
- Psychiatric hospital "Sveti Ivan", Zagreb, 10000, Croatia
- Gen-info Ltd., Zagreb, 10000, Croatia
| | - Bruce M Psaty
- Cardiovascular Health Research Unit, Departments of Medicine, Epidemiology and Health Services, University of Washington, Seattle, 98195, WA, USA
- Kaiser Permanente Washington Health Research Institute, Seattle, 98101, WA, USA
| | - Dan M Roden
- Medicine, Pharmacology, and Biomedical Informatics, Vanderbilt University, Nashville, 37235, TN, USA
| | - Renate B Schnabel
- Department of General and Interventional Cardiology, University Heart Center Hamburg-Eppendorf, Hamburg, 20251, Germany
- DZHK (German Center for Cardiovascular Research) Partner Site, Hamburg/Kiel/Lübeck, Germany
| | - Gianfranco Sinagra
- Cardiovascular Department, "Ospedali Riuniti and University of Trieste", Trieste, 34124, Italy
| | - Kari Stefansson
- deCODE genetics/Amgen, Inc., Reykjavik, IS-101, Iceland
- Faculty of Medicine, University of Iceland, Reykjavik, 101, Iceland
| | - Bruno H Stricker
- Department of Epidemiology, Erasmus Medical Center, Rotterdam, 3015GD, The Netherlands
- Department of Internal Medicine, Erasmus Medical Center, Rotterdam, 3015GD, The Netherlands
- Inspectorate for Health Care, The Hague, 2511VX, The Netherlands
| | - Pim van der Harst
- Department of Cardiology, University Medical Center Groningen, University of Groningen, Groningen, 7913GZ, The Netherlands
- University of Groningen, University Medical Center Groningen, Department of Genetics, Groningen, 7913GZ, The Netherlands
- Durrer Center for Cardiogenetic Research, ICIN-Netherlands Heart Institute, Utrecht, 3511EP, The Netherlands
| | - Cornelia M van Duijn
- Genetic Epidemiology Unit, Department of Epidemiology, Erasmus University Medical Center, Rotterdam, 3015GD, The Netherlands
| | - James F Wilson
- Centre for Global Health Research, Usher Institute of Population Health Sciences and Informatics, University of Edinburgh, Edinburgh, EH8 9YL, UK
- Medical Research Council Human Genetics Unit, Institute of Genetics and Molecular Medicine, University of Edinburgh, Edinburgh, EH8 9YL, UK
| | - Sina A Gharib
- Cardiovascular Health Research Unit, Division of Pulmonary Critical Care and Sleep Medicine, Computational Medicine Core at Center for Lung Biology, Department of Medicine, University of Washington, Seattle, 98195, WA, USA
| | - Paul I W de Bakker
- Department of Genetics, Center for Molecular Medicine, University Medical Center Utrecht, Utrecht, 3584CX, The Netherlands
- Department of Epidemiology, Julius Center for Health Sciences and Primary Care, University Medical Center Utrecht, Utrecht, 3584CX, The Netherlands
| | - Aaron Isaacs
- CARIM School for Cardiovascular Diseases, Maastricht, 6229ER, The Netherlands
- Center for Systems Biology (MaCSBio), Maastricht University, Maastricht, 6229ER, The Netherlands
- Department of Biochemistry, Maastricht University, Maastricht, 6229ER, The Netherlands
| | - Dan E Arking
- McKusick-Nathans Institute of Genetic Medicine, Johns Hopkins University School of Medicine, Baltimore, 21287, MD, USA
| | - Nona Sotoodehnia
- Departments of Medicine and Epidemiology, Cardiovascular Health Research Unit, Division of Cardiology, University of Washington, Seattle, 98101, WA, USA.
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Roselli C, Chaffin MD, Weng LC, Aeschbacher S, Ahlberg G, Albert CM, Almgren P, Alonso A, Anderson CD, Aragam KG, Arking DE, Barnard J, Bartz TM, Benjamin EJ, Bihlmeyer NA, Bis JC, Bloom HL, Boerwinkle E, Bottinger EB, Brody JA, Calkins H, Campbell A, Cappola TP, Carlquist J, Chasman DI, Chen LY, Chen YDI, Choi EK, Choi SH, Christophersen IE, Chung MK, Cole JW, Conen D, Cook J, Crijns HJ, Cutler MJ, Damrauer SM, Daniels BR, Darbar D, Delgado G, Denny JC, Dichgans M, Dörr M, Dudink EA, Dudley SC, Esa N, Esko T, Eskola M, Fatkin D, Felix SB, Ford I, Franco OH, Geelhoed B, Grewal RP, Gudnason V, Guo X, Gupta N, Gustafsson S, Gutmann R, Hamsten A, Harris TB, Hayward C, Heckbert SR, Hernesniemi J, Hocking LJ, Hofman A, Horimoto ARVR, Huang J, Huang PL, Huffman J, Ingelsson E, Ipek EG, Ito K, Jimenez-Conde J, Johnson R, Jukema JW, Kääb S, Kähönen M, Kamatani Y, Kane JP, Kastrati A, Kathiresan S, Katschnig-Winter P, Kavousi M, Kessler T, Kietselaer BL, Kirchhof P, Kleber ME, Knight S, Krieger JE, Kubo M, Launer LJ, Laurikka J, Lehtimäki T, Leineweber K, Lemaitre RN, Li M, Lim HE, Lin HJ, Lin H, Lind L, Lindgren CM, Lokki ML, London B, Loos RJF, Low SK, Lu Y, Lyytikäinen LP, Macfarlane PW, Magnusson PK, Mahajan A, Malik R, Mansur AJ, Marcus GM, Margolin L, Margulies KB, März W, McManus DD, Melander O, Mohanty S, Montgomery JA, Morley MP, Morris AP, Müller-Nurasyid M, Natale A, Nazarian S, Neumann B, Newton-Cheh C, Niemeijer MN, Nikus K, Nilsson P, Noordam R, Oellers H, Olesen MS, Orho-Melander M, Padmanabhan S, Pak HN, Paré G, Pedersen NL, Pera J, Pereira A, Porteous D, Psaty BM, Pulit SL, Pullinger CR, Rader DJ, Refsgaard L, Ribasés M, Ridker PM, Rienstra M, Risch L, Roden DM, Rosand J, Rosenberg MA, Rost N, Rotter JI, Saba S, Sandhu RK, Schnabel RB, Schramm K, Schunkert H, Schurman C, Scott SA, Seppälä I, Shaffer C, Shah S, Shalaby AA, Shim J, Shoemaker MB, Siland JE, Sinisalo J, Sinner MF, Slowik A, Smith AV, Smith BH, Smith JG, Smith JD, Smith NL, Soliman EZ, Sotoodehnia N, Stricker BH, Sun A, Sun H, Svendsen JH, Tanaka T, Tanriverdi K, Taylor KD, Teder-Laving M, Teumer A, Thériault S, Trompet S, Tucker NR, Tveit A, Uitterlinden AG, Van Der Harst P, Van Gelder IC, Van Wagoner DR, Verweij N, Vlachopoulou E, Völker U, Wang B, Weeke PE, Weijs B, Weiss R, Weiss S, Wells QS, Wiggins KL, Wong JA, Woo D, Worrall BB, Yang PS, Yao J, Yoneda ZT, Zeller T, Zeng L, Lubitz SA, Lunetta KL, Ellinor PT. Multi-ethnic genome-wide association study for atrial fibrillation. Nat Genet 2018; 50:1225-1233. [PMID: 29892015 PMCID: PMC6136836 DOI: 10.1038/s41588-018-0133-9] [Citation(s) in RCA: 421] [Impact Index Per Article: 70.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/27/2017] [Accepted: 04/18/2018] [Indexed: 12/13/2022]
Abstract
Atrial fibrillation (AF) affects more than 33 million individuals worldwide1 and has a complex heritability2. We conducted the largest meta-analysis of genome-wide association studies (GWAS) for AF to date, consisting of more than half a million individuals, including 65,446 with AF. In total, we identified 97 loci significantly associated with AF, including 67 that were novel in a combined-ancestry analysis, and 3 that were novel in a European-specific analysis. We sought to identify AF-associated genes at the GWAS loci by performing RNA-sequencing and expression quantitative trait locus analyses in 101 left atrial samples, the most relevant tissue for AF. We also performed transcriptome-wide analyses that identified 57 AF-associated genes, 42 of which overlap with GWAS loci. The identified loci implicate genes enriched within cardiac developmental, electrophysiological, contractile and structural pathways. These results extend our understanding of the biological pathways underlying AF and may facilitate the development of therapeutics for AF.
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Affiliation(s)
- Carolina Roselli
- Program in Medical and Population Genetics, The Broad Institute of MIT and Harvard, Cambridge, MA, USA
| | - Mark D Chaffin
- Program in Medical and Population Genetics, The Broad Institute of MIT and Harvard, Cambridge, MA, USA
| | - Lu-Chen Weng
- Program in Medical and Population Genetics, The Broad Institute of MIT and Harvard, Cambridge, MA, USA
- Cardiovascular Research Center, Massachusetts General Hospital, Boston, MA, USA
| | - Stefanie Aeschbacher
- University Hospital Basel, Basel, Switzerland
- Cardiovascular Research Institute Basel, Basel, Switzerland
| | - Gustav Ahlberg
- Laboratory for Molecular Cardiology, The Heart Centre, Department of Cardiology, Copenhagen University Hospital, Rigshospitalet, Copenhagen, Denmark
- The Danish National Research Foundation Centre for Cardiac Arrhythmia, Department of Biomedical Sciences, University of Copenhagen, Copenhagen, Denmark
- Department of Clinical Medicine, Faculty of Health and Medical Sciences, University of Copenhagen, Copenhagen, Denmark
| | - Christine M Albert
- Divisions of Preventive and Cardiovascular Medicine, Brigham and Women's Hospital & Harvard Medical School, Boston, MA, USA
| | - Peter Almgren
- Department of Clinical Sciences, Lund University, Malmo, Sweden
| | - Alvaro Alonso
- Department of Epidemiology, Rollins School of Public Health, Emory University, Atlanta, GA, USA
| | - Christopher D Anderson
- Program in Medical and Population Genetics, The Broad Institute of MIT and Harvard, Cambridge, MA, USA
- Center for Genomic Medicine, Massachusetts General Hospital, Boston, MA, USA
| | - Krishna G Aragam
- Program in Medical and Population Genetics, The Broad Institute of MIT and Harvard, Cambridge, MA, USA
- Center for Genomic Medicine, Massachusetts General Hospital, Boston, MA, USA
| | - Dan E Arking
- McKusick-Nathans Institute of Genetic Medicine, Johns Hopkins University School of Medicine, Baltimore, MD, USA
| | - John Barnard
- Departments of Cardiovascular Medicine, Cellular and Molecular Medicine, Molecular Cardiology, and Quantitative Health Sciences, Cleveland Clinic, Cleveland, OH, USA
| | - Traci M Bartz
- Cardiovascular Health Research Unit, Departments of Medicine and Biostatistics, University of Washington, Seattle, WA, USA
| | - Emelia J Benjamin
- NHLBI and Boston University's Framingham Heart Study, Framingham, MA, USA
- Department of Medicine, Boston University School of Medicine, Boston, MA, USA
- Department of Epidemiology, Boston University School of Public Health, Boston, MA, USA
| | - Nathan A Bihlmeyer
- Predoctoral Training Program in Human Genetics, McKusick-Nathans Institute of Genetic Medicine, Johns Hopkins University School of Medicine, Baltimore, MD, USA
| | - Joshua C Bis
- Cardiovascular Health Research Unit, Department of Medicine, University of Washington, Seattle, WA, USA
| | - Heather L Bloom
- Division of Cardiology, Emory University and Atlanta VA Medical Center, Atlanta, GA, USA
| | - Eric Boerwinkle
- Human Genome Sequencing Center, Baylor College of Medicine, Houston, TX, USA
| | - Erwin B Bottinger
- The Charles Bronfman Institute for Personalized Medicine, Icahn School of Medicine at Mount Sinai, New York, NY, USA
- Department of Pharmacology and Systems Therapeutics, Icahn School of Medicine at Mount Sinai, New York, NY, USA
| | - Jennifer A Brody
- Cardiovascular Health Research Unit, Department of Medicine, University of Washington, Seattle, WA, USA
| | | | - Archie Campbell
- Generation Scotland, Centre for Genomic and Experimental Medicine, Institute of Genetics and Molecular Medicine, University of Edinburgh, Edinburgh, UK
| | - Thomas P Cappola
- Penn Cardiovascular Institute and Department of Medicine, Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA, USA
| | - John Carlquist
- Intermountain Heart Institute, Intermountain Medical Center, Murray, UT, USA
- Division of Cardiovascular Medicine, University of Utah, Salt Lake City, UT, USA
| | - Daniel I Chasman
- Program in Medical and Population Genetics, The Broad Institute of MIT and Harvard, Cambridge, MA, USA
- Divisions of Preventive Medicine and Genetics, Brigham and Women's Hospital & Harvard Medical School, Boston, MA, USA
| | - Lin Y Chen
- Cardiovascular Division, Department of Medicine, University of Minnesota Medical School, Minneapolis, MN, USA
| | - Yii-Der Ida Chen
- Institute for Translational Genomics and Population Sciences, Department of Pediatrics, LABioMed at Harbor-UCLA Medical Center, Torrance, CA, USA
| | | | - Seung Hoan Choi
- Program in Medical and Population Genetics, The Broad Institute of MIT and Harvard, Cambridge, MA, USA
| | - Ingrid E Christophersen
- Program in Medical and Population Genetics, The Broad Institute of MIT and Harvard, Cambridge, MA, USA
- Cardiovascular Research Center, Massachusetts General Hospital, Boston, MA, USA
- Department of Medical Research, Bærum Hospital, Vestre Viken Hospital Trust, Drammen, Norway
| | - Mina K Chung
- Departments of Cardiovascular Medicine, Cellular and Molecular Medicine, Molecular Cardiology, and Quantitative Health Sciences, Cleveland Clinic, Cleveland, OH, USA
| | - John W Cole
- Baltimore Veterans Affairs Medical Center, Department of Neurology, Baltimore, MD, USA
- University of Maryland School of Medicine, Department of Neurology, Baltimore, MD, USA
| | - David Conen
- University Hospital Basel, Basel, Switzerland
- Cardiovascular Research Institute Basel, Basel, Switzerland
- Population Health Research Institute, McMaster University, Hamilton, Ontario, Canada
| | - James Cook
- Department of Biostatistics, University of Liverpool, Liverpool, UK
| | - Harry J Crijns
- Maastricht University Medical Center+ and Cardiovascular Research Institute Maastricht, Department of Cardiology, Maastricht, The Netherlands
| | - Michael J Cutler
- Intermountain Heart Institute, Intermountain Medical Center, Murray, UT, USA
| | - Scott M Damrauer
- Department of Surgery, Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA, USA
- Department of Surgery, Corporal Michael Crescenz VA Medical Center, Philadelphia, PA, USA
| | - Brian R Daniels
- Program in Medical and Population Genetics, The Broad Institute of MIT and Harvard, Cambridge, MA, USA
| | | | - Graciela Delgado
- Vth Department of Medicine, Medical Faculty Mannheim, Heidelberg University, Heidelberg, Germany
| | - Joshua C Denny
- Department of Medicine, Vanderbilt University Medical Center, Nashville, TN, USA
| | - Martin Dichgans
- Institute for Stroke and Dementia Research (ISD), University Hospital, LMU Munich, Munich, Germany
- Munich Cluster for Systems Neurology (SyNergy), Munich, Germany
- German Center for Neurodegenerative Diseases (DZNE), Munich, Germany
| | - Marcus Dörr
- Department of Internal Medicine B, University Medicine Greifswald, Greifswald, Germany
- DZHK (German Centre for Cardiovascular Research), partner site: Greifswald, Greifswald, Germany
| | - Elton A Dudink
- Maastricht University Medical Center+ and Cardiovascular Research Institute Maastricht, Department of Cardiology, Maastricht, The Netherlands
| | - Samuel C Dudley
- Cardiovascular Division and Lillehei Heart Institute, University of Minnesota, Minneapolis, MN, USA
| | - Nada Esa
- University of Massachusetts Medical School Worcester, Worcester, MA, USA
| | - Tonu Esko
- Program in Medical and Population Genetics, The Broad Institute of MIT and Harvard, Cambridge, MA, USA
- Estonian Genome Center, University of Tartu, Tartu, Estonia
| | - Markku Eskola
- Heart Center, Department of Cardiology, Tampere University Hospital, Finland and Faculty of Medicine and Life Sciences, University of Tampere, Tampere, Finland
| | - Diane Fatkin
- Victor Chang Cardiac Research Institute, Darlinghurst, New South Wales, Australia
- St Vincent's Hospital, Darlinghurst, New South Wales, Australia
- Faculty of Medicine, University of New South Wales, Kensington, New South Wales, Australia
| | - Stephan B Felix
- Department of Internal Medicine B, University Medicine Greifswald, Greifswald, Germany
- DZHK (German Centre for Cardiovascular Research), partner site: Greifswald, Greifswald, Germany
| | - Ian Ford
- Robertson Center for Biostatistics, University of Glasgow, Glasgow, UK
| | - Oscar H Franco
- Department of Epidemiology, Erasmus University Medical Center Rotterdam, Rotterdam, The Netherlands
| | - Bastiaan Geelhoed
- Department of Cardiology, University Medical Center Groningen, University of Groningen, Groningen, The Netherlands
| | - Raji P Grewal
- Dept. of Neuroscience, Saint Francis Medical Center, Trenton, NJ, USA
- School of Health and Medical Sciences, Seton Hall University, South Orange, NJ, USA
| | - Vilmundur Gudnason
- Icelandic Heart Association, Kopavogur, Iceland
- Faculty of Medicine, University of Iceland, Reykavik, Iceland
| | - Xiuqing Guo
- Institute for Translational Genomics and Population Sciences, Department of Pediatrics, LABioMed at Harbor-UCLA Medical Center, Torrance, CA, USA
| | - Namrata Gupta
- Program in Medical and Population Genetics, The Broad Institute of MIT and Harvard, Cambridge, MA, USA
| | - Stefan Gustafsson
- Department of Medical Sciences, Molecular Epidemiology and Science for Life Laboratory, Uppsala University, Uppsala, Sweden
| | - Rebecca Gutmann
- Division of Cardiovascular Medicine and Abboud Cardiovascular Research Center, University of Iowa, Iowa City, IA, USA
| | - Anders Hamsten
- Cardiovascular Genetics and Genomics Group, Atherosclerosis Research Unit, Department of Medicine Solna, Karolinska Institutet, Stockholm, Sweden
