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Teixeira SK, Pontes R, Zuleta LFG, Wang J, Xu D, Hildebrand S, Russell J, Zhan X, Choi M, Tang M, Li X, Ludwig S, Beutler B, Krieger JE. Genetic determinants of blood pressure and heart rate identified through ENU-induced mutagenesis with automated meiotic mapping. Sci Adv 2024; 10:eadj9797. [PMID: 38427739 PMCID: PMC10906923 DOI: 10.1126/sciadv.adj9797] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/27/2023] [Accepted: 01/29/2024] [Indexed: 03/03/2024]
Abstract
We used N-ethyl-N-nitrosurea-induced germline mutagenesis combined with automated meiotic mapping to identify specific systolic blood pressure (SBP) and heart rate (HR) determinant loci. We analyzed 43,627 third-generation (G3) mice from 841 pedigrees to assess the effects of 45,378 variant alleles within 15,760 genes, in both heterozygous and homozygous states. We comprehensively tested 23% of all protein-encoding autosomal genes and found 87 SBP and 144 HR (with 7 affecting both) candidates exhibiting detectable hypomorphic characteristics. Unexpectedly, only 18 of the 87 SBP genes were previously known, while 26 of the 144 genes linked to HR were previously identified. Furthermore, we confirmed the influence of two genes on SBP regulation and three genes on HR control through reverse genetics. This underscores the importance of our research in uncovering genes associated with these critical cardiovascular risk factors and illustrate the effectiveness of germline mutagenesis for defining key determinants of polygenic phenotypes that must be studied in an intact organism.
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Affiliation(s)
- Samantha K. Teixeira
- Laboratório de Genética e Cardiologia Molecular, Instituto do Coração, Hospital das Clínicas HCFMUSP, Faculdade de Medicina, Universidade de São Paulo, São Paulo, Brazil
| | - Roberto Pontes
- Laboratório de Genética e Cardiologia Molecular, Instituto do Coração, Hospital das Clínicas HCFMUSP, Faculdade de Medicina, Universidade de São Paulo, São Paulo, Brazil
| | - Luiz Fernando G. Zuleta
- Laboratório de Genética e Cardiologia Molecular, Instituto do Coração, Hospital das Clínicas HCFMUSP, Faculdade de Medicina, Universidade de São Paulo, São Paulo, Brazil
| | - Jianhui Wang
- Center for the Genetics of Host Defense, University of Texas Southwestern Medical Center, Dallas, TX, USA
| | - Darui Xu
- Center for the Genetics of Host Defense, University of Texas Southwestern Medical Center, Dallas, TX, USA
| | - Sara Hildebrand
- Center for the Genetics of Host Defense, University of Texas Southwestern Medical Center, Dallas, TX, USA
| | - Jamie Russell
- Center for the Genetics of Host Defense, University of Texas Southwestern Medical Center, Dallas, TX, USA
| | - Xiaoming Zhan
- Center for the Genetics of Host Defense, University of Texas Southwestern Medical Center, Dallas, TX, USA
| | - Mihwa Choi
- Center for the Genetics of Host Defense, University of Texas Southwestern Medical Center, Dallas, TX, USA
| | - Miao Tang
- Center for the Genetics of Host Defense, University of Texas Southwestern Medical Center, Dallas, TX, USA
| | - Xiaohong Li
- Center for the Genetics of Host Defense, University of Texas Southwestern Medical Center, Dallas, TX, USA
| | - Sara Ludwig
- Center for the Genetics of Host Defense, University of Texas Southwestern Medical Center, Dallas, TX, USA
| | - Bruce Beutler
- Center for the Genetics of Host Defense, University of Texas Southwestern Medical Center, Dallas, TX, USA
| | - Jose E. Krieger
- Laboratório de Genética e Cardiologia Molecular, Instituto do Coração, Hospital das Clínicas HCFMUSP, Faculdade de Medicina, Universidade de São Paulo, São Paulo, Brazil
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2
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Hughes O, Bentley AR, Breeze CE, Aguet F, Xu X, Nadkarni G, Sun Q, Lin BM, Gilliland T, Meyer MC, Du J, Raffield LM, Kramer H, Morton RW, Gouveia MH, Atkinson EG, Valladares-Salgado A, Wacher-Rodarte N, Dueker ND, Guo X, Hai Y, Adeyemo A, Best LG, Cai J, Chen G, Chong M, Doumatey A, Eales J, Goodarzi MO, Ipp E, Irvin MR, Jiang M, Jones AC, Kooperberg C, Krieger JE, Lange EM, Lanktree MB, Lash JP, Lotufo PA, Loos RJF, Ha My VT, Peralta-Romero J, Qi L, Raffel LJ, Rich SS, Rodriquez EJ, Tarazona-Santos E, Taylor KD, Umans JG, Wen J, Young BA, Yu Z, Zhang Y, Ida Chen YD, Rundek T, Rotter JI, Cruz M, Fornage M, Lima-Costa MF, Pereira AC, Paré G, Natarajan P, Cole SA, Carson AP, Lange LA, Li Y, Perez-Stable EJ, Do R, Charchar FJ, Tomaszewski M, Mychaleckyj JC, Rotimi C, Morris AP, Franceschini N. Genome-wide study investigating effector genes and polygenic prediction for kidney function in persons with ancestry from Africa and the Americas. Cell Genom 2024; 4:100468. [PMID: 38190104 PMCID: PMC10794846 DOI: 10.1016/j.xgen.2023.100468] [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] [Subscribe] [Scholar Register] [Received: 03/06/2023] [Revised: 08/31/2023] [Accepted: 11/28/2023] [Indexed: 01/09/2024]
Abstract
Chronic kidney disease is a leading cause of death and disability globally and impacts individuals of African ancestry (AFR) or with ancestry in the Americas (AMS) who are under-represented in genome-wide association studies (GWASs) of kidney function. To address this bias, we conducted a large meta-analysis of GWASs of estimated glomerular filtration rate (eGFR) in 145,732 AFR and AMS individuals. We identified 41 loci at genome-wide significance (p < 5 × 10-8), of which two have not been previously reported in any ancestry group. We integrated fine-mapped loci with epigenomic and transcriptomic resources to highlight potential effector genes relevant to kidney physiology and disease, and reveal key regulatory elements and pathways involved in renal function and development. We demonstrate the varying but increased predictive power offered by a multi-ancestry polygenic score for eGFR and highlight the importance of population diversity in GWASs and multi-omics resources to enhance opportunities for clinical translation for all.
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Affiliation(s)
- Odessica Hughes
- Centre for Genetics and Genomics Versus Arthritis, Centre for Musculoskeletal Research, The University of Manchester, Manchester, UK
| | - Amy R Bentley
- Center for Research on Genomics and Global Health, National Human Genome Research Institute, National Institutes of Health, Bethesda, MD, USA
| | - Charles E Breeze
- Division of Cancer Epidemiology and Genetics, National Cancer Institute, National Institutes of Health, Department Health and Human Services, Bethesda, MD, USA; UCL Cancer Institute, University College London, London, UK
| | - Francois Aguet
- The Broad Institute of MIT and Harvard, Cambridge, MA, USA
| | - Xiaoguang Xu
- Division of Cardiovascular Sciences, Faculty of Biology, Medicine, and Health, The University of Manchester, Manchester, UK
| | - Girish Nadkarni
- The Charles Bronfman Institute of Personalized Medicine, Icahn School of Medicine at Mount Sinai, New York, NY, USA
| | - Quan Sun
- Department of Biostatistics, University of North Carolina at Chapel Hill, Chapel Hill, NC, USA
| | - Bridget M Lin
- Department of Biostatistics, University of North Carolina at Chapel Hill, Chapel Hill, NC, USA
| | - Thomas Gilliland
- Cardiovascular Research Center and Center for Genomic Medicine, Massachusetts General Hospital, Boston, MA, USA; Program in Medical and Population Genetics and the Cardiovascular Disease Initiative, Broad Institute, Cambridge, MA, USA; Department of Medicine, Harvard Medical School, Boston, MA, USA
| | - Mariah C Meyer
- Department of Biomedical Informatics, University of Colorado Anschutz Medical Campus, Aurora, CO, USA
| | - Jiawen Du
- Department of Biostatistics, University of North Carolina at Chapel Hill, Chapel Hill, NC, USA
| | - Laura M Raffield
- Department of Genetics, University of North Carolina at Chapel Hill, Chapel Hill, NC, USA
| | - Holly Kramer
- Division of Nephrology and Hypertension, Loyola University Chicago, Maywood, IL, USA
| | - Robert W Morton
- Population Health Research Institute, Hamilton, ON, Canada; Department of Pathology and Molecular Medicine, McMaster University, Hamilton, ON, Canada
| | - Mateus H Gouveia
- Center for Research on Genomics and Global Health, National Human Genome Research Institute, National Institutes of Health, Bethesda, MD, USA
| | - Elizabeth G Atkinson
- Department of Molecular and Human Genetics, Baylor College of Medicine, Houston, TX, USA
| | - Adan Valladares-Salgado
- Unidad de Investigación Médica en Bioquímica, Hospital de Especialidades, Centro Médico Nacional Siglo XXI, Instituto Mexicano del Seguro Social, Mexico City, Mexico
| | - Niels Wacher-Rodarte
- Unidad de Investigación Médica en Epidemiologia Clinica, Hospital de Especialidades, Centro Médico Nacional Siglo XXI, Instituto Mexicano del Seguro Social, Mexico City, Mexico
| | - Nicole D Dueker
- John P Hussman Institute for Human Genomics, University of Miami Miller School of Medicine, Miami, FL, USA
| | - Xiuqing Guo
- The Institute for Translational Genomics and Population Sciences, Department of Pediatrics, The Lundquist Institute for Biomedical Innovation at Harbor-UCLA Medical Center, Torrance, CA USA
| | - Yang Hai
- The Institute for Translational Genomics and Population Sciences, Department of Pediatrics, The Lundquist Institute for Biomedical Innovation at Harbor-UCLA Medical Center, Torrance, CA USA
| | - Adebowale Adeyemo
- Center for Research on Genomics and Global Health, National Human Genome Research Institute, National Institutes of Health, Bethesda, MD, USA
| | - Lyle G Best
- Missouri Breaks Industries Research Inc., Eagle Butte, SD, USA
| | - Jianwen Cai
- Department of Biostatistics, University of North Carolina at Chapel Hill, Chapel Hill, NC, USA
| | - Guanjie Chen
- Center for Research on Genomics and Global Health, National Human Genome Research Institute, National Institutes of Health, Bethesda, MD, USA
| | - Michael Chong
- Population Health Research Institute, Hamilton, ON, Canada; Department of Pathology and Molecular Medicine, McMaster University, Hamilton, ON, Canada
| | - Ayo Doumatey
- Center for Research on Genomics and Global Health, National Human Genome Research Institute, National Institutes of Health, Bethesda, MD, USA
| | - James Eales
- Division of Cardiovascular Sciences, Faculty of Biology, Medicine, and Health, The University of Manchester, Manchester, UK
| | - Mark O Goodarzi
- Division of Endocrinology, Diabetes, and Metabolism, Department of Medicine, Cedars-Sinai Medical Center, Los Angeles, CA, USA
| | - Eli Ipp
- Division of Endocrinology and Metabolism, Department of Medicine, The Lundquist Institute for Biomedical Innovation at Harbor-UCLA Medical Center, Torrance, CA, USA
| | - Marguerite Ryan Irvin
- Department of Epidemiology, University of Alabama at Birmingham, Birmingham, AL, USA
| | - Minzhi Jiang
- Department of Applied Physical Sciences, University of North Carolina at Chapel Hill, Chapel Hill, NC, USA
| | - Alana C Jones
- Department of Epidemiology, University of Alabama at Birmingham, Birmingham, AL, USA
| | - Charles Kooperberg
- Division of Public Health Sciences, Fred Hutchinson Cancer Center, Seattle, WA, USA
| | - Jose E Krieger
- Laboratório de Genética e Cardiologia Molecular do Instituto do Coração do Hospital das Clínicas da Faculdade de Medicina da Universidade de São Paulo, São Paulo, Brazil
| | - Ethan M Lange
- Department of Biomedical Informatics, University of Colorado Anschutz Medical Campus, Aurora, CO, USA
| | - Matthew B Lanktree
- Division of Nephrology, Department of Medicine, McMaster University, Hamilton, ON, Canada
| | - James P Lash
- Division of Nephrology, Department of Medicine, University of Illinois, Chicago, IL, USA
| | - Paulo A Lotufo
- Center for Clinical and Epidemiological Research, Hospital Universitário, Universidade de São Paulo (USP), São Paulo, Brazil
| | - Ruth J F Loos
- The Charles Bronfman Institute of Personalized Medicine, Icahn School of Medicine at Mount Sinai, New York, NY, USA; Novo Nordisk Foundation Center for Basic Metabolic Research, Faculty of Health and Medical Sciences, University of Copenhagen, Copenhagen, Denmark
| | - Vy Thi Ha My
- The Charles Bronfman Institute of Personalized Medicine, Icahn School of Medicine at Mount Sinai, New York, NY, USA
| | - Jesús Peralta-Romero
- Unidad de Investigación Médica en Bioquímica, Hospital de Especialidades, Centro Médico Nacional Siglo XXI, Instituto Mexicano del Seguro Social, Mexico City, Mexico
| | - Lihong Qi
- Department of Public Health Sciences, School of Medicine, University of California Davis, Davis, CA, USA
| | - Leslie J Raffel
- Department of Pediatrics, Genetic and Genomic Medicine, University of California, Irvine, Irvine, CA, USA
| | - Stephen S Rich
- Center for Public Health Genomics, University of Virginia, Charlottesville, VA, USA
| | - Erik J Rodriquez
- Division of Intramural Research, National Heart, Lung, and Blood Institute, National Institutes of Health, Bethesda, MD, USA
| | - Eduardo Tarazona-Santos
- Departamento de Genética, Ecologia e Evolução, Instituto de Ciências Biológicas, Universidade Federal de Minas Gerais, Belo Horizonte, Brazil
| | - Kent D Taylor
- The Institute for Translational Genomics and Population Sciences, Department of Pediatrics, The Lundquist Institute for Biomedical Innovation at Harbor-UCLA Medical Center, Torrance, CA USA
| | - Jason G Umans
- MedStar Health Research Institute, Hyattsville MD and Georgetown-Howard Universities Center for Clinical and Translational Science, Washington, DC, USA
| | - Jia Wen
- Department of Genetics, University of North Carolina at Chapel Hill, Chapel Hill, NC, USA
| | - Bessie A Young
- University of Washington School of Medicine, Seattle, WA, USA; Office of Healthcare Equity, UW Justice, Equity, Diversity, and Inclusion Center for Transformational Research (UW JEDI-CTR), University of Washington, Seattle, WA, USA; Division of Nephrology, Department of Medicine, University of Washington, Seattle, WA, USA; Kidney Research Institute, Department of Medicine, University of Washington, Seattle, WA, USA
| | - Zhi Yu
- Cardiovascular Research Center and Center for Genomic Medicine, Massachusetts General Hospital, Boston, MA, USA; Program in Medical and Population Genetics and the Cardiovascular Disease Initiative, Broad Institute, Cambridge, MA, USA
| | - Ying Zhang
- Center for American Indian Health Research, Department of Biostatistics and Epidemiology, Hudson College of Public Health, The University of Oklahoma Health Sciences Center, Oklahoma, OK, USA
| | - Yii-Der Ida Chen
- The Institute for Translational Genomics and Population Sciences, Department of Pediatrics, The Lundquist Institute for Biomedical Innovation at Harbor-UCLA Medical Center, Torrance, CA USA
| | - Tanja Rundek
- Department of Neurology, Epidemiology and Public Health, Miller School of Medicine, University of Miami, Miami, FL, USA
| | - Jerome I Rotter
- The Institute for Translational Genomics and Population Sciences, Department of Pediatrics, The Lundquist Institute for Biomedical Innovation at Harbor-UCLA Medical Center, Torrance, CA USA
| | - Miguel Cruz
- Unidad de Investigación Médica en Bioquímica, Hospital de Especialidades, Centro Médico Nacional Siglo XXI, Instituto Mexicano del Seguro Social, Mexico City, Mexico
| | - Myriam Fornage
- Brown Foundation Institute of Molecular Medicine, Houston, TX, USA
| | | | - Alexandre C Pereira
- Laboratório de Genética e Cardiologia Molecular do Instituto do Coração do Hospital das Clínicas da Faculdade de Medicina da Universidade de São Paulo, São Paulo, Brazil; Aging Division, Brigham Women's Hospital, Department of Medicine, Harvard Medical School, Boston, MA, USA
| | - Guillaume Paré
- Population Health Research Institute, Hamilton, ON, Canada; Department of Pathology and Molecular Medicine, McMaster University, Hamilton, ON, Canada
| | - Pradeep Natarajan
- Cardiovascular Research Center and Center for Genomic Medicine, Massachusetts General Hospital, Boston, MA, USA; Program in Medical and Population Genetics and the Cardiovascular Disease Initiative, Broad Institute, Cambridge, MA, USA; Department of Medicine, Harvard Medical School, Boston, MA, USA
| | - Shelley A Cole
- Texas Biomedical Research Institute, San Antonio, TX, USA
| | - April P Carson
- Department of Medicine, University of Mississippi Medical Center, Jackson, MS, USA
| | - Leslie A Lange
- Department of Biomedical Informatics, University of Colorado Anschutz Medical Campus, Aurora, CO, USA
| | - Yun Li
- Department of Biostatistics, University of North Carolina at Chapel Hill, Chapel Hill, NC, USA
| | - Eliseo J Perez-Stable
- National Institute on Minority Health and Health Disparities, National Institutes of Health, Bethesda, MD, USA
| | - Ron Do
- The Charles Bronfman Institute of Personalized Medicine, Icahn School of Medicine at Mount Sinai, New York, NY, USA
| | - Fadi J Charchar
- School of Science, Psychology and Sport, Federation University, Ballarat, VIC, Australia; Department of Cardiovascular Sciences, University of Leicester, Leicester, UK; Department of Physiology, University of Melbourne, Melbourne, VIC, Australia
| | - Maciej Tomaszewski
- Division of Cardiovascular Sciences, Faculty of Biology, Medicine, and Health, The University of Manchester, Manchester, UK; Manchester Royal Infirmary, Manchester University NHS Foundation Trust, Manchester Academic Health Science Centre, Manchester, UK
| | - Josyf C Mychaleckyj
- Department of Public Health Sciences, School of Medicine, University of California Davis, Davis, CA, USA
| | - Charles Rotimi
- Center for Research on Genomics and Global Health, National Human Genome Research Institute, National Institutes of Health, Bethesda, MD, USA
| | - Andrew P Morris
- Centre for Genetics and Genomics Versus Arthritis, Centre for Musculoskeletal Research, The University of Manchester, Manchester, UK.
| | - Nora Franceschini
- Department of Epidemiology, University of North Carolina at Chapel Hill, Chapel Hill, NC, USA.
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Zorzo RA, Suen VMM, Santos JE, Silva-Jr WA, Suazo VK, Honorato ALSC, Santos RD, Jannes CE, Pereira A, Krieger JE, Liberatore-Jr RDR. LDLR gene's promoter region hypermethylation in patients with familial hypercholesterolemia. Sci Rep 2023; 13:9241. [PMID: 37286669 DOI: 10.1038/s41598-023-34639-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/13/2022] [Accepted: 05/04/2023] [Indexed: 06/09/2023] Open
Abstract
Familial hypercholesterolemia (FH) is characterized by high low-density lipoprotein cholesterol (LDL-C) levels and a high risk of early coronary heart disease. Structural alterations in the LDLR, APOB, and PCSK9 genes were not found in 20-40% of patients diagnosed using the Dutch Lipid Clinic Network (DCLN) criteria. We hypothesized that methylation in canonical genes could explain the origin of the phenotype in these patients. This study included 62 DNA samples from patients with a clinical diagnosis of FH according to the DCLN criteria, who previously tested negative for structural alterations in the canonical genes, and 47 DNA samples from patients with normal blood lipids (control group). All DNA samples were tested for methylation in the CpG islands of the three genes. The prevalence of FH relative to each gene was determined in both groups and the respective prevalence ratios (PRs) were calculated. The methylation analysis of APOB and PCSK9 was negative in both groups, showing no relationship between methylation in these genes and the FH phenotype. As the LDLR gene has two CpG islands, we analyzed each island separately. The analysis of LDLR-island1 showed PR = 0.982 (CI 0.33-2.95; χ2 = 0.001; p = 0.973), also suggesting no relationship between methylation and the FH phenotype. Analysis of LDLR-island2 showed a PR of 4.12 (CI 1.43-11.88; χ2 = 13,921; p = 0.00019), indicating a possible association between methylation on this island and the FH phenotype.
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Affiliation(s)
- R A Zorzo
- Teaching Institute "Saúde Com Evidência", Ribeirão Preto, Brazil.
- Ribeirão Preto Medical School, University of São Paulo University, São Paulo, Brazil.
| | - V M M Suen
- Ribeirão Preto Medical School, University of São Paulo University, São Paulo, Brazil
| | - J E Santos
- Ribeirão Preto Medical School, University of São Paulo University, São Paulo, Brazil
| | - W A Silva-Jr
- Ribeirão Preto Medical School, University of São Paulo University, São Paulo, Brazil
| | - V K Suazo
- Pediatrics Department, Pediatric Endocrinology, Ribeirão Preto Medical School, São Paulo University, São Paulo, Brazil
| | - A L S C Honorato
- Ribeirão Preto Medical School, University of São Paulo University, São Paulo, Brazil
| | - R D Santos
- Heart Institute (InCor), University of São Paulo Medical School Hospital, São Paulo, Brazil
| | - C E Jannes
- Heart Institute (InCor), University of São Paulo Medical School Hospital, São Paulo, Brazil
| | - A Pereira
- Heart Institute (InCor), University of São Paulo Medical School Hospital, São Paulo, Brazil
| | - J E Krieger
- Heart Institute (InCor), University of São Paulo Medical School Hospital, São Paulo, Brazil
| | - R D R Liberatore-Jr
- Ribeirão Preto Medical School, University of São Paulo University, São Paulo, Brazil
- Pediatrics Department, Pediatric Endocrinology, Ribeirão Preto Medical School, São Paulo University, São Paulo, Brazil
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Chen DM, Taporoski TP, Alexandria SJ, Aaby DA, Beijamini F, Krieger JE, von Schantz M, Pereira A, Knutson KL. Altered sleep architecture in diabetes and prediabetes: findings from the Baependi Heart Study. medRxiv 2023:2023.03.23.23287631. [PMID: 36993582 PMCID: PMC10055606 DOI: 10.1101/2023.03.23.23287631] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/19/2023]
Abstract
Objective People with diabetes are more likely to have obstructive sleep apnea, but there are few studies examining sleep architecture in people with diabetes, especially in the absence of moderate-severe sleep apnea. Therefore, we compared sleep architecture among people with diabetes, prediabetes or neither condition, whilst excluding people with moderate-severe sleep apnea. Research design and methods This sample is from the Baependi Heart Study, a prospective, family-based cohort of adults in Brazil. 1,074 participants underwent at-home polysomnography (PSG). Diabetes was defined as 1) FBG>125 OR 2) HbA1c>6.4 OR 3) taking diabetic medication, and prediabetes was defined as 1) [(5.7≤HbA1c≤6.4) OR (100≤FBG≤125)] AND 2) not taking diabetic medication. We excluded participants that had an apnea-hypopnea index (AHI)>30 from these analyses to reduce confounding due to severe sleep apnea. We compared sleep stages among the 3 groups. Results Compared to those without diabetes, we found shorter REM duration for participants with diabetes (-6.7min, 95%CI -13.2, -0.1) or prediabetes (-5.9min, 95%CI -10.5, -1.3), even after adjusting for age, gender, BMI, and AHI. Diabetes was also associated with lower total sleep time (-13.7min, 95%CI -26.8, -0.6), longer slow-wave sleep (N3) duration (+7.6min, 95%CI 0.6, 14.6) and higher N3 percentage (+2.4%, 95%CI 0.6, 4.2), compared to those without diabetes. Conclusions People with diabetes and prediabetes had less REM sleep after taking into account potential confounders, including AHI. People with diabetes also had more N3 sleep. These results suggest that diabetes is associated with different sleep architecture, even in the absence of moderate-severe sleep apnea.
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Venturini G, Alvim JM, Padilha K, Toepfer CN, Gorham JM, Wasson LK, Biagi D, Schenkman S, Carvalho VM, Salgueiro JS, Cardozo KHM, Krieger JE, Pereira AC, Seidman JG, Seidman CE. Cardiomyocyte infection by Trypanosoma cruzi promotes innate immune response and glycolysis activation. Front Cell Infect Microbiol 2023; 13:1098457. [PMID: 36814444 PMCID: PMC9940271 DOI: 10.3389/fcimb.2023.1098457] [Citation(s) in RCA: 7] [Impact Index Per Article: 7.0] [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: 11/14/2022] [Accepted: 01/16/2023] [Indexed: 02/08/2023] Open
Abstract
Introduction Chagas cardiomyopathy, a disease caused by Trypanosoma cruzi (T. cruzi) infection, is a major contributor to heart failure in Latin America. There are significant gaps in our understanding of the mechanism for infection of human cardiomyocytes, the pathways activated during the acute phase of the disease, and the molecular changes that lead to the progression of cardiomyopathy. Methods To investigate the effects of T. cruzi on human cardiomyocytes during infection, we infected induced pluripotent stem cell-derived cardiomyocytes (iPSC-CM) with the parasite and analyzed cellular, molecular, and metabolic responses at 3 hours, 24 hours, and 48 hours post infection (hpi) using transcriptomics (RNAseq), proteomics (LC-MS), and metabolomics (GC-MS and Seahorse) analyses. Results Analyses of multiomic data revealed that cardiomyocyte infection caused a rapid increase in genes and proteins related to activation innate and adaptive immune systems and pathways, including alpha and gamma interferons, HIF-1α signaling, and glycolysis. These responses resemble prototypic responses observed in pathogen-activated immune cells. Infection also caused an activation of glycolysis that was dependent on HIF-1α signaling. Using gene editing and pharmacological inhibitors, we found that T. cruzi uptake was mediated in part by the glucose-facilitated transporter GLUT4 and that the attenuation of glycolysis, HIF-1α activation, or GLUT4 expression decreased T. cruzi infection. In contrast, pre-activation of pro-inflammatory immune responses with LPS resulted in increased infection rates. Conclusion These findings suggest that T. cruzi exploits a HIF-1α-dependent, cardiomyocyte-intrinsic stress-response activation of glycolysis to promote intracellular infection and replication. These chronic immuno-metabolic responses by cardiomyocytes promote dysfunction, cell death, and the emergence of cardiomyopathy.
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Affiliation(s)
- Gabriela Venturini
- Department of Genetics, Harvard Medical School, Boston, MA, United States,Laboratory of Genetics and Molecular Cardiology, University of São Paulo Medical School, São Paulo, Brazil
| | - Juliana M. Alvim
- Laboratory of Genetics and Molecular Cardiology, University of São Paulo Medical School, São Paulo, Brazil
| | - Kallyandra Padilha
- Laboratory of Genetics and Molecular Cardiology, University of São Paulo Medical School, São Paulo, Brazil
| | - Christopher N. Toepfer
- Department of Genetics, Harvard Medical School, Boston, MA, United States,Division of Cardiovascular Medicine, Radcliffe Department of Medicine, University of Oxford, Oxford, United Kingdom,Wellcome Centre for Human Genetics, University of Oxford, Oxford, United Kingdom
| | - Joshua M. Gorham
- Department of Genetics, Harvard Medical School, Boston, MA, United States
| | - Lauren K. Wasson
- Department of Genetics, Harvard Medical School, Boston, MA, United States
| | | | - Sergio Schenkman
- Department of Microbiology, Immunology and Parasitology, Escola Paulista de Medicina, São Paulo, Brazil
| | | | | | | | - Jose E. Krieger
- Laboratory of Genetics and Molecular Cardiology, University of São Paulo Medical School, São Paulo, Brazil
| | - Alexandre C. Pereira
- Department of Genetics, Harvard Medical School, Boston, MA, United States,Laboratory of Genetics and Molecular Cardiology, University of São Paulo Medical School, São Paulo, Brazil
| | | | - Christine E. Seidman
- Department of Genetics, Harvard Medical School, Boston, MA, United States,Division of Cardiovascular Medicine, Department of Medicine, Brigham and Women’s Hospital, Boston, MA, United States,Howard Hughes Medical Institute, Chevy Chase, MD, United States,*Correspondence: Christine E. Seidman,
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Coutinho ER, Miname MH, Rocha VZ, Bittencourt MS, Jannes CE, Krieger JE, Pereira AC, Santos RD. Cardiovascular disease onset in old people with severe hypercholesterolemia. Atherosclerosis 2023; 365:9-14. [PMID: 36646017 DOI: 10.1016/j.atherosclerosis.2022.12.007] [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] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/11/2022] [Revised: 11/14/2022] [Accepted: 12/20/2022] [Indexed: 12/24/2022]
Abstract
BACKGROUND AND AIMS Familial hypercholesterolemia (FH) variants are associated with higher atherosclerotic cardiovascular disease risk (ASCVD) even when compared with other forms of severe hypercholesterolemia, especially in young people. Lipid lowering therapies (LLT) may change hypercholesterolemia natural history. This study aimed at evaluating factors associated with occurrence of ASCVD in old severe hypercholesterolemics diagnosed or not with FH and undergoing LLT. METHODS Hypercholesterolemic individuals ≥60 years participating on a genetic cascade screening for FH were divided in 4 groups (2 × 2) according to the presence (variant+) or not (variant-) of FH genetic variants and previous ASCVD (ASCVD+ and ASCVD-). Biomarkers associated with new incident ASCVD events were tested using Cox models. Continuous data shown as medians (%25; %75). RESULTS From 4,111 genotyped individuals, 377 (9.1%) were elderly [age 66 (63; 71) years], 28.9% males, 42.7% variant+, 32.1% with previous ASCVD, LLT duration 9 (5; 16) years, and on treatment LDL-cholesterol 144 (109; 200) mg/dL. After 4.8 (7; 3) years of follow up there were 47 incident events (12.4%, 2.7% patient/year). The annualized event rates were 0.8% (95% CI 0.36%; 1.70%), 2.3% (95% CI 1.3%; 4.1%), 5.2% (95% CI 2.8%; 9.7%) and 6.3% (95% CI 4.0%; 10.0%) respectively for groups variant-/ASCVD-, variant+/ASCVD-, variant-/ASCVD+ and, variant+/ASCVD+ (p log rank p < 0.001). Only presence of previous ASCVD was independently associated with incident ASCVD [hazard ratio 3.236 (95%CI 1.497-6.993, p = 0.003)]. No interaction was found for previous ASCVD and variants. CONCLUSIONS In old severe hypercholesterolemic individuals undergoing long-term LLT previous ASCVD was associated with incident events while FH causing variants were not.
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Affiliation(s)
- Elaine R Coutinho
- Heart Institute (InCor), University of São Paulo, Medical School Hospital (FMUSP), Sao Paulo, Brazil
| | - Marcio H Miname
- Heart Institute (InCor), University of São Paulo, Medical School Hospital (FMUSP), Sao Paulo, Brazil
| | - Viviane Z Rocha
- Heart Institute (InCor), University of São Paulo, Medical School Hospital (FMUSP), Sao Paulo, Brazil
| | | | - Cinthia E Jannes
- Heart Institute (InCor), University of São Paulo, Medical School Hospital (FMUSP), Sao Paulo, Brazil
| | - Jose E Krieger
- Heart Institute (InCor), University of São Paulo, Medical School Hospital (FMUSP), Sao Paulo, Brazil
| | - Alexandre C Pereira
- Heart Institute (InCor), University of São Paulo, Medical School Hospital (FMUSP), Sao Paulo, Brazil; Genetics Department Harvard Medical School, Boston, MA, USA
| | - Raul D Santos
- Heart Institute (InCor), University of São Paulo, Medical School Hospital (FMUSP), Sao Paulo, Brazil; Hospital Israelita Albert Einstein, Sao Paulo, Brazil.
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7
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Bertoline LMF, Lima AN, Krieger JE, Teixeira SK. Before and after AlphaFold2: An overview of protein structure prediction. Front Bioinform 2023; 3:1120370. [PMID: 36926275 PMCID: PMC10011655 DOI: 10.3389/fbinf.2023.1120370] [Citation(s) in RCA: 24] [Impact Index Per Article: 24.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/09/2022] [Accepted: 02/17/2023] [Indexed: 03/08/2023] Open
Abstract
Three-dimensional protein structure is directly correlated with its function and its determination is critical to understanding biological processes and addressing human health and life science problems in general. Although new protein structures are experimentally obtained over time, there is still a large difference between the number of protein sequences placed in Uniprot and those with resolved tertiary structure. In this context, studies have emerged to predict protein structures by methods based on a template or free modeling. In the last years, different methods have been combined to overcome their individual limitations, until the emergence of AlphaFold2, which demonstrated that predicting protein structure with high accuracy at unprecedented scale is possible. Despite its current impact in the field, AlphaFold2 has limitations. Recently, new methods based on protein language models have promised to revolutionize the protein structural biology allowing the discovery of protein structure and function only from evolutionary patterns present on protein sequence. Even though these methods do not reach AlphaFold2 accuracy, they already covered some of its limitations, being able to predict with high accuracy more than 200 million proteins from metagenomic databases. In this mini-review, we provide an overview of the breakthroughs in protein structure prediction before and after AlphaFold2 emergence.
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Affiliation(s)
- Letícia M F Bertoline
- Laboratory of Genetics and Molecular Cardiology, Heart Institute, University of São Paulo Medical School, São Paulo, Brazil
| | - Angélica N Lima
- Laboratory of Genetics and Molecular Cardiology, Heart Institute, University of São Paulo Medical School, São Paulo, Brazil
| | - Jose E Krieger
- Laboratory of Genetics and Molecular Cardiology, Heart Institute, University of São Paulo Medical School, São Paulo, Brazil
| | - Samantha K Teixeira
- Laboratory of Genetics and Molecular Cardiology, Heart Institute, University of São Paulo Medical School, São Paulo, Brazil
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8
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Fernández-Rhodes L, Graff M, Buchanan VL, Justice AE, Highland HM, Guo X, Zhu W, Chen HH, Young KL, Adhikari K, Palmer ND, Below JE, Bradfield J, Pereira AC, Glover L, Kim D, Lilly AG, Shrestha P, Thomas AG, Zhang X, Chen M, Chiang CW, Pulit S, Horimoto A, Krieger JE, Guindo-Martínez M, Preuss M, Schumann C, Smit RA, Torres-Mejía G, Acuña-Alonzo V, Bedoya G, Bortolini MC, Canizales-Quinteros S, Gallo C, González-José R, Poletti G, Rothhammer F, Hakonarson H, Igo R, Adler SG, Iyengar SK, Nicholas SB, Gogarten SM, Isasi CR, Papnicolaou G, Stilp AM, Qi Q, Kho M, Smith JA, Langefeld CD, Wagenknecht L, Mckean-Cowdin R, Gao XR, Nousome D, Conti DV, Feng Y, Allison MA, Arzumanyan Z, Buchanan TA, Chen YDI, Genter PM, Goodarzi MO, Hai Y, Hsueh W, Ipp E, Kandeel FR, Lam K, Li X, Nadler JL, Raffel LJ, Roll K, Sandow K, Tan J, Taylor KD, Xiang AH, Yao J, Audirac-Chalifour A, Peralta Romero JDJ, Hartwig F, Horta B, Blangero J, Curran JE, Duggirala R, Lehman DE, Puppala S, Fejerman L, John EM, Aguilar-Salinas C, Burtt NP, Florez JC, García-Ortíz H, González-Villalpando C, Mercader J, Orozco L, Tusié-Luna T, Blanco E, Gahagan S, Cox NJ, Hanis C, Butte NF, Cole SA, Comuzzie AG, Voruganti VS, Rohde R, Wang Y, Sofer T, Ziv E, Grant SF, Ruiz-Linares A, Rotter JI, Haiman CA, Parra EJ, Cruz M, Loos RJ, North KE. Erratum: Ancestral diversity improves discovery and fine-mapping of genetic loci for anthropometric traits-The Hispanic/Latino Anthropometry Consortium. HGG Adv 2022; 4:100149. [PMID: 36268164 PMCID: PMC9576563 DOI: 10.1016/j.xhgg.2022.100149] [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] [Subscribe] [Scholar Register] [Indexed: 11/05/2022] Open
Abstract
[This corrects the article DOI: 10.1016/j.xhgg.2022.100099.].
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Sabino EC, Franco LAM, Venturini G, Velho Rodrigues M, Marques E, de Oliveira-da Silva LC, Martins LNA, Ferreira AM, Almeida PEC, Silva FDD, Leite SF, Nunes MDCP, Haikal DS, Oliveira CDL, Cardoso CS, Seidman JG, Seidman CE, Casas JP, Ribeiro ALP, Krieger JE, Pereira AC. Genome-wide association study for Chagas Cardiomyopathy identify a new risk locus on chromosome 18 associated with an immune-related protein and transcriptional signature. PLoS Negl Trop Dis 2022; 16:e0010725. [PMID: 36215317 PMCID: PMC9550069 DOI: 10.1371/journal.pntd.0010725] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [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: 04/13/2022] [Accepted: 08/10/2022] [Indexed: 11/23/2022] Open
Abstract
BACKGROUND Chronic Chagas Cardiomyopathy (CCC) usually develops between 10 and 20 years after the first parasitic infection and is one of the leading causes of end-stage heart failure in Latin America. Despite the great inter-individual variability in CCC susceptibility (only 30% of infected individuals ever present CCC), there are no known predictors for disease development in those chronically infected. METHODOLOGY/PRINCIPAL FINDINGS We describe a new susceptibility locus for CCC through a GWAS analysis in the SaMi-Trop cohort, a population-based study conducted in a Chagas endemic region from Brazil. This locus was also associated with CCC in the REDS II Study. The newly identified locus (rs34238187, OR 0.73, p-value 2.03 x 10-9) spans a haplotype of approximately 30Kb on chromosome 18 (chr18: 5028302-5057621) and is also associated with 80 different traits, most of them blood protein traits significantly enriched for immune-related biological pathways. Hi-C data show that the newly associated locus is able to interact with chromatin sites as far as 10Mb on chromosome 18 in a number of different cell types and tissues. Finally, we were able to confirm, at the tissue transcriptional level, the immune-associated blood protein signature using a multi-tissue differential gene expression and enrichment analysis. CONCLUSIONS/SIGNIFICANCE We suggest that the newly identified locus impacts CCC risk among T cruzi infected individuals through the modulation of a downstream transcriptional and protein signature associated with host-parasite immune response. Functional characterization of the novel risk locus is warranted.