| | - Tamara B Harris
- Laboratory of Epidemiology, Demography, and Biometry, National Institute on Aging, Bethesda, MD, USA
| | - Caroline Hayward
- MRC Human Genetics Unit, Institute of Genetics and Molecular Medicine, University of Edinburgh, Edinburgh, UK
| | - Susan R Heckbert
- Cardiovascular Health Research Unit and Department of Epidemiology, University of Washington, Seattle, WA, USA
- Kaiser Permanente Washington Health Research Institute, Seattle, WA, USA
| | - Jussi Hernesniemi
- Heart Center, Department of Cardiology, Tampere University Hospital, Finland and Faculty of Medicine and Life Sciences, University of Tampere, Tampere, Finland
- Department of Clinical Chemistry, Fimlab Laboratories and Finnish Cardiovascular Research Center-Tampere, Faculty of Medicine and Life Sciences, University of Tampere, Tampere, Finland
| | - Lynne J Hocking
- Institute of Medical Sciences, University of Aberdeen, Aberdeen, UK
| | - Albert Hofman
- Department of Epidemiology, Erasmus University Medical Center Rotterdam, Rotterdam, The Netherlands
| | - Andrea R V R Horimoto
- Laboratory of Genetics and Molecular Cardiology, Heart Institute, University of São Paulo, São Paulo, Brazil
| | - Jie Huang
- Boston VA Research Institute, Inc., Boston, MA, USA
| | - Paul L Huang
- Cardiovascular Research Center, Massachusetts General Hospital, Boston, MA, USA
| | - Jennifer Huffman
- MRC Human Genetics Unit, Institute of Genetics and Molecular Medicine, University of Edinburgh, Edinburgh, UK
| | - Erik Ingelsson
- Department of Medical Sciences, Molecular Epidemiology and Science for Life Laboratory, Uppsala University, Uppsala, Sweden
- Division of Cardiovascular Medicine, Department of Medicine, Stanford University School of Medicine, Stanford, CA, USA
| | | | - Kaoru Ito
- Laboratory for Cardiovascular Diseases, RIKEN Center for Integrative Medical Sciences, Yokohama, Japan
| | - Jordi Jimenez-Conde
- Department of Neurology, Neurovascular Research Group IMIM-Hospital del Mar (Institut Hospital del Mar d'Investigacions Médiques), Barcelona, Spain
- Universitat Autònoma de Barcelona, Medicine Department, Barcelona, Spain
| | - Renee Johnson
- Victor Chang Cardiac Research Institute, Darlinghurst, New South Wales, Australia
| | - J Wouter Jukema
- Department of Cardiology, Leiden University Medical Center, Leiden, The Netherlands
- Durrer Center for Cardiogenetic Research, Amsterdam, The Netherlands
- Interuniversity Cardiology Institute of the Netherlands, Utrecht, The Netherlands
| | - Stefan Kääb
- Department of Medicine I, University Hospital Munich, Ludwig-Maximilians-University, Munich, Germany
- DZHK (German Centre for Cardiovascular Research), partner site: Munich Heart Alliance, Munich, Germany
| | - Mika Kähönen
- Department of Clinical Physiology, Tampere University Hospital, and Finnish Cardiovascular Research Center-Tampere, Faculty of Medicine and Life Sciences, University of Tampere, Tampere, Finland
| | - Yoichiro Kamatani
- Laboratory for Statistical Analysis, RIKEN Center for Integrative Medical Sciences, Yokohama, Japan
| | - John P Kane
- Cardiovascular Research Institute, University of California, San Francisco, San Francisco, CA, USA
| | - Adnan Kastrati
- DZHK (German Centre for Cardiovascular Research), partner site: Munich Heart Alliance, Munich, Germany
- Deutsches Herzzentrum München, Klinik für Herz- und Kreislauferkrankungen, Technische Universität München, Munich, Germany
| | - Sekar Kathiresan
- Program in Medical and Population Genetics, The Broad Institute of MIT and Harvard, Cambridge, MA, USA
- Center for Genomic Medicine, Massachusetts General Hospital, Boston, MA, USA
| | | | - Maryam Kavousi
- Department of Epidemiology, Erasmus University Medical Center Rotterdam, Rotterdam, The Netherlands
| | - Thorsten Kessler
- Deutsches Herzzentrum München, Klinik für Herz- und Kreislauferkrankungen, Technische Universität München, Munich, Germany
| | - Bas L Kietselaer
- Maastricht University Medical Center+ and Cardiovascular Research Institute Maastricht, Department of Cardiology, Maastricht, The Netherlands
| | - Paulus Kirchhof
- Institute of Cardiovascular Sciences, University of Birmingham, Birmingham, UK
- Sandwell and West Birmingham Hospitals NHS Trust and University Hospitals Birmingham NHS Foundation Trust, Birmingham, UK
- AFNET, Muenster, Germany
| | - Marcus E Kleber
- Vth Department of Medicine, Medical Faculty Mannheim, Heidelberg University, Heidelberg, Germany
| | - Stacey Knight
- Intermountain Heart Institute, Intermountain Medical Center, Murray, UT, USA
- Department of Medicine, University of Utah, Salt Lake City, UT, USA
| | - Jose E Krieger
- Laboratory of Genetics and Molecular Cardiology, Heart Institute, University of São Paulo, São Paulo, Brazil
| | - Michiaki Kubo
- RIKEN Center for Integrative Medical Sciences, Yokohama, Japan
| | - Lenore J Launer
- Laboratory of Epidemiology, Demography, and Biometry, National Institute on Aging, Bethesda, MD, USA
| | - Jari Laurikka
- Department of Cardio-Thoracic Surgery, Heart Center, Tampere University Hospital, and Finnish Cardiovascular Research Center-Tampere, Faculty of Medicine and Life Sciences, University of Tampere, Tampere, Finland
| | - Terho Lehtimäki
- Department of Clinical Chemistry, Fimlab Laboratories and Finnish Cardiovascular Research Center-Tampere, Faculty of Medicine and Life Sciences, University of Tampere, Tampere, Finland
| | | | - Rozenn N Lemaitre
- Cardiovascular Health Research Unit, Department of Medicine, University of Washington, Seattle, WA, USA
| | - Man Li
- Department of Epidemiology, Johns Hopkins University, Baltimore, MD, USA
- Division of Nephrology & Hypertension, Internal Medicine, School of Medicine, University of Utah, Salt Lake City, UT, USA
| | | | - Henry J Lin
- Institute for Translational Genomics and Population Sciences, Department of Pediatrics, LABioMed at Harbor-UCLA Medical Center, Torrance, CA, USA
| | - Honghuang Lin
- NHLBI and Boston University's Framingham Heart Study, Framingham, MA, USA
- Department of Medicine, Boston University School of Medicine, Boston, MA, USA
| | - Lars Lind
- Department of Medical Sciences, Cardiovascular Epidemiology, Uppsala University, Uppsala, Sweden
| | - Cecilia M Lindgren
- Wellcome Trust Centre for Human Genetics, University of Oxford, Oxford, UK
| | - Marja-Liisa Lokki
- Transplantation Laboratory, Medicum, University of Helsinki, Helsinki, Finland
| | - Barry London
- Division of Cardiovascular Medicine and Abboud Cardiovascular Research Center, University of Iowa, Iowa City, IA, USA
| | - Ruth J F Loos
- The Charles Bronfman Institute for Personalized Medicine, Icahn School of Medicine at Mount Sinai, New York, NY, USA
- The Genetics of Obesity and Related Metabolic Traits Program, Icahn School of Medicine at Mount Sinai, New York, New York, USA
- The Mindich Child Health and Development Institute, Icahn School of Medicine at Mount Sinai, New York, NY, USA
| | - Siew-Kee Low
- Laboratory for Statistical Analysis, RIKEN Center for Integrative Medical Sciences, Yokohama, Japan
| | - Yingchang Lu
- The Charles Bronfman Institute for Personalized Medicine, Icahn School of Medicine at Mount Sinai, New York, NY, USA
- The Genetics of Obesity and Related Metabolic Traits Program, Icahn School of Medicine at Mount Sinai, New York, New York, USA
| | - Leo-Pekka Lyytikäinen
- Department of Clinical Chemistry, Fimlab Laboratories and Finnish Cardiovascular Research Center-Tampere, Faculty of Medicine and Life Sciences, University of Tampere, Tampere, Finland
| | - Peter W Macfarlane
- Institute of Health and Wellbeing, College of Medical, Veterinary and Life Sciences, University of Glasgow, Glasgow, UK
| | - Patrik K Magnusson
- Department of Medical Epidemiology and Biostatistics, Karolinska Institutet, Stockholm, Sweden
| | - Anubha Mahajan
- Wellcome Trust Centre for Human Genetics, University of Oxford, Oxford, UK
| | - Rainer Malik
- Institute for Stroke and Dementia Research (ISD), University Hospital, LMU Munich, Munich, Germany
| | | | - Gregory M Marcus
- Division of Cardiology, University of California, San Francisco, San Francisco, California, USA
| | - Lauren Margolin
- Program in Medical and Population Genetics, The Broad Institute of MIT and Harvard, Cambridge, MA, USA
| | - Kenneth B Margulies
- Penn Cardiovascular Institute and Department of Medicine, Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA, USA
| | - Winfried März
- Clinical Institute of Medical and Chemical Laboratory Diagnostics, Medical University of Graz, Graz, Austria
- Synlab Academy, Synlab Services GmbH, Mannheim, Germany
| | - David D McManus
- University of Massachusetts Medical School Worcester, Worcester, MA, USA
| | - Olle Melander
- Department of Internal Medicine, Clinical Sciences, Lund University, Malmo, Sweden
| | - Sanghamitra Mohanty
- Texas Cardiac Arrhythmia Institute, St David's Medical Center, Austin, TX, USA
- Dell Medical School, Austin, TX, USA
| | - Jay A Montgomery
- Department of Medicine, Vanderbilt University Medical Center, Nashville, TN, USA
| | - Michael P Morley
- Penn Cardiovascular Institute and Department of Medicine, Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA, USA
| | - Andrew P Morris
- Department of Biostatistics, University of Liverpool, Liverpool, UK
| | - Martina Müller-Nurasyid
- Department of Medicine I, University Hospital Munich, Ludwig-Maximilians-University, Munich, Germany
- DZHK (German Centre for Cardiovascular Research), partner site: Munich Heart Alliance, Munich, Germany
- Institute of Genetic Epidemiology, Helmholtz Zentrum München-German Research Center for Environmental Health, Neuherberg, Germany
| | - Andrea Natale
- Texas Cardiac Arrhythmia Institute, St David's Medical Center, Austin, TX, USA
- Dell Medical School, Austin, TX, USA
| | | | - Benjamin Neumann
- Department of Medicine I, University Hospital Munich, Ludwig-Maximilians-University, Munich, Germany
| | - Christopher Newton-Cheh
- Program in Medical and Population Genetics, The Broad Institute of MIT and Harvard, Cambridge, MA, USA
- Center for Genomic Medicine, Massachusetts General Hospital, Boston, MA, USA
| | - Maartje N Niemeijer
- Department of Epidemiology, Erasmus University Medical Center Rotterdam, Rotterdam, The Netherlands
| | - Kjell Nikus
- Heart Center, Department of Cardiology, Tampere University Hospital, Finland and Faculty of Medicine and Life Sciences, University of Tampere, Tampere, Finland
| | - Peter Nilsson
- Department of Clinical Sciences, Lund University and Skåne University Hospital, Malmo, Sweden
| | - Raymond Noordam
- Section of Gerontology and Geriatrics, Department of Internal Medicine, Leiden University Medical Center, Leiden, The Netherlands
| | | | - Morten S Olesen
- Laboratory for Molecular Cardiology, The Heart Centre, Department of Cardiology, Copenhagen University Hospital, Rigshospitalet, Copenhagen, Denmark
- The Danish National Research Foundation Centre for Cardiac Arrhythmia, Department of Biomedical Sciences, University of Copenhagen, Copenhagen, Denmark
- Department of Clinical Medicine, Faculty of Health and Medical Sciences, University of Copenhagen, Copenhagen, Denmark
| | | | - Sandosh Padmanabhan
- Institute of Cardiovascular and Medical Sciences, BHF Glasgow Cardiovascular Research Centre, University of Glasgow, Glasgow, UK
| | - Hui-Nam Pak
- Yonsei University Health System, Seoul, Korea
| | - Guillaume Paré
- Population Health Research Institute, McMaster University, Hamilton, Ontario, Canada
- Department of Pathology and Molecular Medicine, McMaster University, Hamilton, Ontario, Canada
| | - Nancy L Pedersen
- Department of Medical Epidemiology and Biostatistics, Karolinska Institutet, Stockholm, Sweden
| | - Joanna Pera
- Department of Neurology, Faculty of Medicine, Jagiellonian University Medical College, Krakow, Poland
| | - Alexandre Pereira
- Laboratory of Genetics and Molecular Biology, Heart Institute, University of São Paulo, São Paulo, Brazil
- Department of Genetics, Harvard Medical School, Boston, MA, USA
| | - David Porteous
- Generation Scotland, Centre for Genomic and Experimental Medicine, Institute of Genetics and Molecular Medicine, University of Edinburgh, Edinburgh, UK
| | - Bruce M Psaty
- Kaiser Permanente Washington Health Research Institute, Seattle, WA, USA
- Cardiovascular Health Research Unit, Departments of Medicine, Epidemiology, and Health Services, University of Washington, Seattle, WA, USA
| | - Sara L Pulit
- Program in Medical and Population Genetics, The Broad Institute of MIT and Harvard, Cambridge, MA, USA
- Department of Genetics, Center for Molecular Medicine, University Medical Centre Utrecht, Utrecht University, Utrecht, The Netherlands
- Li Ka Shing Center for Health Information and Discovery, Big Data Institute, Oxford University, Oxford, UK
| | - Clive R Pullinger
- Cardiovascular Research Institute, University of California, San Francisco, San Francisco, CA, USA
| | - Daniel J Rader
- Division of Cardiovascular Medicine, Department of Medicine, Perelman School of Medicine at the University of Pennsylvania, Philadelphia, PA, USA
| | - Lena Refsgaard
- Laboratory for Molecular Cardiology, The Heart Centre, Department of Cardiology, Copenhagen University Hospital, Rigshospitalet, Copenhagen, Denmark
- The Danish National Research Foundation Centre for Cardiac Arrhythmia, Department of Biomedical Sciences, University of Copenhagen, Copenhagen, Denmark
- Department of Clinical Medicine, Faculty of Health and Medical Sciences, University of Copenhagen, Copenhagen, Denmark
| | - Marta Ribasés
- Psychiatric Genetics Unit, Group of Psychiatry, Mental Health and Addiction, Vall d'Hebron Research Institute (VHIR), Universitat Autònoma de Barcelona, Barcelona, Spain
- Department of Psychiatry, Hospital Universitari Vall d'Hebron, Barcelona, Spain
- Biomedical Network Research Centre on Mental Health (CIBERSAM), Instituto de Salud Carlos III, Madrid, Spain
| | - Paul M Ridker
- Divisions of Preventive and Cardiovascular Medicine, Brigham and Women's Hospital & Harvard Medical School, Boston, MA, USA
| | - Michiel Rienstra
- Department of Cardiology, University Medical Center Groningen, University of Groningen, Groningen, The Netherlands
| | - Lorenz Risch
- University Institute of Clinical Chemistry, University of Bern, Bern, Switzerland
- Labormedizinisches Zentrum Dr. Risch, Schaan, Liechtenstein
| | - Dan M Roden
- Department of Medicine, Vanderbilt University Medical Center, Nashville, TN, USA
| | - Jonathan Rosand
- Program in Medical and Population Genetics, The Broad Institute of MIT and Harvard, Cambridge, MA, USA
- Center for Genomic Medicine, Massachusetts General Hospital, Boston, MA, USA
| | - Michael A Rosenberg
- Center for Genomic Medicine, Massachusetts General Hospital, Boston, MA, USA
- University of Colorado School of Medicine, Aurora, CO, USA
| | - Natalia Rost
- Program in Medical and Population Genetics, The Broad Institute of MIT and Harvard, Cambridge, MA, USA
- J. Philip Kistler Stroke Research Center, Massachusetts General Hospital, Boston, MA, USA
| | - Jerome I Rotter
- Institute for Translational Genomics and Population Sciences, Departments of Pediatrics and Medicine, LABioMed at Harbor-UCLA Medical Center, Torrance, CA, USA
| | - Samir Saba
- Division of Cardiology, University of Pittsburgh, Pittsburgh, PA, USA
| | - Roopinder K Sandhu
- Division of Cardiology, University of Alberta, Edmonton, Alberta, Canada
| | - Renate B Schnabel
- Department of General and Interventional Cardiology, University Heart Centre Hamburg, Hamburg, Germany
- DZHK (German Centre for Cardiovascular Research), partner site: Hamburg/Kiel/Lübeck, Hamburg, Germany
| | - Katharina Schramm
- Department of Medicine I, University Hospital Munich, Ludwig-Maximilians-University, Munich, Germany
- Institute of Genetic Epidemiology, Helmholtz Zentrum München-German Research Center for Environmental Health, Neuherberg, Germany
| | - Heribert Schunkert
- DZHK (German Centre for Cardiovascular Research), partner site: Munich Heart Alliance, Munich, Germany
- Deutsches Herzzentrum München, Klinik für Herz- und Kreislauferkrankungen, Technische Universität München, Munich, Germany
| | - Claudia Schurman
- The Charles Bronfman Institute for Personalized Medicine, Icahn School of Medicine at Mount Sinai, New York, NY, USA
- The Genetics of Obesity and Related Metabolic Traits Program, Icahn School of Medicine at Mount Sinai, New York, New York, USA
| | - Stuart A Scott
- Department of Genetics and Genomic Sciences, Icahn School of Medicine at Mount Sinai, New York, NY, USA
| | - Ilkka Seppälä
- Department of Clinical Chemistry, Fimlab Laboratories and Finnish Cardiovascular Research Center-Tampere, Faculty of Medicine and Life Sciences, University of Tampere, Tampere, Finland
| | - Christian Shaffer
- Department of Medicine, Vanderbilt University Medical Center, Nashville, TN, USA
| | - Svati Shah
- Division of Cardiology, Department of Medicine, Duke University School of Medicine, Durham, North Carolina, USA
| | - Alaa A Shalaby
- Division of Cardiology, University of Pittsburgh, Pittsburgh, PA, USA
- Cardiology Division, Pittsburgh VA Healthcare System, Pittsburgh, Pennsylvania, USA
| | - Jaemin Shim
- Korea University Anam Hospital, Seoul, Korea
| | - M Benjamin Shoemaker
- Department of Medicine, Vanderbilt University Medical Center, Nashville, TN, USA
| | - Joylene E Siland
- Department of Cardiology, University Medical Center Groningen, University of Groningen, Groningen, The Netherlands
| | - Juha Sinisalo
- Heart and Lung Center HUS, Helsinki University Central Hospital, Helsinki, Finland
| | - Moritz F Sinner
- Department of Medicine I, University Hospital Munich, Ludwig-Maximilians-University, Munich, Germany
- DZHK (German Centre for Cardiovascular Research), partner site: Munich Heart Alliance, Munich, Germany
| | - Agnieszka Slowik
- Department of Neurology, Faculty of Medicine, Jagiellonian University Medical College, Krakow, Poland
| | - Albert V Smith
- Icelandic Heart Association, Kopavogur, Iceland
- Faculty of Medicine, University of Iceland, Reykavik, Iceland
| | - Blair H Smith
- Division of Population Health Sciences, University of Dundee, Dundee, UK
| | - J Gustav Smith
- Program in Medical and Population Genetics, The Broad Institute of MIT and Harvard, Cambridge, MA, USA
- Department of Cardiology, Clinical Sciences, Lund University and Skåne University Hospital, Lund, Sweden
| | - Jonathan D Smith
- Departments of Cardiovascular Medicine, Cellular and Molecular Medicine, Molecular Cardiology, and Quantitative Health Sciences, Cleveland Clinic, Cleveland, OH, USA
| | - Nicholas L Smith
- Cardiovascular Health Research Unit and Department of Epidemiology, University of Washington, Seattle, WA, USA
- Kaiser Permanente Washington Health Research Institute, Seattle, WA, USA
| | - Elsayed Z Soliman
- Epidemiological Cardiology Research Center (EPICARE), Wake Forest School of Medicine, Winston Salem, NC, USA
| | - Nona Sotoodehnia
- Cardiovascular Health Research Unit, Departments of Medicine and Epidemiology, University of Washington, Seattle, WA, USA
| | - Bruno H Stricker
- Department of Epidemiology and Internal Medicine, Erasmus University Medical Center Rotterdam, Rotterdam, The Netherlands
- Inspectorate of Health Care, Utrecht, The Netherlands
| | - Albert Sun
- Division of Cardiology, Department of Medicine, Duke University School of Medicine, Durham, North Carolina, USA
| | - Han Sun
- Departments of Cardiovascular Medicine, Cellular and Molecular Medicine, Molecular Cardiology, and Quantitative Health Sciences, Cleveland Clinic, Cleveland, OH, USA
| | - Jesper H Svendsen
- Laboratory for Molecular Cardiology, The Heart Centre, Department of Cardiology, Copenhagen University Hospital, Rigshospitalet, Copenhagen, Denmark
- Department of Clinical Medicine, Faculty of Health and Medical Sciences, University of Copenhagen, Copenhagen, Denmark
| | - Toshihiro Tanaka
- Department of Human Genetics and Disease Diversity, Tokyo Medical and Dental University Graduate School of Medical and Dental Sciences, Tokyo, Japan
| | | | - Kent D Taylor
- Institute for Translational Genomics and Population Sciences, Department of Pediatrics, LABioMed at Harbor-UCLA Medical Center, Torrance, CA, USA
| | | | - Alexander Teumer
- DZHK (German Centre for Cardiovascular Research), partner site: Greifswald, Greifswald, Germany
- Institute for Community Medicine, University Medicine Greifswald, Greifswald, Germany
| | - Sébastien Thériault
- Population Health Research Institute, McMaster University, Hamilton, Ontario, Canada
- Department of Pathology and Molecular Medicine, McMaster University, Hamilton, Ontario, Canada
| | - Stella Trompet
- Department of Cardiology, Leiden University Medical Center, Leiden, The Netherlands
- Section of Gerontology and Geriatrics, Department of Internal Medicine, Leiden University Medical Center, Leiden, The Netherlands
| | - Nathan R Tucker
- Program in Medical and Population Genetics, The Broad Institute of MIT and Harvard, Cambridge, MA, USA
- Cardiovascular Research Center, Massachusetts General Hospital, Boston, MA, USA
| | - Arnljot Tveit
- Department of Medical Research, Bærum Hospital, Vestre Viken Hospital Trust, Drammen, Norway
- Institute of Clinical Medicine, University of Oslo, Oslo, Norway
| | - Andre G Uitterlinden
- Department of Epidemiology and Internal Medicine, Erasmus University Medical Center Rotterdam, Rotterdam, The Netherlands
| | - Pim Van Der Harst
- Department of Cardiology, University Medical Center Groningen, University of Groningen, Groningen, The Netherlands
| | - Isabelle C Van Gelder
- Department of Cardiology, University Medical Center Groningen, University of Groningen, Groningen, The Netherlands
| | - David R Van Wagoner
- Departments of Cardiovascular Medicine, Cellular and Molecular Medicine, Molecular Cardiology, and Quantitative Health Sciences, Cleveland Clinic, Cleveland, OH, USA
| | - Niek Verweij
- Department of Cardiology, University Medical Center Groningen, University of Groningen, Groningen, The Netherlands
| | | | - Uwe Völker
- DZHK (German Centre for Cardiovascular Research), partner site: Greifswald, Greifswald, Germany
- Interfaculty Institute for Genetics and Functional Genomics, University Medicine and Ernst-Moritz-Arndt-University Greifswald, Greifswald, Germany
| | - Biqi Wang
- Department of Biostatistics, Boston University School of Public Health, Boston, MA, USA
| | - Peter E Weeke
- Laboratory for Molecular Cardiology, The Heart Centre, Department of Cardiology, Copenhagen University Hospital, Rigshospitalet, Copenhagen, Denmark
- Department of Medicine, Vanderbilt University Medical Center, Nashville, TN, USA
| | - Bob Weijs
- Maastricht University Medical Center+ and Cardiovascular Research Institute Maastricht, Department of Cardiology, Maastricht, The Netherlands
| | - Raul Weiss
- Division of Cardiovascular Medicine, The Ohio State University, Columbus, OH, USA
| | - Stefan Weiss
- DZHK (German Centre for Cardiovascular Research), partner site: Greifswald, Greifswald, Germany
- Interfaculty Institute for Genetics and Functional Genomics, University Medicine and Ernst-Moritz-Arndt-University Greifswald, Greifswald, Germany
| | - Quinn S Wells
- Department of Medicine, Vanderbilt University Medical Center, Nashville, TN, USA
| | - Kerri L Wiggins
- Cardiovascular Health Research Unit, Department of Medicine, University of Washington, Seattle, WA, USA
| | - Jorge A Wong
- Division of Cardiology, Hamilton Health Sciences, McMaster University, Hamilton, Ontario, Canada
| | - Daniel Woo
- University of Cincinnati College of Medicine, Cincinnati, OH, USA
| | - Bradford B Worrall
- Departments of Neurology and Public Health Science, University of Virginia Health System, Charlottesville, VA, USA
| | | | - Jie Yao
- Institute for Translational Genomics and Population Sciences, Department of Pediatrics, LABioMed at Harbor-UCLA Medical Center, Torrance, CA, USA
| | - Zachary T Yoneda
- Department of Medicine, Vanderbilt University Medical Center, Nashville, TN, USA
| | - Tanja Zeller
- Department of General and Interventional Cardiology, University Heart Centre Hamburg, Hamburg, Germany
- DZHK (German Centre for Cardiovascular Research), partner site: Hamburg/Kiel/Lübeck, Hamburg, Germany
| | - Lingyao Zeng
- Deutsches Herzzentrum München, Klinik für Herz- und Kreislauferkrankungen, Technische Universität München, Munich, Germany
| | - Steven A Lubitz
- Program in Medical and Population Genetics, The Broad Institute of MIT and Harvard, Cambridge, MA, USA
- Cardiovascular Research Center, Massachusetts General Hospital, Boston, MA, USA
- Cardiac Arrhythmia Service, Massachusetts General Hospital, Boston, MA, USA
| | - Kathryn L Lunetta
- NHLBI and Boston University's Framingham Heart Study, Framingham, MA, USA
- Department of Biostatistics, Boston University School of Public Health, Boston, MA, USA
| | - Patrick T Ellinor
- Program in Medical and Population Genetics, The Broad Institute of MIT and Harvard, Cambridge, MA, USA.
- Cardiovascular Research Center, Massachusetts General Hospital, Boston, MA, USA.
- Cardiac Arrhythmia Service, Massachusetts General Hospital, Boston, MA, USA.
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Hsu J, Gore-Panter S, Tchou G, Castel L, Lovano B, Moravec CS, Pettersson GB, Roselli EE, Gillinov AM, McCurry KR, Smedira NG, Barnard J, Van Wagoner DR, Chung MK, Smith JD. Genetic Control of Left Atrial Gene Expression Yields Insights into the Genetic Susceptibility for Atrial Fibrillation. Circ Genom Precis Med 2018; 11:e002107. [PMID: 29545482 PMCID: PMC5858469 DOI: 10.1161/circgen.118.002107] [Citation(s) in RCA: 27] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/07/2017] [Accepted: 01/23/2018] [Indexed: 02/01/2023]
Abstract
BACKGROUND Genome-wide association studies have identified 23 loci for atrial fibrillation (AF), but the mechanisms responsible for these associations, as well as the causal genes and genetic variants, remain undefined. METHODS To identify the effect of common genetic variants on gene expression that might explain the mechanisms linking genome-wide association loci with AF risk, we performed RNA sequencing of left atrial appendages from a biracial cohort of 265 subjects. RESULTS Combining gene expression data with genome-wide single nucleotide polymorphism data, we found that approximately two-thirds of the expressed genes were regulated in cis by common genetic variants at a false discovery rate of <0.05, defined as cis-expression quantitative trait loci. Twelve of 23 reported AF genome-wide association loci displayed genome-wide significant cis-expression quantitative trait loci, at PRRX1 (chromosome 1q24), SNRNP27 (1q24), CEP68 (2p14), FKBP7 (2q31), KCNN2 (5q22), FAM13B (5q31), CAV1 (7q31), ASAH1 (8p22), MYOZ1 (10q22), C11ORF45 (11q24), TBX5 (12q24), and SYNE2 (14q23), suggesting that altered expression of these genes plays a role in AF susceptibility. Allelic expression imbalance was used as an independent method to characterize the cis-control of gene expression. One thousand two hundred forty-eight of 5153 queried genes had cis-single nucleotide polymorphisms that significantly regulated allelic expression at a false discovery rate of <0.05. CONCLUSIONS We provide a genome-wide catalog of the genetic control of gene expression in human left atrial appendage. These data can be used to confirm the relevance of genome-wide association loci and to direct future functional studies to identify the genes and genetic variants responsible for complex diseases such as AF.
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Affiliation(s)
- Jeffrey Hsu
- From the Departments of Cellular and Molecular Medicine (J.H., G.T., J.D.S.), Quantitative Health Sciences (J.B.), Molecular Cardiology (S.G.-P., L.C., B.L., C.S.M., D.R.V.W., M.K.C.), Cardiovascular Medicine (C.S.M., D.R.V.W., M.K.C., J.D.S.), and Cardiothoracic Surgery (G.B.P., E.E.R., A.M.G., K.R.M., N.G.S.), Cleveland Clinic, Cleveland, OH
| | - Shamone Gore-Panter
- From the Departments of Cellular and Molecular Medicine (J.H., G.T., J.D.S.), Quantitative Health Sciences (J.B.), Molecular Cardiology (S.G.-P., L.C., B.L., C.S.M., D.R.V.W., M.K.C.), Cardiovascular Medicine (C.S.M., D.R.V.W., M.K.C., J.D.S.), and Cardiothoracic Surgery (G.B.P., E.E.R., A.M.G., K.R.M., N.G.S.), Cleveland Clinic, Cleveland, OH
| | - Gregory Tchou
- From the Departments of Cellular and Molecular Medicine (J.H., G.T., J.D.S.), Quantitative Health Sciences (J.B.), Molecular Cardiology (S.G.-P., L.C., B.L., C.S.M., D.R.V.W., M.K.C.), Cardiovascular Medicine (C.S.M., D.R.V.W., M.K.C., J.D.S.), and Cardiothoracic Surgery (G.B.P., E.E.R., A.M.G., K.R.M., N.G.S.), Cleveland Clinic, Cleveland, OH
| | - Laurie Castel
- From the Departments of Cellular and Molecular Medicine (J.H., G.T., J.D.S.), Quantitative Health Sciences (J.B.), Molecular Cardiology (S.G.-P., L.C., B.L., C.S.M., D.R.V.W., M.K.C.), Cardiovascular Medicine (C.S.M., D.R.V.W., M.K.C., J.D.S.), and Cardiothoracic Surgery (G.B.P., E.E.R., A.M.G., K.R.M., N.G.S.), Cleveland Clinic, Cleveland, OH
| | - Beth Lovano
- From the Departments of Cellular and Molecular Medicine (J.H., G.T., J.D.S.), Quantitative Health Sciences (J.B.), Molecular Cardiology (S.G.-P., L.C., B.L., C.S.M., D.R.V.W., M.K.C.), Cardiovascular Medicine (C.S.M., D.R.V.W., M.K.C., J.D.S.), and Cardiothoracic Surgery (G.B.P., E.E.R., A.M.G., K.R.M., N.G.S.), Cleveland Clinic, Cleveland, OH
| | - Christine S Moravec
- From the Departments of Cellular and Molecular Medicine (J.H., G.T., J.D.S.), Quantitative Health Sciences (J.B.), Molecular Cardiology (S.G.-P., L.C., B.L., C.S.M., D.R.V.W., M.K.C.), Cardiovascular Medicine (C.S.M., D.R.V.W., M.K.C., J.D.S.), and Cardiothoracic Surgery (G.B.P., E.E.R., A.M.G., K.R.M., N.G.S.), Cleveland Clinic, Cleveland, OH
| | - Gosta B Pettersson
- From the Departments of Cellular and Molecular Medicine (J.H., G.T., J.D.S.), Quantitative Health Sciences (J.B.), Molecular Cardiology (S.G.-P., L.C., B.L., C.S.M., D.R.V.W., M.K.C.), Cardiovascular Medicine (C.S.M., D.R.V.W., M.K.C., J.D.S.), and Cardiothoracic Surgery (G.B.P., E.E.R., A.M.G., K.R.M., N.G.S.), Cleveland Clinic, Cleveland, OH
| | - Eric E Roselli
- From the Departments of Cellular and Molecular Medicine (J.H., G.T., J.D.S.), Quantitative Health Sciences (J.B.), Molecular Cardiology (S.G.-P., L.C., B.L., C.S.M., D.R.V.W., M.K.C.), Cardiovascular Medicine (C.S.M., D.R.V.W., M.K.C., J.D.S.), and Cardiothoracic Surgery (G.B.P., E.E.R., A.M.G., K.R.M., N.G.S.), Cleveland Clinic, Cleveland, OH
| | - A Marc Gillinov
- From the Departments of Cellular and Molecular Medicine (J.H., G.T., J.D.S.), Quantitative Health Sciences (J.B.), Molecular Cardiology (S.G.-P., L.C., B.L., C.S.M., D.R.V.W., M.K.C.), Cardiovascular Medicine (C.S.M., D.R.V.W., M.K.C., J.D.S.), and Cardiothoracic Surgery (G.B.P., E.E.R., A.M.G., K.R.M., N.G.S.), Cleveland Clinic, Cleveland, OH
| | - Kenneth R McCurry
- From the Departments of Cellular and Molecular Medicine (J.H., G.T., J.D.S.), Quantitative Health Sciences (J.B.), Molecular Cardiology (S.G.-P., L.C., B.L., C.S.M., D.R.V.W., M.K.C.), Cardiovascular Medicine (C.S.M., D.R.V.W., M.K.C., J.D.S.), and Cardiothoracic Surgery (G.B.P., E.E.R., A.M.G., K.R.M., N.G.S.), Cleveland Clinic, Cleveland, OH
| | - Nicholas G Smedira
- From the Departments of Cellular and Molecular Medicine (J.H., G.T., J.D.S.), Quantitative Health Sciences (J.B.), Molecular Cardiology (S.G.-P., L.C., B.L., C.S.M., D.R.V.W., M.K.C.), Cardiovascular Medicine (C.S.M., D.R.V.W., M.K.C., J.D.S.), and Cardiothoracic Surgery (G.B.P., E.E.R., A.M.G., K.R.M., N.G.S.), Cleveland Clinic, Cleveland, OH
| | - John Barnard
- From the Departments of Cellular and Molecular Medicine (J.H., G.T., J.D.S.), Quantitative Health Sciences (J.B.), Molecular Cardiology (S.G.-P., L.C., B.L., C.S.M., D.R.V.W., M.K.C.), Cardiovascular Medicine (C.S.M., D.R.V.W., M.K.C., J.D.S.), and Cardiothoracic Surgery (G.B.P., E.E.R., A.M.G., K.R.M., N.G.S.), Cleveland Clinic, Cleveland, OH
| | - David R Van Wagoner
- From the Departments of Cellular and Molecular Medicine (J.H., G.T., J.D.S.), Quantitative Health Sciences (J.B.), Molecular Cardiology (S.G.-P., L.C., B.L., C.S.M., D.R.V.W., M.K.C.), Cardiovascular Medicine (C.S.M., D.R.V.W., M.K.C., J.D.S.), and Cardiothoracic Surgery (G.B.P., E.E.R., A.M.G., K.R.M., N.G.S.), Cleveland Clinic, Cleveland, OH
| | - Mina K Chung
- From the Departments of Cellular and Molecular Medicine (J.H., G.T., J.D.S.), Quantitative Health Sciences (J.B.), Molecular Cardiology (S.G.-P., L.C., B.L., C.S.M., D.R.V.W., M.K.C.), Cardiovascular Medicine (C.S.M., D.R.V.W., M.K.C., J.D.S.), and Cardiothoracic Surgery (G.B.P., E.E.R., A.M.G., K.R.M., N.G.S.), Cleveland Clinic, Cleveland, OH
| | - Jonathan D Smith
- From the Departments of Cellular and Molecular Medicine (J.H., G.T., J.D.S.), Quantitative Health Sciences (J.B.), Molecular Cardiology (S.G.-P., L.C., B.L., C.S.M., D.R.V.W., M.K.C.), Cardiovascular Medicine (C.S.M., D.R.V.W., M.K.C., J.D.S.), and Cardiothoracic Surgery (G.B.P., E.E.R., A.M.G., K.R.M., N.G.S.), Cleveland Clinic, Cleveland, OH.