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Affiliation(s)
- Ester Cerdeira Sabino
- Departamento de Moléstias Infecciosas e Parasitárias, Hospital das Clínicas da Faculdade de Medicina da Universidade de São Paulo (FMUSP), São Paulo, Brazil
- Laboratório de Parasitologia Médica (LIM-46), Hospital das Clínicas da Faculdade de Medicina da Universidade de São Paulo (FMUSP), São Paulo, Brazil
| | - Lucas Augusto Moysés Franco
- Departamento de Moléstias Infecciosas e Parasitárias, Hospital das Clínicas da Faculdade de Medicina da Universidade de São Paulo (FMUSP), São Paulo, Brazil
- Laboratório de Parasitologia Médica (LIM-46), Hospital das Clínicas da Faculdade de Medicina da Universidade de São Paulo (FMUSP), São Paulo, Brazil
| | - Gabriela Venturini
- Laboratorio de Genetica e Cardiologia Molecular, Instituto do Coracao (InCor), Faculdade de Medicina da Universidade de São Paulo, São Paulo, Brazila
- Genetics Department, Harvard Medical School, Boston, Massachusetts, United States of America
| | - Mariliza Velho Rodrigues
- Laboratorio de Genetica e Cardiologia Molecular, Instituto do Coracao (InCor), Faculdade de Medicina da Universidade de São Paulo, São Paulo, Brazila
| | - Emanuelle Marques
- Laboratorio de Genetica e Cardiologia Molecular, Instituto do Coracao (InCor), Faculdade de Medicina da Universidade de São Paulo, São Paulo, Brazila
| | - Lea Campos de Oliveira-da Silva
- Departamento de Moléstias Infecciosas e Parasitárias, Hospital das Clínicas da Faculdade de Medicina da Universidade de São Paulo (FMUSP), São Paulo, Brazil
- Laboratório de Parasitologia Médica (LIM-46), Hospital das Clínicas da Faculdade de Medicina da Universidade de São Paulo (FMUSP), São Paulo, Brazil
| | | | - Ariela Mota Ferreira
- Departamento de Moléstias Infecciosas e Parasitárias, Hospital das Clínicas da Faculdade de Medicina da Universidade de São Paulo (FMUSP), São Paulo, Brazil
| | | | - Felipe Dias Da Silva
- Departamento de Moléstias Infecciosas e Parasitárias, Hospital das Clínicas da Faculdade de Medicina da Universidade de São Paulo (FMUSP), São Paulo, Brazil
- Laboratório de Parasitologia Médica (LIM-46), Hospital das Clínicas da Faculdade de Medicina da Universidade de São Paulo (FMUSP), São Paulo, Brazil
| | | | | | | | | | | | - Jonathan G. Seidman
- Genetics Department, Harvard Medical School, Boston, Massachusetts, United States of America
| | - Christine E. Seidman
- Genetics Department, Harvard Medical School, Boston, Massachusetts, United States of America
- Cardiovascular Division, Brigham and Women’s Hospital, Boston, Massachusetts, United States of America
- Howard Hughes Medical Institute, Chevy Chase, Maryland, United States of America
| | - Juan P. Casas
- Massachusetts Veterans Epidemiology Research and Information Center, Veterans Affairs Boston Healthcare System, Boston, Massachusetts, United States of America
- Division of Aging, Brigham and Women’s Hospital, Harvard Medical School, Boston, Massachusetts, United States of America
| | - Antonio Luiz Pinho Ribeiro
- Faculdade de Medicina, Universidade Federal de Minas Gerais, Belo Horizonte, Brazil
- Telehealth Center, Hospital das Clínicas, Universidade Federal de Minas Gerais, Belo Horizonte, Brazil
| | - Jose E. Krieger
- Laboratorio de Genetica e Cardiologia Molecular, Instituto do Coracao (InCor), Faculdade de Medicina da Universidade de São Paulo, São Paulo, Brazila
| | - Alexandre C. Pereira
- Laboratorio de Genetica e Cardiologia Molecular, Instituto do Coracao (InCor), Faculdade de Medicina da Universidade de São Paulo, São Paulo, Brazila
- Genetics Department, Harvard Medical School, Boston, Massachusetts, United States of America
- * E-mail:
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10
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Muñoz JJAM, Dariolli R, da Silva CM, Neri EA, Valadão IC, Turaça LT, Lima VM, de Carvalho MLP, Velho MR, Sobie EA, Krieger JE. Time-regulated transcripts with the potential to modulate human pluripotent stem cell-derived cardiomyocyte differentiation. Stem Cell Res Ther 2022; 13:437. [PMID: 36056380 PMCID: PMC9438174 DOI: 10.1186/s13287-022-03138-x] [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] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/22/2022] [Accepted: 08/14/2022] [Indexed: 11/10/2022] Open
Abstract
Background Human-induced pluripotent stem cell-derived cardiomyocytes (hiPSC-CM) are a promising disease model, even though hiPSC-CMs cultured for extended periods display an undifferentiated transcriptional landscape. MiRNA–target gene interactions contribute to fine-tuning the genetic program governing cardiac maturation and may uncover critical pathways to be targeted. Methods We analyzed a hiPSC-CM public dataset to identify time-regulated miRNA–target gene interactions based on three logical steps of filtering. We validated this process in silico using 14 human and mouse public datasets, and further confirmed the findings by sampling seven time points over a 30-day protocol with a hiPSC-CM clone developed in our laboratory. We then added miRNA mimics from the top eight miRNAs candidates in three cell clones in two different moments of cardiac specification and maturation to assess their impact on differentiation characteristics including proliferation, sarcomere structure, contractility, and calcium handling.
Results We uncovered 324 interactions among 29 differentially expressed genes and 51 miRNAs from 20,543 transcripts through 120 days of hiPSC-CM differentiation and selected 16 genes and 25 miRNAs based on the inverse pattern of expression (Pearson R-values < − 0.5) and consistency in different datasets. We validated 16 inverse interactions among eight genes and 12 miRNAs (Person R-values < − 0.5) during hiPSC-CMs differentiation and used miRNAs mimics to verify proliferation, structural and functional features related to maturation. We also demonstrated that miR-124 affects Ca2+ handling altering features associated with hiPSC-CMs maturation.
Conclusion We uncovered time-regulated transcripts influencing pathways affecting cardiac differentiation/maturation axis and showed that the top-scoring miRNAs indeed affect primarily structural features highlighting their role in the hiPSC-CM maturation. Supplementary Information The online version contains supplementary material available at 10.1186/s13287-022-03138-x.
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Affiliation(s)
- Juan J A M Muñoz
- Laboratory of Genetics and Molecular Cardiology/LIM 13, Heart Institute (InCor), University of São Paulo Medical School, Avenida Dr. Eneas C. Aguiar 44, São Paulo, SP, 05403-000, Brazil.,Universidad Señor de Sipán, Chiclayo, Perú
| | - Rafael Dariolli
- Laboratory of Genetics and Molecular Cardiology/LIM 13, Heart Institute (InCor), University of São Paulo Medical School, Avenida Dr. Eneas C. Aguiar 44, São Paulo, SP, 05403-000, Brazil.,Department of Pharmacological Sciences, Graduate School of Biomedical Sciences, Icahn School of Medicine at Mount Sinai, New York, NY, USA
| | - Caio Mateus da Silva
- Laboratory of Genetics and Molecular Cardiology/LIM 13, Heart Institute (InCor), University of São Paulo Medical School, Avenida Dr. Eneas C. Aguiar 44, São Paulo, SP, 05403-000, Brazil
| | - Elida A Neri
- Laboratory of Genetics and Molecular Cardiology/LIM 13, Heart Institute (InCor), University of São Paulo Medical School, Avenida Dr. Eneas C. Aguiar 44, São Paulo, SP, 05403-000, Brazil
| | - Iuri C Valadão
- Laboratory of Genetics and Molecular Cardiology/LIM 13, Heart Institute (InCor), University of São Paulo Medical School, Avenida Dr. Eneas C. Aguiar 44, São Paulo, SP, 05403-000, Brazil
| | - Lauro Thiago Turaça
- Laboratory of Genetics and Molecular Cardiology/LIM 13, Heart Institute (InCor), University of São Paulo Medical School, Avenida Dr. Eneas C. Aguiar 44, São Paulo, SP, 05403-000, Brazil
| | - Vanessa M Lima
- Laboratory of Genetics and Molecular Cardiology/LIM 13, Heart Institute (InCor), University of São Paulo Medical School, Avenida Dr. Eneas C. Aguiar 44, São Paulo, SP, 05403-000, Brazil
| | - Mariana Lombardi Peres de Carvalho
- Laboratory of Genetics and Molecular Cardiology/LIM 13, Heart Institute (InCor), University of São Paulo Medical School, Avenida Dr. Eneas C. Aguiar 44, São Paulo, SP, 05403-000, Brazil
| | - Mariliza R Velho
- Laboratory of Genetics and Molecular Cardiology/LIM 13, Heart Institute (InCor), University of São Paulo Medical School, Avenida Dr. Eneas C. Aguiar 44, São Paulo, SP, 05403-000, Brazil
| | - Eric A Sobie
- Department of Pharmacological Sciences, Graduate School of Biomedical Sciences, Icahn School of Medicine at Mount Sinai, New York, NY, USA
| | - Jose E Krieger
- Laboratory of Genetics and Molecular Cardiology/LIM 13, Heart Institute (InCor), University of São Paulo Medical School, Avenida Dr. Eneas C. Aguiar 44, São Paulo, SP, 05403-000, Brazil.
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11
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Thériault S, Imboden M, Biggs ML, Austin TR, Aeschbacher S, Schaffner E, Brody JA, Bartz TM, Risch M, Grossmann K, Lin HJ, Soliman EZ, Post WS, Risch L, Krieger JE, Pereira AC, Heckbert SR, Sotoodehnia N, Probst-Hensch NM, Conen D. Genome-wide analyses identify SCN5A as a susceptibility locus for premature atrial contraction frequency. iScience 2022; 25:105210. [PMID: 36267918 PMCID: PMC9576575 DOI: 10.1016/j.isci.2022.105210] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/06/2022] [Revised: 08/29/2022] [Accepted: 09/22/2022] [Indexed: 12/03/2022] Open
Abstract
Premature atrial contractions (PACs) are frequently observed on electrocardiograms and are associated with increased risks of atrial fibrillation (AF), stroke, and mortality. In this study, we aimed to identify genetic susceptibility loci for PAC frequency. We performed a genome-wide association study meta-analysis with PAC frequency obtained from ambulatory cardiac monitoring in 4,831 individuals of European ancestry. We identified a genome-wide significant locus at the SCN5A gene. The lead variant, rs7373862, located in an intron of SCN5A, was associated with an increase of 0.12 [95% CI 0.08–0.16] standard deviations of the normalized PAC frequency per risk allele. Among genetic variants previously associated with AF, there was a significant enrichment in concordance of effect for PAC frequency (n = 73/106, p = 5.1 × 10−5). However, several AF risk loci, including PITX2, were not associated with PAC frequency. These findings suggest the existence of both shared and distinct genetic mechanisms for PAC frequency and AF. Variants in SCN5A are associated with premature atrial contractions (PAC) frequency Other atrial fibrillation (AF) risk variants are also associated with PAC frequency Both shared and distinct genetic mechanisms exist for PAC frequency and AF
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Affiliation(s)
- Sébastien Thériault
- Department of Molecular Biology, Medical Biochemistry and Pathology, Université Laval, Quebec City, QC, Canada
- Population Health Research Institute, McMaster University, Hamilton, ON, Canada
- Corresponding author
| | - Medea Imboden
- Department of Epidemiology and Public Health, Swiss Tropical and Public Health Institute, Basel, Switzerland
- University of Basel, Basel, Switzerland
| | - Mary L. Biggs
- Cardiovascular Health Research Unit, Department of Medicine, University of Washington, Seattle, WA, USA
- Department of Biostatistics, University of Washington, Seattle, WA, USA
| | - Thomas R. Austin
- Department of Epidemiology, University of Washington, Seattle, WA, USA
| | - Stefanie Aeschbacher
- Cardiovascular Research Institute Basel (CRIB), University Hospital Basel, University of Basel, Basel, Switzerland
- Department of Cardiology, University Hospital of Basel, Basel, Switzerland
| | - Emmanuel Schaffner
- Department of Epidemiology and Public Health, Swiss Tropical and Public Health Institute, Basel, Switzerland
- University of Basel, Basel, Switzerland
| | - Jennifer A. Brody
- Cardiovascular Health Research Unit, Department of Medicine, University of Washington, Seattle, WA, USA
| | - Traci M. Bartz
- Cardiovascular Health Research Unit, Department of Medicine, University of Washington, Seattle, WA, USA
- Department of Biostatistics, University of Washington, Seattle, WA, USA
| | - Martin Risch
- Dr. Risch Medical Laboratories, Vaduz, Liechtenstein
- Division of Laboratory Medicine, Cantonal Hospital Graubünden, Chur, Switzerland
| | - Kirsten Grossmann
- Dr. Risch Medical Laboratories, Vaduz, Liechtenstein
- Faculty of Medical Sciences, Private University in the Principality of Liechtenstein, Triesen, Liechtenstein
| | - Henry J. Lin
- Institute for Translational Genomics and Population Sciences and Department of Pediatrics, Los Angeles Biomedical Research Institute at Harbor-UCLA Medical Center, Torrance, CA, USA
| | - Elsayed Z. Soliman
- Epidemiological Cardiology Research Center, Section on Cardiovascular Medicine, Department of Medicine, Wake Forest School of Medicine, Winston-Salem, NC, USA
| | - Wendy S. Post
- Division of Cardiology, Department of Medicine, Johns Hopkins University School of Medicine, Baltimore, MD, USA
| | - Lorenz Risch
- Dr. Risch Medical Laboratories, Vaduz, Liechtenstein
- Center of Laboratory Medicine, University Institute of Clinical Chemistry, University of Bern, Bern, Switzerland
| | - Jose E. Krieger
- Laboratory of Genetics and Molecular Cardiology, Heart Institute, University of Sao Paulo Medical School, Sao Paulo, Brazil
| | - Alexandre C. Pereira
- Laboratory of Genetics and Molecular Cardiology, Heart Institute, University of Sao Paulo Medical School, Sao Paulo, Brazil
| | - Susan R. Heckbert
- Department of Epidemiology, University of Washington, Seattle, WA, USA
- Cardiovascular Health Research Unit, University of Washington, Seattle, WA, USA
| | - Nona Sotoodehnia
- Cardiovascular Health Research Unit, Department of Medicine, University of Washington, Seattle, WA, USA
- Cardiology Division, University of Washington, Seattle, WA, USA
| | - Nicole M. Probst-Hensch
- Department of Epidemiology and Public Health, Swiss Tropical and Public Health Institute, Basel, Switzerland
- University of Basel, Basel, Switzerland
| | - David Conen
- Population Health Research Institute, McMaster University, Hamilton, ON, Canada
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Kuwada Teixeira S, Pontes R, Zuleta LF, Rosa R, Bertoline L, Wang J, xu D, Russell JL, Zhan X, Choi M, Tang M, Li X, Ludwig S, Beutler B, Krieger JE. Abstract 001: Germline Mutagenesis Induces Blood Pressure And Heart Rate Variation In Mice Uncovering Novel Insights On The Genesis Of Cardiovascular Disease Risks. Hypertension 2022. [DOI: 10.1161/hyp.79.suppl_1.001] [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] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
Resting blood pressure (BP) and heart rate (HR) levels are independent risk factors for cardiovascular diseases and mortality. Both phenotypes are critical for lifetime maintenance of the cardiovascular homeostasis and are under the influence of multiple factors. The estimated heritability for both phenotypes is high, but their main genetic determinants remain elusive. To address this shortcoming, we used a strategy to systematically identify genes affecting BP and HR regulation through high-throughput N-ethyl-N-Nitrosurea-induced germline mutagenesis. First, the random chemical-induced mutations were identified in founder animals by whole exome G1 progenitor sequencing and their zygosity established in G2/G3 mice before phenotypic assessment. We used the noninvasive tail cuff method to assess BP and HR in conscious G3 mice distributed in pedigrees of 30-100 G1 descendants. The quantitative traits were then analyzed with Linkage Analyzer in single or multiple combined pedigrees, detecting significant linkage between individual mutations and altered phenotypic scores in heterozygous or homozygous mice. Here, we report the initial results of BP and HR candidate genes selected during the screening of 45,261 G3 mice from 878 pedigrees, testing the effects of 45,317 variant alleles within 14,575 genes, in which 23 % of all autosomal genes were severely damaged. The data indicate that ENU mutagenesis effectively identified 85 candidate genes affecting BP and 132 HR levels, including only 13 and 18 genes previously known to influence BP and HR, respectively. Moreover, we validated the influence of three and seven new genes on BP and HR control through reverse genetics that may be associated with ageing, vascular integrity and cardiac development. These findings shed light on novel underlying mechanisms associated with both phenotypes and highlight sub-systems contributing to the genesis of critical risk factors associated with cardiovascular diseases.
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Affiliation(s)
| | | | | | | | | | - Jianhui Wang
- Cntr for the Genetics of Host Defense, Univ of Texas Southwestern Med Cntr, Dallas, TX
| | | | | | - Xiaoming Zhan
- Cntr for the Genetics of Host Defense, Univ of Texas Southwestern Med Cntr, Dallas, TX
| | - Mihwa Choi
- Cntr for the Genetics of Host Defense, Univ of Texas Southwestern Med Cntr, Dallas, TX
| | - Miao Tang
- Cntr for the Genetics of Host Defense, Univ of Texas Southwestern Med Cntr, Dallas, TX
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Teixeira SK, Souza V, Horta B, Pereira A, Krieger JE. Abstract P049: Blood Pressure Polygenic Risk Score Stratifies Individuals With High Risk Of Hypertension In Different Ancestries. Hypertension 2022. [DOI: 10.1161/hyp.79.suppl_1.p049] [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] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
The heritability of arterial hypertension ranges from 25 to 68%, but the underlying genetic determinants remain elusive. Thousands of variants with small effects on systolic blood pressure (SBP) from European Ancestry Genome-Wide Association Studies have been used to derive genetic risk scores, whose predictive power in samples from diverse ancestries has yet to be determined. We used the LDPred2 algorithm and 423 thousand genetic variants from UK Biobank that were common to an admixed sample population from Brazil to derive SBP polygenic risk scores (PRS). We selected the best model that displayed a score with hyper-parameters ρ = 0.056, h
2
= 0.0739 and without sparsity, which presented the highest correlation coefficient with observed SBP (0.206) and SBP change per standard deviation increase (4.04mmHg) in a different set of data from the UK Biobank prior to test its predictive power on SBP and hypertension in a third set of the UK Biobank and two admixed Brazilian population samples. All three populations displayed similar normal distribution of PRS, with the UK Biobank PRS distribution slightly shifted to the right, presenting higher PRS average (7.8 vs. 5.6 and 6.4 in Baependi and Pelotas, respectively), but with similar standard deviation (3.3 vs. 3.2 for both Baependi and Pelotas). We used the PRS deciles to stratify the populations and observed a significant difference on SBP average between the top and bottom deciles in all three populations (14.43 mmHg, 9.34 mmHg and 7.51 mmHg for the UK Biobank, Baependi and Pelotas, respectively). We then compared the top 10% PRS versus the remaining 90% of the PRS distribution, and observed that high PRS is associated with 1.8, 2 to 3 and 3 to 4-fold increase in prehypertension, hypertension stage I and hypertension stage II risk, respectively, demonstrating that the increased risk is independently of age and ancestry. Considering the highly admixed nature of the Brazilian population, we provide evidence for the generalization of PRS between populations with different genetic structure.
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Oliveira TGM, Venturini G, Alvim JM, Feijó LL, Dinardo CL, Sabino EC, Seidman JG, Seidman CE, Krieger JE, Pereira AC. Different Transcriptomic Response to T. cruzi Infection in hiPSC-Derived Cardiomyocytes From Chagas Disease Patients With and Without Chronic Cardiomyopathy. Front Cell Infect Microbiol 2022; 12:904747. [PMID: 35873155 PMCID: PMC9301326 DOI: 10.3389/fcimb.2022.904747] [Citation(s) in RCA: 0] [Impact Index Per Article: 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: 03/25/2022] [Accepted: 06/16/2022] [Indexed: 11/16/2022] Open
Abstract
Chagas disease is a tropical zoonosis caused by Trypanosoma cruzi. After infection, the host present an acute phase, usually asymptomatic, in which an extensive parasite proliferation and intense innate immune activity occurs, followed by a chronic phase, characterized by low parasitemia and development of specific immunity. Most individuals in the chronic phase remain without symptoms or organ damage, a state called indeterminate IND form. However, 20 to 40% of individuals develop cardiac or gastrointestinal complications at any time in life. Cardiomyocytes have an important role in the development of Chronic Chagas Cardiomyopathy (CCC) due to transcriptional and metabolic alterations that are crucial for the parasite survival and replication. However, it still not clear why some infected individuals progress to a cardiomyopathy phase, while others remain asymptomatic. In this work, we used hiPSCs-derived cardiomyocytes (hiPSC-CM) to investigate patterns of infection, proliferation and transcriptional response in IND and CCC patients. Our data show that T. cruzi infection and proliferation efficiency do not differ significantly in PBMCs and hiPSC-CM from both groups. However, RNA-seq analysis in hiPSC-CM infected for 24 hours showed a significantly different transcriptional response to the parasite in cells from IND or CCC patients. Cardiomyocytes from IND showed significant differences in the expression of genes related to antigen processing and presentation, as well as, immune co-stimulatory molecules. Furthermore, the downregulation of collagen production genes and extracellular matrix components was significantly different in these cells. Cardiomyocytes from CCC, in turn, showed increased expression of mTORC1 pathway and unfolded protein response genes, both associated to increased intracellular ROS production. These data point to a differential pattern of response, determined by baseline genetic differences between groups, which may have an impact on the development of a chronic outcome with or without the presentation of cardiac symptoms.
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Affiliation(s)
- Theo G. M. Oliveira
- Laboratório de Genética e Cardiologia Molecular, Instituto do Coração (InCor), Hospital das Clínicas, Faculdade de Medicina, Universidade de São Paulo (HC/FMUSP), São Paulo, Brazil
- Instituto do Coração (InCor), Hospital das Clínicas, Faculdade de Medicina, Universidade de São Paulo (HC/FMUSP), São Paulo, Brazil
- Fundação Pró-Sangue Hemocentro de São Paulo, Divisão de Pesquisa – São Paulo, SP, Brazil
- *Correspondence: Theo G. M. Oliveira,
| | - Gabriela Venturini
- Laboratório de Genética e Cardiologia Molecular, Instituto do Coração (InCor), Hospital das Clínicas, Faculdade de Medicina, Universidade de São Paulo (HC/FMUSP), São Paulo, Brazil
- Genetics Department, Harvard Medical School, MA, United States
| | - Juliana M. Alvim
- Laboratório de Genética e Cardiologia Molecular, Instituto do Coração (InCor), Hospital das Clínicas, Faculdade de Medicina, Universidade de São Paulo (HC/FMUSP), São Paulo, Brazil
| | - Larissa L. Feijó
- Fundação Pró-Sangue Hemocentro de São Paulo, Divisão de Pesquisa – São Paulo, SP, Brazil
| | - Carla L. Dinardo
- Fundação Pró-Sangue Hemocentro de São Paulo, Divisão de Pesquisa – São Paulo, SP, Brazil
| | - Ester C. Sabino
- Instituto do Medicina Tropical (IMT), Universidade de São Paulo – São Paulo, SP, Brazil
| | | | - Christine E. Seidman
- Genetics Department, Harvard Medical School, MA, United States
- Cardiovascular Division, Brigham and Women’s Hospital, & Harvard Medical School, Boston, MA, United States
- Howard Hughes Medical Institute, Chevy Chase, MD, United States
| | - Jose E. Krieger
- Laboratório de Genética e Cardiologia Molecular, Instituto do Coração (InCor), Hospital das Clínicas, Faculdade de Medicina, Universidade de São Paulo (HC/FMUSP), São Paulo, Brazil
- Instituto do Coração (InCor), Hospital das Clínicas, Faculdade de Medicina, Universidade de São Paulo (HC/FMUSP), São Paulo, Brazil
| | - Alexandre C. Pereira
- Laboratório de Genética e Cardiologia Molecular, Instituto do Coração (InCor), Hospital das Clínicas, Faculdade de Medicina, Universidade de São Paulo (HC/FMUSP), São Paulo, Brazil
- Instituto do Coração (InCor), Hospital das Clínicas, Faculdade de Medicina, Universidade de São Paulo (HC/FMUSP), São Paulo, Brazil
- Genetics Department, Harvard Medical School, MA, United States
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15
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Lima IR, Tada MT, Oliveira TG, Jannes CE, Bensenor I, Lotufo PA, Santos RD, Krieger JE, Pereira AC. Polygenic risk score for hypercholesterolemia in a Brazilian familial hypercholesterolemia cohort. Atheroscler Plus 2022; 49:47-55. [PMID: 36644206 PMCID: PMC9833269 DOI: 10.1016/j.athplu.2022.06.002] [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] [Subscribe] [Scholar Register] [Received: 01/12/2022] [Revised: 06/03/2022] [Accepted: 06/24/2022] [Indexed: 01/18/2023]
Abstract
Background and aims Familial hypercholesterolemia (FH) is a genetic disorder characterized by high levels of LDL-C leading to premature cardiovascular disease (CAD). Only about 40% of individuals with a clinical diagnosis of FH have a causative genetic variant identified, and a proportion of genetically negative cases may have a polygenic cause rather than a still unidentified monogenic cause. This work aims to evaluate and validate the role of a polygenic risk score (PRS) associated with hypercholesterolemia in a Brazilian FH cohort and its clinical implications. Methods We analyzed a previously derived PRS of 12 and 6 SNPs (Single Nucleotide Polymorphism) in 684 FH individuals (491 mutation-negative [FH/M-], 193 mutation-positive [FH/M+]) and in 1605 controls. Coronary artery calcium (CAC) score was also evaluated. Results The PRS was independently associated with LDL-C in control individuals (p < 0.001). Within this group, in individuals in the highest quartile of the 12 SNPs PRS, the odds ratio for CAC score >100 was 1.7 (95% CI: 1.01-2.88, p = 0.04) after adjustment for age and sex. Subjects in the FH/M- group had the highest mean score in both 12 and 6 SNPs PRS (38.25 and 27.82, respectively) when compared to the other two groups (p = 2.2 × 10-16). Both scores were also higher in the FH/M+ group (36.48 and 26.26, respectively) when compared to the control group (p < 0.001 for the two scores) but inferior to the FH/M- group. Within FH individuals, the presence of a higher PRS score was not associated with LDL-C levels or with CAD risk. Conclusion A higher PRS is associated with significantly higher levels of LDL-C and it is independently associated with higher CAC in the Brazilian general population. A polygenic cause can explain a fraction of FH/M- individuals but does not appear to be a modulator of the clinical phenotype among FH individuals, regardless of mutation status.
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Affiliation(s)
- Isabella Ramos Lima
- Laboratory of Genetics and Molecular Cardiology, Heart Institute (InCor), University of São Paulo Medical School, São Paulo, Brazil,Corresponding author.
| | - Mauricio Teruo Tada
- Laboratory of Genetics and Molecular Cardiology, Heart Institute (InCor), University of São Paulo Medical School, São Paulo, Brazil
| | - Theo G.M. Oliveira
- Laboratory of Genetics and Molecular Cardiology, Heart Institute (InCor), University of São Paulo Medical School, São Paulo, Brazil
| | - Cinthia Elim Jannes
- Laboratory of Genetics and Molecular Cardiology, Heart Institute (InCor), University of São Paulo Medical School, São Paulo, Brazil
| | - Isabela Bensenor
- Center for Clinical and Epidemiologic Research, University of São Paulo, São Paulo, Brazil
| | - Paulo A. Lotufo
- Center for Clinical and Epidemiologic Research, University of São Paulo, São Paulo, Brazil
| | - Raul D. Santos
- Lipid Clinic, Heart Institute (InCor), University of São Paulo Medical School Hospital, São Paulo, Brazil
| | - Jose E. Krieger
- Laboratory of Genetics and Molecular Cardiology, Heart Institute (InCor), University of São Paulo Medical School, São Paulo, Brazil
| | - Alexandre C. Pereira
- Laboratory of Genetics and Molecular Cardiology, Heart Institute (InCor), University of São Paulo Medical School, São Paulo, Brazil,Genetics Department, Harvard Medical School, Boston, MA, USA,Corresponding author. Laboratory of Genetics and Molecular Cardiology, Heart Institute (InCor), University of São Paulo Medical School, São Paulo, Brazil
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16
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Fernández-Rhodes L, Graff M, Buchanan VL, Justice AE, Highland HM, Guo X, Zhu W, Chen HH, Young KL, Adhikari K, Palmer ND, Below JE, Bradfield J, Pereira AC, Glover L, Kim D, Lilly AG, Shrestha P, Thomas AG, Zhang X, Chen M, Chiang CW, Pulit S, Horimoto A, Krieger JE, Guindo-Martínez M, Preuss M, Schumann C, Smit RA, Torres-Mejía G, Acuña-Alonzo V, Bedoya G, Bortolini MC, Canizales-Quinteros S, Gallo C, González-José R, Poletti G, Rothhammer F, Hakonarson H, Igo R, Adler SG, Iyengar SK, Nicholas SB, Gogarten SM, Isasi CR, Papnicolaou G, Stilp AM, Qi Q, Kho M, Smith JA, Langefeld CD, Wagenknecht L, Mckean-Cowdin R, Gao XR, Nousome D, Conti DV, Feng Y, Allison MA, Arzumanyan Z, Buchanan TA, Ida Chen YD, Genter PM, Goodarzi MO, Hai Y, Hsueh W, Ipp E, Kandeel FR, Lam K, Li X, Nadler JL, Raffel LJ, Roll K, Sandow K, Tan J, Taylor KD, Xiang AH, Yao J, Audirac-Chalifour A, de Jesus Peralta Romero J, Hartwig F, Horta B, Blangero J, Curran JE, Duggirala R, Lehman DE, Puppala S, Fejerman L, John EM, Aguilar-Salinas C, Burtt NP, Florez JC, García-Ortíz H, González-Villalpando C, Mercader J, Orozco L, Tusié-Luna T, Blanco E, Gahagan S, Cox NJ, Hanis C, Butte NF, Cole SA, Comuzzie AG, Voruganti VS, Rohde R, Wang Y, Sofer T, Ziv E, Grant SF, Ruiz-Linares A, Rotter JI, Haiman CA, Parra EJ, Cruz M, Loos RJ, North KE. Ancestral diversity improves discovery and fine-mapping of genetic loci for anthropometric traits-The Hispanic/Latino Anthropometry Consortium. HGG Adv 2022; 3:100099. [PMID: 35399580 PMCID: PMC8990175 DOI: 10.1016/j.xhgg.2022.100099] [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] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/11/2021] [Accepted: 03/06/2022] [Indexed: 02/05/2023] Open
Abstract
Hispanic/Latinos have been underrepresented in genome-wide association studies (GWAS) for anthropometric traits despite their notable anthropometric variability, ancestry proportions, and high burden of growth stunting and overweight/obesity. To address this knowledge gap, we analyzed densely imputed genetic data in a sample of Hispanic/Latino adults to identify and fine-map genetic variants associated with body mass index (BMI), height, and BMI-adjusted waist-to-hip ratio (WHRadjBMI). We conducted a GWAS of 18 studies/consortia as part of the Hispanic/Latino Anthropometry (HISLA) Consortium (stage 1, n = 59,771) and generalized our findings in 9 additional studies (stage 2, n = 10,538). We conducted a trans-ancestral GWAS with summary statistics from HISLA stage 1 and existing consortia of European and African ancestries. In our HISLA stage 1 + 2 analyses, we discovered one BMI locus, as well as two BMI signals and another height signal each within established anthropometric loci. In our trans-ancestral meta-analysis, we discovered three BMI loci, one height locus, and one WHRadjBMI locus. We also identified 3 secondary signals for BMI, 28 for height, and 2 for WHRadjBMI in established loci. We show that 336 known BMI, 1,177 known height, and 143 known WHRadjBMI (combined) SNPs demonstrated suggestive transferability (nominal significance and effect estimate directional consistency) in Hispanic/Latino adults. Of these, 36 BMI, 124 height, and 11 WHRadjBMI SNPs were significant after trait-specific Bonferroni correction. Trans-ancestral meta-analysis of the three ancestries showed a small-to-moderate impact of uncorrected population stratification on the resulting effect size estimates. Our findings demonstrate that future studies may also benefit from leveraging diverse ancestries and differences in linkage disequilibrium patterns to discover novel loci and additional signals with less residual population stratification.