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Christophersen IE, Magnani JW, Yin X, Barnard J, Weng LC, Arking DE, Niemeijer MN, Lubitz SA, Avery CL, Duan Q, Felix SB, Bis JC, Kerr KF, Isaacs A, Müller-Nurasyid M, Müller C, North KE, Reiner AP, Tinker LF, Kors JA, Teumer A, Petersmann A, Sinner MF, Buzkova P, Smith JD, Van Wagoner DR, Völker U, Waldenberger M, Peters A, Meitinger T, Limacher MC, Wilhelmsen KC, Psaty BM, Hofman A, Uitterlinden A, Krijthe BP, Zhang ZM, Schnabel RB, Kääb S, van Duijn C, Rotter JI, Sotoodehnia N, Dörr M, Li Y, Chung MK, Soliman EZ, Alonso A, Whitsel EA, Stricker BH, Benjamin EJ, Heckbert SR, Ellinor PT. Fifteen Genetic Loci Associated With the Electrocardiographic P Wave. ACTA ACUST UNITED AC 2018; 10:CIRCGENETICS.116.001667. [PMID: 28794112 DOI: 10.1161/circgenetics.116.001667] [Citation(s) in RCA: 35] [Impact Index Per Article: 5.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/10/2016] [Accepted: 05/15/2017] [Indexed: 12/13/2022]
Abstract
BACKGROUND The P wave on an ECG is a measure of atrial electric function, and its characteristics may serve as predictors for atrial arrhythmias. Increased mean P-wave duration and P-wave terminal force traditionally have been used as markers for left atrial enlargement, and both have been associated with increased risk of atrial fibrillation. Here, we explore the genetic basis of P-wave morphology through meta-analysis of genome-wide association study results for P-wave duration and P-wave terminal force from 12 cohort studies. METHODS AND RESULTS We included 44 456 individuals, of which 6778 (16%) were of African ancestry. Genotyping, imputation, and genome-wide association study were performed at each study site. Summary-level results were meta-analyzed centrally using inverse-variance weighting. In meta-analyses of P-wave duration, we identified 6 significant (P<5×10-8) novel loci and replicated a prior association with SCN10A. We identified 3 loci at SCN5A, TBX5, and CAV1/CAV2 that were jointly associated with the PR interval, PR segment, and P-wave duration. We identified 6 novel loci in meta-analysis of P-wave terminal force. Four of the identified genetic loci were significantly associated with gene expression in 329 left atrial samples. Finally, we observed that some of the loci associated with the P wave were linked to overall atrial conduction, whereas others identified distinct phases of atrial conduction. CONCLUSIONS We have identified 6 novel genetic loci associated with P-wave duration and 6 novel loci associated with P-wave terminal force. Future studies of these loci may aid in identifying new targets for drugs that may modify atrial conduction or treat atrial arrhythmias.
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Gore-Panter SR, Rennison JH, Van Wagoner DR. Genetic-Genomic Insights Into the Metabolic Determinants of Spontaneous Atrial Fibrillation. Circ Arrhythm Electrophysiol 2017; 10:CIRCEP.117.005636. [PMID: 28784606 DOI: 10.1161/circep.117.005636] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/25/2023]
Affiliation(s)
| | - Julie H Rennison
- From the Department of Molecular Cardiology, Cleveland Clinic, OH
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Christophersen IE, Rienstra M, Roselli C, Yin X, Geelhoed B, Barnard J, Lin H, Arking DE, Smith AV, Albert CM, Chaffin M, Tucker NR, Li M, Klarin D, Bihlmeyer NA, Low SK, Weeke PE, Müller-Nurasyid M, Smith JG, Brody JA, Niemeijer MN, Dörr M, Trompet S, Huffman J, Gustafsson S, Schurmann C, Kleber ME, Lyytikäinen LP, Seppälä I, Malik R, R V R Horimoto A, Perez M, Sinisalo J, Aeschbacher S, Thériault S, Yao J, Radmanesh F, Weiss S, Teumer A, Choi SH, Weng LC, Clauss S, Deo R, Rader DJ, Shah SH, Sun A, Hopewell JC, Debette S, Chauhan G, Yang Q, Worrall BB, Paré G, Kamatani Y, Hagemeijer YP, Verweij N, Siland JE, Kubo M, Smith JD, Van Wagoner DR, Bis JC, Perz S, Psaty BM, Ridker PM, Magnani JW, Harris TB, Launer LJ, Shoemaker MB, Padmanabhan S, Haessler J, Bartz TM, Waldenberger M, Lichtner P, Arendt M, Krieger JE, Kähönen M, Risch L, Mansur AJ, Peters A, Smith BH, Lind L, Scott SA, Lu Y, Bottinger EB, Hernesniemi J, Lindgren CM, Wong JA, Huang J, Eskola M, Morris AP, Ford I, Reiner AP, Delgado G, Chen LY, Chen YDI, Sandhu RK, Li M, Boerwinkle E, Eisele L, Lannfelt L, Rost N, Anderson CD, Taylor KD, Campbell A, Magnusson PK, Porteous D, Hocking LJ, Vlachopoulou E, Pedersen NL, Nikus K, Orho-Melander M, Hamsten A, Heeringa J, Denny JC, Kriebel J, Darbar D, Newton-Cheh C, Shaffer C, Macfarlane PW, Heilmann-Heimbach S, Almgren P, Huang PL, Sotoodehnia N, Soliman EZ, Uitterlinden AG, Hofman A, Franco OH, Völker U, Jöckel KH, Sinner MF, Lin HJ, Guo X, Dichgans M, Ingelsson E, Kooperberg C, Melander O, J F Loos R, Laurikka J, Conen D, Rosand J, van der Harst P, Lokki ML, Kathiresan S, Pereira A, Jukema JW, Hayward C, Rotter JI, März W, Lehtimäki T, Stricker BH, Chung MK, Felix SB, Gudnason V, Alonso A, Roden DM, Kääb S, Chasman DI, Heckbert SR, Benjamin EJ, Tanaka T, Lunetta KL, Lubitz SA, Ellinor PT. Erratum: Large-scale analyses of common and rare variants identify 12 new loci associated with atrial fibrillation. Nat Genet 2017; 49:1286. [PMID: 28747752 DOI: 10.1038/ng0817-1286c] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/09/2022]
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Zakeri R, Van Wagoner DR, Calkins H, Wong T, Ross HM, Heist EK, Meyer TE, Kowey PR, Mentz RJ, Cleland JG, Pitt B, Zannad F, Linde C. The burden of proof: The current state of atrial fibrillation prevention and treatment trials. Heart Rhythm 2017; 14:763-782. [PMID: 28161513 PMCID: PMC5403606 DOI: 10.1016/j.hrthm.2017.01.032] [Citation(s) in RCA: 25] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/05/2016] [Indexed: 12/19/2022]
Abstract
Atrial fibrillation (AF) is an age-related arrhythmia of enormous socioeconomic significance. In recent years, our understanding of the basic mechanisms that initiate and perpetuate AF has evolved rapidly, catheter ablation of AF has progressed from concept to reality, and recent studies suggest lifestyle modification may help prevent AF recurrence. Emerging developments in genetics, imaging, and informatics also present new opportunities for personalized care. However, considerable challenges remain. These include a paucity of studies examining AF prevention, modest efficacy of existing antiarrhythmic therapies, diverse ablation technologies and practice, and limited evidence to guide management of high-risk patients with multiple comorbidities. Studies examining the long-term effects of AF catheter ablation on morbidity and mortality outcomes are not yet completed. In many ways, further progress in the field is heavily contingent on the feasibility, capacity, and efficiency of clinical trials to incorporate the rapidly evolving knowledge base and to provide substantive evidence for novel AF therapeutic strategies. This review outlines the current state of AF prevention and treatment trials, including the foreseeable challenges, as discussed by a unique forum of clinical trialists, scientists, and regulatory representatives in a session endorsed by the Heart Rhythm Society at the 12th Global CardioVascular Clinical Trialists Forum in Washington, DC, December 3-5, 2015.
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Affiliation(s)
- Rosita Zakeri
- Royal Brompton & Harefield NHS Trust, London, United Kingdom.
| | | | | | - Tom Wong
- Royal Brompton & Harefield NHS Trust, London, United Kingdom
| | | | - E Kevin Heist
- Massachusetts General Hospital, Boston, Massachusetts
| | | | - Peter R Kowey
- Lankenau Heart Institute and Jefferson Medical College, Wynnewood, Pennsylvania
| | - Robert J Mentz
- Duke Clinical Research Institute, Durham, North Carolina
| | - John G Cleland
- Royal Brompton & Harefield NHS Trust, London, United Kingdom
| | | | - Faiez Zannad
- INSERM, Centre d'Investigations Cliniques Plurithématique 1433, INSERM U1116, Université de Lorraine, CHRU de Nancy, F-CRIN INI-CRCT, France
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Gorenek B, Pelliccia A, Benjamin EJ, Boriani G, Crijns HJ, Fogel RI, Van Gelder IC, Halle M, Kudaiberdieva G, Lane DA, Bjerregaard Larsen T, Lip GYH, Løchen ML, Marin F, Niebauer J, Sanders P, Tokgozoglu L, Vos MA, Van Wagoner DR, Fauchier L, Savelieva I, Goette A, Agewall S, Chiang CE, Figueiredo M, Stiles M, Dickfeld T, Patton K, Piepoli M, Corra U, Manuel Marques-Vidal P, Faggiano P, Schmid JP, Abreu A. European Heart Rhythm Association (EHRA)/European Association of Cardiovascular Prevention and Rehabilitation (EACPR) position paper on how to prevent atrial fibrillation endorsed by the Heart Rhythm Society (HRS) and Asia Pacific Heart Rhythm Society (APHRS). Eur J Prev Cardiol 2017; 24:4-40. [PMID: 27815538 PMCID: PMC5427484 DOI: 10.1177/2047487316676037] [Citation(s) in RCA: 55] [Impact Index Per Article: 7.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/19/2022]
Affiliation(s)
| | | | | | | | - Harry J Crijns
- Maastricht University Medical Centre, Maastricht, The Netherlands
| | | | | | - Martin Halle
- Prevention and Sports Medicine, Technical University Munich, München, Germany
| | | | | | | | | | - Maja-Lisa Løchen
- UiT The Arctic University of Norway, Tromso, Norway
- Mary MacKillop Institute for Health Research, Centre for Research Excellence to Reduce Inequality in Heart Disease, Australian Catholic University, Melbourne, Australia
| | | | - Josef Niebauer
- Paracelsus Medical University Salzburg, Salzburg, Austria
| | | | | | | | | | | | | | | | | | | | | | | | | | | | | | - Ugo Corra
- Irccs Rehabilitation Medical Center, Veruno, Italy
| | | | | | | | - Ana Abreu
- Hospital de Santa Marta, Lisboa, Portugal
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Abstract
A surge of data has reproducibly identified strong associations of OSA with cardiac arrhythmias. As an extension of epidemiologic and clinic-based findings, experimental investigations have made strides in advancing our understanding of the putative OSA and cardiac arrhythmogenesis mechanistic underpinnings. Although most studies have focused on the links between OSA and atrial fibrillation (AF), relationships with ventricular arrhythmias have also been characterized. Key findings implicate OSA-related autonomic nervous system fluctuations typified by enhanced parasympathetic activation during respiratory events and sympathetic surges subsequent to respiratory events, which contribute to augmented arrhythmic propensity. Other more immediate pathophysiologic influences of OSA-enhancing arrhythmogenesis include intermittent hypoxia, intrathoracic pressure swings leading to atrial stretch, and hypercapnia. Intermediate pathways by which OSA may trigger arrhythmia include increased systemic inflammation, oxidative stress, enhanced prothrombotic state, and vascular dysfunction. Long-term OSA-associated sequelae such as hypertension, atrial enlargement and fibrosis, ventricular hypertrophy, and coronary artery disease also predispose to cardiac arrhythmia. These factors can lead to a reduction in atrial effective refractory period, triggered and abnormal automaticity, and promote slowed and heterogeneous conduction; all of these mechanisms increase the persistence of reentrant arrhythmias and prolong the QT interval. Cardiac electrical and structural remodeling observed in OSA animal models can progress the arrhythmogenic substrate to further enhance arrhythmia generation. Future investigations clarifying the contribution of specific OSA-related mechanistic pathways to arrhythmia generation may allow targeted preventative therapies to mitigate OSA-induced arrhythmogenicity. Furthermore, interventional studies are needed to clarify the impact of OSA pathophysiology reversal on cardiac arrhythmogenesis and related adverse outcomes.
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Affiliation(s)
- Anna M May
- Division of Pulmonary, Critical Care, and Sleep Medicine, University Hospitals Cleveland Medical Center, Cleveland, OH.
| | - David R Van Wagoner
- Department of Molecular Cardiology, Lerner Research Institute, Cleveland Clinic Lerner College of Medicine of Case Western Reserve University, Cleveland, OH
| | - Reena Mehra
- Neurologic Institute, Respiratory Institute, Heart and Vascular Institute and Molecular Cardiology Department, Lerner Research Institute, Cleveland Clinic Lerner College of Medicine of Case Western Reserve University, Cleveland, OH
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Lin H, Mueller-Nurasyid M, Smith AV, Arking DE, Barnard J, Bartz TM, Lunetta KL, Lohman K, Kleber ME, Lubitz SA, Geelhoed B, Trompet S, Niemeijer MN, Kacprowski T, Chasman DI, Klarin D, Sinner MF, Waldenberger M, Meitinger T, Harris TB, Launer LJ, Soliman EZ, Chen LY, Smith JD, Van Wagoner DR, Rotter JI, Psaty BM, Xie Z, Hendricks AE, Ding J, Delgado GE, Verweij N, van der Harst P, Macfarlane PW, Ford I, Hofman A, Uitterlinden A, Heeringa J, Franco OH, Kors JA, Weiss S, Völzke H, Rose LM, Natarajan P, Kathiresan S, Kääb S, Gudnason V, Alonso A, Chung MK, Heckbert SR, Benjamin EJ, Liu Y, März W, Rienstra M, Jukema JW, Stricker BH, Dörr M, Albert CM, Ellinor PT. Gene-gene Interaction Analyses for Atrial Fibrillation. Sci Rep 2016; 6:35371. [PMID: 27824142 PMCID: PMC5099695 DOI: 10.1038/srep35371] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/17/2016] [Accepted: 09/28/2016] [Indexed: 11/29/2022] Open
Abstract
Atrial fibrillation (AF) is a heritable disease that affects more than thirty million individuals worldwide. Extensive efforts have been devoted to the study of genetic determinants of AF. The objective of our study is to examine the effect of gene-gene interaction on AF susceptibility. We performed a large-scale association analysis of gene-gene interactions with AF in 8,173 AF cases, and 65,237 AF-free referents collected from 15 studies for discovery. We examined putative interactions between genome-wide SNPs and 17 known AF-related SNPs. The top interactions were then tested for association in an independent cohort for replication, which included more than 2,363 AF cases and 114,746 AF-free referents. One interaction, between rs7164883 at the HCN4 locus and rs4980345 at the SLC28A1 locus, was found to be significantly associated with AF in the discovery cohorts (interaction OR = 1.44, 95% CI: 1.27–1.65, P = 4.3 × 10–8). Eight additional gene-gene interactions were also marginally significant (P < 5 × 10–7). However, none of the top interactions were replicated. In summary, we did not find significant interactions that were associated with AF susceptibility. Future increases in sample size and denser genotyping might facilitate the identification of gene-gene interactions associated with AF.
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Affiliation(s)
- Honghuang Lin
- National Heart Lung and Blood Institute's and Boston University's Framingham Heart Study, Framingham, MA, USA.,Section of Computational Biomedicine, Department of Medicine, Boston University School of Medicine, Boston, MA, USA
| | - Martina Mueller-Nurasyid
- Institute of Genetic Epidemiology, Helmholtz Zentrum München, German Research Center for Environmental Health, Neuherberg, Germany.,Department of Medicine I, Ludwig-Maximilians-University Munich, Munich, Germany.,DZHK (German Centre for Cardiovascular Research), partner site Munich Heart Alliance, Munich, Germany
| | - Albert V Smith
- Icelandic Heart Association, Kopavogur, Iceland.,Faculty of Medicine, University of Iceland, Reykjavik, Iceland
| | - Dan E Arking
- McKusick-Nathans Institute of Genetic Medicine, Johns Hopkins University School of Medicine, Baltimore, MD, USA
| | | | - Traci M Bartz
- Department of Biostatistics, University of Washington, Seattle, WA, USA
| | - Kathryn L Lunetta
- National Heart Lung and Blood Institute's and Boston University's Framingham Heart Study, Framingham, MA, USA.,Department of Biostatistics, Boston University School of Public Health, Boston, MA, USA
| | - Kurt Lohman
- Department of Biostatistical Sciences, Public Health Sciences, Wake Forest School of Medicine, Winston-Salem, NC, USA
| | - Marcus E Kleber
- Vth Department of Medicine, Medical Faculty Mannheim, Heidelberg University, Theodor-Kutzer-Ufer 1-3, 68167 Mannheim, Germany
| | - Steven A Lubitz
- Cardiac Arrhythmia Service, Massachusetts General Hospital, Boston, MA, USA.,Harvard Medical School, Boston, MA, USA
| | - Bastiaan Geelhoed
- Department of Cardiology, University of Groningen, University Medical Center Groningen, Groningen, the Netherlands
| | - Stella Trompet
- Department of Cardiology, Leiden University Medical Center, the Netherlands.,Department of Gerontology and Geriatrics, Leiden University Medical Center, Leiden, the Netherlands
| | - Maartje N Niemeijer
- Department of Epidemiology, Erasmus MC - University Medical Center Rotterdam, Rotterdam, the Netherlands
| | - Tim Kacprowski
- Department of Functional Genomics, Interfaculty Institute for Genetics and Functional Genomics, University Medicine and Ernst-Moritz-Arndt University Greifswald, Greifswald, Germany.,DZHK (German Centre for Cardiovascular Research), partner site Greifswald, Greifswald, Germany
| | - Daniel I Chasman
- Division of Preventive Medicine, Brigham and Women's Hospital, Boston MA, USA
| | - Derek Klarin
- Cardiovascular Research Center, Massachusetts General Hospital, Boston, MA, USA.,Center for Human Genetic Research, Massachusetts General Hospital, Boston, MA, USA.,Department of Surgery, Massachusetts General Hospital, Boston, MA, USA.,Program in Medical and Population Genetics, Broad Institute, Cambridge, MA, USA
| | - Moritz F Sinner
- Department of Medicine I, Ludwig-Maximilians-University Munich, Munich, Germany
| | - Melanie Waldenberger
- DZHK (German Centre for Cardiovascular Research), partner site Munich Heart Alliance, Munich, Germany.,Vth Department of Medicine, Medical Faculty Mannheim, Heidelberg University, Theodor-Kutzer-Ufer 1-3, 68167 Mannheim, Germany.,Research Unit of Molecular Epidemiology, Helmholtz Zentrum München, German Research Center for Environmental Health, Neuherberg, Germany
| | - Thomas Meitinger
- DZHK (German Centre for Cardiovascular Research), partner site Munich Heart Alliance, Munich, Germany.,Institute of Human Genetics, Helmholtz Zentrum München - German Research Center for Environmental Health, Neuherberg, Germany.,Institute of Human Genetics, Technische Universität München, Munich, Germany
| | - Tamara B Harris
- National Institute on Aging, National Institutes of Health, Bethesda, MD, USA
| | - Lenore J Launer
- National Institute on Aging, National Institutes of Health, Bethesda, MD, USA
| | - Elsayed Z Soliman
- Epidemiological Cardiology Research Center, Wake Forest School of Medicine, Winston Salem, NC, USA
| | - Lin Y Chen
- Cardiovascular Division, Department of Medicine, University of Minnesota Medical School, Minneapolis, MN, USA
| | | | | | - Jerome I Rotter
- Institute for Translational Genomics and Population Sciences (J.I.R.), Departments of Pediatrics and Medicine, LABioMed at Harbor-UCLA Medical Center, Torrance, CA, USA
| | - Bruce M Psaty
- Cardiovascular Health Research Unit, Departments of Medicine, Epidemiology and Health Services, University of Washington, Seattle, WA, USA.,Group Health Research Institute, Group Health Cooperative, Seattle, WA, USA
| | - Zhijun Xie
- Section of Computational Biomedicine, Department of Medicine, Boston University School of Medicine, Boston, MA, USA
| | - Audrey E Hendricks
- National Heart Lung and Blood Institute's and Boston University's Framingham Heart Study, Framingham, MA, USA.,Mathematical and Statistical Sciences, University of Colorado, Denver, Denver, CO, USA
| | - Jingzhong Ding
- Department of Gerontology and Geriatric Medicine, Wake Forest School of Medicine, Winston-Salem, NC, USA
| | - Graciela E Delgado
- Vth Department of Medicine, Medical Faculty Mannheim, Heidelberg University, Theodor-Kutzer-Ufer 1-3, 68167 Mannheim, Germany
| | - Niek Verweij
- Department of Cardiology, University of Groningen, University Medical Center Groningen, Groningen, the Netherlands
| | - Pim van der Harst
- Department of Cardiology, University of Groningen, University Medical Center Groningen, Groningen, the Netherlands
| | - Peter W Macfarlane
- Institute of Health and Wellbeing, College of Veterinary, Medical and Life Sciences, University of Glasgow, United Kingdom
| | - Ian Ford
- Robertson Center for Biostatistics, University of Glasgow, United Kingdom
| | - Albert Hofman
- Department of Epidemiology, Erasmus MC - University Medical Center Rotterdam, Rotterdam, the Netherlands
| | - André Uitterlinden
- Department of Epidemiology &Internal Medicine, Erasmus MC - University Medical Center Rotterdam, Rotterdam, the Netherlands
| | - Jan Heeringa
- Department of Epidemiology, Erasmus MC - University Medical Center Rotterdam, Rotterdam, the Netherlands
| | - Oscar H Franco
- Department of Epidemiology, Erasmus MC - University Medical Center Rotterdam, Rotterdam, the Netherlands
| | - Jan A Kors
- Department of Medical Informatics, Erasmus MC - University Medical Center Rotterdam, the Netherlands
| | - Stefan Weiss
- Department of Functional Genomics, Interfaculty Institute for Genetics and Functional Genomics, University Medicine and Ernst-Moritz-Arndt University Greifswald, Greifswald, Germany.,DZHK (German Centre for Cardiovascular Research), partner site Greifswald, Greifswald, Germany
| | - Henry Völzke
- DZHK (German Centre for Cardiovascular Research), partner site Greifswald, Greifswald, Germany.,Institute for Community Medicine, University Medicine Greifswald, Greifswald, Germany
| | - Lynda M Rose
- Division of Preventive Medicine, Brigham and Women's Hospital, Boston MA, USA
| | - Pradeep Natarajan
- Harvard Medical School, Boston, MA, USA.,Cardiovascular Research Center, Massachusetts General Hospital, Boston, MA, USA.,Center for Human Genetic Research, Massachusetts General Hospital, Boston, MA, USA.,Program in Medical and Population Genetics, Broad Institute, Cambridge, MA, USA
| | - Sekar Kathiresan
- Harvard Medical School, Boston, MA, USA.,Cardiovascular Research Center, Massachusetts General Hospital, Boston, MA, USA.,Center for Human Genetic Research, Massachusetts General Hospital, Boston, MA, USA.,Program in Medical and Population Genetics, Broad Institute, Cambridge, MA, USA
| | - Stefan Kääb
- Department of Medicine I, Ludwig-Maximilians-University Munich, Munich, Germany.,DZHK (German Centre for Cardiovascular Research), partner site Munich Heart Alliance, Munich, Germany
| | - Vilmundur Gudnason
- Icelandic Heart Association, Kopavogur, Iceland.,Faculty of Medicine, University of Iceland, Reykjavik, Iceland
| | - Alvaro Alonso
- Department of Epidemiology, Rollins School of Public Health, Emory University, Atlanta, GA, USA
| | | | - Susan R Heckbert
- Group Health Research Institute, Group Health Cooperative, Seattle, WA, USA.,Department of Epidemiology, Cardiovascular Health Research Unit, University of Washington, Seattle, WA, USA
| | - Emelia J Benjamin
- National Heart Lung and Blood Institute's and Boston University's Framingham Heart Study, Framingham, MA, USA.,Section of Cardiovascular Medicine and Preventive Medicine, Department of Medicine, Boston University School of Medicine, Boston, MA, USA.,Department of Epidemiology, Boston University School of Public Health, Boston, MA, USA
| | - Yongmei Liu
- Department of Epidemiology &Prevention, Public Health Sciences, Wake Forest School of Medicine, Winston-Salem, NC, USA
| | - Winfried März
- Synlab Academy, Synlab Services, GmbH P5,7, 68161 Mannheim, Germany.,Clinical Institute of Medical and Chemical Laboratory Diagnostics, Medical University of Graz, Graz, Austria.,Medical Clinic V (Nephrology, Hypertensiology, Rheumatology, Endocrinology, Diabetology), Medical Faculty Mannheim, University of Heidelberg, Mannheim, Germany
| | - Michiel Rienstra
- Department of Cardiology, University of Groningen, University Medical Center Groningen, Groningen, the Netherlands
| | - J Wouter Jukema
- Department of Cardiology, Leiden University Medical Center, the Netherlands
| | - Bruno H Stricker
- Department of Epidemiology &Internal Medicine, Erasmus MC - University Medical Center Rotterdam, Rotterdam, the Netherlands.,Inspectorate of Health Care, Utrecht, the Netherlands
| | - Marcus Dörr
- DZHK (German Centre for Cardiovascular Research), partner site Greifswald, Greifswald, Germany.,Department of Internal Medicine B, University Medicine Greifswald, Greifswald, Germany
| | - Christine M Albert
- Division of Preventive Medicine, Brigham and Women's Hospital, Boston MA, USA
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Davuluri G, Allawy A, Thapaliya S, Rennison JH, Singh D, Kumar A, Sandlers Y, Van Wagoner DR, Flask CA, Hoppel C, Kasumov T, Dasarathy S. Hyperammonaemia-induced skeletal muscle mitochondrial dysfunction results in cataplerosis and oxidative stress. J Physiol 2016; 594:7341-7360. [PMID: 27558544 DOI: 10.1113/jp272796] [Citation(s) in RCA: 102] [Impact Index Per Article: 12.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/13/2016] [Accepted: 08/12/2016] [Indexed: 12/18/2022] Open
Abstract
KEY POINTS Hyperammonaemia occurs in hepatic, cardiac and pulmonary diseases with increased muscle concentration of ammonia. We found that ammonia results in reduced skeletal muscle mitochondrial respiration, electron transport chain complex I dysfunction, as well as lower NAD+ /NADH ratio and ATP content. During hyperammonaemia, leak of electrons from complex III results in oxidative modification of proteins and lipids. Tricarboxylic acid cycle intermediates are decreased during hyperammonaemia, and providing a cell-permeable ester of αKG reversed the lower TCA cycle intermediate concentrations and increased ATP content. Our observations have high clinical relevance given the potential for novel approaches to reverse skeletal muscle ammonia toxicity by targeting the TCA cycle intermediates and mitochondrial ROS. ABSTRACT Ammonia is a cytotoxic metabolite that is removed primarily by hepatic ureagenesis in humans. Hyperammonaemia occurs in advanced hepatic, cardiac and pulmonary disease, and in urea cycle enzyme deficiencies. Increased skeletal muscle ammonia uptake and metabolism are the major mechanism of non-hepatic ammonia disposal. Non-hepatic ammonia disposal occurs in the mitochondria via glutamate synthesis from α-ketoglutarate resulting in cataplerosis. We show skeletal muscle mitochondrial dysfunction during hyperammonaemia in a comprehensive array of human, rodent and cellular models. ATP synthesis, oxygen consumption, generation of reactive oxygen species with oxidative stress, and tricarboxylic acid (TCA) cycle intermediates were quantified. ATP content was lower in the skeletal muscle from cirrhotic patients, hyperammonaemic portacaval anastomosis rat, and C2C12 myotubes compared to appropriate controls. Hyperammonaemia in C2C12 myotubes resulted in impaired intact cell respiration, reduced complex I/NADH oxidase activity and electron leak occurring at complex III of the electron transport chain. Consistently, lower NAD+ /NADH ratio was observed during hyperammonaemia with reduced TCA cycle intermediates compared to controls. Generation of reactive oxygen species resulted in increased content of skeletal muscle carbonylated proteins and thiobarbituric acid reactive substances during hyperammonaemia. A cell-permeable ester of α-ketoglutarate reversed the low TCA cycle intermediates and ATP content in myotubes during hyperammonaemia. However, the mitochondrial antioxidant MitoTEMPO did not reverse the lower ATP content during hyperammonaemia. We provide for the first time evidence that skeletal muscle hyperammonaemia results in mitochondrial dysfunction and oxidative stress. Use of anaplerotic substrates to reverse ammonia-induced mitochondrial dysfunction is a novel therapeutic approach.
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Affiliation(s)
- Gangarao Davuluri
- Department of Pathobiology, Cleveland Clinic, 9500 Euclid Avenue, Cleveland, OH, 44195, USA
| | - Allawy Allawy
- Department of Pathobiology, Cleveland Clinic, 9500 Euclid Avenue, Cleveland, OH, 44195, USA
| | - Samjhana Thapaliya
- Department of Pathobiology, Cleveland Clinic, 9500 Euclid Avenue, Cleveland, OH, 44195, USA
| | - Julie H Rennison
- Department of Pathobiology, Cleveland Clinic, 9500 Euclid Avenue, Cleveland, OH, 44195, USA
| | - Dharmvir Singh
- Department of Pathobiology, Cleveland Clinic, 9500 Euclid Avenue, Cleveland, OH, 44195, USA
| | - Avinash Kumar
- Department of Pathobiology, Cleveland Clinic, 9500 Euclid Avenue, Cleveland, OH, 44195, USA
| | - Yana Sandlers
- Department of Chemistry, Cleveland State University, SR 364, 2351 Euclid Avenue, Cleveland, OH, 44115, USA
| | - David R Van Wagoner
- Department of Molecular Cardiology, Cleveland Clinic, 9500 Euclid Avenue, Cleveland, OH, 44195, USA
| | - Chris A Flask
- Department of Biomedical Engineering, School of Medicine, Case Western Reserve University, 10900 Euclid Avenue, Cleveland, OH, 44106, USA
| | - Charles Hoppel
- Department of Pharmacology and Medicine, School of Medicine, Case Western Reserve University, 10900 Euclid Avenue, Cleveland, OH, 44106, USA
| | - Takhar Kasumov
- Department of Pharmaceutical Sciences, Northeast Ohio Medical University, 4209 State Route 44, Rootstown, OH, 44272
| | - Srinivasan Dasarathy
- Department of Pathobiology, Cleveland Clinic, 9500 Euclid Avenue, Cleveland, OH, 44195, USA.,Department of Gastroenterology, Cleveland Clinic, 9500 Euclid Avenue, Cleveland, OH, 44195, USA
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41
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Evans DS, Avery CL, Nalls MA, Li G, Barnard J, Smith EN, Tanaka T, Butler AM, Buxbaum SG, Alonso A, Arking DE, Berenson GS, Bis JC, Buyske S, Carty CL, Chen W, Chung MK, Cummings SR, Deo R, Eaton CB, Fox ER, Heckbert SR, Heiss G, Hindorff LA, Hsueh WC, Isaacs A, Jamshidi Y, Kerr KF, Liu F, Liu Y, Lohman KK, Magnani JW, Maher JF, Mehra R, Meng YA, Musani SK, Newton-Cheh C, North KE, Psaty BM, Redline S, Rotter JI, Schnabel RB, Schork NJ, Shohet RV, Singleton AB, Smith JD, Soliman EZ, Srinivasan SR, Taylor HA, Van Wagoner DR, Wilson JG, Young T, Zhang ZM, Zonderman AB, Evans MK, Ferrucci L, Murray SS, Tranah GJ, Whitsel EA, Reiner AP, Sotoodehnia N. Fine-mapping, novel loci identification, and SNP association transferability in a genome-wide association study of QRS duration in African Americans. Hum Mol Genet 2016; 25:4350-4368. [PMID: 27577874 PMCID: PMC5291202 DOI: 10.1093/hmg/ddw284] [Citation(s) in RCA: 27] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/11/2016] [Revised: 08/03/2016] [Accepted: 08/19/2016] [Indexed: 12/14/2022] Open
Abstract
The electrocardiographic QRS duration, a measure of ventricular depolarization and conduction, is associated with cardiovascular mortality. While single nucleotide polymorphisms (SNPs) associated with QRS duration have been identified at 22 loci in populations of European descent, the genetic architecture of QRS duration in non-European populations is largely unknown. We therefore performed a genome-wide association study (GWAS) meta-analysis of QRS duration in 13,031 African Americans from ten cohorts and a transethnic GWAS meta-analysis with additional results from populations of European descent. In the African American GWAS, a single genome-wide significant SNP association was identified (rs3922844, P = 4 × 10-14) in intron 16 of SCN5A, a voltage-gated cardiac sodium channel gene. The QRS-prolonging rs3922844 C allele was also associated with decreased SCN5A RNA expression in human atrial tissue (P = 1.1 × 10-4). High density genotyping revealed that the SCN5A association region in African Americans was confined to intron 16. Transethnic GWAS meta-analysis identified novel SNP associations on chromosome 18 in MYL12A (rs1662342, P = 4.9 × 10-8) and chromosome 1 near CD1E and SPTA1 (rs7547997, P = 7.9 × 10-9). The 22 QRS loci previously identified in populations of European descent were enriched for significant SNP associations with QRS duration in African Americans (P = 9.9 × 10-7), and index SNP associations in or near SCN5A, SCN10A, CDKN1A, NFIA, HAND1, TBX5 and SETBP1 replicated in African Americans. In summary, rs3922844 was associated with QRS duration and SCN5A expression, two novel QRS loci were identified using transethnic meta-analysis, and a significant proportion of QRS-SNP associations discovered in populations of European descent were transferable to African Americans when adequate power was achieved.