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Affiliation(s)
- Lindsay Fernández-Rhodes
- Department of Biobehavioral Health, Pennsylvania State University, 219 Biobehavioral Health Building, University Park, PA 16802, USA
- Department of Epidemiology, Gillings School of Global Public Health, University of North Carolina at Chapel Hill, Chapel Hill, NC 27599, USA
| | - Mariaelisa Graff
- Department of Epidemiology, Gillings School of Global Public Health, University of North Carolina at Chapel Hill, Chapel Hill, NC 27599, USA
| | - Victoria L. Buchanan
- Department of Epidemiology, Gillings School of Global Public Health, University of North Carolina at Chapel Hill, Chapel Hill, NC 27599, USA
| | - Anne E. Justice
- Department of Epidemiology, Gillings School of Global Public Health, University of North Carolina at Chapel Hill, Chapel Hill, NC 27599, USA
- Department of Biomedical and Translational Informatics, Geisinger Health System, Danville, PA 17822, USA
| | - Heather M. Highland
- Department of Epidemiology, Gillings School of Global Public Health, University of North Carolina at Chapel Hill, Chapel Hill, NC 27599, USA
| | - Xiuqing Guo
- The Institute for Translational Genomics and Population Sciences, Department of Pediatrics, The Lundquist Institute for Biomedical Innovation at Harbor-UCLA Medical Center, Torrance, CA 90502 USA
| | - Wanying Zhu
- Vanderbilt Genetics Institute, Division of Genetic Medicine, Department of Medicine, Vanderbilt University Medical Center, Nashville, TN 37232, USA
| | - Hung-Hsin Chen
- Vanderbilt Genetics Institute, Division of Genetic Medicine, Department of Medicine, Vanderbilt University Medical Center, Nashville, TN 37232, USA
| | - Kristin L. Young
- Department of Epidemiology, Gillings School of Global Public Health, University of North Carolina at Chapel Hill, Chapel Hill, NC 27599, USA
| | - Kaustubh Adhikari
- School of Mathematics and Statistics, Faculty of Science, Technology, Engineering and Mathematics, The Open University, MK7 6AA Milton Keynes, UK
| | - Nicholette D. Palmer
- Department of Biochemistry, Wake Forest School of Medicine, Winston-Salem, NC 27101, USA
| | - Jennifer E. Below
- Vanderbilt Genetics Institute, Division of Genetic Medicine, Department of Medicine, Vanderbilt University Medical Center, Nashville, TN 37232, USA
| | - Jonathan Bradfield
- Center for Applied Genomics, Division of Human Genetics, Department of Pediatrics, The Children’s Hospital of Philadelphia, Philadelphia, PA 19104, USA
| | - Alexandre C. Pereira
- Laboratory of Genetics and Molecular Cardiology, Heart Institute, University of São Paulo, São Paulo 05508-220, Brazil
| | - LáShauntá Glover
- Department of Epidemiology, Gillings School of Global Public Health, University of North Carolina at Chapel Hill, Chapel Hill, NC 27599, USA
| | - Daeeun Kim
- Department of Epidemiology, Gillings School of Global Public Health, University of North Carolina at Chapel Hill, Chapel Hill, NC 27599, USA
| | - Adam G. Lilly
- Department of Sociology, University of North Carolina at Chapel Hill, Chapel Hill, NC 27599, USA
- Carolina Population Center, University of North Carolina at Chapel Hill, Chapel Hill, NC 27599, USA
| | - Poojan Shrestha
- Department of Epidemiology, Gillings School of Global Public Health, University of North Carolina at Chapel Hill, Chapel Hill, NC 27599, USA
- Division of Pediatric and Public Health, Adams School of Dentistry, University of North Carolina at Chapel Hill, Chapel Hill, NC 27599, USA
| | - Alvin G. Thomas
- Department of Epidemiology, Gillings School of Global Public Health, University of North Carolina at Chapel Hill, Chapel Hill, NC 27599, USA
| | - Xinruo Zhang
- Department of Epidemiology, Gillings School of Global Public Health, University of North Carolina at Chapel Hill, Chapel Hill, NC 27599, USA
| | - Minhui Chen
- Center for Genetic Epidemiology, Department of Preventive Medicine, Keck School of Medicine, University of Southern California, Los Angeles, CA 90033, USA
| | - Charleston W.K. Chiang
- Center for Genetic Epidemiology, Department of Preventive Medicine, Keck School of Medicine, University of Southern California, Los Angeles, CA 90033, USA
- Department of Quantitative and Computational Biology, University of Southern California, Los Angeles, CA 90007, USA
| | - Sara Pulit
- Vertex Pharmaceuticals, W2 6BD Oxford, UK
| | - Andrea Horimoto
- Laboratory of Genetics and Molecular Cardiology, Heart Institute, University of São Paulo, São Paulo 05508-220, Brazil
| | - Jose E. Krieger
- Laboratory of Genetics and Molecular Cardiology, Heart Institute, University of São Paulo, São Paulo 05508-220, Brazil
| | - Marta Guindo-Martínez
- The Charles Bronfman Institutes for Personalized Medicine, Icahn School of Medicine at Mount Sinai, New York, NY 10029, USA
- The Novo Nordisk Center for Basic Metabolic Research, University of Copenhagen, 2200 Copenhagen, Denmark
| | - Michael Preuss
- The Charles Bronfman Institutes for Personalized Medicine, Icahn School of Medicine at Mount Sinai, New York, NY 10029, USA
| | - Claudia Schumann
- Hasso Plattner Institute, University of Potsdam, Digital Health Center, 14482 Potsdam, Germany
| | - Roelof A.J. Smit
- The Charles Bronfman Institutes for Personalized Medicine, Icahn School of Medicine at Mount Sinai, New York, NY 10029, USA
| | - Gabriela Torres-Mejía
- Department of Research in Cardiovascular Diseases, Diabetes Mellitus, and Cancer, Population Health Research Center, National Institute of Public Health, Cuernavaca, Morelos 62100, Mexico
| | | | - Gabriel Bedoya
- Molecular Genetics Investigation Group, University of Antioquia, Medellín 1226, Colombia
| | - Maria-Cátira Bortolini
- Department of Genetics, Federal University of Rio Grande do Sul, Porto Alegre 90040-060, Brazil
| | - Samuel Canizales-Quinteros
- Population Genomics Applied to Health Unit, The National Institute of Genomic Medicine and the Faculty of Chemistry at the National Autonomous University of Mexico, Mexico City 04510, Mexico
| | - Carla Gallo
- Laboratorios de Investigación y Desarrollo, Facultad de Ciencias y Filosofía, Universidad Peruana Cayetano Heredia, Lima 15102, Peru
| | - Rolando González-José
- Patagonian Institute of the Social and Human Sciences, Patagonian National Center, Puerto Madryn U9120, Argentina
| | - Giovanni Poletti
- Laboratorios de Investigación y Desarrollo, Facultad de Ciencias y Filosofía, Universidad Peruana Cayetano Heredia, Lima 15102, Peru
| | | | - Hakon Hakonarson
- Center for Applied Genomics, Division of Human Genetics, Department of Pediatrics, The Children’s Hospital of Philadelphia, Philadelphia, PA 19104, USA
| | - Robert Igo
- Department of Population and Quantitative Health Sciences, Case Western Reserve University, Cleveland, OH 44106, USA
| | - Sharon G. Adler
- Division of Nephrology and Hypertension, Harbor-University of California Los Angeles Medical Center, Torrance, CA 90502, USA
| | - Sudha K. Iyengar
- Department of Population and Quantitative Health Sciences, Case Western Reserve University, Cleveland, OH 44106, USA
| | - Susanne B. Nicholas
- Department of Medicine, David Geffen School of Medicine at University of California, Los Angeles, CA 90095, USA
| | | | - Carmen R. Isasi
- Department of Epidemiology and Population Health, Albert Einstein College of Medicine, Bronx, NY 10461, USA
| | | | - Adrienne M. Stilp
- Department of Biostatistics, University of Washington, Seattle, WA 98195, USA
| | - Qibin Qi
- Department of Epidemiology and Population Health, Albert Einstein College of Medicine, Bronx, NY 10461, USA
| | - Minjung Kho
- Department of Epidemiology, School of Public Health, University of Michigan, Ann Arbor, MI 48109, USA
| | - Jennifer A. Smith
- Department of Epidemiology, School of Public Health, University of Michigan, Ann Arbor, MI 48109, USA
| | - Carl D. Langefeld
- Department of Biostatistics and Data Science, Wake Forest School of Medicine, Winston-Salem, NC 27101, USA
| | - Lynne Wagenknecht
- Division of Public Health Sciences, Wake Forest School of Medicine, Winston-Salem, NC 27101, USA
| | - Roberta Mckean-Cowdin
- Department of Preventive Medicine, Keck School of Medicine, University of Southern California, Los Angeles, CA 90032, USA
| | - Xiaoyi Raymond Gao
- Department of Ophthalmology and Visual Sciences, Department of Biomedical Informatics, Division of Human Genetics, The Ohio State University, Columbus, OH 43210, USA
| | - Darryl Nousome
- Department of Preventive Medicine, Keck School of Medicine, University of Southern California, Los Angeles, CA 90032, USA
| | - David V. Conti
- Center for Genetic Epidemiology, Department of Preventive Medicine, Keck School of Medicine, University of Southern California, Los Angeles, CA 90033, USA
| | - Ye Feng
- Department of Preventive Medicine, Keck School of Medicine, University of Southern California, Los Angeles, CA 90032, USA
| | - Matthew A. Allison
- Department of Family Medicine, University of California, San Diego, CA 92161, USA
| | - Zorayr Arzumanyan
- The Institute for Translational Genomics and Population Sciences, Department of Pediatrics, The Lundquist Institute for Biomedical Innovation at Harbor-UCLA Medical Center, Torrance, CA 90502 USA
| | - Thomas A. Buchanan
- Department of Medicine, Keck School of Medicine, University of Southern California, Los Angeles, CA 90033, USA
| | - Yii-Der Ida Chen
- The Institute for Translational Genomics and Population Sciences, Department of Pediatrics, The Lundquist Institute for Biomedical Innovation at Harbor-UCLA Medical Center, Torrance, CA 90502 USA
| | - Pauline M. Genter
- Department of Medicine, Division of Endocrinology, The Lundquist Institute for Biomedical Innovation at Harbor-UCLA Medical Center, Torrance, CA 90502, USA
| | - Mark O. Goodarzi
- Division of Endocrinology, Diabetes, and Metabolism, Department of Medicine, Cedars-Sinai Medical Center, Los Angeles, CA 90048, USA
| | - Yang Hai
- The Institute for Translational Genomics and Population Sciences, Department of Pediatrics, The Lundquist Institute for Biomedical Innovation at Harbor-UCLA Medical Center, Torrance, CA 90502 USA
| | - Willa Hsueh
- Department of Internal Medicine, The Ohio State University Wexner Medical Center, Columbus, OH 43210, USA
| | - Eli Ipp
- Department of Medicine, David Geffen School of Medicine at University of California, Los Angeles, CA 90095, USA
- Department of Medicine, Division of Endocrinology, The Lundquist Institute for Biomedical Innovation at Harbor-UCLA Medical Center, Torrance, CA 90502, USA
| | - Fouad R. Kandeel
- Department of Translational Research & Cellular Therapeutics, Beckman Research Institute of City of Hope, Duarte, CA 91010, USA
| | - Kelvin Lam
- The Institute for Translational Genomics and Population Sciences, Department of Pediatrics, The Lundquist Institute for Biomedical Innovation at Harbor-UCLA Medical Center, Torrance, CA 90502 USA
| | - Xiaohui Li
- The Institute for Translational Genomics and Population Sciences, Department of Pediatrics, The Lundquist Institute for Biomedical Innovation at Harbor-UCLA Medical Center, Torrance, CA 90502 USA
| | - Jerry L. Nadler
- Department of Pharmacology at New York Medical College School of Medicine, Valhalla, NY 10595, USA
| | - Leslie J. Raffel
- Division of Genetic and Genomic Medicine, Department of Pediatrics, University of California, Irvine, CA 92697, USA
| | - Kathryn Roll
- The Institute for Translational Genomics and Population Sciences, Department of Pediatrics, The Lundquist Institute for Biomedical Innovation at Harbor-UCLA Medical Center, Torrance, CA 90502 USA
| | - Kevin Sandow
- The Institute for Translational Genomics and Population Sciences, Department of Pediatrics, The Lundquist Institute for Biomedical Innovation at Harbor-UCLA Medical Center, Torrance, CA 90502 USA
| | - Jingyi Tan
- The Institute for Translational Genomics and Population Sciences, Department of Pediatrics, The Lundquist Institute for Biomedical Innovation at Harbor-UCLA Medical Center, Torrance, CA 90502 USA
| | - Kent D. Taylor
- The Institute for Translational Genomics and Population Sciences, Department of Pediatrics, The Lundquist Institute for Biomedical Innovation at Harbor-UCLA Medical Center, Torrance, CA 90502 USA
| | - Anny H. Xiang
- Research and Evaluation Branch, Kaiser Permanente of Southern California, Pasadena, CA 91101, USA
| | - Jie Yao
- The Institute for Translational Genomics and Population Sciences, Department of Pediatrics, The Lundquist Institute for Biomedical Innovation at Harbor-UCLA Medical Center, Torrance, CA 90502 USA
| | - Astride Audirac-Chalifour
- Medical Research Unit in Biochemistry, Specialty Hospital, National Medical Center of the Twenty-First Century, Mexican Institute of Social Security, Mexico City 06725, Mexico
| | - Jose de Jesus Peralta Romero
- Medical Research Unit in Biochemistry, Specialty Hospital, National Medical Center of the Twenty-First Century, Mexican Institute of Social Security, Mexico City 06725, Mexico
| | - Fernando Hartwig
- Postgraduate Program in Epidemiology, Federal University of Pelotas, Pelotas 96010-610, Brazil
| | - Bernando Horta
- Postgraduate Program in Epidemiology, Federal University of Pelotas, Pelotas 96010-610, Brazil
| | - John Blangero
- Department of Human Genetics and South Texas Diabetes and Obesity Institute, School of Medicine, University of Texas Rio Grande Valley, Brownsville and Edinburg, TX 78520 and 78539, USA
| | - Joanne E. Curran
- Department of Human Genetics and South Texas Diabetes and Obesity Institute, School of Medicine, University of Texas Rio Grande Valley, Brownsville and Edinburg, TX 78520 and 78539, USA
| | - Ravindranath Duggirala
- Department of Human Genetics and South Texas Diabetes and Obesity Institute, School of Medicine, University of Texas Rio Grande Valley, Brownsville and Edinburg, TX 78520 and 78539, USA
| | - Donna E. Lehman
- Department of Medicine, School of Medicine, University of Texas Health San Antonio, San Antonio, TX 78229, USA
| | - Sobha Puppala
- Department of Internal Medicine, Section of Molecular Medicine, Wake Forest School of Medicine, Winston-Salem, NC 27109, USA
| | - Laura Fejerman
- Department of Public Health Sciences, School of Medicine, and the Comprehensive Cancer Center, University of California Davis, Davis, CA 95616, USA
| | - Esther M. John
- Departments of Epidemiology & Population Health and Medicine-Oncology, Stanford University School of Medicine, Stanford, CA 94305, USA
| | - Carlos Aguilar-Salinas
- Division of Nutrition, Salvador Zubirán National Institute of Health Sciences and Nutrition, Mexico City 14080, Mexico
| | - Noël P. Burtt
- Programs in Metabolism and Medical and Population Genetics, Broad Institute of the Massachusetts Institute of Technology and Harvard, Cambridge, MA 02142, USA
| | - Jose C. Florez
- Programs in Metabolism and Medical and Population Genetics, Broad Institute of the Massachusetts Institute of Technology and Harvard, Cambridge, MA 02142, USA
- Department of Medicine, Harvard Medical School, Boston, MA 02115, USA
- Diabetes Unit and Center for Genomic Medicine, Massachusetts General Hospital, Boston, MA 02114, USA
| | - Humberto García-Ortíz
- Laboratory of Immunogenomics and Metabolic Diseases, National Institute of Genomic Medicine, Mexico City 14610, Mexico
| | - Clicerio González-Villalpando
- Center for Diabetes Studies, Research Unit for Diabetes and Cardiovascular Risk, Center for Population Health Studies, National Institute of Public Health, Mexico City 14080, Mexico
| | - Josep Mercader
- Programs in Metabolism and Medical and Population Genetics, Broad Institute of the Massachusetts Institute of Technology and Harvard, Cambridge, MA 02142, USA
- Department of Medicine, Harvard Medical School, Boston, MA 02115, USA
- Diabetes Unit and Center for Genomic Medicine, Massachusetts General Hospital, Boston, MA 02114, USA
| | - Lorena Orozco
- Laboratory of Immunogenomics and Metabolic Diseases, National Institute of Genomic Medicine, Mexico City 14610, Mexico
| | - Teresa Tusié-Luna
- Molecular Biology and Medical Genomics Unity, Institute of Biomedical Research, The National Autonomous University of Mexico and the Salvador Zubirán National Institute of Health Sciences and Nutrition, Mexico City 14080, Mexico
| | - Estela Blanco
- Center for Community Health, Division of Academic General Pediatrics, University of California at San Diego, San Diego, CA 92093, USA
| | - Sheila Gahagan
- Center for Community Health, Division of Academic General Pediatrics, University of California at San Diego, San Diego, CA 92093, USA
| | - Nancy J. Cox
- Vanderbilt Genetics Institute, Division of Genetic Medicine, Department of Medicine, Vanderbilt University Medical Center, Nashville, TN 37232, USA
| | - Craig Hanis
- University of Texas Health Science Center at Houston, Houston, TX 77030, USA
| | - Nancy F. Butte
- United States Department of Agriculture, Agricultural Research Service, The Children’s Nutrition Research Center, and the Department Pediatrics, Baylor College of Medicine, Houston, TX 77030, USA
| | - Shelley A. Cole
- Population Health Program, Texas Biomedical Research Institute, San Antonio, TX 78227, USA
| | | | - V. Saroja Voruganti
- Department of Nutrition and Nutrition Research Institute, University of North Carolina at Chapel Hill, Kannapolis, NC 28081, USA
| | - Rebecca Rohde
- Department of Epidemiology, Gillings School of Global Public Health, University of North Carolina at Chapel Hill, Chapel Hill, NC 27599, USA
| | - Yujie Wang
- Department of Epidemiology, Gillings School of Global Public Health, University of North Carolina at Chapel Hill, Chapel Hill, NC 27599, USA
| | - Tamar Sofer
- Diabetes Unit and Center for Genomic Medicine, Massachusetts General Hospital, Boston, MA 02114, USA
- Division of Sleep and Circadian Disorders, Brigham and Women’s Hospital, Boston, MA 02115, USA
| | - Elad Ziv
- Division of General Internal Medicine, Department of Medicine, Helen Diller Family Comprehensive Cancer Center, Institute for Human Genetics, University of California, San Francisco, San Francisco, CA 94115, USA
| | - Struan F.A. Grant
- Center for Applied Genomics, Division of Human Genetics, Department of Pediatrics, The Children’s Hospital of Philadelphia, Philadelphia, PA 19104, USA
| | - Andres Ruiz-Linares
- Ministry of Education Key Laboratory of Contemporary Anthropology and Collaborative Innovation Center of Genetics and Development, School of Life Sciences and Human Phenome Institute, Fudan University, Shanghai 200438, China
- Department of Genetics, Evolution and Environment, and Genetics Institute of the University College London, London WC1E 6BT, UK
- Laboratory of Biocultural Anthropology, Law, Ethics, and Health, Aix-Marseille University, Marseille 13385, France
| | - Jerome I. Rotter
- The Institute for Translational Genomics and Population Sciences, Department of Pediatrics, The Lundquist Institute for Biomedical Innovation at Harbor-UCLA Medical Center, Torrance, CA 90502 USA
| | - Christopher A. Haiman
- Center for Genetic Epidemiology, Department of Preventive Medicine, Keck School of Medicine, University of Southern California, Los Angeles, CA 90033, USA
| | - Esteban J. Parra
- Department of Anthropology, University of Toronto- Mississauga, Mississauga, ON L5L 1C6, Canada
| | - Miguel Cruz
- Medical Research Unit in Biochemistry, Specialty Hospital, National Medical Center of the Twenty-First Century, Mexican Institute of Social Security, Mexico City 06725, Mexico
| | - Ruth J.F. Loos
- The Charles Bronfman Institutes for Personalized Medicine, Icahn School of Medicine at Mount Sinai, New York, NY 10029, USA
- Novo Nordisk Foundation Center for Basic Metabolic Research, Faculty of Health and Medical Sciences, University of Copenhagen, Copenhagen, Denmark
| | - Kari E. North
- Department of Epidemiology, Gillings School of Global Public Health, University of North Carolina at Chapel Hill, Chapel Hill, NC 27599, USA
- Carolina Center for Genome Sciences, University of North Carolina at Chapel Hill, Chapel Hill, NC 27514, USA
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Pinheiro-de-Sousa I, Fonseca-Alaniz MH, Teixeira SK, Rodrigues MV, Krieger JE. Uncovering emergent phenotypes in endothelial cells by clustering of surrogates of cardiovascular risk factors. Sci Rep 2022; 12:1372. [PMID: 35079076 PMCID: PMC8789842 DOI: 10.1038/s41598-022-05404-7] [Citation(s) in RCA: 8] [Impact Index Per Article: 4.0] [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] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/25/2021] [Accepted: 01/12/2022] [Indexed: 12/12/2022] Open
Abstract
Endothelial dysfunction (ED) is a hallmark of atherosclerosis and is influenced by well-defined risk factors, including hypoxia, dyslipidemia, inflammation, and oscillatory flow. However, the individual and combined contributions to the molecular underpinnings of ED remain elusive. We used global gene expression in human coronary artery endothelial cells to identify gene pathways and cellular processes in response to chemical hypoxia, oxidized lipids, IL-1β induced inflammation, oscillatory flow, and these combined stimuli. We found that clustering of the surrogate risk factors differed from the sum of the individual insults that gave rise to emergent phenotypes such as cell proliferation. We validated these observations in samples of human coronary artery atherosclerotic plaques analyzed using single-cell RNA sequencing. Our findings suggest a hierarchical interaction between surrogates of CV risk factors and the advent of emergent phenotypes in response to combined stimulation in endothelial cells that may influence ED.
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Affiliation(s)
- Iguaracy Pinheiro-de-Sousa
- Laboratório de Genética e Cardiologia Molecular, Instituto do Coração (InCor), Hospital das Clínicas, Faculdade de Medicina, Universidade de São Paulo (HCFMUSP), São Paulo, SP, Brazil
| | - Miriam H Fonseca-Alaniz
- Laboratório de Genética e Cardiologia Molecular, Instituto do Coração (InCor), Hospital das Clínicas, Faculdade de Medicina, Universidade de São Paulo (HCFMUSP), São Paulo, SP, Brazil
| | - Samantha K Teixeira
- Laboratório de Genética e Cardiologia Molecular, Instituto do Coração (InCor), Hospital das Clínicas, Faculdade de Medicina, Universidade de São Paulo (HCFMUSP), São Paulo, SP, Brazil
| | - Mariliza V Rodrigues
- Laboratório de Genética e Cardiologia Molecular, Instituto do Coração (InCor), Hospital das Clínicas, Faculdade de Medicina, Universidade de São Paulo (HCFMUSP), São Paulo, SP, Brazil
| | - Jose E Krieger
- Laboratório de Genética e Cardiologia Molecular, Instituto do Coração (InCor), Hospital das Clínicas, Faculdade de Medicina, Universidade de São Paulo (HCFMUSP), São Paulo, SP, Brazil.
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Costa TBDS, Shinoda L, Moreno RA, Krieger JE, Gutierrez M. Blockchain-based architecture design for personal health record (Preprint). J Med Internet Res 2021; 24:e35013. [PMID: 35416782 PMCID: PMC9047746 DOI: 10.2196/35013] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/16/2021] [Revised: 02/14/2022] [Accepted: 03/07/2022] [Indexed: 11/22/2022] Open
Abstract
Background The importance of blockchain-based architectures for personal health record (PHR) lies in the fact that they are thought and developed to allow patients to control and at least partly collect their health data. Ideally, these systems should provide the full control of such data to the respective owner. In spite of this importance, most of the works focus more on describing how blockchain models can be used in a PHR scenario rather than whether these models are in fact feasible and robust enough to support a large number of users. Objective To achieve a consistent, reproducible, and comparable PHR system, we build a novel ledger-oriented architecture out of a permissioned distributed network, providing patients with a manner to securely collect, store, share, and manage their health data. We also emphasize the importance of suitable ledgers and smart contracts to operate the blockchain network as well as discuss the necessity of standardizing evaluation metrics to compare related (net)works. Methods We adopted the Hyperledger Fabric platform to implement our blockchain-based architecture design and the Hyperledger Caliper framework to provide a detailed assessment of our system: first, under workload, ranging from 100 to 2500 simultaneous record submissions, and second, increasing the network size from 3 to 13 peers. In both experiments, we used throughput and average latency as the primary metrics. We also created a health database, a cryptographic unit, and a server to complement the blockchain network. Results With a 3-peer network, smart contracts that write on the ledger have throughputs, measured in transactions per second (tps) in an order of magnitude close to 102 tps, while those contracts that only read have rates close to 103 tps. Smart contracts that write also have latencies, measured in seconds, in an order of magnitude close to 101 seconds, while that only read have delays close to 100 seconds. In particular, smart contracts that retrieve, list, and view history have throughputs varying, respectively, from 1100 tps to 1300 tps, 650 tps to 750 tps, and 850 tps to 950 tps, impacting the overall system response if they are equally requested under the same workload. Varying the network size and applying an equal fixed load, in turn, writing throughputs go from 102 tps to 101 tps and latencies go from 101 seconds to 102 seconds, while reading ones maintain similar values. Conclusions To the best of our knowledge, we are the first to evaluate, using Hyperledger Caliper, the performance of a PHR blockchain architecture and the first to evaluate each smart contract separately. Nevertheless, blockchain systems achieve performances far below what the traditional distributed databases achieve, indicating that the assessment of blockchain solutions for PHR is a major concern to be addressed before putting them into a real production.
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Affiliation(s)
| | - Lucas Shinoda
- Instituto do Coração, Hospital das Clínicas, Faculdade de Medicina, Universidade de São Paulo, São Paulo, Brazil
| | - Ramon Alfredo Moreno
- Instituto do Coração, Hospital das Clínicas, Faculdade de Medicina, Universidade de São Paulo, São Paulo, Brazil
| | - Jose E Krieger
- Instituto do Coração, Hospital das Clínicas, Faculdade de Medicina, Universidade de São Paulo, São Paulo, Brazil
| | - Marco Gutierrez
- Instituto do Coração, Hospital das Clínicas, Faculdade de Medicina, Universidade de São Paulo, São Paulo, Brazil
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Vallejo-Vaz AJ, Stevens CA, Lyons AR, Dharmayat KI, Freiberger T, Hovingh GK, Mata P, Raal FJ, Santos RD, Soran H, Watts GF, Abifadel M, Aguilar-Salinas CA, Alhabib KF, Alkhnifsawi M, Almahmeed W, Alnouri F, Alonso R, Al-Rasadi K, Al-Sarraf A, Al-Sayed N, Araujo F, Ashavaid TF, Banach M, Béliard S, Benn M, Binder CJ, Bogsrud MP, Bourbon M, Chlebus K, Corral P, Davletov K, Descamps OS, Durst R, Ezhov M, Gaita D, Genest J, Groselj U, Harada-Shiba M, Holven KB, Kayikcioglu M, Khovidhunkit W, Lalic K, Latkovskis G, Laufs U, Liberopoulos E, Lima-Martinez MM, Lin J, Maher V, Marais AD, März W, Mirrakhimov E, Miserez AR, Mitchenko O, Nawawi H, Nordestgaard BG, Panayiotou AG, Paragh G, Petrulioniene Z, Pojskic B, Postadzhiyan A, Raslova K, Reda A, Reiner Ž, Sadiq F, Sadoh WE, Schunkert H, Shek AB, Stoll M, Stroes E, Su TC, Subramaniam T, Susekov AV, Tilney M, Tomlinson B, Truong TH, Tselepis AD, Tybjærg-Hansen A, Vázquez Cárdenas A, Viigimaa M, Wang L, Yamashita S, Kastelein JJ, Bruckert E, Vohnout B, Schreier L, Pang J, Ebenbichler C, Dieplinger H, Innerhofer R, Winhofer-Stöckl Y, Greber-Platzer S, Krychtiuk K, Speidl W, Toplak H, Widhalm K, Stulnig T, Huber K, Höllerl F, Rega-Kaun G, Kleemann L, Mäser M, Scholl-Bürgi S, Säly C, Mayer FJ, Sablon G, Tarantino E, Nzeyimana C, Pojskic L, Sisic I, Nalbantic AD, Jannes CE, Pereira AC, Krieger JE, Petrov I, Goudev A, Nikolov F, Tisheva S, Yotov Y, Tzvetkov I, Baass A, Bergeron J, Bernard S, Brisson D, Brunham LR, Cermakova L, Couture P, Francis GA, Gaudet D, Hegele RA, Khoury E, Mancini GJ, McCrindle BW, Paquette M, Ruel I, Cuevas A, Asenjo S, Wang X, Meng K, Song X, Yong Q, Jiang T, Liu Z, Duan Y, Hong J, Ye P, Chen Y, Qi J, Liu Z, Li Y, Zhang C, Peng J, Yang Y, Yu W, Wang Q, Yuan H, Cheng S, Jiang L, Chong M, Jiao J, Wu Y, Wen W, Xu L, Zhang R, Qu Y, He J, Fan X, Wang Z, Chow E, Pećin I, Perica D, Symeonides P, Vrablik M, Ceska R, Soska V, Tichy L, Adamkova V, Franekova J, Cifkova R, Kraml P, Vonaskova K, Cepova J, Dusejovska M, Pavlickova L, Blaha V, Rosolova H, Nussbaumerova B, Cibulka R, Vaverkova H, Cibickova L, Krejsova Z, Rehouskova K, Malina P, Budikova M, Palanova V, Solcova L, Lubasova A, Podzimkova H, Bujdak J, Vesely J, Jordanova M, Salek T, Urbanek R, Zemek S, Lacko J, Halamkova H, Machacova S, Mala S, Cubova E, Valoskova K, Burda L, Bendary A, Daoud I, Emil S, Elbahry A, Rafla S, Sanad O, Kazamel G, Ashraf M, Sobhy M, El-Hadidy A, Shafy MA, Kamal S, Bendary M, Talviste G, Angoulvant D, Boccara F, Cariou B, Carreau V, Carrie A, Charrieres S, Cottin Y, Di-Fillipo M, Ducluzeau PH, Dulong S, Durlach V, Farnier M, Ferrari E, Ferrieres D, Ferrieres J, Gallo A, hankard R, Inamo J, Lemale J, Moulin P, Paillard F, Peretti N, Perrin A, Pradignac A, Rabes JP, Rigalleau V, Sultan A, Schiele F, Tounian P, Valero R, Verges B, Yelnik C, Ziegler O, Haack IA, Schmidt N, Dressel A, Klein I, Christmann J, Sonntag A, Stumpp C, Boger D, Biedermann D, Usme MM, Beil FU, Klose G, König C, Gouni-Berthold I, Otte B, Böll G, Kirschbaum A, Merke J, Scholl J, Segiet T, Gebauer M, Predica F, Mayer M, Leistikow F, Füllgraf-Horst S, Müller C, Schüler M, Wiener J, Hein K, Baumgartner P, Kopf S, Busch R, Schömig M, Matthias S, Allendorf-Ostwald N, Fink B, Böhm D, Jäkel A, Koschker AC, Schweizer R, Vogt A, Parhofer K, König W, Reinhard W, Bäßler A, Stadelmann A, Schrader V, Katzmann J, Tarr A, Steinhagen-Thiessen E, Kassner U, Paulsen G, Homberger J, Zemmrich C, Seeger W, Biolik K, Deiss D, Richter C, Pantchechnikova E, Dorn E, Schatz U, Julius U, Spens A, Wiesner T, Scholl M, Rizos CV, Sakkas N, Elisaf M, Skoumas I, Tziomalos K, Rallidis L, Kotsis V, Doumas M, Athyros V, Skalidis E, Kolovou G, Garoufi A, Bilianou E, Koutagiar I, Agapakis D, Kiouri E, Antza C, Katsiki N, Zacharis E, Attilakos A, Sfikas G, Koumaras C, Anagnostis P, Anastasiou G, Liamis G, Koutsogianni AD, Karányi Z, Harangi M, Bajnok L, Audikovszky M, Márk L, Benczúr B, Reiber I, Nagy G, Nagy A, Reddy LL, Shah SA, Ponde CK, Dalal JJ, Sawhney JP, Verma IC, Altaey M, Al-Jumaily K, Rasul D, Abdalsahib AF, Jabbar AA, Al-ageedi M, Agar R, Cohen H, Ellis A, Gavishv D, Harats D, Henkin Y, Knobler H, Leavit L, Leitersdorf E, Rubinstein A, Schurr D, Shpitzen S, Szalat A, Casula M, Zampoleri V, Gazzotti M, Olmastroni E, Sarzani R, Ferri C, Repetti E, Sabbà C, Bossi AC, Borghi C, Muntoni S, Cipollone F, Purrello F, Pujia A, Passaro A, Marcucci R, Pecchioli V, Pisciotta L, Mandraffino G, Pellegatta F, Mombelli G, Branchi A, Fiorenza AM, Pederiva C, Werba JP, Parati G, Carubbi F, Iughetti L, Iannuzzi A, Iannuzzo G, Calabrò P, Averna M, Biasucci G, Zambon S, Roscini AR, Trenti C, Arca M, Federici M, Del Ben M, Bartuli A, Giaccari A, Pipolo A, Citroni N, Guardamagna O, Bonomo K, Benso A, Biolo G, Maroni L, Lupi A, Bonanni L, Zenti MG, Matsuki K, Hori M, Ogura M, Masuda D, Kobayashi T, Nagahama K, Al-Jarallah M, Radovic M, Lunegova O, Bektasheva E, Khodzhiboboev E, Erglis A, Gilis D, Nesterovics G, Saripo V, Meiere R, Upena-RozeMicena A, Terauda E, Jambart S, Khoury PE, Elbitar S, Ayoub C, Ghaleb Y, Aliosaitiene U, Kutkiene S, Kasim NA, Nor NS, Ramli AS, Razak SA, Al-Khateeb A, Kadir SH, Muid SA, Rahman TA, Kasim SS, Radzi AB, Ibrahim KS, Razali S, Ismail Z, Ghani RA, Hafidz MI, Chua AL, Rosli MM, Annamalai M, Teh LK, Razali R, Chua YA, Rosman A, Sanusi AR, Murad NA, Jamal ARA, Nazli SA, Razman AZ, Rosman N, Rahmat R, Hamzan NS, Azzopardi C, Mehta R, Martagon AJ, Ramirez GA, Villa NE, Vazquez AV, Elias-Lopez D, Retana GG, Rodriguez B, Macías JJ, Zazueta AR, Alvarado RM, Portano JD, Lopez HA, Sauque-Reyna L, Herrera LG, Mendia LE, Aguilar HG, Cooremans ER, Aparicio BP, Zubieta VM, Gonzalez PA, Ferreira-Hermosillo A, Portilla NC, Dominguez GJ, Garcia AY, Cazares HE, Gonzalez JR, Valencia CV, Padilla FG, Prado RM, De los Rios Ibarra MO, Villicaña RD, Rivera KJ, Carrera RA, Alvarez JA, Martinez JC, de los Reyes Barrera Bustillo M, Vargas GC, Chacon RC, Andrade MH, Ortega AF, Alcala HG, de Leon LE, Guzman BG, Garcia JJ, Cuellar JC, Cruz JR, Garcia AH, Almada JR, Herrera UJ, Sobrevilla FL, Rodriguez EM, Sibaja CM, Rodriguez AB, Oyervides JC, Vazquez DI, Rodriguez EA, Osorio ML, Saucedo JR, Tamayo MT, Talavera LA, Arroyo LE, Carrillo EA, Isara A, Obaseki DE, Al-Waili K, Al-Zadjali F, Al-Zakwani I, Al-Kindi M, Al-Mukhaini S, Al-Barwani H, Rana A, Shah LS, Starostecka E, Konopka A, Lewek J, Bartłomiejczyk M, Gąsior M, Dyrbuś K, Jóźwiak J, Gruchała M, Pajkowski M, Romanowska-Kocejko M, Żarczyńska-Buchowiecka M, Chmara M, Wasąg B, Parczewska A, Gilis-Malinowska N, Borowiec-Wolna J, Stróżyk A, Woś M, Michalska-Grzonkowska A, Medeiros AM, Alves AC, Silva F, Lobarinhas G, Palma I, de Moura JP, Rico MT, Rato Q, Pais P, Correia S, Moldovan O, Virtuoso MJ, Salgado JM, Colaço I, Dumitrescu A, Lengher C, Mosteoru S, Meshkov A, Ershova A, Rozkova T, Korneva V, Yu KT, Zafiraki V, Voevoda M, Gurevich V, Duplyakov D, Ragino Y, Safarova M, Shaposhnik I, Alkaf F, Khudari A, Rwaili N, Al-Allaf F, Alghamdi M, Batais MA, Almigbal TH, Kinsara A, AlQudaimi AH, Awan Z, Elamin OA, Altaradi H, Rajkovic N, Popovic L, Singh S, Stosic L, Rasulic I, Lalic NM, Lam C, Le TJ, Siang EL, Dissanayake S, I-Shing JT, Shyong TE, Jin TC, Balinth K, Buganova I, Fabryova L, Kadurova M, Klabnik A, Kozárová M, Sirotiakova J, Battelino T, Kovac J, Mlinaric M, Sustar U, Podkrajsek KT, Fras Z, Jug B, Cevc M, Pilcher GJ, Blom D, Wolmarans K, Brice B, Muñiz-Grijalvo O, Díaz-Díaz JL, de Isla LP, Fuentes F, Badimon L, Martin F, Lux A, Chang NT, Ganokroj P, Akbulut M, Alici G, Bayram F, Can LH, Celik A, Ceyhan C, Coskun FY, Demir M, Demircan S, Dogan V, Durakoglugil E, Dural IE, Gedikli O, Hacioglu A, Ildizli M, Kilic S, Kirilmaz B, Kutlu M, Oguz A, Ozdogan O, Onrat E, Ozer S, Sabuncu T, Sahin T, Sivri F, Sonmez A, Temizhan A, Topcu S, Tuncez A, Vural M, Yenercag M, Yesilbursa D, Yigit Z, Yildirim AB, Yildirir A, Yilmaz MB, Atallah B, Traina M, Sabbour H, Hay DA, Luqman N, Elfatih A, Abdulrasheed A, Kwok S, Oca ND, Reyes X, Alieva RB, Kurbanov RD, Hoshimov SU, Nizamov UI, Ziyaeva AV, Abdullaeva GJ, Do DL, Nguyen MN, Kim NT, Le TT, Le HA, Tokgozoglu L, Catapano AL, Ray KK. Global perspective of familial hypercholesterolaemia: a cross-sectional study from the EAS Familial Hypercholesterolaemia Studies Collaboration (FHSC). Lancet 2021; 398:1713-1725. [PMID: 34506743 DOI: 10.1016/s0140-6736(21)01122-3] [Citation(s) in RCA: 117] [Impact Index Per Article: 39.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/19/2021] [Revised: 05/06/2021] [Accepted: 05/11/2021] [Indexed: 12/30/2022]
Abstract
BACKGROUND The European Atherosclerosis Society Familial Hypercholesterolaemia Studies Collaboration (FHSC) global registry provides a platform for the global surveillance of familial hypercholesterolaemia through harmonisation and pooling of multinational data. In this study, we aimed to characterise the adult population with heterozygous familial hypercholesterolaemia and described how it is detected and managed globally. METHODS Using FHSC global registry data, we did a cross-sectional assessment of adults (aged 18 years or older) with a clinical or genetic diagnosis of probable or definite heterozygous familial hypercholesterolaemia at the time they were entered into the registries. Data were assessed overall and by WHO regions, sex, and index versus non-index cases. FINDINGS Of the 61 612 individuals in the registry, 42 167 adults (21 999 [53·6%] women) from 56 countries were included in the study. Of these, 31 798 (75·4%) were diagnosed with the Dutch Lipid Clinic Network criteria, and 35 490 (84·2%) were from the WHO region of Europe. Median age of participants at entry in the registry was 46·2 years (IQR 34·3-58·0); median age at diagnosis of familial hypercholesterolaemia was 44·4 years (32·5-56·5), with 40·2% of participants younger than 40 years when diagnosed. Prevalence of cardiovascular risk factors increased progressively with age and varied by WHO region. Prevalence of coronary disease was 17·4% (2·1% for stroke and 5·2% for peripheral artery disease), increasing with concentrations of untreated LDL cholesterol, and was about two times lower in women than in men. Among patients receiving lipid-lowering medications, 16 803 (81·1%) were receiving statins and 3691 (21·2%) were on combination therapy, with greater use of more potent lipid-lowering medication in men than in women. Median LDL cholesterol was 5·43 mmol/L (IQR 4·32-6·72) among patients not taking lipid-lowering medications and 4·23 mmol/L (3·20-5·66) among those taking them. Among patients taking lipid-lowering medications, 2·7% had LDL cholesterol lower than 1·8 mmol/L; the use of combination therapy, particularly with three drugs and with proprotein convertase subtilisin-kexin type 9 inhibitors, was associated with a higher proportion and greater odds of having LDL cholesterol lower than 1·8 mmol/L. Compared with index cases, patients who were non-index cases were younger, with lower LDL cholesterol and lower prevalence of cardiovascular risk factors and cardiovascular diseases (all p<0·001). INTERPRETATION Familial hypercholesterolaemia is diagnosed late. Guideline-recommended LDL cholesterol concentrations are infrequently achieved with single-drug therapy. Cardiovascular risk factors and presence of coronary disease were lower among non-index cases, who were diagnosed earlier. Earlier detection and greater use of combination therapies are required to reduce the global burden of familial hypercholesterolaemia. FUNDING Pfizer, Amgen, Merck Sharp & Dohme, Sanofi-Aventis, Daiichi Sankyo, and Regeneron.
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Wang H, Noordam R, Cade BE, Schwander K, Winkler TW, Lee J, Sung YJ, Bentley AR, Manning AK, Aschard H, Kilpeläinen TO, Ilkov M, Brown MR, Horimoto AR, Richard M, Bartz TM, Vojinovic D, Lim E, Nierenberg JL, Liu Y, Chitrala K, Rankinen T, Musani SK, Franceschini N, Rauramaa R, Alver M, Zee PC, Harris SE, van der Most PJ, Nolte IM, Munroe PB, Palmer ND, Kühnel B, Weiss S, Wen W, Hall KA, Lyytikäinen LP, O'Connell J, Eiriksdottir G, Launer LJ, de Vries PS, Arking DE, Chen H, Boerwinkle E, Krieger JE, Schreiner PJ, Sidney S, Shikany JM, Rice K, Chen YDI, Gharib SA, Bis JC, Luik AI, Ikram MA, Uitterlinden AG, Amin N, Xu H, Levy D, He J, Lohman KK, Zonderman AB, Rice TK, Sims M, Wilson G, Sofer T, Rich SS, Palmas W, Yao J, Guo X, Rotter JI, Biermasz NR, Mook-Kanamori DO, Martin LW, Barac A, Wallace RB, Gottlieb DJ, Komulainen P, Heikkinen S, Mägi R, Milani L, Metspalu A, Starr JM, Milaneschi Y, Waken RJ, Gao C, Waldenberger M, Peters A, Strauch K, Meitinger T, Roenneberg T, Völker U, Dörr M, Shu XO, Mukherjee S, Hillman DR, Kähönen M, Wagenknecht LE, Gieger C, Grabe HJ, Zheng W, Palmer LJ, Lehtimäki T, Gudnason V, Morrison AC, Pereira AC, Fornage M, Psaty BM, van Duijn CM, Liu CT, Kelly TN, Evans MK, Bouchard C, Fox ER, Kooperberg C, Zhu X, Lakka TA, Esko T, North KE, Deary IJ, Snieder H, Penninx BWJH, Gauderman WJ, Rao DC, Redline S, van Heemst D. Multi-ancestry genome-wide gene-sleep interactions identify novel loci for blood pressure. Mol Psychiatry 2021; 26:6293-6304. [PMID: 33859359 PMCID: PMC8517040 DOI: 10.1038/s41380-021-01087-0] [Citation(s) in RCA: 10] [Impact Index Per Article: 3.3] [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] [Received: 06/11/2020] [Revised: 03/18/2021] [Accepted: 03/29/2021] [Indexed: 02/02/2023]
Abstract
Long and short sleep duration are associated with elevated blood pressure (BP), possibly through effects on molecular pathways that influence neuroendocrine and vascular systems. To gain new insights into the genetic basis of sleep-related BP variation, we performed genome-wide gene by short or long sleep duration interaction analyses on four BP traits (systolic BP, diastolic BP, mean arterial pressure, and pulse pressure) across five ancestry groups in two stages using 2 degree of freedom (df) joint test followed by 1df test of interaction effects. Primary multi-ancestry analysis in 62,969 individuals in stage 1 identified three novel gene by sleep interactions that were replicated in an additional 59,296 individuals in stage 2 (stage 1 + 2 Pjoint < 5 × 10-8), including rs7955964 (FIGNL2/ANKRD33) that increases BP among long sleepers, and rs73493041 (SNORA26/C9orf170) and rs10406644 (KCTD15/LSM14A) that increase BP among short sleepers (Pint < 5 × 10-8). Secondary ancestry-specific analysis identified another novel gene by long sleep interaction at rs111887471 (TRPC3/KIAA1109) in individuals of African ancestry (Pint = 2 × 10-6). Combined stage 1 and 2 analyses additionally identified significant gene by long sleep interactions at 10 loci including MKLN1 and RGL3/ELAVL3 previously associated with BP, and significant gene by short sleep interactions at 10 loci including C2orf43 previously associated with BP (Pint < 10-3). 2df test also identified novel loci for BP after modeling sleep that has known functions in sleep-wake regulation, nervous and cardiometabolic systems. This study indicates that sleep and primary mechanisms regulating BP may interact to elevate BP level, suggesting novel insights into sleep-related BP regulation.