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Affiliation(s)
- Daniel S Evans
- California Pacific Medical Center Research Institute, San Francisco, CA, USA .
| | - Christy L Avery
- Department of Epidemiology, Gillings School of Global Public Health, University of North Carolina, Chapel Hill, NC, USA
| | - Mike A Nalls
- Laboratory of Neurogenetics, National Institute on Aging, National Institutes of Health, Bethesda, MD, USA
| | - Guo Li
- Cardiovascular Health Research Unit, Department of Medicine, University of Washington, Seattle, WA, USA
| | - John Barnard
- Department of Quantitative Health Sciences, Lerner Research Institute, Cleveland Clinic, Cleveland, OH, USA
| | - Erin N Smith
- Department of Pediatrics and Rady Children's Hospital, University of California at San Diego, School of Medicine, La Jolla, CA, USA
| | - Toshiko Tanaka
- Translational Gerontology Branch, National Institute on Aging, National Institutes of Health, Baltimore, MD, USA
| | - Anne M Butler
- Department of Epidemiology, Gillings School of Global Public Health, University of North Carolina, Chapel Hill, NC, USA
| | - Sarah G Buxbaum
- Center of Excellence in Minority Health and Health Disparities, Jackson State University, Jackson, MS, USA
- Department of Epidemiology and Biostatistics, Jackson State University School of Public Health (Initiative), Jackson, MS, USA
| | - Alvaro Alonso
- Department of Epidemiology, Rollins School of Public Health, Emory University, Atlanta, GA, USA
| | - Dan E Arking
- McKusick-Nathans Institute of Genetic Medicine, Johns Hopkins University School of Medicine, Baltimore, MD, USA
| | - Gerald S Berenson
- Department of Medicine and Cardiology, Tulane University, New Orleans, LA, USA
| | - Joshua C Bis
- Cardiovascular Health Research Unit, Department of Medicine, University of Washington, Seattle, WA, USA
| | - Steven Buyske
- Department of Statistics and Biostatistics and Department of Genetics, Rutgers University, Piscataway, NJ, USA
| | - Cara L Carty
- Division of Public Health Sciences, Fred Hutchinson Cancer Research Center, Seattle, WA, USA
| | - Wei Chen
- Department of Epidemiology, Tulane University, New Orleans, LA, USA
| | - Mina K Chung
- Department of Cardiovascular Medicine, Heart and Vascular Institute, Cleveland Clinic, Cleveland, OH, USA
- Department of Molecular Cardiology, Lerner Research Institute, Cleveland Clinic, Cleveland, OH, USA
- Cleveland Clinic Lerner College of Medicine of Case Western Reserve University, Cleveland, OH, USA
| | - Steven R Cummings
- California Pacific Medical Center Research Institute, San Francisco, CA, USA
| | - Rajat Deo
- Division of Cardiovascular Medicine, University of Pennsylvania, Philadelphia, PA, USA
| | - Charles B Eaton
- Departments of Family Medicine and Epidemiology, Alpert Medical School, Brown University, Providence, RI, USA
| | - Ervin R Fox
- Department of Medicine, Division of Cardiovascular Disease, University of Mississippi Medical Center, Jackson, MS, USA
| | - Susan R Heckbert
- Cardiovascular Health Research Unit, Department of Medicine, University of Washington, Seattle, WA, USA
- Department of Epidemiology, University of Washington, Seattle, WA, USA
- Group Health Research Institute, Group Health Cooperative, Seattle, WA, USA
| | - Gerardo Heiss
- Department of Epidemiology, Gillings School of Global Public Health, University of North Carolina, Chapel Hill, NC, USA
| | - Lucia A Hindorff
- National Institutes of Health, National Human Genome Research Institute, Office of Population Genomics, Bethesda, MD, USA
| | - Wen-Chi Hsueh
- Phoenix Epidemiology and Clinical Research Branch, National Institute of Diabetes and Digestive and Kidney Diseases, National Institutes of Health, Phoenix, AZ, USA
| | - Aaron Isaacs
- Genetic Epidemiology Unit, Department of Epidemiology, Erasmus University Medical Center, Rotterdam, the Netherlands
- CARIM School for Cardiovascular Diseases, Maastricht Centre for Systems Biology (MaCSBio), Dept. of Biochemistry, Maastricht University, Maastricht, the Netherlands
| | - Yalda Jamshidi
- Cardiogenetics Lab, Institute of Cardiovascular and Cell Sciences, St George's University of London, UK
| | - Kathleen F Kerr
- Department of Biostatistics, School of Public Health, University of Washington, Seattle, WA, USA
| | - Felix Liu
- Department of Epidemiology and Biostatistics, University of California, San Francisco, CA, USA
| | - Yongmei Liu
- Department of Epidemiology and Prevention, Division of Public Health Sciences, Wake Forest University, Winston-Salem, NC, USA
| | - Kurt K Lohman
- Department of Epidemiology and Prevention, Division of Public Health Sciences, Wake Forest University, Winston-Salem, NC, USA
| | - Jared W Magnani
- Department of Medicine, Division of Cardiology, University of Pittsburgh Medical Center Heart and Vascular Institute, University of Pittsburgh, Pittsburgh, PA, USA
| | - Joseph F Maher
- Department of Medicine, University of Mississippi Medical Center, Jackson, MS, USA
| | - Reena Mehra
- Program for Medical and Population Genetics, Broad Institute of Harvard and Massachusetts Institute of Technology, Cambridge, MA, USA
| | - Yan A Meng
- Jackson Heart Study, University of Mississippi Medical Center, Jackson, MS, USA
| | - Solomon K Musani
- Cardiovascular Research Center and Center for Human Genetic Research, Massachusetts General Hospital and Harvard Medical School, Boston,MA, USA
| | - Christopher Newton-Cheh
- Jackson Heart Study, University of Mississippi Medical Center, Jackson, MS, USA
- Carolina Center for Genome Sciences, University of North Carolina, Chapel Hill, NC, USA
| | - Kari E North
- Department of Epidemiology, Gillings School of Global Public Health, University of North Carolina, Chapel Hill, NC, USA
- Department of Health Services, University of Washington, Seattle, WA, USA
| | - Bruce M Psaty
- Cardiovascular Health Research Unit, Department of Medicine, University of Washington, Seattle, WA, USA
- Department of Epidemiology, University of Washington, Seattle, WA, USA
- Group Health Research Institute, Group Health Cooperative, Seattle, WA, USA
- Department of Medicine, Division of Sleep Medicine, Brigham and Women's Hospital, Harvard Medical School, Boston, MA, USA
| | - Susan Redline
- Institute for Translational Genomics and Population Sciences, Los Angeles Biomedical Research Institute and Departments of Medicine and Pediatrics, Harbor-UCLA Medical Center, Torrance, CA, USA
| | - Jerome I Rotter
- University Heart Center Hamburg and German Center for Cardiovascular Research, Hamburg, Germany
| | | | - Nicholas J Schork
- Center for Cardiovascular Research, John A. Burns School of Medicine, University of Hawaii, Honolulu, HI, USA
| | - Ralph V Shohet
- Department of Cellular and Molecular Medicine, Cleveland Clinic, Cleveland, OH, USA
| | - Andrew B Singleton
- Laboratory of Neurogenetics, National Institute on Aging, National Institutes of Health, Bethesda, MD, USA
| | - Jonathan D Smith
- Epidemiological Cardiology Research Center (EPICARE), Department of Epidemiology and Prevention, Division of Public Health Sciences, Wake Forest School of Medicine, Winston-Salem, NC, USA
| | - Elsayed Z Soliman
- Department of Physiology and Biophysics, University of Mississippi Medical Center, Jackson, MS, USA
| | | | - Herman A Taylor
- Department of Medicine, University of Mississippi Medical Center, Jackson, MS, USA
| | - David R Van Wagoner
- Department of Molecular Cardiology, Lerner Research Institute, Cleveland Clinic, Cleveland, OH, USA
| | - James G Wilson
- Laboratory of Epidemiology and Population Science, National Institute on Aging, National Institutes of Health, Baltimore, MD, USA
| | - Taylor Young
- Jackson Heart Study, University of Mississippi Medical Center, Jackson, MS, USA
| | - Zhu-Ming Zhang
- Department of Physiology and Biophysics, University of Mississippi Medical Center, Jackson, MS, USA
| | - Alan B Zonderman
- Department of Pathology, University of California San Diego, La Jolla, CA, USA
| | - Michele K Evans
- Department of Pathology, University of California San Diego, La Jolla, CA, USA
| | - Luigi Ferrucci
- Translational Gerontology Branch, National Institute on Aging, National Institutes of Health, Baltimore, MD, USA
| | - Sarah S Murray
- Department of Medicine, School of Medicine, University of North Carolina, Chapel Hill, NC, USA
| | - Gregory J Tranah
- California Pacific Medical Center Research Institute, San Francisco, CA, USA
| | - Eric A Whitsel
- Department of Epidemiology, Gillings School of Global Public Health, University of North Carolina, Chapel Hill, NC, USA
- Membership of the CHARGE QRS Consortium is provided in the acknowledgements and
| | - Alex P Reiner
- Cardiovascular Health Research Unit, Department of Medicine, University of Washington, Seattle, WA, USA
- Division of Public Health Sciences, Fred Hutchinson Cancer Research Center, Seattle, WA, USA
| | - Nona Sotoodehnia
- Department of Epidemiology, University of Washington, Seattle, WA, USA .
- Division of Cardiology, University of Washington, Seattle, WA, USA
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42
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Li N, Csepe TA, Hansen BJ, Sul LV, Kalyanasundaram A, Zakharkin SO, Zhao J, Guha A, Van Wagoner DR, Kilic A, Mohler PJ, Janssen PML, Biesiadecki BJ, Hummel JD, Weiss R, Fedorov VV. Adenosine-Induced Atrial Fibrillation: Localized Reentrant Drivers in Lateral Right Atria due to Heterogeneous Expression of Adenosine A1 Receptors and GIRK4 Subunits in the Human Heart. Circulation 2016; 134:486-98. [PMID: 27462069 DOI: 10.1161/circulationaha.115.021165] [Citation(s) in RCA: 75] [Impact Index Per Article: 9.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/31/2015] [Accepted: 06/02/2016] [Indexed: 11/16/2022]
Abstract
BACKGROUND Adenosine provokes atrial fibrillation (AF) with a higher activation frequency in right atria (RA) versus left atria (LA) in patients, but the underlying molecular and functional substrates are unclear. We tested the hypothesis that adenosine-induced AF is driven by localized reentry in RA areas with highest expression of adenosine A1 receptor and its downstream GIRK (G protein-coupled inwardly rectifying potassium channels) channels (IK,Ado). METHODS We applied biatrial optical mapping and immunoblot mapping of various atrial regions to reveal the mechanism of adenosine-induced AF in explanted failing and nonfailing human hearts (n=37). RESULTS Optical mapping of coronary-perfused atria (n=24) revealed that adenosine perfusion (10-100 µmol/L) produced more significant shortening of action potential durations in RA (from 290±45 to 239±41 ms, 17.3±10.4%; P<0.01) than LA (from 307±24 to 286±23 ms, 6.7±6.6%; P<0.01). In 10 hearts, adenosine induced AF (317±116 s) that, when sustained (≥2 minutes), was primarily maintained by 1 to 2 localized reentrant drivers in lateral RA. Tertiapin (10-100 nmol/L), a selective GIRK channel blocker, counteracted adenosine-induced action potential duration shortening and prevented AF induction. Immunoblotting showed that the superior/middle lateral RA had significantly higher adenosine A1 receptor (2.7±1.7-fold; P<0.01) and GIRK4 (1.7±0.8-fold; P<0.05) protein expression than lateral/posterior LA. CONCLUSIONS This study revealed a 3-fold RA-to-LA adenosine A1 receptor protein expression gradient in the human heart, leading to significantly greater RA versus LA repolarization sensitivity in response to adenosine. Sustained adenosine-induced AF is maintained by reentrant drivers localized in lateral RA regions with the highest adenosine A1 receptor/GIRK4 expression. Selective atrial GIRK channel blockade may effectively treat AF during conditions with increased endogenous adenosine.
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Affiliation(s)
- Ning Li
- From Department of Physiology & Cell Biology, The Ohio State University Wexner Medical Center, Columbus (N.L., T.A.C., B.J.H., L.V.S., A. Kalyanasundaram, S.O.Z., A.G., P.J.M., P.M.L.J., B.J.B., V.V.F.); Davis Heart & Lung Research Institute, The Ohio State University Wexner Medical Center, Columbus (N.L., T.A.C., B.J.H., L.V.S., A. Kalyanasundaram, A. Kilic, P.J.M., P.M.L.J., B.J.B., J.D.H., R.W., V.V.F.); Auckland Bioengineering Institute, The University of Auckland, New Zealand (J.Z.); Department of Internal Medicine, The Ohio State University Wexner Medical Center, Columbus (A.G., A. Kilic, P.J.M., P.M.L.J., J.D.H., R.W.); Department of Molecular Cardiology, Cleveland Clinic, OH (D.R.V.W.); and Department of Surgery, Division of Cardiac Surgery, Wexner Medical Center, The Ohio State University, Columbus (A. Kilic, J.D.H., R.W.)
| | - Thomas A Csepe
- From Department of Physiology & Cell Biology, The Ohio State University Wexner Medical Center, Columbus (N.L., T.A.C., B.J.H., L.V.S., A. Kalyanasundaram, S.O.Z., A.G., P.J.M., P.M.L.J., B.J.B., V.V.F.); Davis Heart & Lung Research Institute, The Ohio State University Wexner Medical Center, Columbus (N.L., T.A.C., B.J.H., L.V.S., A. Kalyanasundaram, A. Kilic, P.J.M., P.M.L.J., B.J.B., J.D.H., R.W., V.V.F.); Auckland Bioengineering Institute, The University of Auckland, New Zealand (J.Z.); Department of Internal Medicine, The Ohio State University Wexner Medical Center, Columbus (A.G., A. Kilic, P.J.M., P.M.L.J., J.D.H., R.W.); Department of Molecular Cardiology, Cleveland Clinic, OH (D.R.V.W.); and Department of Surgery, Division of Cardiac Surgery, Wexner Medical Center, The Ohio State University, Columbus (A. Kilic, J.D.H., R.W.)
| | - Brian J Hansen
- From Department of Physiology & Cell Biology, The Ohio State University Wexner Medical Center, Columbus (N.L., T.A.C., B.J.H., L.V.S., A. Kalyanasundaram, S.O.Z., A.G., P.J.M., P.M.L.J., B.J.B., V.V.F.); Davis Heart & Lung Research Institute, The Ohio State University Wexner Medical Center, Columbus (N.L., T.A.C., B.J.H., L.V.S., A. Kalyanasundaram, A. Kilic, P.J.M., P.M.L.J., B.J.B., J.D.H., R.W., V.V.F.); Auckland Bioengineering Institute, The University of Auckland, New Zealand (J.Z.); Department of Internal Medicine, The Ohio State University Wexner Medical Center, Columbus (A.G., A. Kilic, P.J.M., P.M.L.J., J.D.H., R.W.); Department of Molecular Cardiology, Cleveland Clinic, OH (D.R.V.W.); and Department of Surgery, Division of Cardiac Surgery, Wexner Medical Center, The Ohio State University, Columbus (A. Kilic, J.D.H., R.W.)
| | - Lidiya V Sul
- From Department of Physiology & Cell Biology, The Ohio State University Wexner Medical Center, Columbus (N.L., T.A.C., B.J.H., L.V.S., A. Kalyanasundaram, S.O.Z., A.G., P.J.M., P.M.L.J., B.J.B., V.V.F.); Davis Heart & Lung Research Institute, The Ohio State University Wexner Medical Center, Columbus (N.L., T.A.C., B.J.H., L.V.S., A. Kalyanasundaram, A. Kilic, P.J.M., P.M.L.J., B.J.B., J.D.H., R.W., V.V.F.); Auckland Bioengineering Institute, The University of Auckland, New Zealand (J.Z.); Department of Internal Medicine, The Ohio State University Wexner Medical Center, Columbus (A.G., A. Kilic, P.J.M., P.M.L.J., J.D.H., R.W.); Department of Molecular Cardiology, Cleveland Clinic, OH (D.R.V.W.); and Department of Surgery, Division of Cardiac Surgery, Wexner Medical Center, The Ohio State University, Columbus (A. Kilic, J.D.H., R.W.)
| | - Anuradha Kalyanasundaram
- From Department of Physiology & Cell Biology, The Ohio State University Wexner Medical Center, Columbus (N.L., T.A.C., B.J.H., L.V.S., A. Kalyanasundaram, S.O.Z., A.G., P.J.M., P.M.L.J., B.J.B., V.V.F.); Davis Heart & Lung Research Institute, The Ohio State University Wexner Medical Center, Columbus (N.L., T.A.C., B.J.H., L.V.S., A. Kalyanasundaram, A. Kilic, P.J.M., P.M.L.J., B.J.B., J.D.H., R.W., V.V.F.); Auckland Bioengineering Institute, The University of Auckland, New Zealand (J.Z.); Department of Internal Medicine, The Ohio State University Wexner Medical Center, Columbus (A.G., A. Kilic, P.J.M., P.M.L.J., J.D.H., R.W.); Department of Molecular Cardiology, Cleveland Clinic, OH (D.R.V.W.); and Department of Surgery, Division of Cardiac Surgery, Wexner Medical Center, The Ohio State University, Columbus (A. Kilic, J.D.H., R.W.)
| | - Stanislav O Zakharkin
- From Department of Physiology & Cell Biology, The Ohio State University Wexner Medical Center, Columbus (N.L., T.A.C., B.J.H., L.V.S., A. Kalyanasundaram, S.O.Z., A.G., P.J.M., P.M.L.J., B.J.B., V.V.F.); Davis Heart & Lung Research Institute, The Ohio State University Wexner Medical Center, Columbus (N.L., T.A.C., B.J.H., L.V.S., A. Kalyanasundaram, A. Kilic, P.J.M., P.M.L.J., B.J.B., J.D.H., R.W., V.V.F.); Auckland Bioengineering Institute, The University of Auckland, New Zealand (J.Z.); Department of Internal Medicine, The Ohio State University Wexner Medical Center, Columbus (A.G., A. Kilic, P.J.M., P.M.L.J., J.D.H., R.W.); Department of Molecular Cardiology, Cleveland Clinic, OH (D.R.V.W.); and Department of Surgery, Division of Cardiac Surgery, Wexner Medical Center, The Ohio State University, Columbus (A. Kilic, J.D.H., R.W.)
| | - Jichao Zhao
- From Department of Physiology & Cell Biology, The Ohio State University Wexner Medical Center, Columbus (N.L., T.A.C., B.J.H., L.V.S., A. Kalyanasundaram, S.O.Z., A.G., P.J.M., P.M.L.J., B.J.B., V.V.F.); Davis Heart & Lung Research Institute, The Ohio State University Wexner Medical Center, Columbus (N.L., T.A.C., B.J.H., L.V.S., A. Kalyanasundaram, A. Kilic, P.J.M., P.M.L.J., B.J.B., J.D.H., R.W., V.V.F.); Auckland Bioengineering Institute, The University of Auckland, New Zealand (J.Z.); Department of Internal Medicine, The Ohio State University Wexner Medical Center, Columbus (A.G., A. Kilic, P.J.M., P.M.L.J., J.D.H., R.W.); Department of Molecular Cardiology, Cleveland Clinic, OH (D.R.V.W.); and Department of Surgery, Division of Cardiac Surgery, Wexner Medical Center, The Ohio State University, Columbus (A. Kilic, J.D.H., R.W.)
| | - Avirup Guha
- From Department of Physiology & Cell Biology, The Ohio State University Wexner Medical Center, Columbus (N.L., T.A.C., B.J.H., L.V.S., A. Kalyanasundaram, S.O.Z., A.G., P.J.M., P.M.L.J., B.J.B., V.V.F.); Davis Heart & Lung Research Institute, The Ohio State University Wexner Medical Center, Columbus (N.L., T.A.C., B.J.H., L.V.S., A. Kalyanasundaram, A. Kilic, P.J.M., P.M.L.J., B.J.B., J.D.H., R.W., V.V.F.); Auckland Bioengineering Institute, The University of Auckland, New Zealand (J.Z.); Department of Internal Medicine, The Ohio State University Wexner Medical Center, Columbus (A.G., A. Kilic, P.J.M., P.M.L.J., J.D.H., R.W.); Department of Molecular Cardiology, Cleveland Clinic, OH (D.R.V.W.); and Department of Surgery, Division of Cardiac Surgery, Wexner Medical Center, The Ohio State University, Columbus (A. Kilic, J.D.H., R.W.)
| | - David R Van Wagoner
- From Department of Physiology & Cell Biology, The Ohio State University Wexner Medical Center, Columbus (N.L., T.A.C., B.J.H., L.V.S., A. Kalyanasundaram, S.O.Z., A.G., P.J.M., P.M.L.J., B.J.B., V.V.F.); Davis Heart & Lung Research Institute, The Ohio State University Wexner Medical Center, Columbus (N.L., T.A.C., B.J.H., L.V.S., A. Kalyanasundaram, A. Kilic, P.J.M., P.M.L.J., B.J.B., J.D.H., R.W., V.V.F.); Auckland Bioengineering Institute, The University of Auckland, New Zealand (J.Z.); Department of Internal Medicine, The Ohio State University Wexner Medical Center, Columbus (A.G., A. Kilic, P.J.M., P.M.L.J., J.D.H., R.W.); Department of Molecular Cardiology, Cleveland Clinic, OH (D.R.V.W.); and Department of Surgery, Division of Cardiac Surgery, Wexner Medical Center, The Ohio State University, Columbus (A. Kilic, J.D.H., R.W.)
| | - Ahmet Kilic
- From Department of Physiology & Cell Biology, The Ohio State University Wexner Medical Center, Columbus (N.L., T.A.C., B.J.H., L.V.S., A. Kalyanasundaram, S.O.Z., A.G., P.J.M., P.M.L.J., B.J.B., V.V.F.); Davis Heart & Lung Research Institute, The Ohio State University Wexner Medical Center, Columbus (N.L., T.A.C., B.J.H., L.V.S., A. Kalyanasundaram, A. Kilic, P.J.M., P.M.L.J., B.J.B., J.D.H., R.W., V.V.F.); Auckland Bioengineering Institute, The University of Auckland, New Zealand (J.Z.); Department of Internal Medicine, The Ohio State University Wexner Medical Center, Columbus (A.G., A. Kilic, P.J.M., P.M.L.J., J.D.H., R.W.); Department of Molecular Cardiology, Cleveland Clinic, OH (D.R.V.W.); and Department of Surgery, Division of Cardiac Surgery, Wexner Medical Center, The Ohio State University, Columbus (A. Kilic, J.D.H., R.W.)
| | - Peter J Mohler
- From Department of Physiology & Cell Biology, The Ohio State University Wexner Medical Center, Columbus (N.L., T.A.C., B.J.H., L.V.S., A. Kalyanasundaram, S.O.Z., A.G., P.J.M., P.M.L.J., B.J.B., V.V.F.); Davis Heart & Lung Research Institute, The Ohio State University Wexner Medical Center, Columbus (N.L., T.A.C., B.J.H., L.V.S., A. Kalyanasundaram, A. Kilic, P.J.M., P.M.L.J., B.J.B., J.D.H., R.W., V.V.F.); Auckland Bioengineering Institute, The University of Auckland, New Zealand (J.Z.); Department of Internal Medicine, The Ohio State University Wexner Medical Center, Columbus (A.G., A. Kilic, P.J.M., P.M.L.J., J.D.H., R.W.); Department of Molecular Cardiology, Cleveland Clinic, OH (D.R.V.W.); and Department of Surgery, Division of Cardiac Surgery, Wexner Medical Center, The Ohio State University, Columbus (A. Kilic, J.D.H., R.W.)
| | - Paul M L Janssen
- From Department of Physiology & Cell Biology, The Ohio State University Wexner Medical Center, Columbus (N.L., T.A.C., B.J.H., L.V.S., A. Kalyanasundaram, S.O.Z., A.G., P.J.M., P.M.L.J., B.J.B., V.V.F.); Davis Heart & Lung Research Institute, The Ohio State University Wexner Medical Center, Columbus (N.L., T.A.C., B.J.H., L.V.S., A. Kalyanasundaram, A. Kilic, P.J.M., P.M.L.J., B.J.B., J.D.H., R.W., V.V.F.); Auckland Bioengineering Institute, The University of Auckland, New Zealand (J.Z.); Department of Internal Medicine, The Ohio State University Wexner Medical Center, Columbus (A.G., A. Kilic, P.J.M., P.M.L.J., J.D.H., R.W.); Department of Molecular Cardiology, Cleveland Clinic, OH (D.R.V.W.); and Department of Surgery, Division of Cardiac Surgery, Wexner Medical Center, The Ohio State University, Columbus (A. Kilic, J.D.H., R.W.)
| | - Brandon J Biesiadecki
- From Department of Physiology & Cell Biology, The Ohio State University Wexner Medical Center, Columbus (N.L., T.A.C., B.J.H., L.V.S., A. Kalyanasundaram, S.O.Z., A.G., P.J.M., P.M.L.J., B.J.B., V.V.F.); Davis Heart & Lung Research Institute, The Ohio State University Wexner Medical Center, Columbus (N.L., T.A.C., B.J.H., L.V.S., A. Kalyanasundaram, A. Kilic, P.J.M., P.M.L.J., B.J.B., J.D.H., R.W., V.V.F.); Auckland Bioengineering Institute, The University of Auckland, New Zealand (J.Z.); Department of Internal Medicine, The Ohio State University Wexner Medical Center, Columbus (A.G., A. Kilic, P.J.M., P.M.L.J., J.D.H., R.W.); Department of Molecular Cardiology, Cleveland Clinic, OH (D.R.V.W.); and Department of Surgery, Division of Cardiac Surgery, Wexner Medical Center, The Ohio State University, Columbus (A. Kilic, J.D.H., R.W.)
| | - John D Hummel
- From Department of Physiology & Cell Biology, The Ohio State University Wexner Medical Center, Columbus (N.L., T.A.C., B.J.H., L.V.S., A. Kalyanasundaram, S.O.Z., A.G., P.J.M., P.M.L.J., B.J.B., V.V.F.); Davis Heart & Lung Research Institute, The Ohio State University Wexner Medical Center, Columbus (N.L., T.A.C., B.J.H., L.V.S., A. Kalyanasundaram, A. Kilic, P.J.M., P.M.L.J., B.J.B., J.D.H., R.W., V.V.F.); Auckland Bioengineering Institute, The University of Auckland, New Zealand (J.Z.); Department of Internal Medicine, The Ohio State University Wexner Medical Center, Columbus (A.G., A. Kilic, P.J.M., P.M.L.J., J.D.H., R.W.); Department of Molecular Cardiology, Cleveland Clinic, OH (D.R.V.W.); and Department of Surgery, Division of Cardiac Surgery, Wexner Medical Center, The Ohio State University, Columbus (A. Kilic, J.D.H., R.W.)
| | - Raul Weiss
- From Department of Physiology & Cell Biology, The Ohio State University Wexner Medical Center, Columbus (N.L., T.A.C., B.J.H., L.V.S., A. Kalyanasundaram, S.O.Z., A.G., P.J.M., P.M.L.J., B.J.B., V.V.F.); Davis Heart & Lung Research Institute, The Ohio State University Wexner Medical Center, Columbus (N.L., T.A.C., B.J.H., L.V.S., A. Kalyanasundaram, A. Kilic, P.J.M., P.M.L.J., B.J.B., J.D.H., R.W., V.V.F.); Auckland Bioengineering Institute, The University of Auckland, New Zealand (J.Z.); Department of Internal Medicine, The Ohio State University Wexner Medical Center, Columbus (A.G., A. Kilic, P.J.M., P.M.L.J., J.D.H., R.W.); Department of Molecular Cardiology, Cleveland Clinic, OH (D.R.V.W.); and Department of Surgery, Division of Cardiac Surgery, Wexner Medical Center, The Ohio State University, Columbus (A. Kilic, J.D.H., R.W.)
| | - Vadim V Fedorov
- From Department of Physiology & Cell Biology, The Ohio State University Wexner Medical Center, Columbus (N.L., T.A.C., B.J.H., L.V.S., A. Kalyanasundaram, S.O.Z., A.G., P.J.M., P.M.L.J., B.J.B., V.V.F.); Davis Heart & Lung Research Institute, The Ohio State University Wexner Medical Center, Columbus (N.L., T.A.C., B.J.H., L.V.S., A. Kalyanasundaram, A. Kilic, P.J.M., P.M.L.J., B.J.B., J.D.H., R.W., V.V.F.); Auckland Bioengineering Institute, The University of Auckland, New Zealand (J.Z.); Department of Internal Medicine, The Ohio State University Wexner Medical Center, Columbus (A.G., A. Kilic, P.J.M., P.M.L.J., J.D.H., R.W.); Department of Molecular Cardiology, Cleveland Clinic, OH (D.R.V.W.); and Department of Surgery, Division of Cardiac Surgery, Wexner Medical Center, The Ohio State University, Columbus (A. Kilic, J.D.H., R.W.).
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Tan N, Chung MK, Smith JD, Van Wagoner DR, Barnard J. Abstract 470: Computational Identification of NKX2-5 Binding Sites and Downstream Gene Targets Using Transcription Factor Motif and Human Heart-specific Experimental Data. Circ Res 2016. [DOI: 10.1161/res.119.suppl_1.470] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
Background:
While NKX2-5 plays pivotal roles in human cardiac development and disease, no ChIP-Seq studies of NKX2-5 in human cardiac tissues currently exist, resulting in an incomplete understanding of its direct gene targets. Modern computational methods which identify binding sites using transcription factor motif and tissue-specific experimental data can help to fill this knowledge gap.
Objective:
To use computational methods to identify likely NKX2-5 binding sites and downstream gene targets using human heart-specific experimental data.
Methods:
Human cardiomyocyte DNAse hypersensitivity data (2 replicates) were downloaded from the Encyclopedia of DNA Elements (ENCODE) database. The position weight matrix (PWM) representing the transcription factor motif of NKX2-5 was obtained from JASPAR. We applied the Protein Interaction Quantification (PIQ) algorithm to detect NKX2-5 binding sites using the PWM and DNAse hypersensitivity data as inputs. RNA-Seq data from 108 human heart-specific samples (atrial appendages and left ventricles) were downloaded from the Genotype-Tissue Expression (GTEx) database. Protein-coding genes significantly expressed in the heart (RPKM <= 1 based on the GTEx RNA-Seq data) that were within 100kb of the predicted binding sites were then identified. Pathway analysis of these genes was performed using Ingenuity Pathway Analysis (IPA).
Results:
1283 binding sites for NKX2-5 were discovered by PIQ. Of 12698 protein-coding, heart-expressed genes, 625 were within 100kb of these binding sites. The identified genes were highly enriched in physiologic categories like “Vasculogenesis” and “Development of Cardiovascular Tissue” (p = 2.36x10-9 and 2.31x10-8 respectively). Notable genes included: cardiac transcription factors (MEF2A, TBX20); growth factors (TGFB2, BMP2); muscle and ion channel function (ACTA2, BIN1), and; calcium signaling (CALM2, CAMK2D).
Conclusion:
By using computational analyses of transcription factor motif and human heart-specific experimental data, we have identified candidate downstream targets of NKX2-5. Future work will include validation studies in an external cohort and analysis of associations between these candidate genes and cardiac disease.
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Zhu Y, Hanick A, Wright M, Barnard J, Roselli EE, Van Wagoner DR. Abstract 244: Differential mRNA Expressions in Thoracic Aortic Aneurysm in Patients with Bicuspid and Tricuspid Aortic Valve. Circ Res 2016. [DOI: 10.1161/res.119.suppl_1.244] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
Objective:
Bicuspid aortic valve (BAV), the most common congenital heart condition, is frequently associated with thoracic aortic aneurysm (TAA). Aortic mRNA expression patterns in BAV patients and expression differences between BAV and tricuspid aortic valve (TAV) patients are unclear. We sought to compare mRNA expressions in TAA in patients with BAV and TAV.
Methods and Results:
Ascending aorta tissue was obtained from 58 aortic aneurysm repair patients (31 BAV, 27 TAV) and from 8 heart transplant donors. Illumina Human HT-12v4 microarrays were used to assess mRNA expression. After standard QC and filtering, probes were analyzed using multivariable linear regression analysis, adjusting for age, gender, medication use (beta blockers, ACE-Is, ARBs), and 10 surrogate variables. Ingenuity Pathway Analysis (IPA) was used to identify pathways and top regulator effect networks that were differentially expressed in BAV vs. TAV and BAV vs. donors.
In BAV vs. TAV, MMP9, ESM1 and IL1B were downregulated 0.63, 0.74 and 0.77 fold, whereas COMP was upregulated 2.29 fold (p < 0.05 for all). In BAV vs. donors, IL1R2, MCEMP1, IL18RAP and ACAN were downregulated 0.66, 0.2, 0.2 and 0.05 fold, while ADAMTS8, CCL21 and CIDEA were upregulated 6.97, 6.24 and 4.65 fold (p < 0.0001). IPA analysis showed P53 as the top upstream regulator for both BAV vs. TAV (p = 1.9e-8) and BAV vs. donors (p = 2.3e-25). IRF7, which protects against angiotensin II-induced hypertrophy in cardiomyocytes, was also a significant upstream regulator for BAV vs. TAV (p = 3.6e-7). Additionally, miR-124-3p in BAV vs. TAV (p = 6.3e-7) and BAV vs. donors (p = 1.7e-22), as well as miR-96-5p in BAV vs. TAV (p = 4e-7) were predicted significant upstream regulators. Immune response was shown to be the top regulator effect network in BAV vs. TAV, whereas perivascular fibrosis was shown to be an important regulator effect network in BAV vs. donors. Cell stress pathways were also activated in BAV vs. donors.