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Affiliation(s)
- Heming Wang
- Division of Sleep and Circadian Disorders, Brigham and Women's Hospital, Harvard Medical School, Boston, MA, USA.
- Program in Medical and Population Genetics, Broad Institute, Cambridge, MA, USA.
| | - Raymond Noordam
- Department of Internal Medicine, Section of Gerontology and Geriatrics, Leiden University Medical Center, Leiden, The Netherlands
| | - Brian E Cade
- Division of Sleep and Circadian Disorders, Brigham and Women's Hospital, Harvard Medical School, Boston, MA, USA
- Program in Medical and Population Genetics, Broad Institute, Cambridge, MA, USA
| | - Karen Schwander
- Division of Biostatistics, Washington University School of Medicine, St. Louis, MO, USA
- Division of Statistical Genomics, Department of Genetics, Washington University School of Medicine, St. Louis, MO, USA
| | - Thomas W Winkler
- Department of Genetic Epidemiology, University of Regensburg, Regensburg, Germany
| | - Jiwon Lee
- Division of Sleep and Circadian Disorders, Brigham and Women's Hospital, Harvard Medical School, Boston, MA, USA
- Joint Carnegie Mellon University-University of Pittsburgh PhD Program in Computational Biology, Pittsburgh, PA, USA
- Department of Computational and Systems Biology, School of Medicine, University of Pittsburgh, Pittsburgh, PA, USA
- Pittsburgh Center for Evolutionary Biology and Medicine, School of Medicine, University of Pittsburgh, Pittsburgh, PA, USA
| | - Yun Ju Sung
- Division of Biostatistics, Washington University School of Medicine, St. Louis, MO, USA
| | - Amy R Bentley
- Center for Research on Genomics and Global Health, National Human Genome Research Institute, National Institutes of Health, Bethesda, MD, USA
| | - Alisa K Manning
- Program in Medical and Population Genetics, Broad Institute, Cambridge, MA, USA
- Clinical and Translational Epidemiology Unit, Massachusetts General Hospital, Harvard Medical School, Boston, MA, USA
| | - Hugues Aschard
- Department of Epidemiology, Harvard School of Public Health, Boston, MA, USA
- Centre de Bioinformatique, Biostatistique et Biologie Intégrative (C3BI), Institut Pasteur, Paris, France
| | - Tuomas O Kilpeläinen
- Novo Nordisk Foundation Center for Basic Metabolic Research, Faculty of Health and Medical Sciences, University of Copenhagen, Copenhagen, Denmark
- Department of Environmental Medicine and Public Health, The Icahn School of Medicine at Mount Sinai, New York, NY, USA
| | | | - Michael R Brown
- 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
| | - Andrea R Horimoto
- Laboratory of Genetics and Molecular Cardiology, Heart Institute (InCor), University of São Paulo Medical School, São Paulo, Brazil
| | - Melissa Richard
- Brown Foundation Institute of Molecular Medicine, McGovern Medical School, University of Texas Health Science Center at Houston, Houston, TX, USA
| | - Traci M Bartz
- Cardiovascular Health Research Unit, Department of Medicine, University of Washington, Seattle, WA, USA
- Department of Biostatistics, University of Washington, Seattle, WA, USA
| | - Dina Vojinovic
- Department of Epidemiology, Erasmus MC, University Medical Center, Rotterdam, The Netherlands
- Molecular Epidemiology, Department of Biomedical Data Sciences, Leiden University Medical Center, Leiden, the Netherlands
| | - Elise Lim
- Department of Biostatistics, Boston University School of Public Health, Boston, MA, USA
| | - Jovia L Nierenberg
- Department of Epidemiology, Tulane University School of Public Health and Tropical Medicine, New Orleans, LA, USA
| | - Yongmei Liu
- Division of Cardiology, Department of Medicine, Duke Molecular Physiology Institute Duke University School of Medicine, Durham, NC, USA
| | - Kumaraswamynaidu Chitrala
- Laboratory of Epidemiology and Population Sciences, National Institute on Aging, National Institutes of Health, Baltimore, MD, USA
| | - Tuomo Rankinen
- Human Genomics Laboratory, Pennington Biomedical Research Center, Baton Rouge, LA, USA
| | - Solomon K Musani
- Department of Medicine, University of Mississippi Medical Center, Jackson, MS, USA
| | - Nora Franceschini
- Department of Epidemiology, Gillings School of Global Public Health, University of North Carolina, Chapel Hill, NC, USA
| | - Rainer Rauramaa
- Foundation for Research in Health Exercise and Nutrition, Kuopio Research Institute of Exercise Medicine, Kuopio, Finland
| | - Maris Alver
- Estonian Genome Centre, Institute of Genomics, University of Tartu, Tartu, Estonia
- Department of Genetic Medicine and Development, University of Geneva, Geneva, Switzerland
| | - Phyllis C Zee
- Division of Sleep Medicine, Department of Neurology, Northwestern University, Chicago, IL, USA
| | - Sarah E Harris
- Lothian Birth Cohorts group, Department of Psychology, University of Edinburgh, Edinburgh, UK
| | - Peter J van der Most
- Department of Epidemiology, University of Groningen, University Medical Center Groningen, Groningen, The Netherlands
| | - Ilja M Nolte
- Department of Epidemiology, University of Groningen, University Medical Center Groningen, Groningen, The Netherlands
| | - Patricia B Munroe
- Clinical Pharmacology, William Harvey Research Institute, Barts and The London School of Medicine and Dentistry, Queen Mary University of London, London, UK
- National Institute for Health Research Barts Cardiovascular Biomedical Research Unit, Queen Mary University of London, London, London, UK
| | | | - Brigitte Kühnel
- Research Unit of Molecular Epidemiology, Helmholtz Zentrum München, German Research Center for Environmental Health, Neuherberg, Germany
- Institute of Epidemiology, Helmholtz Zentrum München, German Research Center for Environmental Health, Neuherberg, Germany
| | - Stefan Weiss
- Interfaculty Institute for Genetics and Functional Genomics, Department of Functional Genomics, University Medicine Greifswald, Greifswald, Germany
- German Center for Cardiovascular Research (DZHK), partner site Greifswald, Greifswald, Germany
| | - Wanqing Wen
- Division of Epidemiology, Department of Medicine, Vanderbilt University School of Medicine, Nashville, TN, USA
| | - Kelly A Hall
- School of Public Health, The University of Adelaide, Adelaide, SA, Australia
| | - Leo-Pekka Lyytikäinen
- Department of Clinical Chemistry, Fimlab Laboratories, Tampere, Finland
- Department of Clinical Chemistry, Finnish Cardiovascular Research Center - Tampere, Faculty of Medicine and Health Technology, Tampere University, Tampere, Finland
| | - Jeff O'Connell
- Division of Endocrinology, Diabetes, and Nutrition, University of Maryland School of Medicine, Baltimore, MD, USA
- Program for Personalized and Genomic Medicine, University of Maryland School of Medicine, Baltimore, MD, USA
| | | | - Lenore J Launer
- Laboratory of Epidemiology and Population Sciences, National Institute on Aging, National Institutes of Health, Baltimore, MD, USA
| | - Paul S de Vries
- 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
| | - Dan E Arking
- McKusick-Nathans Institute of Genetic Medicine, Johns Hopkins University School of Medicine, Baltimore, MD, USA
| | - Han Chen
- 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
- Center for Precision Health, School of Public Health & School of Biomedical Informatics, The University of Texas Health Science Center at Houston, Houston, TX, 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
- Human Genome Sequencing Center, Baylor College of Medicine, Houston, TX, USA
| | - Jose E Krieger
- Laboratory of Genetics and Molecular Cardiology, Heart Institute (InCor), University of São Paulo Medical School, São Paulo, Brazil
| | - Pamela J Schreiner
- Division of Epidemiology & Community Health, School of Public Health, University of Minnesota, Minneapolis, MN, USA
| | | | - James M Shikany
- Division of Preventive Medicine, School of Medicine, University of Alabama at Birmingham, Birmingham, AL, USA
| | - Kenneth Rice
- Department of Biostatistics, University of Washington, Seattle, WA, USA
| | - Yii-Der Ida Chen
- The Institute for Translational Genomics and Population Sciences, Department of Pediatrics, The Lundquist Institute for Biomedical Innovation at Harbor-UCLA Medical Center, Torrance, CA, USA
| | - Sina A Gharib
- Computational Medicine Core, Center for Lung Biology, UW Medicine Sleep Center, Department of Medicine, University of Washington, Seattle, WA, USA
| | - Joshua C Bis
- Cardiovascular Health Research Unit, Department of Medicine, University of Washington, Seattle, WA, USA
| | - Annemarie I Luik
- Department of Epidemiology, Erasmus MC, University Medical Center, Rotterdam, The Netherlands
| | - M Arfan Ikram
- Department of Epidemiology, Erasmus MC, University Medical Center, Rotterdam, The Netherlands
- Department of Radiology and Nuclear Medicine, Erasmus University Medical Center, Rotterdam, The Netherlands
| | - André G Uitterlinden
- Department of Epidemiology, Erasmus MC, University Medical Center, Rotterdam, The Netherlands
- Department of Internal Medicine, Erasmus MC, University Medical Center, Rotterdam, the Netherlands
| | - Najaf Amin
- Department of Epidemiology, Erasmus MC, University Medical Center, Rotterdam, The Netherlands
| | - Hanfei Xu
- Department of Biostatistics, Boston University School of Public Health, Boston, MA, USA
| | - Daniel Levy
- Department of Biostatistics, Boston University School of Public Health, Boston, MA, USA
- Population Sciences Branch, National Heart, Lung, and Blood Institute Framingham Heart Study, Framingham, MA, USA
| | - Jiang He
- Department of Epidemiology, Tulane University School of Public Health and Tropical Medicine, New Orleans, LA, USA
| | - Kurt K Lohman
- Division of Cardiology, Department of Medicine, Duke Molecular Physiology Institute Duke University School of Medicine, Durham, NC, USA
| | - Alan B Zonderman
- Laboratory of Epidemiology and Population Sciences, National Institute on Aging, National Institutes of Health, Baltimore, MD, USA
| | - Treva K Rice
- Division of Biostatistics, Washington University School of Medicine, St. Louis, MO, USA
| | - Mario Sims
- Department of Medicine, University of Mississippi Medical Center, Jackson, MS, USA
| | - Gregory Wilson
- JHS Graduate Training and Education Center, Jackson State University, Jackson, MS, USA
| | - Tamar Sofer
- Division of Sleep and Circadian Disorders, Brigham and Women's Hospital, Harvard Medical School, Boston, MA, USA
- Program in Medical and Population Genetics, Broad Institute, Cambridge, MA, USA
| | - Stephen S Rich
- Center for Public Health Genomics, University of Virginia, Charlottesville, VA, USA
| | - Walter Palmas
- Division of General Medicine, Department of Medicine, Columbia University, New York, NY, USA
| | - Jie Yao
- The Institute for Translational Genomics and Population Sciences, Department of Pediatrics, The Lundquist Institute for Biomedical Innovation at Harbor-UCLA Medical Center, Torrance, CA, USA
| | - Xiuqing Guo
- The Institute for Translational Genomics and Population Sciences, Department of Pediatrics, The Lundquist Institute for Biomedical Innovation at Harbor-UCLA Medical Center, Torrance, CA, USA
| | - Jerome I Rotter
- The Institute for Translational Genomics and Population Sciences, Department of Pediatrics, The Lundquist Institute for Biomedical Innovation at Harbor-UCLA Medical Center, Torrance, CA, USA
| | - Nienke R Biermasz
- Division of Endocrinology, Department of Internal Medicine, Leiden University Medical Center, Leiden, The Netherlands
| | - Dennis O Mook-Kanamori
- Department of Clinical Epidemiology, Leiden University Medical Center, Leiden, Netherlands
- Department of Public Health and Primary Care, Leiden University Medical Center, Leiden, The Netherlands
| | - Lisa W Martin
- George Washington University School of Medicine and Health Sciences, Washington, DC, USA
| | - Ana Barac
- MedStar Heart and Vascular Institute, Washington, DC, USA
| | - Robert B Wallace
- Department of Epidemiology, University of Iowa College of Public Health, Iowa City, IA, USA
| | - Daniel J Gottlieb
- Division of Sleep and Circadian Disorders, Brigham and Women's Hospital, Harvard Medical School, Boston, MA, USA
- VA Boston Healthcare System, Boston, MA, USA
| | - Pirjo Komulainen
- Foundation for Research in Health Exercise and Nutrition, Kuopio Research Institute of Exercise Medicine, Kuopio, Finland
| | - Sami Heikkinen
- Institute of Biomedicine, School of Medicine, University of Eastern Finland, Kuopio Campus, Finland
- Institute of Clinical Medicine, Internal Medicine, University of Eastern Finland, Kuopio, Finland
| | - Reedik Mägi
- Estonian Genome Centre, Institute of Genomics, University of Tartu, Tartu, Estonia
| | - Lili Milani
- Estonian Genome Centre, Institute of Genomics, University of Tartu, Tartu, Estonia
| | - Andres Metspalu
- Estonian Genome Centre, Institute of Genomics, University of Tartu, Tartu, Estonia
| | - John M Starr
- Alzheimer Scotland Dementia Research Centre, The University of Edinburgh, Edinburgh, UK
| | - Yuri Milaneschi
- Department of Psychiatry, Amsterdam Neuroscience and Amsterdam Public Health Research Institute, Amsterdam UMC, Vrije Universiteit, Amsterdam, HJ, The Netherlands
| | - R J Waken
- Division of Cardiology, Department of Medicine, Washington University in St. Louis, St. Louis, MO, USA
| | - Chuan Gao
- Molecular Genetics and Genomics Program, Wake Forest School of Medicine, Winston-Salem, NC, USA
| | - Melanie Waldenberger
- Research Unit of Molecular Epidemiology, Helmholtz Zentrum München, German Research Center for Environmental Health, Neuherberg, Germany
- Institute of Epidemiology, Helmholtz Zentrum München, German Research Center for Environmental Health, Neuherberg, Germany
| | - Annette Peters
- Institute of Epidemiology, Helmholtz Zentrum München, German Research Center for Environmental Health, Neuherberg, Germany
- German Centre for Cardiovascular Research (DZHK), partner site Munich Heart Alliance, Neuherberg, Germany
| | - Konstantin Strauch
- Institute of Medical Biostatistics, Epidemiology and Informatics (IMBEI), University Medical Center, Johannes Gutenberg University, Mainz, Germany
- Institute of Genetic Epidemiology, Helmholtz Zentrum München, German Research Center for Environmental Health, Neuherberg, Germany
- Chair of Genetic Epidemiology, IBE, Faculty of Medicine, LMU Munich, Munich, Germany
| | - Thomas Meitinger
- Institute of Human Genetics, Helmholtz Zentrum München, German Research Center for Environmental Health, Neuherberg, Germany
| | - Till Roenneberg
- Institute and Polyclinic for Occupational-, Social- and Environmental Medicine, LMU Munich, Munich, Germany
| | - Uwe Völker
- Interfaculty Institute for Genetics and Functional Genomics, Department of Functional Genomics, University Medicine Greifswald, Greifswald, Germany
- German Center for Cardiovascular Research (DZHK), partner site Greifswald, Greifswald, Germany
| | - Marcus Dörr
- German Center for Cardiovascular Research (DZHK), partner site Greifswald, Greifswald, Germany
- Department of Internal Medicine B, University Medicine Greifswald, Greifswald, Germany
| | - Xiao-Ou Shu
- Division of Epidemiology, Department of Medicine, Vanderbilt University School of Medicine, Nashville, TN, USA
| | - Sutapa Mukherjee
- Sleep Health Service, Respiratory and Sleep Services, Southern Adelaide Local Health Network, Adelaide, SA, Australia
- Adelaide Institute for Sleep Health, Flinders Health and Medical Research Institute, College of Medicine and Public Health, Flinders University, Adelaide, SA, Australia
| | - David R Hillman
- Department of Pulmonary Physiology and Sleep Medicine, Sir Charles Gairdner Hospital, Perth, WA, Australia
| | - Mika Kähönen
- Department of Clinical Physiology, Tampere University Hospital, Tampere, Finland
- Department of Clinical Physiology, Finnish Cardiovascular Research Center - Tampere, Faculty of Medicine and Health Technology, Tampere University, Tampere, Finland
| | - Lynne E Wagenknecht
- Public Health Sciences, Wake Forest School of Medicine, Winston-Salem, NC, USA
| | - Christian Gieger
- Research Unit of Molecular Epidemiology, Helmholtz Zentrum München, German Research Center for Environmental Health, Neuherberg, Germany
- German Center for Diabetes Research (DZD e.V.), Neuherberg, Germany
| | - Hans J Grabe
- Department Psychiatry and Psychotherapy, University Medicine Greifswald, Greifswald, Germany
| | - Wei Zheng
- Division of Epidemiology, Department of Medicine, Vanderbilt University School of Medicine, Nashville, TN, USA
| | - Lyle J Palmer
- School of Public Health, The University of Adelaide, Adelaide, SA, Australia
| | - Terho Lehtimäki
- Department of Clinical Chemistry, Fimlab Laboratories, Tampere, Finland
- Department of Clinical Chemistry, Finnish Cardiovascular Research Center - Tampere, Faculty of Medicine and Health Technology, Tampere University, Tampere, Finland
| | - Vilmundur Gudnason
- Icelandic Heart Association, Kopavogur, Iceland
- Faculty of Medicine, University of Iceland, Reykjavik, Iceland
| | - Alanna C Morrison
- 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
| | - Alexandre C Pereira
- Laboratory of Genetics and Molecular Cardiology, Heart Institute (InCor), University of São Paulo Medical School, São Paulo, Brazil
- Department of Genetics, Harvard Medical School, Boston, MA, USA
| | - Myriam Fornage
- 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
- Brown Foundation Institute of Molecular Medicine, McGovern Medical School, University of Texas Health Science Center at Houston, Houston, TX, USA
| | - Bruce M Psaty
- Cardiovascular Health Research Unit, Department of Medicine, University of Washington, Seattle, WA, USA
- Cardiovascular Health Research Unit, Departments of Epidemiology and Health Services, University of Washington, Seattle, WA, USA
| | - Cornelia M van Duijn
- Department of Epidemiology, Erasmus MC, University Medical Center, Rotterdam, The Netherlands
- Nuffield Department of Population Health, University of Oxford, Oxford, UK
| | - Ching-Ti Liu
- Department of Biostatistics, Boston University School of Public Health, Boston, MA, USA
| | - Tanika N Kelly
- Department of Epidemiology, Tulane University School of Public Health and Tropical Medicine, New Orleans, LA, USA
| | - Michele K Evans
- Laboratory of Epidemiology and Population Sciences, National Institute on Aging, National Institutes of Health, Baltimore, MD, USA
| | - Claude Bouchard
- Human Genomics Laboratory, Pennington Biomedical Research Center, Baton Rouge, LA, USA
| | - Ervin R Fox
- Department of Medicine, University of Mississippi Medical Center, Jackson, MS, USA
| | - Charles Kooperberg
- Division of Public Health Sciences, Fred Hutchinson Cancer Research Center, Seattle, WA, USA
| | - Xiaofeng Zhu
- Department of Population and Quantitative Health Sciences, Case Western Reserve University, Cleveland, OH, USA
| | - Timo A Lakka
- Foundation for Research in Health Exercise and Nutrition, Kuopio Research Institute of Exercise Medicine, Kuopio, Finland
- Institute of Biomedicine, School of Medicine, University of Eastern Finland, Kuopio Campus, Finland
- Department of Clinical Physiology and Nuclear Medicine, Kuopio University Hospital, Kuopio, Finland
| | - Tõnu Esko
- Estonian Genome Centre, Institute of Genomics, University of Tartu, Tartu, Estonia
| | - Kari E North
- Department of Epidemiology, Gillings School of Global Public Health, University of North Carolina, Chapel Hill, NC, USA
| | - Ian J Deary
- Lothian Birth Cohorts group, Department of Psychology, University of Edinburgh, Edinburgh, UK
| | - Harold Snieder
- Department of Epidemiology, University of Groningen, University Medical Center Groningen, Groningen, The Netherlands
| | - Brenda W J H Penninx
- Department of Psychiatry, Amsterdam Neuroscience and Amsterdam Public Health Research Institute, Amsterdam UMC, Vrije Universiteit, Amsterdam, HJ, The Netherlands
| | - W James Gauderman
- Division of Biostatistics, Department of Preventive Medicine, University of Southern California, Los Angeles, CA, USA
| | - Dabeeru C Rao
- Division of Biostatistics, Washington University School of Medicine, St. Louis, MO, USA
| | - Susan Redline
- Division of Sleep and Circadian Disorders, Brigham and Women's Hospital, Harvard Medical School, Boston, MA, USA
- Division of Pulmonary Medicine, Department of Medicine, Beth Israel Deaconess Medical Center, Boston, MA, USA
| | - Diana van Heemst
- Department of Internal Medicine, Section of Gerontology and Geriatrics, Leiden University Medical Center, Leiden, The Netherlands.
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21
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Bensenor I, Padilha K, Lima IR, Santos RD, Lambert G, Ramin-Mangata S, Bittencourt MS, Goulart AC, Santos IS, Mill JG, Krieger JE, Lotufo PA, Pereira AC. Genome-Wide Association of Proprotein Convertase Subtilisin/Kexin Type 9 Plasma Levels in the ELSA-Brasil Study. Front Genet 2021; 12:728526. [PMID: 34659352 PMCID: PMC8514075 DOI: 10.3389/fgene.2021.728526] [Citation(s) in RCA: 1] [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] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/21/2021] [Accepted: 08/16/2021] [Indexed: 11/15/2022] Open
Abstract
Pharmacological inhibition of PCSK9 (proprotein convertase subtilisin/kexin type 9) is an established therapeutic option to treat hypercholesterolemia, and plasma PCSK9 levels have been implicated in cardiovascular disease incidence. A number of genetic variants within the PCSK9 gene locus have been shown to modulate PCSK9 levels, but these only explain a very small percentage of the overall PCSK9 interindividual variation. Here we present data on the genetic association structure between PCSK9 levels and genom-wide genetic variation in a healthy sample from the general population. We performed a genome-wide association study of plasma PCSK9 levels in a sample of Brazilian individuals enrolled in the Estudo Longitudinal de Saude do Adulto cohort (n=810). Enrolled individuals were free from cardiovascular disease, diabetes and were not under lipid-lowering medication. Genome-wide genotyping was conducted using the Axiom_PMRA.r3 array, and imputation was performed using the TOPMED multi-ancestry sample panel as reference. Total PCSK9 plasma concentrations were determined using the Quantikine SPC900 ELISA kit. We observed two genome-wide significant loci and seven loci that reached the pre-defined value of p threshold of 1×10−6. Significant variants were near KCNA5 and KCNA1, and LINC00353. Genetic variation at the PCSK9 locus was able to explain approximately 4% of the overall interindividual variations in PCSK9 levels. Colocalization analysis using eQTL data suggested RWDD3, ATXN7L1, KCNA1, and FAM177A1 to be potential mediators of some of the observed associations. Our results suggest that PCSK9 levels may be modulated by trans genetic variation outside of the PCSK9 gene and this may have clinical implications. Understanding both environmental and genetic predictors of PCSK9 levels may help identify new targets for cardiovascular disease treatment and contribute to a better assessment of the benefits of long-term PCSK9 inhibition.
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Affiliation(s)
- Isabela Bensenor
- Center for Clinical and Epidemiologic Research, University of São Paulo, São Paulo, Brazil
| | - Kallyandra Padilha
- Laboratory of Genetics and Molecular Cardiology, Heart Institute (InCor), University of São Paulo Medical School Hospital, São Paulo, Brazil
| | - Isabella Ramos Lima
- Laboratory of Genetics and Molecular Cardiology, Heart Institute (InCor), University of São Paulo Medical School Hospital, São Paulo, Brazil
| | - Raul Dias Santos
- Lipid Clinic, Heart Institute (InCor), University of São Paulo Medical School Hospital, São Paulo, Brazil
| | - Gilles Lambert
- Inserm UMR 1188 DéTROI, Université La Réunion, Sainte Clotilde, France
| | | | - Marcio S Bittencourt
- Lipid Clinic, Heart Institute (InCor), University of São Paulo Medical School Hospital, São Paulo, Brazil
| | - Alessandra C Goulart
- Center for Clinical and Epidemiologic Research, University of São Paulo, São Paulo, Brazil
| | - Itamar S Santos
- Center for Clinical and Epidemiologic Research, University of São Paulo, São Paulo, Brazil
| | - Jose G Mill
- Department of Physiological Sciences, Federal University of Espírito Santo, Vitória, Brazil
| | - Jose E Krieger
- Laboratory of Genetics and Molecular Cardiology, Heart Institute (InCor), University of São Paulo Medical School Hospital, São Paulo, Brazil
| | - Paulo A Lotufo
- Center for Clinical and Epidemiologic Research, University of São Paulo, São Paulo, Brazil
| | - Alexandre C Pereira
- Laboratory of Genetics and Molecular Cardiology, Heart Institute (InCor), University of São Paulo Medical School Hospital, São Paulo, Brazil
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22
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Antoniazzi L, Arroyo-Olivares R, Bittencourt MS, Tada MT, Lima I, Jannes CE, Krieger JE, Pereira AC, Quintana-Navarro G, Muñiz-Grijalvo O, Díaz-Díaz JL, Alonso R, Mata P, Santos RD. Adherence to a Mediterranean diet, dyslipidemia and inflammation in familial hypercholesterolemia. Nutr Metab Cardiovasc Dis 2021; 31:2014-2022. [PMID: 34039501 DOI: 10.1016/j.numecd.2021.04.006] [Citation(s) in RCA: 24] [Impact Index Per Article: 8.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/21/2021] [Revised: 04/01/2021] [Accepted: 04/06/2021] [Indexed: 10/21/2022]
Abstract
BACKGROUND AND AIMS Familial Hypercholesterolemia (FH) is characterized by elevated LDL-cholesterol (LDL-C) and high atherosclerosis risk. The impact of different dietary patterns on atherosclerosis biomarkers has been poorly studied in FH. This study verified the association of adherence to a Mediterranean diet with biomarkers of dyslipidemia and low-grade inflammation in molecularly proven FH adults from Brazil (BR) and Spain (SP). METHODS AND RESULTS In this cross-sectional study adherence to the Mediterranean diet was assessed by a validated score and generalized estimating equations were used to evaluate its association with plasma LDL-C, apolipoprotein-B (ApoB) and high sensitivity C-reactive protein (hs-CRP) concentrations. We included 92 (mean age 45 years, 58.7% females) and 98 FH individuals (mean age 46.8 years, 60.2% females) respectively from BR and SP. FH causing variants did not differ between countries. LDL-C, ApoB and hs-CRP concentrations were higher in BR than in SP: 179 (135-250) and 161 (133-193) mg/dL; 141 (109-181) and 103 (88-134) mg/dL; and 1.6 (0.8-4.0) and 0.8 (0.4-1.5) mg/L respectively (all p < 0.001). Most of BR had low adherence (n = 77, 83.7%), while the majority of SP were divided into moderate (n = 35, 35.7%) and strong adherence to the Mediterranean diet (n = 37, 37.8%), p < 0.001. There was a significant inverse association of adherence to the Mediterranean diet score with higher LDL-C, ApoB, and hs-CRP after adjusting for socio economic parameters, caloric and fatty acid intakes as well as pharmacological lipid lowering therapies. CONCLUSIONS Higher adherence to a Mediterranean diet was associated with better dyslipidemia and low-grade inflammation profiles in FH.
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Affiliation(s)
- Luiza Antoniazzi
- Heart Institute (InCor) University of Sao Paulo Medical School Hospital, Sao Paulo, Brazil
| | | | - Marcio S Bittencourt
- School of Medicine, Faculdade Israelita de Ciências da Saúde Albert Einstein, Sao Paulo, Brazil; Center for Clinical and Epidemiological Research, University Hospital, University of São Paulo School of Medicine, Sao Paulo, Brazil
| | - Mauricio T Tada
- Heart Institute (InCor) University of Sao Paulo Medical School Hospital, Sao Paulo, Brazil
| | - Isabella Lima
- Heart Institute (InCor) University of Sao Paulo Medical School Hospital, Sao Paulo, Brazil
| | - Cinthia E Jannes
- Heart Institute (InCor) University of Sao Paulo Medical School Hospital, Sao Paulo, Brazil
| | - Jose E Krieger
- Heart Institute (InCor) University of Sao Paulo Medical School Hospital, Sao Paulo, Brazil
| | - Alexandre C Pereira
- Heart Institute (InCor) University of Sao Paulo Medical School Hospital, Sao Paulo, Brazil
| | - Gracia Quintana-Navarro
- Unidad de Lípidos y Arteriosclerosis, IMIBIC, Hospital Universitario Reina Sofía, Córdoba, Spain
| | | | - José L Díaz-Díaz
- Servicio de Medicina Interna, Hospital Abente y Lago, A Coruña, Spain
| | - Rodrigo Alonso
- Center for Advanced Metabolic Medicine and Nutrition, Santiago de Chile, Chile
| | - Pedro Mata
- Fundación Hipercolesterolemia Familiar, Madrid, Spain
| | - Raul D Santos
- Heart Institute (InCor) University of Sao Paulo Medical School Hospital, Sao Paulo, Brazil; Hospital Israelita Albert Einstein, São Paulo, Brazil.
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23
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Joviano-Santos JV, Santos-Miranda A, Neri EA, Fonseca-Alaniz MH, Krieger JE, Pereira AC, Roman-Campos D. SCN5A compound heterozygosity mutation in Brugada syndrome: Functional consequences and the implication for pharmacological treatment. Life Sci 2021; 278:119646. [PMID: 34048814 DOI: 10.1016/j.lfs.2021.119646] [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] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/14/2020] [Revised: 05/13/2021] [Accepted: 05/18/2021] [Indexed: 11/28/2022]
Abstract
AIMS SCN5A gene encodes the α-subunit of Nav1.5, mainly found in the human heart. SCN5A variants are the most common genetic alterations associated with Brugada syndrome (BrS). In rare cases, compound heterozygosity is observed; however, its functional consequences are poorly understood. We aimed to analyze the functional impact of de novo Nav1.5 mutations in compound heterozygosity in distinct alleles (G400R and T1461S positions) previously found in a patient with BrS. Moreover, we evaluated the potential benefits of quinidine to improve the phenotype of mutant Na+ channels in vitro. MATERIALS AND METHODS The functional properties of human wild-type and Nav1.5 variants were evaluated using whole-cell patch-clamp and immunofluorescence techniques in transiently expressed human embryonic kidney (HEK293) cells. KEY FINDINGS Both variants occur in the highly conservative positions of SCN5A. Although all variants were expressed in the cell membrane, a significant reduction in the Na+ current density (except for G400R alone, which was undetected) was observed along with abnormal biophysical properties, once the variants were expressed in homozygosis and heterozygosis. Interestingly, the incubation of transfected cells with quinidine partially rescued the biophysical properties of the mutant Na+ channel. SIGNIFICANCE De novo compound heterozygosis mutations in SNC5A disrupt the Na+ macroscopic current. Quinidine could partially reverse the in vitro loss-of-function phenotype of Na+ current. Thus, our data provide, for the first time, a detailed biophysical characterization of dysfunctional Na+ channels linked to compound heterozygosity in BrS as well as the benefits of the pharmacological treatment using quinidine on the biophysical properties of Nav1.5.
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Affiliation(s)
- J V Joviano-Santos
- Laboratory of CardioBiology, Department of Biophysics, Federal University of São Paulo, Brazil
| | - A Santos-Miranda
- Laboratory of CardioBiology, Department of Biophysics, Federal University of São Paulo, Brazil
| | - E A Neri
- Laboratory of Genetics and Molecular Cardiology, Heart Institute, University of São Paulo Medical School, São Paulo, Brazil
| | - M H Fonseca-Alaniz
- Laboratory of Genetics and Molecular Cardiology, Heart Institute, University of São Paulo Medical School, São Paulo, Brazil
| | - J E Krieger
- Laboratory of Genetics and Molecular Cardiology, Heart Institute, University of São Paulo Medical School, São Paulo, Brazil
| | - A C Pereira
- Laboratory of Genetics and Molecular Cardiology, Heart Institute, University of São Paulo Medical School, São Paulo, Brazil
| | - D Roman-Campos
- Laboratory of CardioBiology, Department of Biophysics, Federal University of São Paulo, Brazil.
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24
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Evans SL, Leocadio-Miguel MA, Taporoski TP, Gomez LM, Horimoto A, Alkan E, Beijamini F, Pedrazzoli M, Knutson KL, Krieger JE, Vallada HP, Sterr A, Pereira AC, Negrão AB, von Schantz M. Evening preference correlates with regional brain volumes in the anterior occipital lobe. Chronobiol Int 2021; 38:1135-1142. [PMID: 33906520 DOI: 10.1080/07420528.2021.1912077] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/21/2022]
Abstract
Chronotype or diurnal preference is a questionnaire-based measure influenced both by circadian period and by the sleep homeostat. In order to further characterize the biological determinants of these measures, we used a hypothesis-free approach to investigate the association between the score of the morningness-eveningness questionnaire (MEQ) and the Munich chronotype questionnaire (MCTQ), as continuous variables, and volumetric measures of brain regions acquired by magnetic resonance imaging (MRI). Data were collected from the Baependi Heart Study cohort, based in a rural town in South-Eastern Brazil. MEQ and anatomical 1.5-T MRI scan data were available from 410 individuals, and MCTQ scores were available from a subset of 198 of them. The average MEQ (62.2 ± 10.6) and MCTQ (average MSFsc 201 ± 85 min) scores were suggestive of a previously reported strong general tendency toward morningness in this community. Setting the significance threshold at P > .002 to account for multiple comparisons, we observed a significant association between lower MEQ score (eveningness) and greater volume of the left anterior occipital sulcus (β = -0.163, p = .001) of the occipital lobe. No significant associations were observed for MCTQ. This may reflect the smaller dataset for MCTQ, and/or the fact that MEQ, which asks questions about preferred timings, is more trait-like than the MCTQ, which asks questions about actual timings. The association between MEQ and a brain region dedicated to visual information processing is suggestive of the increasingly recognized fluidity in the interaction between visual and nonvisual photoreception and the circadian system, and the possibility that chronotype includes an element of masking.
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Affiliation(s)
- S L Evans
- Faculty of Health and Medical Sciences, University of Surrey, Guildford, Surrey, UK
| | - M A Leocadio-Miguel
- Faculty of Health and Medical Sciences, University of Surrey, Guildford, Surrey, UK.,Department of Physiology and Behavior, Federal University of Rio Grande Do Norte, Natal, Rio Grande do Norte, Brazil
| | - T P Taporoski
- Faculty of Health and Medical Sciences, University of Surrey, Guildford, Surrey, UK.,Department of Psychiatry, University of São Paulo School of Medicine, São Paulo, São Paulo, Brazil.,Northwestern University Feinberg School of Medicine, Chicago, Illinois, USA
| | - L M Gomez
- Incor, University of São Paulo School of Medicine, São Paulo, São Paulo, Brazil
| | - Arvr Horimoto
- Incor, University of São Paulo School of Medicine, São Paulo, São Paulo, Brazil.,Department of Biostatistics, School of Public Health, University of Washington, Seattle, Washington, USA
| | - E Alkan
- Faculty of Health and Medical Sciences, University of Surrey, Guildford, Surrey, UK
| | - F Beijamini
- Department of Psychiatry, University of São Paulo School of Medicine, São Paulo, São Paulo, Brazil.,Federal University of Fronteira Sul, Realeza, Paraná, Brazil
| | - M Pedrazzoli
- School of Arts, Sciences, and Humanities, University of São Paulo, São Paulo, São Paulo, Brazil
| | - K L Knutson
- Northwestern University Feinberg School of Medicine, Chicago, Illinois, USA
| | - J E Krieger
- Incor, University of São Paulo School of Medicine, São Paulo, São Paulo, Brazil
| | - H P Vallada
- Department of Psychiatry, University of São Paulo School of Medicine, São Paulo, São Paulo, Brazil
| | - A Sterr
- Faculty of Health and Medical Sciences, University of Surrey, Guildford, Surrey, UK
| | - A C Pereira
- Incor, University of São Paulo School of Medicine, São Paulo, São Paulo, Brazil
| | - A B Negrão
- Department of Psychiatry, University of São Paulo School of Medicine, São Paulo, São Paulo, Brazil.,Incor, University of São Paulo School of Medicine, São Paulo, São Paulo, Brazil
| | - M von Schantz
- Faculty of Health and Medical Sciences, University of Surrey, Guildford, Surrey, UK
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25
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Sun D, Richard MA, Musani SK, Sung YJ, Winkler TW, Schwander K, Chai JF, Guo X, Kilpeläinen TO, Vojinovic D, Aschard H, Bartz TM, Bielak LF, Brown MR, Chitrala K, Hartwig FP, Horimoto AR, Liu Y, Manning AK, Noordam R, Smith AV, Harris SE, Kühnel B, Lyytikäinen LP, Nolte IM, Rauramaa R, van der Most PJ, Wang R, Ware EB, Weiss S, Wen W, Yanek LR, Arking DE, Arnett DK, Barac A, Boerwinkle E, Broeckel U, Chakravarti A, Chen YDI, Cupples LA, Davigulus ML, de las Fuentes L, de Mutsert R, de Vries PS, Delaney JA, Diez Roux AV, Dörr M, Faul JD, Fretts AM, Gallo LC, Grabe HJ, Gu CC, Harris TB, Hartman CC, Heikkinen S, Ikram MA, Isasi C, Johnson WC, Jonas JB, Kaplan RC, Komulainen P, Krieger JE, Levy D, Liu J, Lohman K, Luik AI, Martin LW, Meitinger T, Milaneschi Y, O’Connell JR, Palmas WR, Peters A, Peyser PA, Pulkki-Råback L, Raffel LJ, Reiner AP, Rice K, Robinson JG, Rosendaal FR, Schmidt CO, Schreiner PJ, Schwettmann L, Shikany JM, Shu XO, Sidney S, Sims M, Smith JA, Sotoodehnia N, Strauch K, Tai ES, Taylor KD, Uitterlinden AG, van Duijn CM, Waldenberger M, Wee HL, Wei WB, Wilson G, Xuan D, Yao J, Zeng D, Zhao W, Zhu X, Zonderman AB, Becker DM, Deary IJ, Gieger C, Lakka TA, Lehtimäki T, North KE, Oldehinkel AJ, Penninx BW, Snieder H, Wang YX, Weir DR, Zheng W, Evans MK, Gauderman WJ, Gudnason V, Horta BL, Liu CT, Mook-Kanamori DO, Morrison AC, Pereira AC, Psaty BM, Amin N, Fox ER, Kooperberg C, Sim X, Bierut L, Rotter JI, Kardia SL, Franceschini N, Rao DC, Fornage M. Multi-Ancestry Genome-wide Association Study Accounting for Gene-Psychosocial Factor Interactions Identifies Novel Loci for Blood Pressure Traits. HGG Adv 2021; 2:100013. [PMID: 34734193 PMCID: PMC8562625 DOI: 10.1016/j.xhgg.2020.100013] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [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] [Subscribe] [Scholar Register] [Indexed: 12/12/2022] Open
Abstract
Psychological and social factors are known to influence blood pressure (BP) and risk of hypertension and associated cardiovascular diseases. To identify novel BP loci, we carried out genome-wide association meta-analyses of systolic, diastolic, pulse, and mean arterial BP taking into account the interaction effects of genetic variants with three psychosocial factors: depressive symptoms, anxiety symptoms, and social support. Analyses were performed using a two-stage design in a sample of up to 128,894 adults from 5 ancestry groups. In the combined meta-analyses of Stages 1 and 2, we identified 59 loci (p value <5e-8), including nine novel BP loci. The novel associations were observed mostly with pulse pressure, with fewer observed with mean arterial pressure. Five novel loci were identified in African ancestry, and all but one showed patterns of interaction with at least one psychosocial factor. Functional annotation of the novel loci supports a major role for genes implicated in the immune response (PLCL2), synaptic function and neurotransmission (LIN7A, PFIA2), as well as genes previously implicated in neuropsychiatric or stress-related disorders (FSTL5, CHODL). These findings underscore the importance of considering psychological and social factors in gene discovery for BP, especially in non-European populations.
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Affiliation(s)
- Daokun Sun
- Brown Foundation Institute of Molecular Medicine, McGovern Medical School, University of Texas Health Science Center at Houston, Houston, TX 77030, USA
| | - Melissa A. Richard
- Brown Foundation Institute of Molecular Medicine, McGovern Medical School, University of Texas Health Science Center at Houston, Houston, TX 77030, USA
| | - Solomon K. Musani
- Department of Medicine, University of Mississippi Medical Center, Jackson, MS 39216, USA
| | - Yun Ju Sung
- Division of Biostatistics, Washington University School of Medicine, St. Louis, MO 63110, USA
| | - Thomas W. Winkler
- Department of Genetic Epidemiology, University of Regensburg, Regensburg 93040, Germany
| | - Karen Schwander
- Division of Biostatistics, Washington University School of Medicine, St. Louis, MO 63110, USA
| | - Jin Fang Chai
- Saw Swee Hock School of Public Health, National University of Singapore and National University Health System, Singapore 119228, Singapore
| | - Xiuqing Guo
- The Institute for Translational Genomics and Population Sciences, Department of Pediatrics, The Lundquist Institute for Biomedical Innovation at Harbor-UCLA Medical Center, Torrance, CA 90502, USA
| | - Tuomas O. Kilpeläinen
- Novo Nordisk Foundation Center for Basic Metabolic Research, Faculty of Health and Medical Sciences, University of Copenhagen, Copenhagen 2200, Denmark
- Department of Environmental Medicine and Public Health, The Icahn School of Medicine at Mount Sinai, New York, NY 10029, USA
| | - Dina Vojinovic
- Department of Epidemiology, Erasmus University Medical Center, Rotterdam 3000 CA, the Netherlands
| | - Hugues Aschard
- Department of Epidemiology, Harvard School of Public Health, Boston, MA 02115, USA
- Département de Génomes et Génétique, Institut Pasteur, Paris 75015, France
| | - Traci M. Bartz
- Cardiovascular Health Research Unit, Biostatistics and Medicine, University of Washington, Seattle, WA 98195, USA
| | - Lawrence F. Bielak
- Department of Epidemiology, School of Public Health, University of Michigan, Ann Arbor, MI 48108, USA
| | - Michael R. Brown
- 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 77030, USA
| | - Kumaraswamy Chitrala
- Health Disparities Research Section, Laboratory of Epidemiology and Population Sciences, National Institute on Aging, National Institutes of Health, Baltimore, MD 20892, USA
| | - Fernando P. Hartwig
- Postgraduate Programme in Epidemiology, Federal University of Pelotas, Pelotas RS 96010-610, Brazil
- Medical Research Council Integrative Epidemiology Unit, University of Bristol, Bristol BS8 1TH, UK
| | - Andrea R.V.R. Horimoto
- Laboratory of Genetics and Molecular Cardiology, Heart Institute (InCor), University of São Paulo Medical School, São Paulo 01246-903, Brazil
| | - Yongmei Liu
- Division of Cardiology, Department of Medicine, Duke Molecular Physiology Institute, Duke University School of Medicine, Durham, NC 27701, USA
| | - Alisa K. Manning
- Clinical and Translational Epidemiology Unit, Massachusetts General Hospital, Boston, MA 02114, USA
- Department of Medicine, Harvard Medical School, Boston, MA 02115, USA
| | - Raymond Noordam
- Section of Gerontology and Geriatrics, Department of Internal Medicine, Leiden University Medical Center, Leiden 2311 EZ, the Netherlands
| | - Albert V. Smith
- Department of Biostatistics, University of Michigan, Ann Arbor, MI 48108, USA
- Icelandic Heart Association, Kopavogur 201, Iceland
| | - Sarah E. Harris
- Department of Psychology, Centre for Cognitive Ageing and Cognitive Epidemiology, The University of Edinburgh, Edinburgh EH8 9JZ, UK
- Centre for Cognitive Ageing and Cognitive Epidemiology, The University of Edinburgh, Edinburgh EH8 9JZ, UK
| | - Brigitte Kühnel
- Research Unit of Molecular Epidemiology, Helmholtz Zentrum München, German Research Center for Environmental Health, Neuherberg 85764, Germany
- Institute of Epidemiology, Helmholtz Zentrum München, German Research Center for Environmental Health, Neuherberg 85764, Germany
| | - Leo-Pekka Lyytikäinen
- Department of Clinical Chemistry, Fimlab Laboratories, Tampere 33101, Finland
- Department of Clinical Chemistry, Finnish Cardiovascular Research Center - Tampere, Faculty of Medicine and Life Sciences, University of Tampere, Tampere 33101, Finland
| | - Ilja M. Nolte
- Department of Epidemiology, University of Groningen, University Medical Center Groningen, Groningen 9713 GZ, the Netherlands
| | - Rainer Rauramaa
- Foundation for Research in Health Exercise and Nutrition, Kuopio Research Institute of Exercise Medicine, Kuopio 70100, Finland
| | - Peter J. van der Most
- Department of Epidemiology, University of Groningen, University Medical Center Groningen, Groningen 9713 GZ, the Netherlands
| | - Rujia Wang
- Department of Epidemiology, University of Groningen, University Medical Center Groningen, Groningen 9713 GZ, the Netherlands
| | - Erin B. Ware
- Survey Research Center, Institute for Social Research, University of Michigan, Ann Arbor, MI 48104, USA
| | - Stefan Weiss
- Interfaculty Institute for Genetics and Functional Genomics, University Medicine Greifswald, Greifswald 17489, Germany
- DZHK (German Centre for Cardiovascular Health), Partner Site Greifswald, Greifswald 17475, Germany
| | - Wanqing Wen
- Division of Epidemiology, Department of Medicine, Vanderbilt University School of Medicine, Nashville, TN 37232, USA
| | - Lisa R. Yanek
- Division of General Internal Medicine, Department of Medicine, Johns Hopkins University School of Medicine, Baltimore, MD 21205, USA
| | - Dan E. Arking
- McKusick-Nathans Institute of Genetic Medicine, Johns Hopkins University School of Medicine, Baltimore, MD 21205, USA
| | - Donna K. Arnett
- Dean’s Office, University of Kentucky College of Public Health, Lexington, KY 40563, USA
| | - Ana Barac
- MedStar Heart and Vascular Institute, Washington, DC 20010, 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 77030, USA
- Human Genome Sequencing Center, Baylor College of Medicine, Houston, TX 77030, USA
| | - Ulrich Broeckel
- Section of Genomic Pediatrics, Department of Pediatrics, Medicine and Physiology, Medical College of Wisconsin, Milwaukee, WI 53226, USA
| | - Aravinda Chakravarti
- Center for Human Genetics and Genomics, New York University School of Medicine, New York, NY 10016, USA
| | - Yii-Der Ida Chen
- The Institute for Translational Genomics and Population Sciences, Department of Pediatrics, The Lundquist Institute for Biomedical Innovation at Harbor-UCLA Medical Center, Torrance, CA 90502, USA
| | - L. Adrienne Cupples
- Department of Biostatistics, Boston University School of Public Health, Boston, MA 02118, USA
- NHLBI Framingham Heart Study, Framingham, MA 01702, USA
| | - Martha L. Davigulus
- Division of Minority Health, Department of Epidemiology, University of Illinois, Chicago, IL, USA
| | - Lisa de las Fuentes
- Division of Biostatistics, Washington University School of Medicine, St. Louis, MO 63110, USA
- Cardiovascular Division, Department of Medicine, Washington University, St. Louis, MO, USA
| | - Renée de Mutsert
- Department of Clinical Epidemiology, Leiden University Medical Center, Leiden 2311 EZ, the Netherlands
| | - Paul S. de Vries
- 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 77030, USA
| | | | - Ana V. Diez Roux
- Department of Epidemiology and Biostatistics, Drexel University, Philadelphia, PA 19104, USA
| | - Marcus Dörr
- DZHK (German Centre for Cardiovascular Health), Partner Site Greifswald, Greifswald 17475, Germany
- Department of Internal Medicine B, University Medicine Greifswald, Greifswald 17489, Germany
| | - Jessica D. Faul
- Survey Research Center, Institute for Social Research, University of Michigan, Ann Arbor, MI 48104, USA
| | - Amanda M. Fretts
- Cardiovascular Health Research Unit, Epidemiology, Medicine, and Health Services, University of Washington, Seattle, WA 98195, USA
| | - Linda C. Gallo
- Department of Psychology, San Diego State University, San Diego, CA 92182, USA
| | - Hans Jörgen Grabe
- DZHK (German Centre for Cardiovascular Health), Partner Site Greifswald, Greifswald 17475, Germany
- Department Psychiatry and Psychotherapy, University Medicine Greifswald, Greifswald 17489, Germany
| | - C. Charles Gu
- Division of Biostatistics, Washington University School of Medicine, St. Louis, MO 63110, USA
| | - Tamara B. Harris
- Laboratory of Epidemiology and Population Sciences, National Institute on Aging, National Institutes of Health, Bethesda, MD 20892, USA
| | - Catharina C.A. Hartman
- Interdisciplinary Center Psychopathology and Emotion Regulation, University of Groningen, University Medical Center Groningen, Groningen 9713 GZ, the Netherlands
| | - Sami Heikkinen
- Institute of Clinical Medicine, Internal Medicine, University of Eastern Finland, Kuopio 70100, Finland
- Institute of Biomedicine, School of Medicine, University of Eastern Finland, Kuopio Campus 70100, Finland
| | - M. Arfan Ikram
- Department of Epidemiology, Erasmus University Medical Center, Rotterdam 3000 CA, the Netherlands
- Department of Neurology, Erasmus University Medical Center, Rotterdam 3000 CA, the Netherlands
| | - Carmen Isasi
- Department of Epidemiology and Population Health, Albert Einstein College of Medicine, New York, NY 10461, USA
| | - W. Craig Johnson
- Department of Biostatistics, University of Washington, Seattle, WA 98195, USA
| | - Jost Bruno Jonas
- Department of Ophthalmology, Medical Faculty Mannheim, University Heidelberg, Mannheim 68167, Germany
- Beijing Institute of Ophthalmology, Beijing Ophthalmology and Visual Science Key Lab, Beijing Tongren Eye Center, Capital Medical University, Beijing, China
| | - Robert C. Kaplan
- Department of Epidemiology and Population Health, Albert Einstein College of Medicine, New York, NY 10461, USA
- Division of Public Health Sciences, Fred Hutchinson Cancer Research Center, Seattle, WA 98109, USA
| | - Pirjo Komulainen
- Foundation for Research in Health Exercise and Nutrition, Kuopio Research Institute of Exercise Medicine, Kuopio 70100, Finland
| | - Jose E. Krieger
- Laboratory of Genetics and Molecular Cardiology, Heart Institute (InCor), University of São Paulo Medical School, São Paulo 01246-903, Brazil
| | - Daniel Levy
- NHLBI Framingham Heart Study, Framingham, MA 01702, USA
- Department of Medicine, Boston University, Boston, MA 02118, USA
| | | | - Jianjun Liu
- Genome Institute of Singapore, Agency for Science Technology and Research, Singapore 138632, Singapore
| | - Kurt Lohman
- Division of Cardiology, Department of Medicine, Duke Molecular Physiology Institute, Duke University School of Medicine, Durham, NC 27701, USA
| | - Annemarie I. Luik
- Department of Epidemiology, Erasmus University Medical Center, Rotterdam 3000 CA, the Netherlands
| | - Lisa W. Martin
- Division of Cardiology, George Washington University School of Medicine and Health Sciences, Washington, DC 20052, USA
| | - Thomas Meitinger
- Institute of Human Genetics, Helmholtz Zentrum München, German Research Center for Environmental Health, Neuherberg 85764, Germany
- Institute of Human Genetics, Technische Universität München, Munich 81675, Germany
| | - Yuri Milaneschi
- Department of Psychiatry, Amsterdam Neuroscience and Amsterdam Public Health Research Institute, VU University Medical Center, Amsterdam 1081 HV, the Netherlands
| | - Jeff R. O’Connell
- Division of Endocrinology, Diabetes, and Nutrition, University of Maryland School of Medicine, Baltimore, MD 21201, USA
- Program for Personalized and Genomic Medicine, University of Maryland School of Medicine, Baltimore, MD 21201, USA
| | - Walter R. Palmas
- Division of General Medicine, Department of Medicine, Columbia University Medical Center, New York, NY 10032, USA
| | - Annette Peters
- Institute of Epidemiology, Helmholtz Zentrum München, German Research Center for Environmental Health, Neuherberg 85764, Germany
- DZHK (German Centre for Cardiovascular Research), Partner Site Munich Heart Alliance, Neuherberg 85764, Germany
| | - Patricia A. Peyser
- Department of Epidemiology, School of Public Health, University of Michigan, Ann Arbor, MI 48108, USA
| | - Laura Pulkki-Råback
- Faculty of Medicine, Department of Psychology and Logopedics, University of Helsinki, Helsinki 0100, Finland
| | - Leslie J. Raffel
- Division of Genetic and Genomic Medicine, Department of Pediatrics, University of California, Irvine, Irvine, CA 92697, USA
| | - Alex P. Reiner
- Division of Public Health Sciences, Fred Hutchinson Cancer Research Center, Seattle, WA 98109, USA
| | - Kenneth Rice
- Department of Biostatistics, University of Washington, Seattle, WA 98195, USA
| | - Jennifer G. Robinson
- Departments of Epidemiology and Medicine, University of Iowa, Iowa City, IA 52242, USA
| | - Frits R. Rosendaal
- Department of Clinical Epidemiology, Leiden University Medical Center, Leiden 2311 EZ, the Netherlands
| | - Carsten Oliver Schmidt
- DZHK (German Centre for Cardiovascular Health), Partner Site Greifswald, Greifswald 17475, Germany
- Institute for Community Medicine, University Medicine Greifswald, Greifswald 17489, Germany
| | - Pamela J. Schreiner
- Division of Epidemiology & Community Health, School of Public Health, University of Minnesota, Minneapolis, MN 55455, USA
| | - Lars Schwettmann
- Institute of Health Economics and Health Care Management, Helmholtz Zentrum München, German Research Center for Environmental Health, Neuherberg 85764, Germany
| | - James M. Shikany
- Division of Preventive Medicine, School of Medicine, University of Alabama at Birmingham, Birmingham, AL 35294, USA
| | - Xiao-ou Shu
- Division of Epidemiology, Department of Medicine, Vanderbilt University School of Medicine, Nashville, TN 37232, USA
| | - Stephen Sidney
- Division of Research, Kaiser Permanente of Northern California, Oakland, CA 94612, USA
| | - Mario Sims
- Department of Medicine, University of Mississippi Medical Center, Jackson, MS 39216, USA
| | - Jennifer A. Smith
- Department of Epidemiology, School of Public Health, University of Michigan, Ann Arbor, MI 48108, USA
- Survey Research Center, Institute for Social Research, University of Michigan, Ann Arbor, MI 48104, USA
| | - Nona Sotoodehnia
- Cardiovascular Health Research Unit, Division of Cardiology, University of Washington, Seattle, WA 98195, USA
| | - Konstantin Strauch
- Institute of Genetic Epidemiology, Helmholtz Zentrum München, German Research Center for Environmental Health, Neuherberg 85764, Germany
- Institute of Medical Informatics, Biometry, and Epidemiology, Ludwig-Maximilians-Universitat Munchen, Munich, 80539 Germany
| | - E. Shyong Tai
- Saw Swee Hock School of Public Health, National University of Singapore and National University Health System, Singapore 119228, Singapore
- Department of Medicine, Yong Loo Lin School of Medicine, National University of Singapore, Singapore 119077, Singapore
| | - Kent D. Taylor
- The Institute for Translational Genomics and Population Sciences, Department of Pediatrics, The Lundquist Institute for Biomedical Innovation at Harbor-UCLA Medical Center, Torrance, CA 90502, USA
| | - André G. Uitterlinden
- Department of Epidemiology, Erasmus University Medical Center, Rotterdam 3000 CA, the Netherlands
- Department of Internal Medicine, Erasmus University Medical Center, Rotterdam 3000 CA, the Netherlands
| | - Cornelia M. van Duijn
- Department of Epidemiology, Erasmus University Medical Center, Rotterdam 3000 CA, the Netherlands
- Nuffield Department of Population Health, University of Oxford, Oxford OX3 7LF, UK
| | - Melanie Waldenberger
- Research Unit of Molecular Epidemiology, Helmholtz Zentrum München, German Research Center for Environmental Health, Neuherberg 85764, Germany
- Institute of Epidemiology, Helmholtz Zentrum München, German Research Center for Environmental Health, Neuherberg 85764, Germany
- German Center for Cardiovascular Research (DZHK), Partner Site Munich Heart Alliance, Munich 85764, Germany
| | - Hwee-Lin Wee
- Saw Swee Hock School of Public Health, National University of Singapore and National University Health System, Singapore 119228, Singapore
- Department of Pharmacy, Faculty of Science, National University of Singapore, Singapore 119077, Singapore
| | - Wen-Bin Wei
- Beijing Tongren Eye Center, Beijing Tongren Hospital, Capital Medical University, Beijing, China
| | - Gregory Wilson
- Jackson Heart Study, School of Public Health, Jackson State University, Jackson, MS 39217, USA
| | - Deng Xuan
- Department of Biostatistics, Boston University School of Public Health, Boston, MA 02118, USA
| | - Jie Yao
- The Institute for Translational Genomics and Population Sciences, Department of Pediatrics, The Lundquist Institute for Biomedical Innovation at Harbor-UCLA Medical Center, Torrance, CA 90502, USA
| | - Donglin Zeng
- Department of Biostatistics, University of North Carolina Gilling School of Global Public Health, Chapel Hill, NC 27599, USA
| | - Wei Zhao
- Department of Epidemiology, School of Public Health, University of Michigan, Ann Arbor, MI 48108, USA
| | - Xiaofeng Zhu
- Department of Epidemiology and Biostatistics, Case Western Reserve University, Cleveland, OH 44106, USA
| | - Alan B. Zonderman
- Behavioral Epidemiology Section, Laboratory of Epidemiology and Population Sciences, National Institute on Aging, National Institutes of Health, Baltimore, MD 21201, USA
| | - Diane M. Becker
- Division of General Internal Medicine, Department of Medicine, Johns Hopkins University School of Medicine, Baltimore, MD 21205, USA
| | - Ian J. Deary
- Department of Psychology, Centre for Cognitive Ageing and Cognitive Epidemiology, The University of Edinburgh, Edinburgh EH8 9JZ, UK
- Centre for Cognitive Ageing and Cognitive Epidemiology, The University of Edinburgh, Edinburgh EH8 9JZ, UK
| | - Christian Gieger
- Research Unit of Molecular Epidemiology, Helmholtz Zentrum München, German Research Center for Environmental Health, Neuherberg 85764, Germany
- Institute of Epidemiology, Helmholtz Zentrum München, German Research Center for Environmental Health, Neuherberg 85764, Germany
- German Center for Diabetes Research (DZD e.V.), Neuherberg 85764, Germany
| | - Timo A. Lakka
- Foundation for Research in Health Exercise and Nutrition, Kuopio Research Institute of Exercise Medicine, Kuopio 70100, Finland
- Institute of Biomedicine, School of Medicine, University of Eastern Finland, Kuopio Campus, Kuopio 70211, Finland
- Department of Clinical Physiology and Nuclear Medicine, Kuopio University Hospital, Kuopio 70211, Finland
| | - Terho Lehtimäki
- Department of Clinical Chemistry, Fimlab Laboratories, Tampere 33101, Finland
- Department of Clinical Chemistry, Finnish Cardiovascular Research Center - Tampere, Faculty of Medicine and Health Technology, University of Tampere, Tampere 33100, Finland
| | - Kari E. North
- Department of Epidemiology, University of North Carolina Gillings School of Global Public Health, Chapel Hill, NC 27516, USA
| | - Albertine J. Oldehinkel
- Interdisciplinary Center Psychopathology and Emotion Regulation, University of Groningen, University Medical Center Groningen, Groningen 9713 GZ, the Netherlands
| | - Brenda W.J.H. Penninx
- Department of Psychiatry, Amsterdam Neuroscience and Amsterdam Public Health Research Institute, VU University Medical Center, Amsterdam 1081 HV, the Netherlands
| | - Harold Snieder
- Department of Epidemiology, University of Groningen, University Medical Center Groningen, Groningen 9713 GZ, the Netherlands
| | - Ya-Xing Wang
- Beijing Institute of Ophthalmology, Beijing Tongren Eye Center, Beijing Ophthalmology and Visual Science Key Lab, Beijing Tongren Hospital, Capital Medical University, Beijing, China
| | - David R. Weir
- Survey Research Center, Institute for Social Research, University of Michigan, Ann Arbor, MI 48104, USA
| | - Wei Zheng
- Division of Epidemiology, Department of Medicine, Vanderbilt University School of Medicine, Nashville, TN 37232, USA
| | - Michele K. Evans
- Health Disparities Research Section, Laboratory of Epidemiology and Population Sciences, National Institute on Aging, National Institutes of Health, Baltimore, MD 20892, USA
| | - W. James Gauderman
- Biostatistics, Preventive Medicine, University of Southern California, Los Angeles, CA 90007, USA
| | - Vilmundur Gudnason
- Icelandic Heart Association, Kopavogur 201, Iceland
- Faculty of Medicine, University of Iceland, Reykjavik 102, Iceland
| | - Bernardo L. Horta
- Postgraduate Programme in Epidemiology, Federal University of Pelotas, Pelotas RS 96010-610, Brazil
| | - Ching-Ti Liu
- Department of Biostatistics, Boston University School of Public Health, Boston, MA 02118, USA
| | - Dennis O. Mook-Kanamori
- Department of Clinical Epidemiology, Leiden University Medical Center, Leiden 2311 EZ, the Netherlands
- Department of Public Health and Primary Care, Leiden University Medical Center, Leiden 2311 EZ, the Netherlands
| | - Alanna C. Morrison
- 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 77030, USA
| | - Alexandre C. Pereira
- Laboratory of Genetics and Molecular Cardiology, Heart Institute (InCor), University of São Paulo Medical School, São Paulo 01246-903, Brazil
| | - Bruce M. Psaty
- Cardiovascular Health Research Unit, Epidemiology, Medicine, and Health Services, University of Washington, Seattle, WA 98195, USA
- Kaiser Permanente Washington Health Research Institute, Seattle, WA 98101, USA
| | - Najaf Amin
- Department of Epidemiology, Erasmus University Medical Center, Rotterdam 3000 CA, the Netherlands
| | - Ervin R. Fox
- Department of Medicine, University of Mississippi Medical Center, Jackson, MS 39216, USA
| | - Charles Kooperberg
- Division of Public Health Sciences, Fred Hutchinson Cancer Research Center, Seattle, WA 98109, USA
| | - Xueling Sim
- Saw Swee Hock School of Public Health, National University of Singapore and National University Health System, Singapore 119228, Singapore
| | - Laura Bierut
- Department of Psychiatry, Washington University School of Medicine, St. Louis, MO 63110, USA
| | - Jerome I. Rotter
- The Institute for Translational Genomics and Population Sciences, Department of Pediatrics, The Lundquist Institute for Biomedical Innovation at Harbor-UCLA Medical Center, Torrance, CA 90502, USA
| | - Sharon L.R. Kardia
- Department of Epidemiology, School of Public Health, University of Michigan, Ann Arbor, MI 48108, USA
| | - Nora Franceschini
- Department of Epidemiology, University of North Carolina Gillings School of Global Public Health, Chapel Hill, NC 27516, USA
| | - Dabeeru C. Rao
- Division of Biostatistics, Washington University School of Medicine, St. Louis, MO 63110, USA
| | - Myriam Fornage
- Brown Foundation Institute of Molecular Medicine, McGovern Medical School, University of Texas Health Science Center at Houston, Houston, TX 77030, USA
- 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 77030, USA
- Corresponding author
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26
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Coutinho ER, Miname MH, Rocha VZ, Bittencourt MS, Jannes CE, Tada MT, Lima IR, Filho WS, Chacra AP, Pereira AC, Krieger JE, Santos RD. Familial hypercholesterolemia and cardiovascular disease in older individuals. Atherosclerosis 2020; 318:32-37. [PMID: 33450476 DOI: 10.1016/j.atherosclerosis.2020.12.012] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.8] [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: 08/10/2020] [Revised: 12/09/2020] [Accepted: 12/16/2020] [Indexed: 12/29/2022]
Abstract
BACKGROUND AND AIMS Familial hypercholesterolemia (FH) is characterized by high LDL-cholesterol (LDL-C) and early atherosclerotic cardiovascular disease (ASCVD). With a lipid lowering therapy (LLT), most individuals with FH may have a longer ASCVD-free survival. However, there is scant data about older individuals with FH. METHODS We compared characteristics of genetically defined FH older individuals with age-matched non-FH counterparts. RESULTS From 4111 genotyped individuals, 462 older than 60 years were included (198 positive and 264 negative for FH variants). There were no differences regarding median age [%25; 75%] 66.0 (62.0; 71.0) and 66.0 (62.2; 71.0) years, p = 0.68 for FH and non-FH, respectively. In both groups, there was a higher frequency of females, however, there were more males in the FH group 37.4% vs. 24.2%, p = 0.002. No differences were seen between FH and non-FH in LLT use: 88.5% vs. 91.5%, p = 0.29. Despite a longer LLT duration in FH patients (with 11.0 (7.0; 20.0) vs. 7.0 (3.0; 13.0) years, p < 0.001), treatment was started late in both groups: at 54.0 (47.0; 61.0) and 59.0 (52.0; 64.0) years, p < 0.001, in FH and non-FH, respectively. FH had greater frequencies of previous and early ASCVD (40.9% vs. 27.3%, p = 0.002, and 22.2% vs. 9.0%, p < 0.001). In FH, male sex [HR (95%CI)] 2.67 (1.50-4.73), p = 0.001, and LLT onset age 0.96 (0.93-0.99), p = 0.009, were independently associated with ASCVD. CONCLUSIONS Among hypercholesterolemic older individuals participating in a cascade screening program, the genetic diagnosis of FH was associated with higher ASCVD rates, emphasizing the relevance of a monogenic defect as the cause of long-lasting hypercholesterolemia and ASCVD risk, particularly in men.
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Affiliation(s)
- Elaine R Coutinho
- Heart Institute (InCor), University of São Paulo, Medical School Hospital (FMUSP), Sao Paulo, Brazil
| | - Marcio H Miname
- Heart Institute (InCor), University of São Paulo, Medical School Hospital (FMUSP), Sao Paulo, Brazil
| | - Viviane Z Rocha
- Heart Institute (InCor), University of São Paulo, Medical School Hospital (FMUSP), Sao Paulo, Brazil
| | - Marcio S Bittencourt
- Center for Clinical and Epidemiological Research, University Hospital, University of Sao Paulo, Sao Paulo, Brazil
| | - Cinthia E Jannes
- Heart Institute (InCor), University of São Paulo, Medical School Hospital (FMUSP), Sao Paulo, Brazil
| | - Mauricio T Tada
- Heart Institute (InCor), University of São Paulo, Medical School Hospital (FMUSP), Sao Paulo, Brazil
| | - Isabella R Lima
- Heart Institute (InCor), University of São Paulo, Medical School Hospital (FMUSP), Sao Paulo, Brazil
| | - Wilson Salgado Filho
- Heart Institute (InCor), University of São Paulo, Medical School Hospital (FMUSP), Sao Paulo, Brazil
| | - Ana P Chacra
- Heart Institute (InCor), University of São Paulo, Medical School Hospital (FMUSP), Sao Paulo, Brazil
| | - Alexandre C Pereira
- Heart Institute (InCor), University of São Paulo, Medical School Hospital (FMUSP), Sao Paulo, Brazil
| | - Jose E Krieger
- Heart Institute (InCor), University of São Paulo, Medical School Hospital (FMUSP), Sao Paulo, Brazil
| | - Raul D Santos
- Heart Institute (InCor), University of São Paulo, Medical School Hospital (FMUSP), Sao Paulo, Brazil; Academic Research Organization, Hospital Israelita Albert Einstein, Sao Paulo, Brazil.
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27
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Crestani T, Steichen C, Neri E, Rodrigues M, Fonseca-Alaniz MH, Ormrod B, Holt MR, Pandey P, Harding S, Ehler E, Krieger JE. Electrical stimulation applied during differentiation drives the hiPSC-CMs towards a mature cardiac conduction-like cells. Biochem Biophys Res Commun 2020; 533:376-382. [PMID: 32962862 DOI: 10.1016/j.bbrc.2020.09.021] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/04/2020] [Accepted: 09/07/2020] [Indexed: 12/13/2022]
Abstract
Human induced pluripotent stem cell derived cardiomyocytes (hiPSC-CMs) resemble fetal cardiomyocytes and electrical stimulation (ES) has been explored to mature the differentiated cells. Here, we hypothesize that ES applied at the beginning of the differentiation process, triggers both differentiation of the hiPSC-CMs into a specialized conduction system (CS) phenotype and cell maturation. We applied ES for 15 days starting on day 0 of the differentiation process and found an increased expression of transcription factors and proteins associated with the development and function of CS including Irx3, Nkx2.5 and contactin 2, Hcn4 and Scn5a, respectively. We also found activation of intercalated disc proteins (Nrap and β-catenin). We detected ES-induced CM maturation as indicated by increased Tnni1 and Tnni3 expression. Confocal micrographs showed a shift towards expression of the gap junction protein connexin 40 in ES hiPSC-CM compared to the more dominant expression of connexin 43 in controls. Finally, analysis of functional parameters revealed that ES hiPSC-CMs exhibited faster action potential (AP) depolarization, longer intracellular Ca2+ transients, and slower AP duration at 90% of repolarization, resembling fast conducting fibers. Altogether, we provided evidence that ES during the differentiation of hiPSC to cardiomyocytes lead to development of cardiac conduction-like cells with more mature cytoarchitecture. Thus, hiPSC-CMs exposed to ES during differentiation can be instrumental to develop CS cells for cardiac disease modelling, screening individual drugs on a precison medicine type platform and support the development of novel therapeutics for arrhythmias.
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Affiliation(s)
- Thayane Crestani
- Heart Institute (InCor), University of São Paulo Medical School, São Paulo, SP, Brazil
| | - Clara Steichen
- Heart Institute (InCor), University of São Paulo Medical School, São Paulo, SP, Brazil
| | - Elida Neri
- Heart Institute (InCor), University of São Paulo Medical School, São Paulo, SP, Brazil
| | - Mariliza Rodrigues
- Heart Institute (InCor), University of São Paulo Medical School, São Paulo, SP, Brazil
| | | | - Beth Ormrod
- School of Cardiovascular Medicine and Sciences, BHF Research Excellence Centre, King's College London, UK; Randall Centre for Cell and Molecular Biophysics (School of Basic and Medical Biosciences, King's College London), UK
| | - Mark R Holt
- School of Cardiovascular Medicine and Sciences, BHF Research Excellence Centre, King's College London, UK; Randall Centre for Cell and Molecular Biophysics (School of Basic and Medical Biosciences, King's College London), UK
| | - Pragati Pandey
- National Heart and Lung Institute, Imperial College London, UK
| | - Sian Harding
- National Heart and Lung Institute, Imperial College London, UK
| | - Elisabeth Ehler
- School of Cardiovascular Medicine and Sciences, BHF Research Excellence Centre, King's College London, UK; Randall Centre for Cell and Molecular Biophysics (School of Basic and Medical Biosciences, King's College London), UK
| | - Jose E Krieger
- Heart Institute (InCor), University of São Paulo Medical School, São Paulo, SP, Brazil.
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28
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Pereira RF, Rebelo MS, Moreno RA, Marco AG, Lima DM, Arruda MAF, Krieger JE, Gutierrez MA. Fully Automated Quantification of Cardiac Indices from Cine MRI Using a Combination of Convolution Neural Networks. Annu Int Conf IEEE Eng Med Biol Soc 2020; 2020:1221-1224. [PMID: 33018207 DOI: 10.1109/embc44109.2020.9176166] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
Abstract
Cardiovascular magnetic resonance imaging (CMRI) is one of the most accurate non-invasive modalities for evaluation of cardiac function, especially the left ventricle (LV). In this modality, the manual or semi-automatic delineation of LV by experts is currently the standard clinical practice for chambers segmentation. Despite these efforts, global quantification of LV remains a challenge. In this work, a combination of two convolutional neural network (CNN) architectures for quantitative evaluation of the LV is described, which estimates the cavity and the myocardium areas, endocardial cavity dimensions in three directions, and the myocardium regional wall thickness in six radial directions. The method was validated in CMRI exams of 56 patients (LVQuan19 dataset) and evaluated by metrics Dice Index, Mean Absolute Error, and Correlation with superior performance compared to the state-of-the-art methods. The combination of the CNN architectures provided a simpler yet fully automated approach, requiring no specialist interaction.Clinical Relevance- With the proposed method, it is possible to perform automatically the full quantification of regional clinically relevant parameters of the left ventricle in short-axis CMRI images with superior performance compared to state-of-the-art methods.
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29
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Sacilotto L, Scanavacca MI, Olivetti N, Lemes C, Pessente GD, Wulkan F, Hachul DT, Krieger JE, Pereira AC, Darrieux FCC. Low rate of life-threatening events and limitations in predicting invasive and noninvasive markers of symptoms in a cohort of type 1 Brugada syndrome patients: Data and insights from the GenBra registry. J Cardiovasc Electrophysiol 2020; 31:2920-2928. [PMID: 32870538 DOI: 10.1111/jce.14732] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [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: 06/12/2020] [Revised: 08/03/2020] [Accepted: 08/08/2020] [Indexed: 12/31/2022]
Abstract
BACKGROUND Brugada syndrome (BrS) has diagnostic challenges and controversial risk assessment. We aimed to investigate invasive and noninvasive parameters in symptomatic and asymptomatic patients from a Brazilian cohort of type-1 BrS. METHODS Patients with spontaneous and drug-induced type-1 BrS were classified into two groups, asymptomatic (n = 116, 84.1%) and symptomatic (n = 22, 15.9%; 13 with arrhythmogenic syncope, 9 with aborted sudden cardiac death). Genetic testing, EPS parameters, and electrocardiogram (ECG) parameters were analyzed. RESULTS A total of 138 consecutive patients were eligible, 101 men (73.2%), mean 41.4 years, mostly probands (79%). Spontaneous pattern, observed in 77.5% of the patients, was associated with symptoms only if expressed in V1 and V2 standard position (not high precordial leads; p = .014). All symptomatic patients were probands. The presence of right ventricular outflow tract conduction delay (RVOTcd) signs, positive EPS, and SCN5A status was similar between symptomatic and asymptomatic subjects. During the mean 75-month follow-up, eight patients had appropriate therapies. All had spontaneous type-1 ECG pattern and 2/8 (25%) were asymptomatic, with positive EPS. The overall LAE incidence of 1.1% per year dropped to 0.27% in asymptomatic patients. RVOTcd occurred more frequently in SCN5A carriers (QRS-f 33.3% vs. 7.7%; p = .005, AVR sign 58.3% vs. 13.6%; p < .001; deep S in lead I 75% vs. 48.5%, p = .025%), as well as longer HV interval (66 vs. 49 ms; p < .001). CONCLUSIONS Spontaneous type-1 Brugada pattern in standard leads and proband status were more frequent in symptomatic subjects. RVOTcd, more common in SCN5A carriers, did not predict symptoms in BrS patients. EPS exhibited limited prognostic value for this low-risk population.