Conclusions:
Distinct pathways and regulator effect networks exist in TAA with BAV or TAV. TAV associated TAA is more associated with inflammatory responses, while BAV aortopathy is more associated with extracellular matrix remodelling and cell stress. MiRs may also play an important role in BAV aortopathy.
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Goette A, Kalman JM, Aguinaga L, Akar J, Cabrera JA, Chen SA, Chugh SS, Corradi D, D'Avila A, Dobrev D, Fenelon G, Gonzalez M, Hatem SN, Helm R, Hindricks G, Ho SY, Hoit B, Jalife J, Kim YH, Lip GYH, Ma CS, Marcus GM, Murray K, Nogami A, Sanders P, Uribe W, Van Wagoner DR, Nattel S. EHRA/HRS/APHRS/SOLAECE expert consensus on Atrial cardiomyopathies: Definition, characterisation, and clinical implication. J Arrhythm 2016; 32:247-78. [PMID: 27588148 PMCID: PMC4996910 DOI: 10.1016/j.joa.2016.05.002] [Citation(s) in RCA: 75] [Impact Index Per Article: 9.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/19/2022] Open
Affiliation(s)
- Andreas Goette
- Departement of Cardiology and Intensive Care Medicine, St. Vincenz-Hospital Paderborn, Working Group: Molecular Electrophysiology, University Hospital Magdeburg, Germany
| | - Jonathan M Kalman
- University of Melbourne, Royal Melbourne Hospital, Melbourne, VIC, Australia
| | | | | | | | | | - Sumeet S Chugh
- The Heart Institute, Cedars-Sinai Medical Center, Los Angeles, CA, USA
| | | | | | - Dobromir Dobrev
- Institute of Pharmacology, West German Heart and Vascular Center, University Duisburg-Essen, Essen, Germany
| | | | - Mario Gonzalez
- Penn State Heart and Vascular Institute, Penn State University, Hershey, PA, USA
| | - Stephane N Hatem
- Department of Cardiology, Assistance Publique - Hô pitaux de Paris, Pitié-Salpêtrière Hospital, Sorbonne University, INSERM UMR_S1166, Institute of Cardiometabolism and Nutrition-ICAN, Paris, France
| | - Robert Helm
- Boston University School of Medicine, Boston Medical Center, Boston, MA, USA
| | | | - Siew Yen Ho
- Royal Brompton Hospital and Imperial College London, London, UK
| | - Brian Hoit
- UH Case Medical Center, Cleveland, OH, USA
| | | | | | | | | | | | | | | | - Prashanthan Sanders
- Centre for Heart Rhythm Disorders, South Australian Health and Medical Research Institute, University of Adelaide and Royal Adelaide Hospital, Adelaide, Australia
| | - William Uribe
- Electrophysiology Deparment at Centros Especializados de San Vicente Fundació n and Clínica CES. Universidad CES, Universidad Pontificia Bolivariana (UPB), Medellin, Colombia
| | | | - Stanley Nattel
- Université de Montréal, Montreal Heart Institute Research Center and McGill University, Montreal, Quebec, Canada; Institute of Pharmacology, West German Heart and Vascular Center, Faculty of Medicine, University Duisburg-Essen, Essen, Germany
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Goette A, Kalman JM, Aguinaga L, Akar J, Cabrera JA, Chen SA, Chugh SS, Corradi D, D'Avila A, Dobrev D, Fenelon G, Gonzalez M, Hatem SN, Helm R, Hindricks G, Ho SY, Hoit B, Jalife J, Kim YH, Lip GYH, Ma CS, Marcus GM, Murray K, Nogami A, Sanders P, Uribe W, Van Wagoner DR, Nattel S. EHRA/HRS/APHRS/SOLAECE expert consensus on atrial cardiomyopathies: definition, characterization, and clinical implication. Europace 2016; 18:1455-1490. [PMID: 27402624 DOI: 10.1093/europace/euw161] [Citation(s) in RCA: 408] [Impact Index Per Article: 51.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/13/2022] Open
Affiliation(s)
- Andreas Goette
- Departement of Cardiology and Intensive Care Medicine, St. Vincenz-Hospital Paderborn, Working Group: Molecular Electrophysiology, University Hospital Magdeburg, Germany
| | - Jonathan M Kalman
- University of Melbourne, Royal Melbourne Hospital, Melbourne, VIC, Australia
| | | | | | | | | | - Sumeet S Chugh
- The Heart Institute, Cedars-Sinai Medical Center, Los Angeles, CA, USA
| | | | | | - Dobromir Dobrev
- Institute of Pharmacology, West German Heart and Vascular Center, University Duisburg-Essen, Essen, Germany
| | | | - Mario Gonzalez
- Penn State Heart and Vascular Institute, Penn State University, Hershey, PA, USA
| | - Stephane N Hatem
- Department of Cardiology, Assistance Publique - Hôpitaux de Paris, Pitié-Salpêtrière Hospital; Sorbonne University; INSERM UMR_S1166; Institute of Cardiometabolism and Nutrition-ICAN, Paris, France
| | - Robert Helm
- Boston University School of Medicine, Boston Medical Center, Boston, MA, USA
| | | | - Siew Yen Ho
- Royal Brompton Hospital and Imperial College London, London, UK
| | - Brian Hoit
- UH Case Medical Center, Cleveland, OH, USA
| | | | | | | | | | | | | | | | - Prashanthan Sanders
- Centre for Heart Rhythm Disorders, South Australian Health and Medical Research Institute, University of Adelaide and Royal Adelaide Hospital, Adelaide, Australia
| | - William Uribe
- Electrophysiology Deparment at Centros Especializados de San Vicente Fundación and Clínica CES. Universidad CES, Universidad Pontificia Bolivariana (UPB), Medellin, Colombia
| | | | - Stanley Nattel
- Université de Montréal, Montreal Heart Institute Research Center and McGill University, Montreal, Quebec, Canada .,Institute of Pharmacology, West German Heart and Vascular Center, Faculty of Medicine, University Duisburg-Essen, Essen, Germany
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Zeitler EP, Al-Khatib SM, Slotwiner D, Kumar UN, Varosy P, Van Wagoner DR, Marcus GM, Kusumoto FM, Blum L. Proceedings from Heart Rhythm Society's emerging technologies forum, Boston, MA, May 12, 2015. Heart Rhythm 2016; 13:e39-49. [PMID: 26801401 DOI: 10.1016/j.hrthm.2015.12.001] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/30/2015] [Indexed: 11/15/2022]
Abstract
Physicians are in an excellent position to significantly contribute to medical device innovation, but the process of bringing an idea to the bedside is complex. To begin to address these perceived barriers, the Heart Rhythm Society convened a forum of stakeholders in medical device innovation in conjunction with the 2015 Heart Rhythm Society Annual Scientific Sessions. The forum facilitated open discussion on medical device innovation, including obstacles to physician involvement and possible solutions. This report is based on the themes that emerged. First, physician innovators must take an organized approach to identifying unmet clinical needs and potential solutions. Second, extensive funds, usually secured through solicitation for investment, are often required to achieve meaningful progress, developing an idea into a device. Third, planning for regulatory requirements of the US Food and Drug Administration and Centers for Medicare & Medicaid Services is essential. In addition to these issues, intellectual property and overall trends in health care, including international markets, are critically relevant considerations for the physician innovator. Importantly, there are a number of ways in which professional societies can assist physician innovators to navigate the complex medical device innovation landscape, bring clinically meaningful devices to market more quickly, and ultimately improve patient care. These efforts include facilitating interaction between potential collaborators through scientific meetings and other gatherings; collecting, evaluating, and disseminating state-of-the-art scientific information; and representing the interests of members in interactions with regulators and policymakers.
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Affiliation(s)
- Emily P Zeitler
- Duke Clinical Research Institute; Duke University Hospital, Durham, North Carolina.
| | - Sana M Al-Khatib
- Duke Clinical Research Institute; Duke University Hospital, Durham, North Carolina
| | | | - Uday N Kumar
- Biodesign Program, Stanford University, Stanford, California
| | - Paul Varosy
- University of Colorado Anschutz Medical Campus, Aurora, Colorado
| | - David R Van Wagoner
- Cleveland Clinic Lerner College of Medicine, Case Western Research University, Cleveland, Ohio
| | - Gregory M Marcus
- University of California, San Francisco, San Francisco, California
| | | | - Laura Blum
- Heart Rhythm Society, Washington, District of Columbia
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Goldberg A, Kusunose K, Qamruddin S, Rodriguez LL, Mazgalev TN, Griffin BP, Van Wagoner DR, Zhang Y, Popović ZB. Left Atrial Size and Function in a Canine Model of Chronic Atrial Fibrillation and Heart Failure. PLoS One 2016; 11:e0147015. [PMID: 26771573 PMCID: PMC4714887 DOI: 10.1371/journal.pone.0147015] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/08/2015] [Accepted: 12/28/2015] [Indexed: 11/18/2022] Open
Abstract
BACKGROUND Our aim was to assess how atrial fibrillation (AF) induction, chronicity, and RR interval irregularity affect left atrial (LA) function and size in the setting of underlying heart failure (HF), and to determine whether AF effects can be mitigated by vagal nerve stimulation (VNS). METHODS HF was induced by 4-weeks of rapid ventricular pacing in 24 dogs. Subsequently, AF was induced and maintained by atrial pacing at 600 bpm. Dogs were randomized into control (n = 9) and VNS (n = 15) groups. In the VNS group, atrioventricular node fat pad stimulation (310 μs, 20 Hz, 3-7 mA) was delivered continuously for 6 months. LA volume and LA strain data were calculated from bi-weekly echocardiograms. RESULTS RR intervals decreased with HF in both groups (p = 0.001), and decreased further during AF in control group (p = 0.014), with a non-significant increase in the VNS group during AF. LA size increased with HF (p<0.0001), with no additional increase during AF. LA strain decreased with HF (p = 0.025) and further decreased after induction of AF (p = 0.0001). LA strain decreased less (p = 0.001) in the VNS than in the control group. Beat-by-beat analysis showed a curvilinear increase of LA strain with longer preceding RR interval, (r = 0.45, p <0.0001) with LA strain 1.1% higher (p = 0.02) in the VNS-treated animals, independent of preceding RR interval duration. The curvilinear relationship between ratio of preceding and pre-preceding RR intervals, and subsequent LA strain was weaker, (r = 0.28, p = 0.001). However, VNS-treated animals again had higher LA strain (by 2.2%, p = 0.002) independently of the ratio of preceding and pre-preceding RR intervals. CONCLUSIONS In the underlying presence of pacing-induced HF, AF decreased LA strain, with little impact on LA size. LA strain depends on the preceding RR interval duration.
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Affiliation(s)
- Adam Goldberg
- Department of Cardiovascular Medicine, Cleveland Clinic, Cleveland, Ohio, United States of America
| | - Kenya Kusunose
- Department of Cardiovascular Medicine, Cleveland Clinic, Cleveland, Ohio, United States of America
| | - Salima Qamruddin
- Department of Cardiovascular Medicine, Cleveland Clinic, Cleveland, Ohio, United States of America
| | - L. Leonardo Rodriguez
- Department of Cardiovascular Medicine, Cleveland Clinic, Cleveland, Ohio, United States of America
| | - Todor N. Mazgalev
- Department of Molecular Cardiology, Cleveland Clinic, Cleveland, Ohio, United States of America
| | - Brian P. Griffin
- Department of Cardiovascular Medicine, Cleveland Clinic, Cleveland, Ohio, United States of America
| | - David R. Van Wagoner
- Department of Molecular Cardiology, Cleveland Clinic, Cleveland, Ohio, United States of America
| | - Youhua Zhang
- Department of Molecular Cardiology, Cleveland Clinic, Cleveland, Ohio, United States of America
| | - Zoran B. Popović
- Department of Cardiovascular Medicine, Cleveland Clinic, Cleveland, Ohio, United States of America
- * E-mail:
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Gore-Panter SR, Hsu J, Barnard J, Moravec CS, Van Wagoner DR, Chung MK, Smith JD. PANCR, the PITX2 Adjacent Noncoding RNA, Is Expressed in Human Left Atria and Regulates PITX2c Expression. Circ Arrhythm Electrophysiol 2016; 9:e003197. [PMID: 26783232 PMCID: PMC4719779 DOI: 10.1161/circep.115.003197] [Citation(s) in RCA: 44] [Impact Index Per Article: 5.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/24/2022]
Abstract
BACKGROUND Genome-wide studies reveal that genetic variants at chromosome 4q25 constitute the strongest locus associated with atrial fibrillation, the most frequent arrhythmia. However, the mechanisms underlying this association are unknown. Our goal is to find and characterize left atrial-expressed transcripts in the chromosome 4q25 atrial fibrillation risk locus that may play a role in atrial fibrillation pathogenesis. METHODS AND RESULTS RNA sequencing performed on human left/right pairs identified an intergenic long noncoding RNA adjacent to the PITX2 gene, which we have named PANCR (PITX2 adjacent noncoding RNA). In a human tissue screen, PANCR was expressed specifically in the left atria and eye and in no other chambers of the heart. The levels of PANCR and PITX2c RNAs were highly correlated in 233 human left atrial appendage samples. PANCR levels were not associated with either atrial rhythm status or the genotypes of the chromosome 4q25 atrial fibrillation risk variants. Both PANCR and PITX2c RNAs were induced early during differentiation of human embryonic stem cells into cardiomyocytes. Because long noncoding RNAs often control gene expression, we performed siRNA-mediated knockdown of PANCR, and this treatment repressed PITX2c expression and mimicked the effects of PITX2c knockdown on global mRNA and miRNA expression. Cell fractionation studies demonstrate that PANCR is primarily localized in the cytoplasm. CONCLUSIONS PANCR and PITX2c are coordinately expressed early during cardiomyocyte differentiation from stem cells. PANCR knockdown decreased PITX2c expression in differentiated cardiomyocytes, altering the transcriptome in a manner similar to PITX2c knockdown.
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Affiliation(s)
- Shamone R Gore-Panter
- From the Department of Molecular Cardiology, Lerner Research Institute (S.R.G.-P., C.S.M., D.R.V.W., M.K.C.), Department of Cellular & Molecular Medicine, Lerner Research Institute (S.R.G.-P., J.H., J.D.S.), Department of Quantitative Health Sciences (J.B.), and Department of Cardiovascular Medicine (C.S.M., D.R.V.W., M.K.C., J.D.S.), Cleveland Clinic, OH
| | - Jeffrey Hsu
- From the Department of Molecular Cardiology, Lerner Research Institute (S.R.G.-P., C.S.M., D.R.V.W., M.K.C.), Department of Cellular & Molecular Medicine, Lerner Research Institute (S.R.G.-P., J.H., J.D.S.), Department of Quantitative Health Sciences (J.B.), and Department of Cardiovascular Medicine (C.S.M., D.R.V.W., M.K.C., J.D.S.), Cleveland Clinic, OH
| | - John Barnard
- From the Department of Molecular Cardiology, Lerner Research Institute (S.R.G.-P., C.S.M., D.R.V.W., M.K.C.), Department of Cellular & Molecular Medicine, Lerner Research Institute (S.R.G.-P., J.H., J.D.S.), Department of Quantitative Health Sciences (J.B.), and Department of Cardiovascular Medicine (C.S.M., D.R.V.W., M.K.C., J.D.S.), Cleveland Clinic, OH
| | - Christine S Moravec
- From the Department of Molecular Cardiology, Lerner Research Institute (S.R.G.-P., C.S.M., D.R.V.W., M.K.C.), Department of Cellular & Molecular Medicine, Lerner Research Institute (S.R.G.-P., J.H., J.D.S.), Department of Quantitative Health Sciences (J.B.), and Department of Cardiovascular Medicine (C.S.M., D.R.V.W., M.K.C., J.D.S.), Cleveland Clinic, OH
| | - David R Van Wagoner
- From the Department of Molecular Cardiology, Lerner Research Institute (S.R.G.-P., C.S.M., D.R.V.W., M.K.C.), Department of Cellular & Molecular Medicine, Lerner Research Institute (S.R.G.-P., J.H., J.D.S.), Department of Quantitative Health Sciences (J.B.), and Department of Cardiovascular Medicine (C.S.M., D.R.V.W., M.K.C., J.D.S.), Cleveland Clinic, OH
| | - Mina K Chung
- From the Department of Molecular Cardiology, Lerner Research Institute (S.R.G.-P., C.S.M., D.R.V.W., M.K.C.), Department of Cellular & Molecular Medicine, Lerner Research Institute (S.R.G.-P., J.H., J.D.S.), Department of Quantitative Health Sciences (J.B.), and Department of Cardiovascular Medicine (C.S.M., D.R.V.W., M.K.C., J.D.S.), Cleveland Clinic, OH
| | - Jonathan D Smith
- From the Department of Molecular Cardiology, Lerner Research Institute (S.R.G.-P., C.S.M., D.R.V.W., M.K.C.), Department of Cellular & Molecular Medicine, Lerner Research Institute (S.R.G.-P., J.H., J.D.S.), Department of Quantitative Health Sciences (J.B.), and Department of Cardiovascular Medicine (C.S.M., D.R.V.W., M.K.C., J.D.S.), Cleveland Clinic, OH.
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Nelson BW, Van Wagoner DR. How Does Diazoxide Elicit Arrhythmias in Rats With Type 2 Diabetes? J Am Coll Cardiol 2015; 66:1157-9. [DOI: 10.1016/j.jacc.2015.07.028] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/16/2015] [Accepted: 07/19/2015] [Indexed: 11/25/2022]
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