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Affiliation(s)
- Luciana Sacilotto
- Instituto do Coração (InCor), Hospital das Clínicas HCFMUSP, Faculdade de Medicina, Universidade de São Paulo, São Paulo, Brazil
| | - Mauricio I Scanavacca
- Instituto do Coração (InCor), Hospital das Clínicas HCFMUSP, Faculdade de Medicina, Universidade de São Paulo, São Paulo, Brazil
| | - Natália Olivetti
- Instituto do Coração (InCor), Hospital das Clínicas HCFMUSP, Faculdade de Medicina, Universidade de São Paulo, São Paulo, Brazil
| | - Carolina Lemes
- Instituto do Coração (InCor), Hospital das Clínicas HCFMUSP, Faculdade de Medicina, Universidade de São Paulo, São Paulo, Brazil
| | - Gabrielle D Pessente
- Instituto do Coração (InCor), Hospital das Clínicas HCFMUSP, Faculdade de Medicina, Universidade de São Paulo, São Paulo, Brazil
| | - Fanny Wulkan
- Instituto do Coração (InCor), Hospital das Clínicas HCFMUSP, Faculdade de Medicina, Universidade de São Paulo, São Paulo, Brazil
| | - Denise T Hachul
- Instituto do Coração (InCor), Hospital das Clínicas HCFMUSP, Faculdade de Medicina, Universidade de São Paulo, São Paulo, Brazil
| | - Jose E Krieger
- Instituto do Coração (InCor), Hospital das Clínicas HCFMUSP, Faculdade de Medicina, Universidade de São Paulo, São Paulo, Brazil
| | - Alexandre C Pereira
- Instituto do Coração (InCor), Hospital das Clínicas HCFMUSP, Faculdade de Medicina, Universidade de São Paulo, São Paulo, Brazil
| | - Francisco C C Darrieux
- Instituto do Coração (InCor), Hospital das Clínicas HCFMUSP, Faculdade de Medicina, Universidade de São Paulo, São Paulo, Brazil
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30
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Ribeiro da Silva A, Neri EA, Turaça LT, Dariolli R, Fonseca-Alaniz MH, Santos-Miranda A, Roman-Campos D, Venturini G, Krieger JE. NOTCH1 is critical for fibroblast-mediated induction of cardiomyocyte specialization into ventricular conduction system-like cells in vitro. Sci Rep 2020; 10:16163. [PMID: 32999360 PMCID: PMC7527973 DOI: 10.1038/s41598-020-73159-0] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.5] [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] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/26/2020] [Accepted: 08/31/2020] [Indexed: 12/12/2022] Open
Abstract
Cardiac fibroblasts are present throughout the myocardium and are enriched in the microenvironment surrounding the ventricular conduction system (VCS). Several forms of arrhythmias are linked to VCS abnormalities, but it is still unclear whether VCS malformations are cardiomyocyte autonomous or could be linked to crosstalk between different cell types. We reasoned that fibroblasts influence cardiomyocyte specialization in VCS cells. We developed 2D and 3D culture models of neonatal rat cardiac cells to assess the influence of cardiac fibroblasts on cardiomyocytes. Cardiomyocytes adjacent to cardiac fibroblasts showed a two-fold increase in expression of VCS markers (NAV1.5 and CONTACTIN 2) and calcium transient duration, displaying a Purkinje-like profile. Fibroblast-conditioned media (fCM) was sufficient to activate VCS-related genes (Irx3, Scn5a, Connexin 40) and to induce action potential prolongation, a hallmark of Purkinge phenotype. fCM-mediated response seemed to be spatially-dependent as cardiomyocyte organoids treated with fCM had increased expression of connexin 40 and NAV1.5 primarily on its outer surface. Finally, NOTCH1 activation in both cardiomyocytes and fibroblasts was required for connexin 40 up-regulation (a proxy of VCS phenotype). Altogether, we provide evidence that cardiac fibroblasts influence cardiomyocyte specialization into VCS-like cells via NOTCH1 signaling in vitro.
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Affiliation(s)
- Agatha Ribeiro da Silva
- Lab Genetics & Molec Cardiology, Instituto do Coracao (InCor) da Faculdade de Medicina da Universidade de Sao Paulo (FMUSP), São Paulo, Brazil
| | - Elida A Neri
- Lab Genetics & Molec Cardiology, Instituto do Coracao (InCor) da Faculdade de Medicina da Universidade de Sao Paulo (FMUSP), São Paulo, Brazil
| | - Lauro Thiago Turaça
- Lab Genetics & Molec Cardiology, Instituto do Coracao (InCor) da Faculdade de Medicina da Universidade de Sao Paulo (FMUSP), São Paulo, Brazil
| | - Rafael Dariolli
- Lab Genetics & Molec Cardiology, Instituto do Coracao (InCor) da Faculdade de Medicina da Universidade de Sao Paulo (FMUSP), São Paulo, Brazil
| | - Miriam H Fonseca-Alaniz
- Lab Genetics & Molec Cardiology, Instituto do Coracao (InCor) da Faculdade de Medicina da Universidade de Sao Paulo (FMUSP), São Paulo, Brazil
| | - Artur Santos-Miranda
- Paulista School of Medicine, Federal University of São Paulo (EPM-UNIFESP), São Paulo, Brazil
| | - Danilo Roman-Campos
- Paulista School of Medicine, Federal University of São Paulo (EPM-UNIFESP), São Paulo, Brazil
| | - Gabriela Venturini
- Lab Genetics & Molec Cardiology, Instituto do Coracao (InCor) da Faculdade de Medicina da Universidade de Sao Paulo (FMUSP), São Paulo, Brazil
| | - Jose E Krieger
- Lab Genetics & Molec Cardiology, Instituto do Coracao (InCor) da Faculdade de Medicina da Universidade de Sao Paulo (FMUSP), São Paulo, Brazil.
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31
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Alves AC, Alonso R, Diaz-Diaz JL, Medeiros AM, Jannes CE, Merchan A, Vasques-Cardenas NA, Cuevas A, Chacra AP, Krieger JE, Arroyo R, Arrieta F, Schreier L, Corral P, Bañares VG, Araujo MB, Bustos P, Asenjo S, Stoll M, Dell'Oca N, Reyes M, Ressia A, Campo R, Magaña-Torres MT, Metha R, Aguilar-Salinas CA, Ceballos-Macias JJ, Morales ÁJR, Mata P, Bourbon M, Santos RD. Phenotypical, Clinical, and Molecular Aspects of Adults and Children With Homozygous Familial Hypercholesterolemia in Iberoamerica. Arterioscler Thromb Vasc Biol 2020; 40:2508-2515. [PMID: 32757650 DOI: 10.1161/atvbaha.120.313722] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
OBJECTIVE Characterize homozygous familial hypercholesterolemia (HoFH) individuals from Iberoamerica. Approach and Results: In a cross-sectional retrospective evaluation 134 individuals with a HoFH phenotype, 71 adults (age 39.3±15.8 years, 38.0% males), and 63 children (age 8.8±4.0 years, 50.8% males) were studied. Genetic characterization was available in 129 (96%). The majority (91%) were true homozygotes (true HoFH, n=79, 43.0% children, 46.8% males) or compound heterozygotes (compound heterozygous familial hypercholesterolemia, n=39, 51.3% children, 46.2% males) with putative pathogenic variants in the LDLR. True HoFH due to LDLR variants had higher total (P=0.015) and LDL (low-density lipoprotein)-cholesterol (P=0.008) compared with compound heterozygous familial hypercholesterolemia. Children with true HoFH (n=34) tended to be diagnosed earlier (P=0.051) and had a greater frequency of xanthomas (P=0.016) than those with compound heterozygous familial hypercholesterolemia (n=20). Previous major cardiovascular events were present in 25 (48%) of 52 children (missing information in 2 cases), and in 43 (67%) of 64 adults with LDLR variants. Children who are true HoFH had higher frequency of major cardiovascular events (P=0.02), coronary heart (P=0.013), and aortic/supra-aortic valve diseases (P=0.022) than compound heterozygous familial hypercholesterolemia. In adults, no differences were observed in major cardiovascular events according to type of LDLR variant. From 118 subjects with LDLR variants, 76 (64%) had 2 likely pathogenic or pathogenic variants. In 89 subjects with 2 LDLR variants, those with at least one null allele were younger (P=0.003) and had a greater frequency of major cardiovascular events (P=0.038) occurring at an earlier age (P=0.001). CONCLUSIONS There was a high frequency of cardiovascular disease even in children. Phenotype and cardiovascular complications were heterogeneous and associated with the type of molecular defect.
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Affiliation(s)
- Ana Catarina Alves
- Instituto Nacional de Saúde Doutor Ricardo Jorge, Lisboa, Portugal (A.C.A., A.M.M., M.B.).,Departamento de Promoção da Saúde e Prevenção de Doenças Não Transmissíveis, Unidade de I&D, Grupo de Investigação Cardiovascular, Lisboa, Portugal (A.C.A., A.M.M., M.B.).,Faculdade de Ciências, Universidade de Lisboa, BioISI-Biosystems & Integrative Sciences Institute, Portugal (A.C.A., A.M.M., M.B.)
| | - Rodrigo Alonso
- Center for Advanced Metabolic Medicine and Nutrition, Santiago, Chile (R. Alonso, A.C.).,Fundación Hipercolesterolemia Familiar, Madrid, Spain (R. Alonso, R. Arroyo, P.M.)
| | - José Luís Diaz-Diaz
- Department of Internal Medicine. Hospital Universitario A Coruña, Spain (J.L.D.-D.)
| | - Ana Margarida Medeiros
- Instituto Nacional de Saúde Doutor Ricardo Jorge, Lisboa, Portugal (A.C.A., A.M.M., M.B.).,Departamento de Promoção da Saúde e Prevenção de Doenças Não Transmissíveis, Unidade de I&D, Grupo de Investigação Cardiovascular, Lisboa, Portugal (A.C.A., A.M.M., M.B.).,Faculdade de Ciências, Universidade de Lisboa, BioISI-Biosystems & Integrative Sciences Institute, Portugal (A.C.A., A.M.M., M.B.)
| | - Cinthia E Jannes
- Heart Institute (InCor) University of São Paulo Medical School Hospital São Paulo, Brazil (C.E.J., A.P.C., J.E.K., R.D.S.)
| | - Alonso Merchan
- Fundacion Clinica SHAIO, Cardiologia, Bogota, Colombia (A.M.)
| | | | - Ada Cuevas
- Center for Advanced Metabolic Medicine and Nutrition, Santiago, Chile (R. Alonso, A.C.)
| | - Ana Paula Chacra
- Heart Institute (InCor) University of São Paulo Medical School Hospital São Paulo, Brazil (C.E.J., A.P.C., J.E.K., R.D.S.)
| | - Jose E Krieger
- Heart Institute (InCor) University of São Paulo Medical School Hospital São Paulo, Brazil (C.E.J., A.P.C., J.E.K., R.D.S.)
| | - Raquel Arroyo
- Fundación Hipercolesterolemia Familiar, Madrid, Spain (R. Alonso, R. Arroyo, P.M.)
| | - Francisco Arrieta
- Department of Endocrinology, Hospital Ramón y Cajal, Madrid, Spain (F.A.)
| | - Laura Schreier
- Facultad de Farmacia y Bioquimica, Universidad de Buenos Aires, Departamento de Bioquímica Clínica, Laboratorio de Lípidos y Aterosclerosis, Argentina (L.S.)
| | - Pablo Corral
- Universidad FASTA, Facultad de Medicina, Cátedra Farmacología e Investigación, Mar del Plata, Argentina (P.C.)
| | - Virginia G Bañares
- Administracion Nacional de Laboratorios e Institutos de Salud "Dr Carlos G. Malbrán'', Centro Nacional de Genética Médica, Departamento de Genética Experimental, Buenos Aires, Argentina (V.G.B.)
| | - Maria B Araujo
- Hospital Nacional de Pediatria ¨Dr JP Garraham¨, Servicio de Nutrición, Buenos Aires, Argentina (M.B.A.)
| | - Paula Bustos
- Facultad de Farmacia (P.B.), Universidad de Concepción, Chile
| | - Sylvia Asenjo
- Facultad de Medicina (S.A.), Universidad de Concepción, Chile
| | - Mario Stoll
- Comision Honoraria de Salud Cardiovascular, Programa GENYCO, Laboratorio de Genética Molecular, Montevideo, Uruguay (M.S., N.D., X.R., A.R.)
| | - Nicolás Dell'Oca
- Comision Honoraria de Salud Cardiovascular, Programa GENYCO, Laboratorio de Genética Molecular, Montevideo, Uruguay (M.S., N.D., X.R., A.R.)
| | - Maria Reyes
- Fundación Cardiovascular de Colombia, Cardiologia, Bogotá (R.C.)
| | - Andrés Ressia
- Comision Honoraria de Salud Cardiovascular, Programa GENYCO, Laboratorio de Genética Molecular, Montevideo, Uruguay (M.S., N.D., X.R., A.R.)
| | - Rafael Campo
- Fundación Cardiovascular de Colombia, Cardiologia, Bogotá (R.C.)
| | - Maria T Magaña-Torres
- Instituto Mexicano del Seguro Social, Centro de Investigación Biomédica del Occidente, Guadalajara, México (M.T.M.-T.)
| | - Roopa Metha
- Unidad de Investigación de Enfermedades Metabólicas (R.M., C.A.A.S.)
| | | | - José J Ceballos-Macias
- Departamento de Endocrinología y Metabolismo, Instituto Nacional de Ciencias Médicas y Nutrición Salvador Zubirán, México. Servicio de Endocrinología, Unidad de Especialidades Médicas, Secretaría de la Defensa Nacional, Mexico (J.J.C.-M.)
| | - Álvaro J Ruiz Morales
- Departamento de Medicina Interna, Facultad de Medicina, Pontificia Universidad Javerina, Bogotá, Colombia (A.J.R.)
| | - Pedro Mata
- Fundación Hipercolesterolemia Familiar, Madrid, Spain (R. Alonso, R. Arroyo, P.M.)
| | - Mafalda Bourbon
- Instituto Nacional de Saúde Doutor Ricardo Jorge, Lisboa, Portugal (A.C.A., A.M.M., M.B.).,Departamento de Promoção da Saúde e Prevenção de Doenças Não Transmissíveis, Unidade de I&D, Grupo de Investigação Cardiovascular, Lisboa, Portugal (A.C.A., A.M.M., M.B.).,Faculdade de Ciências, Universidade de Lisboa, BioISI-Biosystems & Integrative Sciences Institute, Portugal (A.C.A., A.M.M., M.B.)
| | - Raul D Santos
- Heart Institute (InCor) University of São Paulo Medical School Hospital São Paulo, Brazil (C.E.J., A.P.C., J.E.K., R.D.S.).,Hospital Israelita Albert Einstein, Sao Paulo, Brazil (R.D.S.)
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Zogbi C, Oliveira NC, Levy D, Bydlowski SP, Bassaneze V, Neri EA, Krieger JE. Beneficial effects of IL-4 and IL-6 on rat neonatal target cardiac cells. Sci Rep 2020; 10:12350. [PMID: 32704142 PMCID: PMC7378182 DOI: 10.1038/s41598-020-69413-0] [Citation(s) in RCA: 14] [Impact Index Per Article: 3.5] [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: 03/16/2020] [Accepted: 06/23/2020] [Indexed: 02/06/2023] Open
Abstract
The nature of the early post-natal immune response in rodents appears to influence cardiac regeneration even though the underlying molecules remain poorly understood. Consistent with this idea, we show now significant changes in the expression of immune and cell movement gene pathways in heart samples from 1- and 7-day-old rats with ventricle resection. We then tested whether conditioned media from adult M2 anti-inflammatory macrophages target neonatal cardiac cells to a pro-regenerative like phenotype compared to the M1 pro-inflammatory macrophages. We found that M2 compared to M1 macrophage-conditioned media upregulates neonatal cardiomyocyte proliferation, suppresses myofibroblast-induced differentiation and stimulates endothelial cell tube formation. Using a cytokine array, we selected four candidate cytokine molecules uniquely expressed in M2 macrophage-conditioned media and showed that two of them (IL-4 and IL-6) induce endothelial cell proliferation whilst IL-4 promotes proliferation in neonatal cardiomyocytes and prevents myofibroblast-induced collagen type I secretion. Altogether, we provided evidence that adult M2 macrophage-conditioned media displays a paracrine beneficial pro-regenerative response in target cardiac cells and that IL-4 and IL-6 recapitulate, at least in part, these pleiotropic effects. Further characterization of macrophage immune phenotypes and their secreted molecules may give rise to novel therapeutic approaches for post-natal cardiac repair.
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Affiliation(s)
- Camila Zogbi
- Lab Genetics & Mol Cardiology/LIM 13, Heart Institute (InCor), University of São Paulo Medical School, Av Dr Eneas C Aguiar 44, Sao Paulo, SP, 05403-000, Brazil
| | - Nathalia C Oliveira
- Lab Genetics & Mol Cardiology/LIM 13, Heart Institute (InCor), University of São Paulo Medical School, Av Dr Eneas C Aguiar 44, Sao Paulo, SP, 05403-000, Brazil
| | - Débora Levy
- Lab Genetics & Mol Cardiology/LIM 13, Heart Institute (InCor), University of São Paulo Medical School, Av Dr Eneas C Aguiar 44, Sao Paulo, SP, 05403-000, Brazil
| | - Sergio P Bydlowski
- Lab Genetics & Mol Cardiology/LIM 13, Heart Institute (InCor), University of São Paulo Medical School, Av Dr Eneas C Aguiar 44, Sao Paulo, SP, 05403-000, Brazil
| | - Vinicius Bassaneze
- Lab Genetics & Mol Cardiology/LIM 13, Heart Institute (InCor), University of São Paulo Medical School, Av Dr Eneas C Aguiar 44, Sao Paulo, SP, 05403-000, Brazil
| | - Elida A Neri
- Lab Genetics & Mol Cardiology/LIM 13, Heart Institute (InCor), University of São Paulo Medical School, Av Dr Eneas C Aguiar 44, Sao Paulo, SP, 05403-000, Brazil
| | - Jose E Krieger
- Lab Genetics & Mol Cardiology/LIM 13, Heart Institute (InCor), University of São Paulo Medical School, Av Dr Eneas C Aguiar 44, Sao Paulo, SP, 05403-000, Brazil.
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33
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Marcondes-Braga FG, Gioli-Pereira L, Bernardez-Pereira S, Batista GL, Mangini S, Issa VS, Fernandes F, Bocchi EA, Ayub-Ferreira SM, Mansur AJ, Gutz IGR, Krieger JE, Pereira AC, Bacal F. Exhaled breath acetone for predicting cardiac and overall mortality in chronic heart failure patients. ESC Heart Fail 2020; 7:1744-1752. [PMID: 32383349 PMCID: PMC7373929 DOI: 10.1002/ehf2.12736] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.5] [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: 11/12/2019] [Revised: 03/27/2020] [Accepted: 04/15/2020] [Indexed: 11/11/2022] Open
Abstract
Aims Exhaled breath acetone (EBA) has been described as a new biomarker of heart failure (HF) diagnosis. EBA concentration increases according to severity of HF and is associated with poor prognosis, especially in acute decompensated HF. However, there are no data on chronic HF patients. The aim is to evaluate the role of EBA for predicting cardiac and overall mortality in chronic HF patients. Methods and results In GENIUS‐HF cohort, chronic patients were enrolled between August 2012 and December 2014. All patients had left ventricular ejection fraction ≤ 50%, and the diagnosis was established according to Framingham criteria. After consent, patients were submitted to clinical evaluation and exhaled breath collection. EBA identification and quantitative determination were done by spectrophotometry. The clinical characteristics associated with acetone were identified. All participants were followed for 18 months to assess cardiac and overall mortality. Around 700 participants were enrolled in the current analysis. Patients were 55.4 ± 12.2 years old, 67.6% male patients, and 81% New York Heart Association I/II with left ventricular ejection fraction of 32 ± 8.6%. EBA median concentration was 0.6 (0.3–1.2) ug/L. Acetone levels increased with the number of symptoms of HF and were associated with right HF signs/symptoms and liver biochemical changes. EBA at highest quartile (EBA > 1.2ug/L) was associated with a significantly worse prognosis (log rank test, P < 0.001). Cox proportional multivariable regression model revealed that EBA > 1.20ug/L was an independent predictor of cardiac (P = 0.011) and overall (P = 0.010) mortality in our population. Conclusions This study shows that EBA levels reflect clinical HF features, especially right HF signs/symptoms. EBA is an independent predictor of cardiac and overall mortality in chronic HF patients.
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Affiliation(s)
- Fabiana G Marcondes-Braga
- Instituto do Coração (InCor), Hospital das Clínicas, Faculdade de Medicina, Universidade de São Paulo, Dr Eneas de Carvalho Aguiar, 44-Cerqueira Cesar, São Paulo, 0540300, Brazil
| | - Luciana Gioli-Pereira
- Instituto do Coração (InCor), Hospital das Clínicas, Faculdade de Medicina, Universidade de São Paulo, Dr Eneas de Carvalho Aguiar, 44-Cerqueira Cesar, São Paulo, 0540300, Brazil
| | - Sabrina Bernardez-Pereira
- Instituto do Coração (InCor), Hospital das Clínicas, Faculdade de Medicina, Universidade de São Paulo, Dr Eneas de Carvalho Aguiar, 44-Cerqueira Cesar, São Paulo, 0540300, Brazil
| | | | - Sandrigo Mangini
- Instituto do Coração (InCor), Hospital das Clínicas, Faculdade de Medicina, Universidade de São Paulo, Dr Eneas de Carvalho Aguiar, 44-Cerqueira Cesar, São Paulo, 0540300, Brazil
| | - Victor S Issa
- Instituto do Coração (InCor), Hospital das Clínicas, Faculdade de Medicina, Universidade de São Paulo, Dr Eneas de Carvalho Aguiar, 44-Cerqueira Cesar, São Paulo, 0540300, Brazil
| | - Fabio Fernandes
- Instituto do Coração (InCor), Hospital das Clínicas, Faculdade de Medicina, Universidade de São Paulo, Dr Eneas de Carvalho Aguiar, 44-Cerqueira Cesar, São Paulo, 0540300, Brazil
| | - Edimar A Bocchi
- Instituto do Coração (InCor), Hospital das Clínicas, Faculdade de Medicina, Universidade de São Paulo, Dr Eneas de Carvalho Aguiar, 44-Cerqueira Cesar, São Paulo, 0540300, Brazil
| | - Silvia M Ayub-Ferreira
- Instituto do Coração (InCor), Hospital das Clínicas, Faculdade de Medicina, Universidade de São Paulo, Dr Eneas de Carvalho Aguiar, 44-Cerqueira Cesar, São Paulo, 0540300, Brazil
| | - Alfredo J Mansur
- Instituto do Coração (InCor), Hospital das Clínicas, Faculdade de Medicina, Universidade de São Paulo, Dr Eneas de Carvalho Aguiar, 44-Cerqueira Cesar, São Paulo, 0540300, Brazil
| | - Ivano G R Gutz
- Institute of Chemistry (IQ-USP), University of Sao Paulo, Sao Paulo, Brazil
| | - Jose E Krieger
- Instituto do Coração (InCor), Hospital das Clínicas, Faculdade de Medicina, Universidade de São Paulo, Dr Eneas de Carvalho Aguiar, 44-Cerqueira Cesar, São Paulo, 0540300, Brazil
| | - Alexandre C Pereira
- Instituto do Coração (InCor), Hospital das Clínicas, Faculdade de Medicina, Universidade de São Paulo, Dr Eneas de Carvalho Aguiar, 44-Cerqueira Cesar, São Paulo, 0540300, Brazil
| | - Fernando Bacal
- Instituto do Coração (InCor), Hospital das Clínicas, Faculdade de Medicina, Universidade de São Paulo, Dr Eneas de Carvalho Aguiar, 44-Cerqueira Cesar, São Paulo, 0540300, Brazil
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34
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Noordam R, Bos MM, Wang H, Winkler TW, Bentley AR, Kilpeläinen TO, de Vries PS, Sung YJ, Schwander K, Cade BE, Manning A, Aschard H, Brown MR, Chen H, Franceschini N, Musani SK, Richard M, Vojinovic D, Aslibekyan S, Bartz TM, de Las Fuentes L, Feitosa M, Horimoto AR, Ilkov M, Kho M, Kraja A, Li C, Lim E, Liu Y, Mook-Kanamori DO, Rankinen T, Tajuddin SM, van der Spek A, Wang Z, Marten J, Laville V, Alver M, Evangelou E, Graff ME, He M, Kühnel B, Lyytikäinen LP, Marques-Vidal P, Nolte IM, Palmer ND, Rauramaa R, Shu XO, Snieder H, Weiss S, Wen W, Yanek LR, Adolfo C, Ballantyne C, Bielak L, Biermasz NR, Boerwinkle E, Dimou N, Eiriksdottir G, Gao C, Gharib SA, Gottlieb DJ, Haba-Rubio J, Harris TB, Heikkinen S, Heinzer R, Hixson JE, Homuth G, Ikram MA, Komulainen P, Krieger JE, Lee J, Liu J, Lohman KK, Luik AI, Mägi R, Martin LW, Meitinger T, Metspalu A, Milaneschi Y, Nalls MA, O'Connell J, Peters A, Peyser P, Raitakari OT, Reiner AP, Rensen PCN, Rice TK, Rich SS, Roenneberg T, Rotter JI, Schreiner PJ, Shikany J, Sidney SS, Sims M, Sitlani CM, Sofer T, Strauch K, Swertz MA, Taylor KD, Uitterlinden AG, van Duijn CM, Völzke H, Waldenberger M, Wallance RB, van Dijk KW, Yu C, Zonderman AB, Becker DM, Elliott P, Esko T, Gieger C, Grabe HJ, Lakka TA, Lehtimäki T, North KE, Penninx BWJH, Vollenweider P, Wagenknecht LE, Wu T, Xiang YB, Zheng W, Arnett DK, Bouchard C, Evans MK, Gudnason V, Kardia S, Kelly TN, Kritchevsky SB, Loos RJF, Pereira AC, Province M, Psaty BM, Rotimi C, Zhu X, Amin N, Cupples LA, Fornage M, Fox EF, Guo X, Gauderman WJ, Rice K, Kooperberg C, Munroe PB, Liu CT, Morrison AC, Rao DC, van Heemst D, Redline S. Multi-ancestry sleep-by-SNP interaction analysis in 126,926 individuals reveals lipid loci stratified by sleep duration. Nat Commun 2019; 10:5121. [PMID: 31719535 PMCID: PMC6851116 DOI: 10.1038/s41467-019-12958-0] [Citation(s) in RCA: 44] [Impact Index Per Article: 8.8] [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: 03/08/2019] [Accepted: 10/04/2019] [Indexed: 12/12/2022] Open
Abstract
Both short and long sleep are associated with an adverse lipid profile, likely through different biological pathways. To elucidate the biology of sleep-associated adverse lipid profile, we conduct multi-ancestry genome-wide sleep-SNP interaction analyses on three lipid traits (HDL-c, LDL-c and triglycerides). In the total study sample (discovery + replication) of 126,926 individuals from 5 different ancestry groups, when considering either long or short total sleep time interactions in joint analyses, we identify 49 previously unreported lipid loci, and 10 additional previously unreported lipid loci in a restricted sample of European-ancestry cohorts. In addition, we identify new gene-sleep interactions for known lipid loci such as LPL and PCSK9. The previously unreported lipid loci have a modest explained variance in lipid levels: most notable, gene-short-sleep interactions explain 4.25% of the variance in triglyceride level. Collectively, these findings contribute to our understanding of the biological mechanisms involved in sleep-associated adverse lipid profiles. Sleep duration is associated with an adverse lipid profile. Here, the authors perform genome-wide gene-by-sleep interaction analysis and find 49 previously unreported lipid loci when considering short or long total sleep time.
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Affiliation(s)
- Raymond Noordam
- Department of Internal Medicine, Section of Gerontology and Geriatrics, Leiden University Medical Center, Leiden, The Netherlands.
| | - Maxime M Bos
- Department of Internal Medicine, Section of Gerontology and Geriatrics, Leiden University Medical Center, Leiden, The Netherlands
| | - Heming Wang
- Division of Sleep and Circadian Disorders, Harvard Medical School, Brigham and Women's Hospital, Boston, MA, USA
| | - Thomas W Winkler
- Department of Genetic Epidemiology, University of Regensburg, Regensburg, Germany
| | - Amy R Bentley
- Center for Research on Genomics and Global Health, National Human Genome Research Institute, National Institutes of Health, Bethesda, MD, USA
| | - Tuomas O Kilpeläinen
- Novo Nordisk Foundation Center for Basic Metabolic Research, Faculty of Health and Medical Sciences, University of Copenhagen, Copenhagen, 2200, Denmark.,Department of Environmental Medicine and Public Health, The Icahn School of Medicine at Mount Sinai, New York, New York, USA
| | - Paul S de Vries
- 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
| | - Yun Ju Sung
- Division of Biostatistics, Washington University School of Medicine, St. Louis, MO, USA
| | - Karen Schwander
- Division of Biostatistics, Washington University School of Medicine, St. Louis, MO, USA
| | - Brian E Cade
- Division of Sleep and Circadian Disorders, Harvard Medical School, Brigham and Women's Hospital, Boston, MA, USA
| | - Alisa Manning
- Clinical and Translational Epidemiology Unit, Massachusetts General Hospital, Boston, MA, USA.,Department of Medicine, Harvard Medical School, Boston, MA, USA
| | - Hugues Aschard
- Department of Epidemiology, Harvard School of Public Health, Boston, MA, USA.,Centre de Bioinformatique, Biostatistique et Biologie Intégrative (C3BI), Institut Pasteur, Paris, France
| | - Michael R Brown
- 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
| | - Han Chen
- 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.,Center for Precision Health, School of Public Health & School of Biomedical Informatics, The University of Texas Health Science Center at Houston, Houston, TX, USA
| | - Nora Franceschini
- Department of Epidemiology, Gillings School of Global Public Health, University of North Carolina, Chapel Hill, NC, USA
| | - Solomon K Musani
- Jackson Heart Study, Department of Medicine, University of Mississippi Medical Center, Jackson, MS, USA
| | - Melissa Richard
- Brown Foundation Institute of Molecular Medicine, The University of Texas Health Science Center at Houston, Houston, TX, USA
| | - Dina Vojinovic
- Department of Epidemiology, Erasmus University Medical Center, Rotterdam, The Netherlands
| | - Stella Aslibekyan
- Department of Epidemiology, University of Alabama at Birmingham, Birmingham, AL, USA
| | - Traci M Bartz
- Cardiovascular Health Research Unit, Biostatistics and Medicine, University of Washington, Seattle, WA, USA
| | - Lisa de Las Fuentes
- Division of Biostatistics, Washington University School of Medicine, St. Louis, MO, USA.,Cardiovascular Division, Department of Medicine, Washington University School of Medicine, St. Louis, MO, USA
| | - Mary Feitosa
- Division of Statistical Genomics, Department of Genetics, Washington University School of Medicine, St. Louis, MO, USA
| | - Andrea R Horimoto
- Laboratory of Genetics and Molecular Cardiology, Heart Institute (InCor), University of São Paulo Medical School, São Paulo, SP, Brazil
| | | | - Minjung Kho
- Department of Epidemiology, School of Public Health, University of Michigan, Ann Arbor, MI, USA
| | - Aldi Kraja
- Division of Statistical Genomics, Department of Genetics, Washington University School of Medicine, St. Louis, MO, USA
| | - Changwei Li
- Epidemiology and Biostatistics, University of Georgia at Athens College of Public Health, Athens, GA, USA
| | - Elise Lim
- Department of Biostatistics, Boston University School of Public Health, Boston, MA, USA
| | - Yongmei Liu
- Public Health Sciences, Epidemiology and Prevention, Wake Forest University Health Sciences, Winston-Salem, NC, USA
| | - Dennis O Mook-Kanamori
- Department of Clinical Epidemiology, Leiden University Medical Center, Leiden, Netherlands.,Department of Public Health and Primary Care, Leiden University Medical Center, Leiden, Netherlands
| | - Tuomo Rankinen
- Human Genomics Laboratory, Pennington Biomedical Research Center, Baton Rouge, LA, USA
| | - Salman M Tajuddin
- Health Disparities Research Section, Laboratory of Epidemiology and Population Sciences, National Institute on Aging, National Institutes of Health, Baltimore, MD, USA
| | - Ashley van der Spek
- Department of Epidemiology, Erasmus University Medical Center, Rotterdam, The Netherlands
| | - Zhe Wang
- 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
| | - Jonathan Marten
- Medical Research Council Human Genetics Unit, Institute of Genetics and Molecular Medicine, Institute of Genetics and Molecular Medicine, University of Edinburgh, Edinburgh, UK
| | - Vincent Laville
- Centre de Bioinformatique, Biostatistique et Biologie Intégrative (C3BI), Institut Pasteur, Paris, France
| | - Maris Alver
- Estonian Genome Center, Institute of Genomics, University of Tartu, Tartu, Estonia.,Department of Biotechnology, Institute of Molecular and Cell Biology, University of Tartu, Tartu, Estonia
| | - Evangelos Evangelou
- Department of Epidemiology and Biostatistics, School of Public Health, Imperial College London, London, UK.,Department of Hygiene and Epidemiology, University of Ioannina Medical School, Ioannina, Greece
| | - Maria E Graff
- Department of Epidemiology, Gillings School of Global Public Health, University of North Carolina, Chapel Hill, NC, USA
| | - Meian He
- Department of Occupational and Environmental Health and State Key Laboratory of Environmental Health for Incubating, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
| | - Brigitte Kühnel
- Research Unit of Molecular Epidemiology, Helmholtz Zentrum München, German Research Center for Environmental Health, Neuherberg, Germany.,Institute of Epidemiology, Helmholtz Zentrum München, German Research Center for Environmental Health, Neuherberg, Germany
| | - Leo-Pekka Lyytikäinen
- Department of Clinical Chemistry, Fimlab Laboratories, Tampere, Finland.,Department of Clinical Chemistry, Finnish Cardiovascular Research Center-Tampere, Faculty of Medicine and Health Technology, Tampere University, Tampere, Finland
| | - Pedro Marques-Vidal
- Medicine, Internal Medicine, Lausanne University Hospital, Lausanne, Switzerland
| | - Ilja M Nolte
- University of Groningen, University Medical Center Groningen, Department of Epidemiology, Groningen, The Netherlands
| | | | - Rainer Rauramaa
- Foundation for Research in Health Exercise and Nutrition, Kuopio Research Institute of Exercise Medicine, Kuopio, Finland
| | - Xiao-Ou Shu
- Division of Epidemiology, Department of Medicine, Vanderbilt University School of Medicine, Nashville, TN, USA
| | - Harold Snieder
- University of Groningen, University Medical Center Groningen, Department of Epidemiology, Groningen, The Netherlands
| | - Stefan Weiss
- Interfaculty Institute for Genetics and Functional Genomics, Department of Functional Genomics, University Medicine Greifswald, Greifswald, Germany
| | - Wanqing Wen
- Division of Epidemiology, Department of Medicine, Vanderbilt University School of Medicine, Nashville, TN, USA
| | - Lisa R Yanek
- Division of General Internal Medicine, Department of Medicine, Johns Hopkins University School of Medicine, Baltimore, MD, USA
| | - Correa Adolfo
- Jackson Heart Study, Department of Medicine, University of Mississippi Medical Center, Jackson, MS, USA
| | - Christie Ballantyne
- Section of Cardiovascular Research, Baylor College of Medicine, Houston, TX, USA.,Houston Methodist Debakey Heart and Vascular Center, Houston, TX, USA
| | - Larry Bielak
- Department of Epidemiology, School of Public Health, University of Michigan, Ann Arbor, MI, USA
| | - Nienke R Biermasz
- Department of Internal Medicine, Division of Endocrinology, Leiden University Medical Center, Leiden, The Netherlands.,Einthoven Laboratory for Experimental Vascular Medicine, Leiden, The Netherlands
| | - 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.,Human Genome Sequencing Center, Baylor College of Medicine, Houston, TX, USA
| | - Niki Dimou
- Department of Hygiene and Epidemiology, University of Ioannina Medical School, Ioannina, Greece
| | | | - Chuan Gao
- Molecular Genetics and Genomics Program, Wake Forest School of Medicine, Winston-Salem, NC, USA
| | - Sina A Gharib
- Computational Medicine Core, Center for Lung Biology, UW Medicine Sleep Center, Medicine, University of Washington, Seattle, WA, USA
| | - Daniel J Gottlieb
- Division of Sleep and Circadian Disorders, Harvard Medical School, Brigham and Women's Hospital, Boston, MA, USA.,Department of Medicine, Harvard Medical School, Boston, MA, USA.,VA Boston Healthcare System, Boston, MA, USA
| | - José Haba-Rubio
- Medicine, Sleep Laboratory, Lausanne University Hospital, Lausanne, Switzerland
| | - Tamara B Harris
- Laboratory of Epidemiology and Population Sciences, National Institute on Aging, National Institutes of Health, Bethesda, MD, USA
| | - Sami Heikkinen
- Institute of Clinical Medicine, Internal Medicine, University of Eastern Finland, Kuopio, Finland.,Institute of Biomedicine, School of Medicine, University of Eastern Finland, Kuopio Campus, Finland
| | - Raphaël Heinzer
- Medicine, Sleep Laboratory, Lausanne University Hospital, Lausanne, Switzerland
| | - James E Hixson
- 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
| | - Georg Homuth
- Interfaculty Institute for Genetics and Functional Genomics, Department of Functional Genomics, University Medicine Greifswald, Greifswald, Germany
| | - M Arfan Ikram
- Department of Epidemiology, Erasmus University Medical Center, Rotterdam, The Netherlands.,Department of Radiology and Nuclear Medicine, Erasmus University Medical Center, Rotterdam, The Netherlands
| | - Pirjo Komulainen
- Foundation for Research in Health Exercise and Nutrition, Kuopio Research Institute of Exercise Medicine, Kuopio, Finland
| | - Jose E Krieger
- Laboratory of Genetics and Molecular Cardiology, Heart Institute (InCor), University of São Paulo Medical School, São Paulo, SP, Brazil
| | - Jiwon Lee
- Division of Sleep and Circadian Disorders, Harvard Medical School, Brigham and Women's Hospital, Boston, MA, USA
| | - Jingmin Liu
- Fred Hutchinson Cancer Research Center, University of Washington School of Public Health, Seattle, WA, USA
| | - Kurt K Lohman
- Public Health Sciences, Biostatistical Sciences, Wake Forest University Health Sciences, Winston-Salem, NC, USA
| | - Annemarie I Luik
- Department of Epidemiology, Erasmus University Medical Center, Rotterdam, The Netherlands
| | - Reedik Mägi
- Estonian Genome Center, Institute of Genomics, University of Tartu, Tartu, Estonia
| | - Lisa W Martin
- Cardiology, School of Medicine and Health Sciences, George Washington University, Washington, D.C., USA
| | - Thomas Meitinger
- Institute of Human Genetics, Helmholtz Zentrum München, German Research Center for Environmental Health, Neuherberg, Germany
| | - Andres Metspalu
- Estonian Genome Center, Institute of Genomics, University of Tartu, Tartu, Estonia.,Department of Biotechnology, Institute of Molecular and Cell Biology, University of Tartu, Tartu, Estonia
| | - Yuri Milaneschi
- Cardiology, School of Medicine and Health Sciences, George Washington University, Washington, D.C., USA
| | - Mike A Nalls
- Laboratory of Neurogenetics, National Institute on Aging, Bethesda, MD, USA.,Data Tecnica International, Glen Echo, MD, USA
| | - Jeff O'Connell
- Division of Endocrinology, Diabetes, and Nutrition, University of Maryland School of Medicine, Baltimore, MD, USA.,Program for Personalized and Genomic Medicine, University of Maryland School of Medicine, Baltimore, MD, USA
| | - Annette Peters
- Institute of Epidemiology, Helmholtz Zentrum München, German Research Center for Environmental Health, Neuherberg, Germany.,DZHK (German Centre for Cardiovascular Research), partner site Munich Heart Alliance, Neuherberg, Germany
| | - Patricia Peyser
- Department of Epidemiology, School of Public Health, University of Michigan, Ann Arbor, MI, USA
| | - Olli T Raitakari
- Department of Clinical Physiology and Nuclear Medicine, Turku University Hospital, Turku, Finland.,University of Turku, Turku, Finland
| | - Alex P Reiner
- Fred Hutchinson Cancer Research Center, University of Washington School of Public Health, Seattle, WA, USA
| | - Patrick C N Rensen
- Department of Internal Medicine, Division of Endocrinology, Leiden University Medical Center, Leiden, The Netherlands.,Einthoven Laboratory for Experimental Vascular Medicine, Leiden, The Netherlands
| | - Treva K Rice
- Division of Biostatistics, Washington University School of Medicine, St. Louis, MO, USA
| | - Stephen S Rich
- Center for Public Health Genomics, University of Virginia, Charlottesville, VA, USA
| | - Till Roenneberg
- Institute of Medical Psychology, Ludwig-Maximilians-Universitat Munchen, Munich, Germany
| | - Jerome I Rotter
- Genomic Outcomes, Department of Pediatrics, Institute for Translational Genomics and Population Sciences, LABioMed at Harbor-UCLA Medical Center, Torrance, CC, USA
| | - Pamela J Schreiner
- Division of Epidemiology & Community Health, School of Public Health, University of Minnesota, Minneapolis, MN, USA
| | - James Shikany
- Division of Preventive Medicine, Department of Medicine, University of Alabama at Birmingham, Birmingham, AL, USA
| | - Stephen S Sidney
- Division of Research, Kaiser Permanente Northern California, Oakland, CA, USA
| | - Mario Sims
- Jackson Heart Study, Department of Medicine, University of Mississippi Medical Center, Jackson, MS, USA
| | - Colleen M Sitlani
- Cardiovascular Health Research Unit, Medicine, University of Washington, Seattle, WA, USA
| | - Tamar Sofer
- Division of Sleep and Circadian Disorders, Harvard Medical School, Brigham and Women's Hospital, Boston, MA, USA.,Institute of Human Genetics, Technische Universität München, Munich, Germany
| | - Konstantin Strauch
- Institute of Genetic Epidemiology, Helmholtz Zentrum München, German Research Center for Environmental Health, Neuherberg, Germany.,Institute for Medical Informatics Biometry and Epidemiology, Ludwig-Maximilians-Universitat Munchen, Munich, Germany
| | - Morris A Swertz
- University of Groningen, University Medical Center Groningen, Department of Genetics, Groningen, The Netherlands
| | - Kent D Taylor
- Genomic Outcomes, Department of Pediatrics, Institute for Translational Genomics and Population Sciences, LABioMed at Harbor-UCLA Medical Center, Torrance, CC, USA
| | - André G Uitterlinden
- Department of Epidemiology, Erasmus University Medical Center, Rotterdam, The Netherlands.,Department of Internal Medicine, Erasmus University Medical Center, Rotterdam, The Netherlands
| | - Cornelia M van Duijn
- Department of Epidemiology, Erasmus University Medical Center, Rotterdam, The Netherlands.,Nuffield Department of Population Health, University of Oxford, Oxford, UK
| | - Henry Völzke
- Institute for Community Medicine, University Medicine Greifswald, Greifswald, Germany
| | - Melanie Waldenberger
- Research Unit of Molecular Epidemiology, Helmholtz Zentrum München, German Research Center for Environmental Health, Neuherberg, Germany.,Institute of Epidemiology, Helmholtz Zentrum München, German Research Center for Environmental Health, Neuherberg, Germany.,DZHK (German Centre for Cardiovascular Research), partner site Munich Heart Alliance, Neuherberg, Germany
| | - Robert B Wallance
- Department of Epidemiology, University of Iowa College of Public Health, Iowa City, IA, USA
| | - Ko Willems van Dijk
- Department of Internal Medicine, Division of Endocrinology, Leiden University Medical Center, Leiden, The Netherlands.,Einthoven Laboratory for Experimental Vascular Medicine, Leiden, The Netherlands.,Department of Human Genetics, Leiden University Medical Center, Leiden, The Netherlands
| | - Caizheng Yu
- Department of Occupational and Environmental Health and State Key Laboratory of Environmental Health for Incubating, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
| | - Alan B Zonderman
- Behavioral Epidemiology Section, Laboratory of Epidemiology and Population Sciences, National Institute on Aging, National Institutes of Health, Baltimore, MD, USA
| | - Diane M Becker
- Division of General Internal Medicine, Department of Medicine, Johns Hopkins University School of Medicine, Baltimore, MD, USA
| | - Paul Elliott
- Department of Biotechnology, Institute of Molecular and Cell Biology, University of Tartu, Tartu, Estonia.,MRC-PHE Centre for Environment and Health, School of Public Health, Imperial College London, London, UK.,National Institute of Health Research Imperial College London Biomedical Research Centre, London, UK.,UK-DRI Dementia Research Institute at Imperial College London, London, UK
| | - Tõnu Esko
- Estonian Genome Center, Institute of Genomics, University of Tartu, Tartu, Estonia.,Broad Institute of the Massachusetts Institute of Technology and Harvard University, Boston, MA, USA
| | - Christian Gieger
- Research Unit of Molecular Epidemiology, Helmholtz Zentrum München, German Research Center for Environmental Health, Neuherberg, Germany.,German Center for Diabetes Research (DZD e.V.), Neuherberg, Germany
| | - Hans J Grabe
- Department Psychiatry and Psychotherapy, University Medicine Greifswald, Greifswald, Germany
| | - Timo A Lakka
- Foundation for Research in Health Exercise and Nutrition, Kuopio Research Institute of Exercise Medicine, Kuopio, Finland.,Institute of Biomedicine, School of Medicine, University of Eastern Finland, Kuopio Campus, Finland.,Department of Clinical Phsiology and Nuclear Medicine, Kuopia University Hospital, Kuopio, Finland
| | - Terho Lehtimäki
- Department of Clinical Chemistry, Fimlab Laboratories, Tampere, Finland.,Department of Clinical Chemistry, Finnish Cardiovascular Research Center-Tampere, Faculty of Medicine and Health Technology, Tampere University, Tampere, Finland
| | - Kari E North
- Department of Epidemiology, Gillings School of Global Public Health, University of North Carolina, Chapel Hill, NC, USA
| | - Brenda W J H Penninx
- Department of Psychiatry, Amsterdam Neuroscience and Amsterdam Public Health Research Institute, Amsterdam UMC, Vrije Universiteit, Amsterdam, The Netherlands
| | - Peter Vollenweider
- Medicine, Internal Medicine, Lausanne University Hospital, Lausanne, Switzerland
| | - Lynne E Wagenknecht
- Public Health Sciences, Wake Forest School of Medicine, Winston-Salem, NC, USA
| | - Tangchun Wu
- Department of Occupational and Environmental Health and State Key Laboratory of Environmental Health for Incubating, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
| | - Yong-Bing Xiang
- SKLORG & Department of Epidemiology, Shanghai Cancer Institute, Renji Hospital, Shanghai Jiaotong University School of Medicine, Shanghai, P. R. China
| | - Wei Zheng
- Division of Epidemiology, Department of Medicine, Vanderbilt University School of Medicine, Nashville, TN, USA
| | - Donna K Arnett
- Dean's Office, University of Kentucky College of Public Health, Lexington, KS, USA
| | - Claude Bouchard
- Human Genomics Laboratory, Pennington Biomedical Research Center, Baton Rouge, LA, USA
| | - Michele K Evans
- Health Disparities Research Section, Laboratory of Epidemiology and Population Sciences, National Institute on Aging, National Institutes of Health, Baltimore, MD, USA
| | - Vilmundur Gudnason
- Icelandic Heart Association, Kopavogur, Iceland.,Faculty of Medicine, University of Iceland, Reykjavik, Iceland
| | - Sharon Kardia
- Department of Epidemiology, School of Public Health, University of Michigan, Ann Arbor, MI, USA
| | - Tanika N Kelly
- Epidemiology, Tulane University School of Public Health and Tropical Medicine, New Orleans, LA, USA
| | - Stephen B Kritchevsky
- Sticht Center for Healthy Aging and Rehabilitation, Gerontology and Geriatric Medicine, Wake Forest School of Medicine, Winston-Salem, NC, USA
| | - Ruth J F Loos
- The Charles Bronfman Institute for Personalized Medicine, The Icahn School of Medicine at Mount Sinai, New York, NY, USA.,The Mindich Child Health Development Institute, The Icahn School of Medicine at Mount Sinai, New York, NY, USA
| | - Alexandre C Pereira
- Laboratory of Genetics and Molecular Cardiology, Heart Institute (InCor), University of São Paulo Medical School, São Paulo, SP, Brazil
| | - Mike Province
- Division of Statistical Genomics, Department of Genetics, Washington University School of Medicine, St. Louis, MO, USA
| | - Bruce M Psaty
- Cardiovascular Health Research Unit, Epidemiology, Medicine and Health Services, University of Washington, Seattle, WA, USA.,Kaiser Permanente Washington, Health Research Institute, Seattle, WA, USA
| | - Charles Rotimi
- Center for Research on Genomics and Global Health, National Human Genome Research Institute, National Institutes of Health, Bethesda, MD, USA
| | - Xiaofeng Zhu
- Department of Population Quantitative and Health Sciences, Case Western Reserve University, Cleveland, OH, USA
| | - Najaf Amin
- Department of Epidemiology, Erasmus University Medical Center, Rotterdam, The Netherlands
| | - L Adrienne Cupples
- Department of Biostatistics, Boston University School of Public Health, Boston, MA, USA.,NHLBI Framingham Heart Study, Framingham, MA, USA
| | - Myriam Fornage
- Brown Foundation Institute of Molecular Medicine, The University of Texas Health Science Center at Houston, Houston, TX, USA
| | - Ervin F Fox
- Cardiology, Medicine, University of Mississippi Medical Center, Jackson, MS, USA
| | - Xiuqing Guo
- Genomic Outcomes, Department of Pediatrics, Institute for Translational Genomics and Population Sciences, LABioMed at Harbor-UCLA Medical Center, Torrance, CC, USA
| | - W James Gauderman
- Biostatistics, Preventive Medicine, University of Southern California, Los Angeles, CA, USA
| | - Kenneth Rice
- Department of Biostatistics, University of Washington, Seattle, WA, USA
| | - Charles Kooperberg
- Fred Hutchinson Cancer Research Center, University of Washington School of Public Health, Seattle, WA, USA
| | - Patricia B Munroe
- Clinical Pharmacology, William Harvey Research Institute, Barts and The London School of Medicine and Dentistry, Queen Mary University of London, London, UK.,NIHR Barts Cardiovascular Biomedical Research Centre, Queen Mary University of London, London, London, UK
| | - Ching-Ti Liu
- Department of Biostatistics, Boston University School of Public Health, Boston, MA, USA
| | - Alanna C Morrison
- 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
| | - Dabeeru C Rao
- Division of Biostatistics, Washington University School of Medicine, St. Louis, MO, USA
| | - Diana van Heemst
- Department of Internal Medicine, Section of Gerontology and Geriatrics, Leiden University Medical Center, Leiden, The Netherlands
| | - Susan Redline
- Division of Sleep and Circadian Disorders, Harvard Medical School, Brigham and Women's Hospital, Boston, MA, USA. .,Division of Pulmonary Medicine, Department of Medicine, Beth Israel Deaconess Medical Center, Harvard Medical School, Boston, MA, USA.
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Miname MH, Bittencourt MS, Pereira AC, Jannes CE, Krieger JE, Nasir K, Santos RD. Vascular age derived from coronary artery calcium score on the risk stratification of individuals with heterozygous familial hypercholesterolaemia. Eur Heart J Cardiovasc Imaging 2019; 21:251-257. [DOI: 10.1093/ehjci/jez280] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.2] [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] [Received: 06/28/2019] [Revised: 08/27/2019] [Accepted: 10/18/2019] [Indexed: 12/25/2022] Open
Abstract
Abstract
Aims
The objective of this study was to evaluate if vascular age derived from coronary artery calcium (CAC) score improves atherosclerosis cardiovascular disease (ASCVD) risk discrimination in primary prevention asymptomatic heterozygous familial hypercholesterolaemia (FH) patients undergoing standard lipid-lowering therapy.
Methods and results
Two hundred and six molecularly confirmed FH individuals (age 45 ± 14 years, 36% males, baseline LDL-cholesterol 6.2 ± 2.2 mmol/L; 239 ± 85mg/dL) were followed by 4.4 ± 2.9 years (median: 3.7 years, interquartile ranges 2.7–6.8). CAC measurement was performed, and lipid-lowering therapy was optimized according to FH guidelines. Vascular age was derived from CAC and calculated according to the Multi Ethnic Study of Atherosclerosis algorithm. Risk estimation based on the Framingham equations was calculated for both biological (bFRS) and vascular (vaFRS) age. During follow-up, 15 ASCVD events (7.2%) were documented. The annualized rate of events for bFRS <10%, 10–20%, and >20% was respectively: 8.45 [95% confidence interval (CI) 3.17–22.52], 23.28 (95% CI 9.69–55.94), and 28.13 (95% CI 12.63–62.61) per 1000 patients. The annualized rate of events for vaFRS <10%, 10–20%, and >20% was respectively: 0, 0, and 50.37 (95% CI 30.37–83.56) per 1000 patients. vaFRS presented a better discrimination for ASCVD events compared to bFRS 0.7058 (95% CI 0.5866–0.8250) vs. vaFRS 0.8820 (95% CI 0.8286–0.9355), P = 0.0005.
Conclusion
CAC derived vascular age can improve ASCVD risk discrimination in primary prevention FH subjects. This tool may help further stratify risk in FH patients already receiving lipid-lowering medication who might be candidates for further treatment with newer therapies.
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Affiliation(s)
- Marcio H Miname
- Heart Institute (InCor), University of São Paulo Medical School Hospital, Av. Dr Eneas C Aguiar 44, 05403900, São Paulo, Brazil
| | - Marcio Sommers Bittencourt
- Hospital Israelita Albert Einstein & School of Medicine, Faculdade Israelita de Ciência da Saúde Albert Einstein, Av. Professor Francisco Morato, 4293, 05521200, São Paulo, Brazil
- Center for Clinical and Epidemiological Research, University Hospital, University of São Paulo, Av. Prof. Lineu Prestes, 2565, 05508000, São Paulo, Brazil
| | - Alexandre C Pereira
- Heart Institute (InCor), University of São Paulo Medical School Hospital, Av. Dr Eneas C Aguiar 44, 05403900, São Paulo, Brazil
| | - Cinthia E Jannes
- Heart Institute (InCor), University of São Paulo Medical School Hospital, Av. Dr Eneas C Aguiar 44, 05403900, São Paulo, Brazil
| | - Jose E Krieger
- Heart Institute (InCor), University of São Paulo Medical School Hospital, Av. Dr Eneas C Aguiar 44, 05403900, São Paulo, Brazil
| | - Khurram Nasir
- Division of Cardiovascular Prevention and Wellness Houston Methodist DeBakey Heart & Vascular Center & Center for Outcomes Research Houston Methodist Hospital, 6565 Fannin St, 77030, Houston, TX, USA
| | - Raul D Santos
- Heart Institute (InCor), University of São Paulo Medical School Hospital, Av. Dr Eneas C Aguiar 44, 05403900, São Paulo, Brazil
- Hospital Israelita Albert Einstein, Av. Albert Einstein, 627, 05652-900, São Paulo, Brazil
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36
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Souto AC, Miname MH, Fukushima J, Jannes CE, Krieger JE, Hagger M, Pereira AC, Santos RD. Health related quality of life in individuals at high risk for familial hypercholesterolemia undergoing genetic cascade screening in Brazil. Atherosclerosis 2019; 277:464-469. [PMID: 30270086 DOI: 10.1016/j.atherosclerosis.2018.05.036] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [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: 03/23/2018] [Revised: 04/25/2018] [Accepted: 05/22/2018] [Indexed: 01/20/2023]
Abstract
BACKGROUND AND AIMS Familial hypercholesterolemia (FH) is a genetic disorder associated with high risk of early major cardiovascular events (MACE) that can impact the health related quality of life (HRQoL), however, this association is unclear. This study evaluated HRQoL in index cases (IC) and first-degree relatives (FDR) of individuals at high risk of FH undergoing genetic cascade screening. METHODS Data collection was performed before awareness of molecular diagnosis results. Individuals were divided into four groups according to the molecular diagnosis: IC with (IC+) and without (IC-) identified mutations (n = 93 and n = 175, respectively), and affected (FDR+, n = 231) and non-affected (FDR-, n = 159) FDR of IC+. HRQoL measurements, mental (MCS) and physical component (PCS) scores were carried out with SF-12 questionnaire. Associations were tested by generalized linear models. RESULTS The mean age was 49 ± 15 years, 42.2% were men, MACE had occurred in 30.7%. Overall, both PCS and MCS did not differ between FH and non-FH individuals, however, IC trended to have lower PCS independent of FH presence (p=0.003). Lower PCS were associated with female sex (p=0.018), lower education (p<0.001), professional inactivity (p=0.028), previous MACE occurrence (p<0.001), hypertension (p=0.016), depression (p<0.001) and obesity (p<0.001). Lower MCS were associated with female sex (p=0.009), previous MACE occurrence (p=0.034), depression (p<0.001) and smoking (p=0.009). Neither the presence of FH causing mutations nor pharmacological lipid lowering treatment was associated with HRQoL. CONCLUSIONS HRQoL is not reduced in both IC and FDR FH individuals in comparison with their non-affected counterparts. Previous MACE and co-morbidities are associated with reduced HRQoL.
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Affiliation(s)
- Ana Cristina Souto
- Heart Institute (InCor) University of Sao Paulo Medical School Hospital, Sao Paulo, Brazil
| | - Marcio H Miname
- Heart Institute (InCor) University of Sao Paulo Medical School Hospital, Sao Paulo, Brazil
| | - Julia Fukushima
- Heart Institute (InCor) University of Sao Paulo Medical School Hospital, Sao Paulo, Brazil
| | - Cinthia E Jannes
- Heart Institute (InCor) University of Sao Paulo Medical School Hospital, Sao Paulo, Brazil
| | - Jose E Krieger
- Heart Institute (InCor) University of Sao Paulo Medical School Hospital, Sao Paulo, Brazil
| | - Martin Hagger
- Faculty of Sport and Health Sciences, University of Jyva ¨skyla, Finland; School of Psychology, Curtin University, Australia; School of Applied Psychology, Griffith University, Australia
| | - Alexandre C Pereira
- Heart Institute (InCor) University of Sao Paulo Medical School Hospital, Sao Paulo, Brazil
| | - Raul D Santos
- Heart Institute (InCor) University of Sao Paulo Medical School Hospital, Sao Paulo, Brazil; Hospital Israelita Albert Einstein, Sao Paulo, Brazil.
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37
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Sung YJ, de las Fuentes L, Winkler TW, Chasman DI, Bentley AR, Kraja AT, Ntalla I, Warren HR, Guo X, Schwander K, Manning AK, Brown MR, Aschard H, Feitosa MF, Franceschini N, Lu Y, Cheng CY, Sim X, Vojinovic D, Marten J, Musani SK, Kilpeläinen TO, Richard MA, Aslibekyan S, Bartz TM, Dorajoo R, Li C, Liu Y, Rankinen T, Smith AV, Tajuddin SM, Tayo BO, Zhao W, Zhou Y, Matoba N, Sofer T, Alver M, Amini M, Boissel M, Chai JF, Chen X, Divers J, Gandin I, Gao C, Giulianini F, Goel A, Harris SE, Hartwig FP, He M, Horimoto ARVR, Hsu FC, Jackson AU, Kammerer CM, Kasturiratne A, Komulainen P, Kühnel B, Leander K, Lee WJ, Lin KH, Luan J, Lyytikäinen LP, McKenzie CA, Nelson CP, Noordam R, Scott RA, Sheu WHH, Stančáková A, Takeuchi F, van der Most PJ, Varga TV, Waken RJ, Wang H, Wang Y, Ware EB, Weiss S, Wen W, Yanek LR, Zhang W, Zhao JH, Afaq S, Alfred T, Amin N, Arking DE, Aung T, Barr RG, Bielak LF, Boerwinkle E, Bottinger EP, Braund PS, Brody JA, Broeckel U, Cade B, Campbell A, Canouil M, Chakravarti A, Cocca M, Collins FS, Connell JM, de Mutsert R, de Silva HJ, Dörr M, Duan Q, Eaton CB, Ehret G, Evangelou E, Faul JD, Forouhi NG, Franco OH, Friedlander Y, Gao H, Gigante B, Gu CC, Gupta P, Hagenaars SP, Harris TB, He J, Heikkinen S, Heng CK, Hofman A, Howard BV, Hunt SC, Irvin MR, Jia Y, Katsuya T, Kaufman J, Kerrison ND, Khor CC, Koh WP, Koistinen HA, Kooperberg CB, Krieger JE, Kubo M, Kutalik Z, Kuusisto J, Lakka TA, Langefeld CD, Langenberg C, Launer LJ, Lee JH, Lehne B, Levy D, Lewis CE, Li Y, Lim SH, Liu CT, Liu J, Liu J, Liu Y, Loh M, Lohman KK, Louie T, Mägi R, Matsuda K, Meitinger T, Metspalu A, Milani L, Momozawa Y, Mosley, Jr TH, Nalls MA, Nasri U, O'Connell JR, Ogunniyi A, Palmas WR, Palmer ND, Pankow JS, Pedersen NL, Peters A, Peyser PA, Polasek O, Porteous D, Raitakari OT, Renström F, Rice TK, Ridker PM, Robino A, Robinson JG, Rose LM, Rudan I, Sabanayagam C, Salako BL, Sandow K, Schmidt CO, Schreiner PJ, Scott WR, Sever P, Sims M, Sitlani CM, Smith BH, Smith JA, Snieder H, Starr JM, Strauch K, Tang H, Taylor KD, Teo YY, Tham YC, Uitterlinden AG, Waldenberger M, Wang L, Wang YX, Wei WB, Wilson G, Wojczynski MK, Xiang YB, Yao J, Yuan JM, Zonderman AB, Becker DM, Boehnke M, Bowden DW, Chambers JC, Chen YDI, Weir DR, de Faire U, Deary IJ, Esko T, Farrall M, Forrester T, Freedman BI, Froguel P, Gasparini P, Gieger C, Horta BL, Hung YJ, Jonas JB, Kato N, Kooner JS, Laakso M, Lehtimäki T, Liang KW, Magnusson PKE, Oldehinkel AJ, Pereira AC, Perls T, Rauramaa R, Redline S, Rettig R, Samani NJ, Scott J, Shu XO, van der Harst P, Wagenknecht LE, Wareham NJ, Watkins H, Wickremasinghe AR, Wu T, Kamatani Y, Laurie CC, Bouchard C, Cooper RS, Evans MK, Gudnason V, Hixson J, Kardia SLR, Kritchevsky SB, Psaty BM, van Dam RM, Arnett DK, Mook-Kanamori DO, Fornage M, Fox ER, Hayward C, van Duijn CM, Tai ES, Wong TY, Loos RJF, Reiner AP, Rotimi CN, Bierut LJ, Zhu X, Cupples LA, Province MA, Rotter JI, Franks PW, Rice K, Elliott P, Caulfield MJ, Gauderman WJ, Munroe PB, Rao DC, Morrison AC. A multi-ancestry genome-wide study incorporating gene-smoking interactions identifies multiple new loci for pulse pressure and mean arterial pressure. Hum Mol Genet 2019; 28:2615-2633. [PMID: 31127295 PMCID: PMC6644157 DOI: 10.1093/hmg/ddz070] [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] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/05/2018] [Revised: 03/25/2019] [Accepted: 03/26/2019] [Indexed: 12/24/2022] Open
Abstract
Elevated blood pressure (BP), a leading cause of global morbidity and mortality, is influenced by both genetic and lifestyle factors. Cigarette smoking is one such lifestyle factor. Across five ancestries, we performed a genome-wide gene-smoking interaction study of mean arterial pressure (MAP) and pulse pressure (PP) in 129 913 individuals in stage 1 and follow-up analysis in 480 178 additional individuals in stage 2. We report here 136 loci significantly associated with MAP and/or PP. Of these, 61 were previously published through main-effect analysis of BP traits, 37 were recently reported by us for systolic BP and/or diastolic BP through gene-smoking interaction analysis and 38 were newly identified (P < 5 × 10-8, false discovery rate < 0.05). We also identified nine new signals near known loci. Of the 136 loci, 8 showed significant interaction with smoking status. They include CSMD1 previously reported for insulin resistance and BP in the spontaneously hypertensive rats. Many of the 38 new loci show biologic plausibility for a role in BP regulation. SLC26A7 encodes a chloride/bicarbonate exchanger expressed in the renal outer medullary collecting duct. AVPR1A is widely expressed, including in vascular smooth muscle cells, kidney, myocardium and brain. FHAD1 is a long non-coding RNA overexpressed in heart failure. TMEM51 was associated with contractile function in cardiomyocytes. CASP9 plays a central role in cardiomyocyte apoptosis. Identified only in African ancestry were 30 novel loci. Our findings highlight the value of multi-ancestry investigations, particularly in studies of interaction with lifestyle factors, where genomic and lifestyle differences may contribute to novel findings.
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Affiliation(s)
- Yun Ju Sung
- Division of Biostatistics, Washington University School of Medicine, St. Louis, MO, USA
| | - Lisa de las Fuentes
- Division of Biostatistics, Washington University School of Medicine, St. Louis, MO, USA
- Cardiovascular Division, Department of Medicine, Washington University, St. Louis, MO, USA
| | - Thomas W Winkler
- Department of Genetic Epidemiology, University of Regensburg, Regensburg, Germany
| | - Daniel I Chasman
- Preventive Medicine, Brigham and Women’s Hospital, Boston, MA, USA
| | - Amy R Bentley
- Center for Research on Genomics and Global Health, National Human Genome Research Institute, National Institutes of Health, Bethesda, MD, USA
| | - Aldi T Kraja
- Division of Statistical Genomics, Department of Genetics, Washington University School of Medicine, St. Louis, MO, USA
| | - Ioanna Ntalla
- Clinical Pharmacology, William Harvey Research Institute, Barts and The London School of Medicine and Dentistry, Queen Mary University of London, London, UK
| | - Helen R Warren
- Clinical Pharmacology, William Harvey Research Institute, Barts and The London School of Medicine and Dentistry, Queen Mary University of London, London, UK
- NIHR Barts Cardiovascular Biomedical Research Centre, Queen Mary University of London, London, London, UK
| | - Xiuqing Guo
- Division of Genomic Outcomes, Department of Pediatrics, The Institute for Translational Genomics and Population Sciences, Los Angeles Biomedical Research Institute at Harbor-UCLA Medical Center, Torrance, CA, USA
| | - Karen Schwander
- Division of Biostatistics, Washington University School of Medicine, St. Louis, MO, USA
| | - Alisa K Manning
- Center for Human Genetics Research, Massachusetts General Hospital, Boston, MA, USA
- Program in Medical and Population Genetics, Broad Institute of MIT and Harvard, Cambridge, MA, USA
| | - Michael R Brown
- 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
| | - Hugues Aschard
- Department of Epidemiology, Harvard School of Public Health, Boston, MA, USA
- Centre de Bioinformatique, Biostatistique et Biologie Intégrative (C3BI), Institut Pasteur, Paris, France
| | - Mary F Feitosa
- Division of Statistical Genomics, Department of Genetics, Washington University School of Medicine, St. Louis, MO, USA
| | - Nora Franceschini
- Epidemiology, University of North Carolina Gillings School of Global Public Health, Chapel Hill, NC, USA
| | - Yingchang Lu
- Icahn School of Medicine at Mount Sinai, The Charles Bronfman Institute for Personalized Medicine, New York, NY, USA
| | - Ching-Yu Cheng
- Singapore Eye Research Institute, Singapore National Eye Centre, Singapore, Singapore
- Ophthalmology & Visual Sciences Academic Clinical Program (Eye ACP), Duke-NUS Medical School, Singapore, Singapore
- Department of Ophthalmology, Yong Loo Lin School of Medicine, National University of Singapore, Singapore, Singapore
| | - Xueling Sim
- Saw Swee Hock School of Public Health, National University Health System and National University of Singapore, Singapore, Singapore
| | - Dina Vojinovic
- Department of Epidemiology, Erasmus University Medical Center, Rotterdam, The Netherlands
| | - Jonathan Marten
- Medical Research Council Human Genetics Unit, MRC Institute of Genetics and Molecular Medicine, University of Edinburgh, Edinburgh, UK
| | - Solomon K Musani
- Jackson Heart Study, Department of Medicine, University of Mississippi Medical Center, Jackson, MS, USA
| | - Tuomas O Kilpeläinen
- Novo Nordisk Foundation Center for Basic Metabolic Research, Section of Metabolic Genetics, Faculty of Health and Medical Sciences, University of Copenhagen, Copenhagen, Denmark
- Department of Environmental Medicine and Public Health, The Icahn School of Medicine at Mount Sinai, New York, NY, USA
| | - Melissa A Richard
- Brown Foundation Institute of Molecular Medicine, The University of Texas Health Science Center at Houston, Houston, TX, USA
| | - Stella Aslibekyan
- Department of Epidemiology, University of Alabama at Birmingham, Birmingham, AL, USA
| | - Traci M Bartz
- Cardiovascular Health Research Unit, Biostatistics and Medicine, University of Washington, Seattle, WA, USA
| | - Rajkumar Dorajoo
- Genome Institute of Singapore, Agency for Science Technology and Research, Singapore, Singapore
| | - Changwei Li
- Epidemiology and Biostatistics, University of Georgia at Athens College of Public Health, Athens, GA, USA
| | - Yongmei Liu
- Public Health Sciences, Epidemiology and Prevention, Wake Forest University Health Sciences, Winston-Salem, NC, USA
| | - Tuomo Rankinen
- Human Genomics Laboratory, Pennington Biomedical Research Center, Baton Rouge, LA, USA
| | - Albert Vernon Smith
- Icelandic Heart Association, Kopavogur, Iceland
- Faculty of Medicine, University of Iceland, Reykjavik, Iceland
| | - Salman M Tajuddin
- Health Disparities Research Section, Laboratory of Epidemiology and Population Sciences, National Institute on Aging, National Institutes of Health, Baltimore, MD, USA
| | - Bamidele O Tayo
- Department of Public Health Sciences, Loyola University Chicago, Maywood, IL, USA
| | - Wei Zhao
- Department of Epidemiology, School of Public Health, University of Michigan, Ann Arbor, MI, USA
| | - Yanhua Zhou
- Biostatistics, Boston University School of Public Health, Boston, MA, USA
| | - Nana Matoba
- Laboratory for Statistical Analysis, RIKEN Center for Integrative Medical Sciences, Yokohama, Japan
| | - Tamar Sofer
- Department of Medicine, Harvard Medical School, Boston, MA, USA
- Division of Sleep and Circadian Disorders, Brigham and Women’s Hospital, Boston, MA, USA
| | - Maris Alver
- Estonian Genome Center, Institute of Genomics, University of Tartu, Tartu, Estonia
| | - Marzyeh Amini
- Department of Epidemiology, University of Groningen, University Medical Center Groningen, Groningen RB, The Netherlands
| | - Mathilde Boissel
- CNRS UMR 8199, European Genomic Institute for Diabetes (EGID), Institut Pasteur de Lille, University of Lille, Lille, France
| | - Jin Fang Chai
- Saw Swee Hock School of Public Health, National University Health System and National University of Singapore, Singapore, Singapore
| | - Xu Chen
- Department of Medical Epidemiology and Biostatistics, Karolinska Institutet, Stockholm, Stockholm, Sweden
| | - Jasmin Divers
- Biostatistical Sciences, Public Health Sciences, Wake Forest School of Medicine, Winston-Salem, NC, USA
| | - Ilaria Gandin
- Department of Medical Sciences, University of Trieste, Trieste, Italy
| | - Chuan Gao
- Molecular Genetics and Genomics Program, Wake Forest School of Medicine, Winston-Salem, NC, USA
| | | | - Anuj Goel
- Division of Cardiovascular Medicine, Radcliffe Department of Medicine, University of Oxford, Oxford, Oxfordshire, UK
- Wellcome Centre for Human Genetics, University of Oxford, Oxford, Oxfordshire, UK
| | - Sarah E Harris
- Centre for Cognitive Ageing and Cognitive Epidemiology, The University of Edinburgh, Edinburgh, UK
- Medical Genetics Section, University of Edinburgh Centre for Genomic and Experimental Medicine and MRC Institute of Genetics and Molecular Medicine, The University of Edinburgh, Edinburgh, UK
| | - Fernando P Hartwig
- Postgraduate Programme in Epidemiology, Federal University of Pelotas, Pelotas, RS, Brazil
- Medical Research Council Integrative Epidemiology Unit, University of Bristol, Bristol, UK
| | - Meian He
- Lab Genetics and Molecular Cardiology, Cardiology, Heart Institute, University of Sao Paulo, Sao Paulo, CA, USA
| | - Andrea R V R Horimoto
- Department of Biostatistics and Center for Statistical Genetics, University of Michigan, Ann Arbor, MI, USA
| | - Fang-Chi Hsu
- Biostatistical Sciences, Public Health Sciences, Wake Forest School of Medicine, Winston-Salem, NC, USA
| | - Anne U Jackson
- Department of Human Genetics, Graduate School of Public Health, University of Pittsburgh, Pittsburgh, PA, USA
| | - Candace M Kammerer
- Department of Public Health, Faculty of Medicine, University of Kelaniya, Ragama, Sri Lanka
| | - Anuradhani Kasturiratne
- Foundation for Research in Health Exercise and Nutrition, Kuopio Research Institute of Exercise Medicine, Kuopio, Finland
| | - Pirjo Komulainen
- Research Unit of Molecular Epidemiology, Helmholtz Zentrum München, German Research Center for Environmental Health, Neuherberg, Germany
| | - Brigitte Kühnel
- Institute of Epidemiology, Helmholtz Zentrum München, German Research Center for Environmental Health, Neuherberg, Germany
- Institute of Environmental Medicine, Karolinska Institutet, Stockholm, Sweden
| | - Karin Leander
- Medical Research, Taichung Veterans General Hospital, Department of Social Work, Tunghai University, Taichung, Taiwan
| | - Wen-Jane Lee
- Ophthalmology, Taichung Veterans General Hospital, Taichung, Taiwan
| | - Keng-Hung Lin
- MRC Epidemiology Unit, University of Cambridge, Cambridge, UK
| | - Jian’an Luan
- Department of Clinical Chemistry, Fimlab Laboratories, Tampere, Finland
| | - Leo-Pekka Lyytikäinen
- Department of Clinical Chemistry, Finnish Cardiovascular Research Center—Tampere, Faculty of Medicine and Life Sciences, University of Tampere, Tampere, Finland
- Tropical Metabolism Research Unit, Tropical Medicine Research Institute, University of the West Indies, Mona, Jamaica
| | - Colin A McKenzie
- School of Public Health, Department of Occupational and Environmental Health and State Key Laboratory of Environmental Health for Incubating, Tongi Medical College, Huazhong University of Science and Technology, Wuhan, China
| | - Christopher P Nelson
- Department of Cardiovascular Sciences, University of Leicester, Leicester, UK
- NIHR Leicester Biomedical Research Centre, Glenfield Hospital, Leicester, UK
| | - Raymond Noordam
- Internal Medicine, Gerontology and Geriatrics, Leiden University Medical Center, Leiden, The Netherlands
| | - Robert A Scott
- Department of Clinical Chemistry, Fimlab Laboratories, Tampere, Finland
| | - Wayne H H Sheu
- Endocrinology and Metabolism, Internal Medicine, Taichung Veterans General Hospital, Taichung, Taiwan
- School of Medicine, National Yang-ming University, Taipei, Taiwan
- School of Medicine, National Defense Medical Center, Taipei, Taiwan
- Institute of Medical Technology, National Chung-Hsing University, Taichung, Taiwan
| | - Alena Stančáková
- Institute of Clinical Medicine, Internal Medicine, University of Eastern Finland, Kuopio, Finland
| | - Fumihiko Takeuchi
- Department of Gene Diagnostics and Therapeutics, Research Institute, National Center for Global Health and Medicine, Tokyo, Japan
| | - Peter J van der Most
- Department of Epidemiology, University of Groningen, University Medical Center Groningen, Groningen RB, The Netherlands
| | - Tibor V Varga
- Department of Clinical Sciences, Genetic and Molecular Epidemiology Unit, Lund University Diabetes Centre, Skåne University Hospital, Malmö, Sweden
| | - Robert J Waken
- Division of Biostatistics, Washington University School of Medicine, St. Louis, MO, USA
| | - Heming Wang
- Department of Medicine, Harvard Medical School, Boston, MA, USA
- Division of Sleep and Circadian Disorders, Brigham and Women’s Hospital, Boston, MA, USA
| | - Yajuan Wang
- Department of Epidemiology and Biostatistics, Case Western Reserve University, Cleveland, OH, USA
| | - Erin B Ware
- Department of Epidemiology, School of Public Health, University of Michigan, Ann Arbor, MI, USA
- Survey Research Center, Institute for Social Research, University of Michigan, Ann Arbor, MI, USA
| | - Stefan Weiss
- Interfaculty Institute for Genetics and Functional Genomics, University Medicine Ernst Moritz Arndt University Greifswald, Greifswald, Germany
- DZHK (German Centre for Cardiovascular Health), Partner Site Greifswald, Greifswald, Germany
| | - Wanqing Wen
- Division of Epidemiology, Department of Medicine, Vanderbilt University School of Medicine, Nashville, TN, USA
| | - Lisa R Yanek
- General Internal Medicine, GeneSTAR Research Program, Medicine, Johns Hopkins University School of Medicine, Baltimore, MD, USA
| | - Weihua Zhang
- MRC-PHE Centre for Environment and Health, Department of Epidemiology and Biostatistics, Imperial College London, London, UK
- Department of Cardiology, Ealing Hospital, Middlesex, UK
| | - Jing Hua Zhao
- Department of Clinical Chemistry, Fimlab Laboratories, Tampere, Finland
| | - Saima Afaq
- MRC-PHE Centre for Environment and Health, Department of Epidemiology and Biostatistics, Imperial College London, London, UK
| | - Tamuno Alfred
- Icahn School of Medicine at Mount Sinai, The Charles Bronfman Institute for Personalized Medicine, New York, NY, USA
| | - Najaf Amin
- Department of Epidemiology, Erasmus University Medical Center, Rotterdam, The Netherlands
| | - Dan E Arking
- McKusick-Nathans Institute of Genetic Medicine, Johns Hopkins University School of Medicine, Baltimore, MD, USA
| | - Tin Aung
- Singapore Eye Research Institute, Singapore National Eye Centre, Singapore, Singapore
- Ophthalmology & Visual Sciences Academic Clinical Program (Eye ACP), Duke-NUS Medical School, Singapore, Singapore
- Department of Ophthalmology, Yong Loo Lin School of Medicine, National University of Singapore, Singapore, Singapore
| | - R Graham Barr
- Departments of Medicine and Epidemiology, Columbia University Medical Center, New York, NY, USA
| | - Lawrence F Bielak
- Department of Epidemiology, School of Public Health, University of Michigan, Ann Arbor, MI, 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
- Human Genome Sequencing Center, Baylor College of Medicine, Houston, TX, USA
| | - Erwin P Bottinger
- Icahn School of Medicine at Mount Sinai, The Charles Bronfman Institute for Personalized Medicine, New York, NY, USA
| | - Peter S Braund
- Department of Cardiovascular Sciences, University of Leicester, Leicester, UK
- NIHR Leicester Biomedical Research Centre, Glenfield Hospital, Leicester, UK
| | - Jennifer A Brody
- Cardiovascular Health Research Unit, Medicine, University of Washington, Seattle, WA, USA
| | - Ulrich Broeckel
- Section of Genomic Pediatrics, Department of Pediatrics, Medicine and Physiology, Medical College of Wisconsin, Milwaukee, WI, USA
| | - Brian Cade
- Division of Sleep and Circadian Disorders, Brigham and Women’s Hospital, Boston, MA, USA
| | - Archie Campbell
- Centre for Genomic & Experimental Medicine, Institute of Genetics & Molecular Medicine, University of Edinburgh, Edinburgh, UK
| | - Mickaël Canouil
- CNRS UMR 8199, European Genomic Institute for Diabetes (EGID), Institut Pasteur de Lille, University of Lille, Lille, France
| | - Aravinda Chakravarti
- McKusick-Nathans Institute of Genetic Medicine, Johns Hopkins University School of Medicine, Baltimore, MD, USA
| | | | - Francis S Collins
- Medical Genomics and Metabolic Genetics Branch, National Human Genome Research Institute, National Institutes of Health, Bethesda, MD, USA
| | - John M Connell
- Ninewells Hospital & Medical School, University of Dundee, Dundee, Scotland, UK
| | - Renée de Mutsert
- Clinical Epidemiology, Leiden University Medical Center, Leiden, The Netherlands
| | - H Janaka de Silva
- Department of Medicine, Faculty of Medicine, University of Kelaniya, Ragama, Sri Lanka
| | - Marcus Dörr
- DZHK (German Centre for Cardiovascular Health), Partner Site Greifswald, Greifswald, Germany
- Department of Internal Medicine B, University Medicine Greifswald, Greifswald, Germany
| | - Qing Duan
- Department of Genetics, University of North Carolina, Chapel Hill, USA
| | - Charles B Eaton
- Department of Family Medicine and Epidemiology, Alpert Medical School of Brown University, Providence, RI, USA
| | - Georg Ehret
- McKusick-Nathans Institute of Genetic Medicine, Johns Hopkins University School of Medicine, Baltimore, MD, USA
- Cardiology, Department of Specialties of Medicine, Geneva University Hospital, Geneva, Switzerland
| | - Evangelos Evangelou
- MRC-PHE Centre for Environment and Health, Department of Epidemiology and Biostatistics, Imperial College London, London, UK
- Department of Hygiene and Epidemiology, University of Ioannina Medical School, Ioannina, Greece
| | - Jessica D Faul
- Survey Research Center, Institute for Social Research, University of Michigan, Ann Arbor, MI, USA
| | - Nita G Forouhi
- Department of Clinical Chemistry, Fimlab Laboratories, Tampere, Finland
| | - Oscar H Franco
- Department of Epidemiology, Erasmus University Medical Center, Rotterdam, The Netherlands
| | - Yechiel Friedlander
- Braun School of Public Health, Hebrew University-Hadassah Medical Center, Jerusalem, Israel
| | - He Gao
- MRC-PHE Centre for Environment and Health, Department of Epidemiology and Biostatistics, Imperial College London, London, UK
| | - Bruna Gigante
- Medical Research, Taichung Veterans General Hospital, Department of Social Work, Tunghai University, Taichung, Taiwan
| | - C Charles Gu
- Division of Biostatistics, Washington University School of Medicine, St. Louis, MO, USA
| | - Preeti Gupta
- Singapore Eye Research Institute, Singapore National Eye Centre, Singapore, Singapore
| | - Saskia P Hagenaars
- Centre for Cognitive Ageing and Cognitive Epidemiology, The University of Edinburgh, Edinburgh, UK
- Psychology, The University of Edinburgh, Edinburgh, UK
| | - Tamara B Harris
- Laboratory of Epidemiology and Population Sciences, National Institute on Aging, National Institutes of Health, Bethesda, MD, USA
| | - Jiang He
- Epidemiology, Tulane University School of Public Health and Tropical Medicine, New Orleans, LA, USA
- Medicine, Tulane University School of Medicine, New Orleans, LA, USA
| | - Sami Heikkinen
- Institute of Clinical Medicine, Internal Medicine, University of Eastern Finland, Kuopio, Finland
- Institute of Biomedicine, School of Medicine, University of Eastern Finland, Kuopio Campus, Finland
| | - Chew-Kiat Heng
- Department of Paediatrics, Yong Loo Lin School of Medicine, National University of Singapore, Singapore, Singapore
- Khoo Teck Puat—National University Children’s Medical Institute, National University Health System, Singapore, Singapore
| | - Albert Hofman
- Department of Epidemiology, Erasmus University Medical Center, Rotterdam, The Netherlands
| | - Barbara V Howard
- MedStar Health Research Institute, Hyattsville, MD, USA
- Center for Clinical and Translational Sciences and Department of Medicine, Georgetown–Howard Universities, Washington, DC, USA
| | - Steven C Hunt
- Division of Epidemiology, Department of Internal Medicine, University of Utah School of Medicine, Salt Lake City, UT, USA
- Department of Genetic Medicine, Weill Cornell Medicine, Doha, Qatar
| | - Marguerite R Irvin
- Department of Biostatistics, University of Alabama at Birmingham, Birmingham, AL, USA
| | - Yucheng Jia
- Division of Genomic Outcomes, Department of Pediatrics, The Institute for Translational Genomics and Population Sciences, Los Angeles Biomedical Research Institute at Harbor-UCLA Medical Center, Torrance, CA, USA
| | - Tomohiro Katsuya
- Department of Clinical Gene Therapy, Osaka University Graduate School of Medicine, Suita, Japan
- Department of Geriatric Medicine and Nephrology, Osaka University Graduate School of Medicine, Suita, Japan
| | - Joel Kaufman
- Epidemiology, Occupational and Environmental Medicine Program, University of Washington, Seattle, WA, USA
| | - Nicola D Kerrison
- Department of Clinical Chemistry, Fimlab Laboratories, Tampere, Finland
| | - Chiea Chuen Khor
- Genome Institute of Singapore, Agency for Science Technology and Research, Singapore, Singapore
- Department of Biochemistry, National University of Singapore, Singapore, Singapore
| | - Woon-Puay Koh
- Saw Swee Hock School of Public Health, National University Health System and National University of Singapore, Singapore, Singapore
- Health Services and Systems Research, Duke–NUS Medical School, Singapore, Singapore
| | - Heikki A Koistinen
- Department of Public Health Solutions, National Institute for Health and Welfare, Helsinki, Finland
- Department of Medicine and Abdominal Center: Endocrinology, University of Helsinki and Helsinki University Central Hospital, Helsinki, Finland
- Minerva Foundation Institute for Medical Research, Biomedicum 2U, Helsinki Finland
| | - Charles B Kooperberg
- Fred Hutchinson Cancer Research Center, University of Washington School of Public Health, Seattle, WA, USA
| | - Jose E Krieger
- Department of Biostatistics and Center for Statistical Genetics, University of Michigan, Ann Arbor, MI, USA
| | - Michiaki Kubo
- RIKEN Center for Integrative Medical Sciences, Yokohama, Japan
| | - Zoltan Kutalik
- Institute of Social Preventive Medicine, Lausanne University Hospital, Lausanne, Switzerland
- Swiss Institute of Bioinformatics, Lausanne, Switzerland
| | - Johanna Kuusisto
- Institute of Clinical Medicine, Internal Medicine, University of Eastern Finland, Kuopio, Finland
| | - Timo A Lakka
- Research Unit of Molecular Epidemiology, Helmholtz Zentrum München, German Research Center for Environmental Health, Neuherberg, Germany
- Institute of Biomedicine, School of Medicine, University of Eastern Finland, Kuopio Campus, Finland
- Department of Clinical Physiology and Nuclear Medicine, Kuopio University Hospital, Kuopio, Finland
| | - Carl D Langefeld
- Biostatistical Sciences, Public Health Sciences, Wake Forest School of Medicine, Winston-Salem, NC, USA
| | | | - Lenore J Launer
- Laboratory of Epidemiology and Population Sciences, National Institute on Aging, National Institutes of Health, Bethesda, MD, USA
| | - Joseph H Lee
- Sergievsky Center, College of Physicians and Surgeons, Columbia University Mailman School of Public Health, New York, NY, USA
| | - Benjamin Lehne
- MRC-PHE Centre for Environment and Health, Department of Epidemiology and Biostatistics, Imperial College London, London, UK
| | - Daniel Levy
- NHLBI Framingham Heart Study, Framingham, MA, USA
- The Population Sciences Branch, National Heart, Lung, and Blood Institute, National Institutes of Health, Bethesda, MD, USA
| | - Cora E Lewis
- Department of Medicine, University of Alabama at Birmingham, Birmingham, AL, USA
| | - Yize Li
- Division of Biostatistics, Washington University School of Medicine, St. Louis, MO, USA
| | | | - Sing Hui Lim
- Singapore Eye Research Institute, Singapore National Eye Centre, Singapore, Singapore
| | - Ching-Ti Liu
- Biostatistics, Boston University School of Public Health, Boston, MA, USA
| | - Jianjun Liu
- Saw Swee Hock School of Public Health, National University Health System and National University of Singapore, Singapore, Singapore
- Genome Institute of Singapore, Agency for Science Technology and Research, Singapore, Singapore
| | - Jingmin Liu
- WHI CCC, Fred Hutchinson Cancer Research Center, Seattle, WA, USA
| | - Yeheng Liu
- Division of Genomic Outcomes, Department of Pediatrics, The Institute for Translational Genomics and Population Sciences, Los Angeles Biomedical Research Institute at Harbor-UCLA Medical Center, Torrance, CA, USA
| | - Marie Loh
- MRC-PHE Centre for Environment and Health, Department of Epidemiology and Biostatistics, Imperial College London, London, UK
- Translational Laboratory in Genetic Medicine, Agency for Science, Technology and Research, Singapore
| | - Kurt K Lohman
- Biostatistical Sciences, Public Health Sciences, Wake Forest School of Medicine, Winston-Salem, NC, USA
| | - Tin Louie
- Department of Biostatistics, University of Washington, Seattle, WA, USA
| | - Reedik Mägi
- Estonian Genome Center, Institute of Genomics, University of Tartu, Tartu, Estonia
| | - Koichi Matsuda
- Laboratory for Clinical Genome Sequencing, Department of Computational Biology and Medical Sciences, Graduate School of Frontier Sciences, The University of Tokyo, Minato-ku, Japan
| | - Thomas Meitinger
- Institute of Human Genetics, Helmholtz Zentrum München, German Research Center for Environmental Health, Neuherberg, Germany
- Institute of Human Genetics, Technische Universität München, Munich, Germany
| | - Andres Metspalu
- Estonian Genome Center, Institute of Genomics, University of Tartu, Tartu, Estonia
| | - Lili Milani
- Cardiovascular Division, Department of Medicine, Washington University, St. Louis, MO, USA
| | - Yukihide Momozawa
- Laboratory for Genotyping Development, RIKEN Center for Integrative Medical Sciences, Yokohama, Japan
| | | | - Mike A Nalls
- Laboratory of Neurogenetics, National Institute on Aging, Bethesda, MD, USA
| | - Ubaydah Nasri
- Division of Genomic Outcomes, Department of Pediatrics, The Institute for Translational Genomics and Population Sciences, Los Angeles Biomedical Research Institute at Harbor-UCLA Medical Center, Torrance, CA, USA
| | - Jeff R O'Connell
- Division of Endocrinology, Diabetes, and Nutrition, University of Maryland School of Medicine, Baltimore, MD, USA
- Program for Personalized and Genomic Medicine, University of Maryland School of Medicine, Baltimore, MD, USA
| | | | | | | | - James S Pankow
- Division of Epidemiology and Community Health, University of Minnesota School of Public Health, Minneapolis, MN, USA
| | - Nancy L Pedersen
- Department of Medical Epidemiology and Biostatistics, Karolinska Institutet, Stockholm, Stockholm, Sweden
| | - Annette Peters
- Institute of Epidemiology, Helmholtz Zentrum München, German Research Center for Environmental Health, Neuherberg, Germany
- DZHK (German Centre for Cardiovascular Research), partner site Munich Heart Alliance, Neuherberg, Germany
| | - Patricia A Peyser
- Department of Epidemiology, School of Public Health, University of Michigan, Ann Arbor, MI, USA
| | - Ozren Polasek
- Department of Public Health, Department of Medicine, University of Split, Split, Croatia
- Psychiatric Hospital ‘Sveti Ivan’, Zagreb, Croatia
- Gen-info Ltd, Zagreb, Croatia
| | - David Porteous
- Centre for Genomic & Experimental Medicine, Institute of Genetics & Molecular Medicine, University of Edinburgh, Edinburgh, UK
| | - Olli T Raitakari
- Department of Clinical Physiology and Nuclear Medicine, Turku University Hospital, Turku, Finland
- Research Centre of Applied and Preventive Cardiovascular Medicine, University of Turku, Turku, Finland
| | - Frida Renström
- Department of Clinical Sciences, Genetic and Molecular Epidemiology Unit, Lund University Diabetes Centre, Skåne University Hospital, Malmö, Sweden
- Department of Biobank Research, Umeå University, Umeå, Västerbotten, Sweden
| | - Treva K Rice
- Division of Biostatistics, Washington University School of Medicine, St. Louis, MO, USA
| | - Paul M Ridker
- Preventive Medicine, Brigham and Women’s Hospital, Boston, MA, USA
| | - Antonietta Robino
- Institute for Maternal and Child Health—IRCCS ‘Burlo Garofolo’, Trieste, Italy
| | - Jennifer G Robinson
- Department of Epidemiology and Medicine, University of Iowa, Iowa City, IA, USA
| | - Lynda M Rose
- Preventive Medicine, Brigham and Women’s Hospital, Boston, MA, USA
| | - Igor Rudan
- Centre for Global Health Research, Usher Institute of Population Health Sciences and Informatics, University of Edinburgh, Edinburgh, UK
| | - Charumathi Sabanayagam
- Singapore Eye Research Institute, Singapore National Eye Centre, Singapore, Singapore
- Ophthalmology & Visual Sciences Academic Clinical Program (Eye ACP), Duke-NUS Medical School, Singapore, Singapore
| | | | - Kevin Sandow
- Division of Genomic Outcomes, Department of Pediatrics, The Institute for Translational Genomics and Population Sciences, Los Angeles Biomedical Research Institute at Harbor-UCLA Medical Center, Torrance, CA, USA
| | - Carsten O Schmidt
- DZHK (German Centre for Cardiovascular Health), Partner Site Greifswald, Greifswald, Germany
- Institute for Community Medicine, University Medicine Greifswald, Greifswald, Germany
| | - Pamela J Schreiner
- Division of Epidemiology and Community Health, University of Minnesota School of Public Health, Minneapolis, MN, USA
| | - William R Scott
- MRC-PHE Centre for Environment and Health, Department of Epidemiology and Biostatistics, Imperial College London, London, UK
- National Heart and Lung Institute, Imperial College London, London, UK
| | - Peter Sever
- International Centre for Circulatory Health, Imperial College London, London, UK
| | - Mario Sims
- Jackson Heart Study, Department of Medicine, University of Mississippi Medical Center, Jackson, MS, USA
| | - Colleen M Sitlani
- Cardiovascular Health Research Unit, Medicine, University of Washington, Seattle, WA, USA
| | - Blair H Smith
- Division of Population Health Sciences, Ninewells Hospital and Medical School, University of Dundee, Dundee, UK
| | - Jennifer A Smith
- Department of Epidemiology, School of Public Health, University of Michigan, Ann Arbor, MI, USA
- Survey Research Center, Institute for Social Research, University of Michigan, Ann Arbor, MI, USA
| | - Harold Snieder
- Department of Epidemiology, University of Groningen, University Medical Center Groningen, Groningen RB, The Netherlands
| | - John M Starr
- Centre for Cognitive Ageing and Cognitive Epidemiology, The University of Edinburgh, Edinburgh, UK
- Alzheimer Scotland Dementia Research Centre, The University of Edinburgh, Edinburgh, UK
| | - Konstantin Strauch
- Institute of Genetic Epidemiology, Helmholtz Zentrum München, German Research Center for Environmental Health, Neuherberg, Germany
- Genetic Epidemiology, IBE, Faculty of Medicine, LMU, Munich, Germany
| | - Hua Tang
- Department of Genetics, Stanford University, Stanford, CA, USA
| | - Kent D Taylor
- Division of Genomic Outcomes, Department of Pediatrics, The Institute for Translational Genomics and Population Sciences, Los Angeles Biomedical Research Institute at Harbor-UCLA Medical Center, Torrance, CA, USA
| | - Yik Ying Teo
- Saw Swee Hock School of Public Health, National University Health System and National University of Singapore, Singapore, Singapore
- Genome Institute of Singapore, Agency for Science Technology and Research, Singapore, Singapore
- Life Sciences Institute, National University of Singapore, Singapore, Singapore
- NUS Graduate School for Integrative Science and Engineering, National University of Singapore, Singapore, Singapore
- Department of Statistics and Applied Probability, National University of Singapore, Singapore, Singapore
| | - Yih Chung Tham
- Singapore Eye Research Institute, Singapore National Eye Centre, Singapore, Singapore
| | - André G Uitterlinden
- Department of Internal Medicine, Erasmus University Medical Center, Rotterdam, The Netherlands
| | - Melanie Waldenberger
- Research Unit of Molecular Epidemiology, Helmholtz Zentrum München, German Research Center for Environmental Health, Neuherberg, Germany
- Institute of Epidemiology, Helmholtz Zentrum München, German Research Center for Environmental Health, Neuherberg, Germany
- MRC Epidemiology Unit, University of Cambridge, Cambridge, UK
| | - Lihua Wang
- Division of Statistical Genomics, Department of Genetics, Washington University School of Medicine, St. Louis, MO, USA
| | - Ya Xing Wang
- Beijing Institute of Ophthalmology, Beijing Tongren Eye Center, Beijing Ophthalmology and Visual Science Key Lab, Beijing Tongren Hospital, Capital Medical University, Beijing, China
| | - Wen Bin Wei
- Beijing Tongren Eye Center, Beijing Tongren Hospital, Capital Medical University, Beijing, China
| | - Gregory Wilson
- Jackson Heart Study, School of Public Health, Jackson State University, Jackson, MS, USA
| | - Mary K Wojczynski
- Division of Statistical Genomics, Department of Genetics, Washington University School of Medicine, St. Louis, MO, USA
| | - Yong-Bing Xiang
- State Key Laboratory of Oncogene and Related Genes & Department of Epidemiology, Shanghai Cancer Institute, Renji Hospital, Shanghai Jiaotong University School of Medicine, Shanghai, P.R. China
| | - Jie Yao
- Division of Genomic Outcomes, Department of Pediatrics, The Institute for Translational Genomics and Population Sciences, Los Angeles Biomedical Research Institute at Harbor-UCLA Medical Center, Torrance, CA, USA
| | - Jian-Min Yuan
- Department of Epidemiology, Graduate School of Public Health, University of Pittsburgh, Pittsburgh, PA, USA
- Division of Cancer Control and Population Sciences, UPMC Hillman Cancer, University of Pittsburgh, Pittsburgh, PA, USA
| | - Alan B Zonderman
- Behavioral Epidemiology Section, Laboratory of Epidemiology and Population Sciences, National Institute on Aging, National Institutes of Health, Baltimore, MD, USA
| | - Diane M Becker
- General Internal Medicine, GeneSTAR Research Program, Medicine, Johns Hopkins University School of Medicine, Baltimore, MD, USA
| | - Michael Boehnke
- Department of Biostatistics and Center for Statistical Genetics, University of Michigan, Ann Arbor, MI, USA
| | - Donald W Bowden
- Biochemistry, Wake Forest School of Medicine, Winston-Salem, NC, USA
| | - John C Chambers
- MRC-PHE Centre for Environment and Health, Department of Epidemiology and Biostatistics, Imperial College London, London, UK
- Department of Cardiology, Ealing Hospital, Middlesex, UK
| | - Yii-Der Ida Chen
- Division of Genomic Outcomes, Department of Pediatrics, The Institute for Translational Genomics and Population Sciences, Los Angeles Biomedical Research Institute at Harbor-UCLA Medical Center, Torrance, CA, USA
| | - David R Weir
- Survey Research Center, Institute for Social Research, University of Michigan, Ann Arbor, MI, USA
| | - Ulf de Faire
- Institute of Environmental Medicine, Karolinska Institutet, Stockholm, Sweden
| | - Ian J Deary
- Centre for Cognitive Ageing and Cognitive Epidemiology, The University of Edinburgh, Edinburgh, UK
- Psychology, The University of Edinburgh, Edinburgh, UK
| | - Tõnu Esko
- Estonian Genome Center, Institute of Genomics, University of Tartu, Tartu, Estonia
- Broad Institute of the Massachusetts Institute of Technology and Harvard University, Boston, MA, USA
| | - Martin Farrall
- Division of Cardiovascular Medicine, Radcliffe Department of Medicine, University of Oxford, Oxford, Oxfordshire, UK
- Wellcome Centre for Human Genetics, University of Oxford, Oxford, Oxfordshire, UK
| | - Terrence Forrester
- Tropical Metabolism Research Unit, Tropical Medicine Research Institute, University of the West Indies, Mona, Jamaica
| | - Barry I Freedman
- Nephrology, Internal Medicine, Wake Forest School of Medicine, Winston-Salem, NC, USA
| | - Philippe Froguel
- CNRS UMR 8199, European Genomic Institute for Diabetes (EGID), Institut Pasteur de Lille, University of Lille, Lille, France
- Department of Genomics of Common Disease, Imperial College London, London, UK
| | - Paolo Gasparini
- Department of Medical Sciences, University of Trieste, Trieste, Italy
- Department of Genetic Medicine, Weill Cornell Medicine, Doha, Qatar
| | - Christian Gieger
- Research Unit of Molecular Epidemiology, Helmholtz Zentrum München, German Research Center for Environmental Health, Neuherberg, Germany
- Institute of Epidemiology, Helmholtz Zentrum München, German Research Center for Environmental Health, Neuherberg, Germany
- German Center for Diabetes Research (DZD e.V.), Neuherberg, Germany
| | - Bernardo Lessa Horta
- Postgraduate Programme in Epidemiology, Federal University of Pelotas, Pelotas, RS, Brazil
| | - Yi-Jen Hung
- Endocrinology and Metabolism, Tri-Service General Hospital, National Defense Medical Center, Taipei City, Taipei, Taiwan
| | - Jost Bruno Jonas
- Beijing Tongren Eye Center, Beijing Tongren Hospital, Capital Medical University, Beijing, China
- Department of Ophthalmology, Medical Faculty Mannheim, University Heidelberg, Mannheim, Germany
| | - Norihiro Kato
- Department of Gene Diagnostics and Therapeutics, Research Institute, National Center for Global Health and Medicine, Tokyo, Japan
| | - Jaspal S Kooner
- Department of Cardiology, Ealing Hospital, Middlesex, UK
- National Heart and Lung Institute, Imperial College London, London, UK
| | - Markku Laakso
- Institute of Clinical Medicine, Internal Medicine, University of Eastern Finland, Kuopio, Finland
| | - Terho Lehtimäki
- Department of Clinical Chemistry, Fimlab Laboratories, Tampere, Finland
- Department of Clinical Chemistry, Finnish Cardiovascular Research Center—Tampere, Faculty of Medicine and Life Sciences, University of Tampere, Tampere, Finland
| | - Kae-Woei Liang
- School of Medicine, National Yang-ming University, Taipei, Taiwan
- Cardiovascular Center, Taichung Veterans General Hospital, Taichung, Taiwan
- Department of Medicine, China Medical University, Taichung, Taiwan
| | - Patrik K E Magnusson
- Department of Medical Epidemiology and Biostatistics, Karolinska Institutet, Stockholm, Stockholm, Sweden
| | - Albertine J Oldehinkel
- Department of Psychiatry, University of Groningen, University Medical Center Groningen, Groningen RB, The Netherlands
| | - Alexandre C Pereira
- Lab Genetics and Molecular Cardiology, Cardiology, Heart Institute, University of Sao Paulo, Sao Paulo, CA, USA
- Department of Genetics, Harvard Medical School, Boston, MA, USA
| | - Thomas Perls
- Geriatrics Section, Boston University Medical Center, Boston, MA, USA
| | - Rainer Rauramaa
- Foundation for Research in Health Exercise and Nutrition, Kuopio Research Institute of Exercise Medicine, Kuopio, Finland
| | - Susan Redline
- Division of Sleep and Circadian Disorders, Brigham and Women’s Hospital, Boston, MA, USA
| | - Rainer Rettig
- DZHK (German Centre for Cardiovascular Health), Partner Site Greifswald, Greifswald, Germany
- Institute of Physiology, University of Medicine Greifswald, Greifswald, Germany
| | - Nilesh J Samani
- Department of Cardiovascular Sciences, University of Leicester, Leicester, UK
- NIHR Leicester Biomedical Research Centre, Glenfield Hospital, Leicester, UK
| | - James Scott
- National Heart and Lung Institute, Imperial College London, London, UK
| | - Xiao-Ou Shu
- Division of Epidemiology, Department of Medicine, Vanderbilt University School of Medicine, Nashville, TN, USA
| | - Pim van der Harst
- Department of Cardiology, University of Groningen, University Medical Center Groningen, Groningen RB, The Netherlands
| | - Lynne E Wagenknecht
- Public Health Sciences, Wake Forest School of Medicine, Winston-Salem, NC, USA
| | | | - Hugh Watkins
- Division of Cardiovascular Medicine, Radcliffe Department of Medicine, University of Oxford, Oxford, Oxfordshire, UK
- Wellcome Centre for Human Genetics, University of Oxford, Oxford, Oxfordshire, UK
| | | | - Tangchun Wu
- School of Public Health, Department of Occupational and Environmental Health and State Key Laboratory of Environmental Health for Incubating, Tongi Medical College, Huazhong University of Science and Technology, Wuhan, China
| | - Yoichiro Kamatani
- Laboratory for Statistical Analysis, RIKEN Center for Integrative Medical Sciences, Yokohama, Japan
| | - Cathy C Laurie
- Department of Biostatistics, University of Washington, Seattle, WA, USA
| | - Claude Bouchard
- Human Genomics Laboratory, Pennington Biomedical Research Center, Baton Rouge, LA, USA
| | - Richard S Cooper
- Department of Public Health Sciences, Loyola University Chicago, Maywood, IL, USA
| | - Michele K Evans
- Health Disparities Research Section, Laboratory of Epidemiology and Population Sciences, National Institute on Aging, National Institutes of Health, Baltimore, MD, USA
| | - Vilmundur Gudnason
- Icelandic Heart Association, Kopavogur, Iceland
- Faculty of Medicine, University of Iceland, Reykjavik, Iceland
| | - James Hixson
- 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
| | - Sharon L R Kardia
- Department of Epidemiology, School of Public Health, University of Michigan, Ann Arbor, MI, USA
| | - Stephen B Kritchevsky
- Department of Internal Medicine, Section on Gerontology and Geriatric Medicine, Wake Forest School of Medicine, Winston-Salem, NC, USA
| | - Bruce M Psaty
- Cardiovascular Health Research Unit, Epidemiology, Medicine and Health Services, University of Washington, Seattle, WA, USA
- Kaiser Permanente Washington Health Research Institute, Seattle, WA, USA
| | - Rob M van Dam
- Saw Swee Hock School of Public Health, National University Health System and National University of Singapore, Singapore, Singapore
- Department of Medicine, Yong Loo Lin School of Medicine, National University of Singapore, Singapore, Singapore
| | - Donna K Arnett
- Dean’s Office, University of Kentucky College of Public Health, Lexington, KY, USA
| | - Dennis O Mook-Kanamori
- Clinical Epidemiology, Leiden University Medical Center, Leiden, The Netherlands
- Public Health and Primary Care, Leiden University Medical Center, Leiden, The Netherlands
| | - Myriam Fornage
- Brown Foundation Institute of Molecular Medicine, The University of Texas Health Science Center at Houston, Houston, TX, USA
| | - Ervin R Fox
- Cardiology, Medicine, University of Mississippi Medical Center, Jackson, MS, USA
| | - Caroline Hayward
- Medical Research Council Human Genetics Unit, MRC Institute of Genetics and Molecular Medicine, University of Edinburgh, Edinburgh, UK
| | - Cornelia M van Duijn
- Department of Epidemiology, Erasmus University Medical Center, Rotterdam, The Netherlands
| | - E Shyong Tai
- Saw Swee Hock School of Public Health, National University Health System and National University of Singapore, Singapore, Singapore
- Health Services and Systems Research, Duke–NUS Medical School, Singapore, Singapore
- Department of Medicine, Yong Loo Lin School of Medicine, National University of Singapore, Singapore, Singapore
| | - Tien Yin Wong
- Singapore Eye Research Institute, Singapore National Eye Centre, Singapore, Singapore
- Ophthalmology & Visual Sciences Academic Clinical Program (Eye ACP), Duke-NUS Medical School, Singapore, Singapore
- Department of Ophthalmology, Yong Loo Lin School of Medicine, National University of Singapore, Singapore, Singapore
| | - Ruth J F Loos
- Icahn School of Medicine at Mount Sinai, The Charles Bronfman Institute for Personalized Medicine, New York, NY, USA
- Icahn School of Medicine at Mount Sinai, The Mindich Child Health and Development Institute, New York, NY, USA
| | - Alex P Reiner
- Fred Hutchinson Cancer Research Center, University of Washington School of Public Health, Seattle, WA, USA
| | - Charles N Rotimi
- Center for Research on Genomics and Global Health, National Human Genome Research Institute, National Institutes of Health, Bethesda, MD, USA
| | - Laura J Bierut
- Department of Psychiatry, Washington University School of Medicine, St. Louis, MO, USA
| | - Xiaofeng Zhu
- Department of Epidemiology and Biostatistics, Case Western Reserve University, Cleveland, OH, USA
| | - L Adrienne Cupples
- Biostatistics, Boston University School of Public Health, Boston, MA, USA
| | - Michael A Province
- Division of Statistical Genomics, Department of Genetics, Washington University School of Medicine, St. Louis, MO, USA
| | - Jerome I Rotter
- Division of Genomic Outcomes, Department of Pediatrics, The Institute for Translational Genomics and Population Sciences, Los Angeles Biomedical Research Institute at Harbor-UCLA Medical Center, Torrance, CA, USA
| | - Paul W Franks
- Department of Clinical Sciences, Genetic and Molecular Epidemiology Unit, Lund University Diabetes Centre, Skåne University Hospital, Malmö, Sweden
- Harvard T. H. Chan School of Public Health, Department of Nutrition, Harvard University, Boston, MA, USA
- Department of Public Health & Clinical Medicine, Umeå University, Umeå, Västerbotten, Sweden
| | - Kenneth Rice
- Department of Biostatistics, University of Washington, Seattle, WA, USA
| | - Paul Elliott
- MRC-PHE Centre for Environment and Health, Department of Epidemiology and Biostatistics, Imperial College London, London, UK
| | - Mark J Caulfield
- Clinical Pharmacology, William Harvey Research Institute, Barts and The London School of Medicine and Dentistry, Queen Mary University of London, London, UK
- NIHR Barts Cardiovascular Biomedical Research Centre, Queen Mary University of London, London, London, UK
| | - W James Gauderman
- Biostatistics, Preventive Medicine, University of Southern California, Los Angeles, CA, USA
| | - Patricia B Munroe
- Clinical Pharmacology, William Harvey Research Institute, Barts and The London School of Medicine and Dentistry, Queen Mary University of London, London, UK
- NIHR Barts Cardiovascular Biomedical Research Centre, Queen Mary University of London, London, London, UK
| | - Dabeeru C Rao
- Division of Biostatistics, Washington University School of Medicine, St. Louis, MO, USA
| | - Alanna C Morrison
- 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
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de Vries PS, Brown MR, Bentley AR, Sung YJ, Winkler TW, Ntalla I, Schwander K, Kraja AT, Guo X, Franceschini N, Cheng CY, Sim X, Vojinovic D, Huffman JE, Musani SK, Li C, Feitosa MF, Richard MA, Noordam R, Aschard H, Bartz TM, Bielak LF, Deng X, Dorajoo R, Lohman KK, Manning AK, Rankinen T, Smith AV, Tajuddin SM, Evangelou E, Graff M, Alver M, Boissel M, Chai JF, Chen X, Divers J, Gandin I, Gao C, Goel A, Hagemeijer Y, Harris SE, Hartwig FP, He M, Horimoto ARVR, Hsu FC, Jackson AU, Kasturiratne A, Komulainen P, Kühnel B, Laguzzi F, Lee JH, Luan J, Lyytikäinen LP, Matoba N, Nolte IM, Pietzner M, Riaz M, Said MA, Scott RA, Sofer T, Stančáková A, Takeuchi F, Tayo BO, van der Most PJ, Varga TV, Wang Y, Ware EB, Wen W, Yanek LR, Zhang W, Zhao JH, Afaq S, Amin N, Amini M, Arking DE, Aung T, Ballantyne C, Boerwinkle E, Broeckel U, Campbell A, Canouil M, Charumathi S, Chen YDI, Connell JM, de Faire U, de las Fuentes L, de Mutsert R, de Silva HJ, Ding J, Dominiczak AF, Duan Q, Eaton CB, Eppinga RN, Faul JD, Fisher V, Forrester T, Franco OH, Friedlander Y, Ghanbari M, Giulianini F, Grabe HJ, Grove ML, Gu CC, Harris TB, Heikkinen S, Heng CK, Hirata M, Hixson JE, Howard BV, Ikram MA, Jacobs DR, Johnson C, Jonas JB, Kammerer CM, Katsuya T, Khor CC, Kilpeläinen TO, Koh WP, Koistinen HA, Kolcic I, Kooperberg C, Krieger JE, Kritchevsky SB, Kubo M, Kuusisto J, Lakka TA, Langefeld CD, Langenberg C, Launer LJ, Lehne B, Lemaitre RN, Li Y, Liang J, Liu J, Liu K, Loh M, Louie T, Mägi R, Manichaikul AW, McKenzie CA, Meitinger T, Metspalu A, Milaneschi Y, Milani L, Mohlke KL, Mosley TH, Mukamal KJ, Nalls MA, Nauck M, Nelson CP, Sotoodehnia N, O'Connell JR, Palmer ND, Pazoki R, Pedersen NL, Peters A, Peyser PA, Polasek O, Poulter N, Raffel LJ, Raitakari OT, Reiner AP, Rice TK, Rich SS, Robino A, Robinson JG, Rose LM, Rudan I, Schmidt CO, Schreiner PJ, Scott WR, Sever P, Shi Y, Sidney S, Sims M, Smith BH, Smith JA, Snieder H, Starr JM, Strauch K, Tan N, Taylor KD, Teo YY, Tham YC, Uitterlinden AG, van Heemst D, Vuckovic D, Waldenberger M, Wang L, Wang Y, Wang Z, Wei WB, Williams C, Wilson G, Wojczynski MK, Yao J, Yu B, Yu C, Yuan JM, Zhao W, Zonderman AB, Becker DM, Boehnke M, Bowden DW, Chambers JC, Deary IJ, Esko T, Farrall M, Franks PW, Freedman BI, Froguel P, Gasparini P, Gieger C, Horta BL, Kamatani Y, Kato N, Kooner JS, Laakso M, Leander K, Lehtimäki T, Magnusson PKE, Penninx B, Pereira AC, Rauramaa R, Samani NJ, Scott J, Shu XO, van der Harst P, Wagenknecht LE, Wang YX, Wareham NJ, Watkins H, Weir DR, Wickremasinghe AR, Zheng W, Elliott P, North KE, Bouchard C, Evans MK, Gudnason V, Liu CT, Liu Y, Psaty BM, Ridker PM, van Dam RM, Kardia SLR, Zhu X, Rotimi CN, Mook-Kanamori DO, Fornage M, Kelly TN, Fox ER, Hayward C, van Duijn CM, Tai ES, Wong TY, Liu J, Rotter JI, Gauderman WJ, Province MA, Munroe PB, Rice K, Chasman DI, Cupples LA, Rao DC, Morrison AC. Multiancestry Genome-Wide Association Study of Lipid Levels Incorporating Gene-Alcohol Interactions. Am J Epidemiol 2019; 188:1033-1054. [PMID: 30698716 PMCID: PMC6545280 DOI: 10.1093/aje/kwz005] [Citation(s) in RCA: 61] [Impact Index Per Article: 12.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/12/2018] [Revised: 01/05/2019] [Accepted: 01/08/2019] [Indexed: 12/27/2022] Open
Abstract
A person's lipid profile is influenced by genetic variants and alcohol consumption, but the contribution of interactions between these exposures has not been studied. We therefore incorporated gene-alcohol interactions into a multiancestry genome-wide association study of levels of high-density lipoprotein cholesterol, low-density lipoprotein cholesterol, and triglycerides. We included 45 studies in stage 1 (genome-wide discovery) and 66 studies in stage 2 (focused follow-up), for a total of 394,584 individuals from 5 ancestry groups. Analyses covered the period July 2014-November 2017. Genetic main effects and interaction effects were jointly assessed by means of a 2-degrees-of-freedom (df) test, and a 1-df test was used to assess the interaction effects alone. Variants at 495 loci were at least suggestively associated (P < 1 × 10-6) with lipid levels in stage 1 and were evaluated in stage 2, followed by combined analyses of stage 1 and stage 2. In the combined analysis of stages 1 and 2, a total of 147 independent loci were associated with lipid levels at P < 5 × 10-8 using 2-df tests, of which 18 were novel. No genome-wide-significant associations were found testing the interaction effect alone. The novel loci included several genes (proprotein convertase subtilisin/kexin type 5 (PCSK5), vascular endothelial growth factor B (VEGFB), and apolipoprotein B mRNA editing enzyme, catalytic polypeptide 1 (APOBEC1) complementation factor (A1CF)) that have a putative role in lipid metabolism on the basis of existing evidence from cellular and experimental models.
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Affiliation(s)
- Paul S de Vries
- 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, Texas
| | - Michael R Brown
- 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, Texas
| | - Amy R Bentley
- Center for Research on Genomics and Global Health, National Human Genome Research Institute, National Institutes of Health, Bethesda, Maryland
| | - Yun J Sung
- Division of Biostatistics, Washington University School of Medicine, St. Louis, Missouri
| | - Thomas W Winkler
- Department of Genetic Epidemiology, University of Regensburg, Regensburg, Germany
| | - Ioanna Ntalla
- Clinical Pharmacology, William Harvey Research Institute, Barts and The London School of Medicine and Dentistry, Queen Mary University of London, London, United Kingdom
| | - Karen Schwander
- Division of Biostatistics, Washington University School of Medicine, St. Louis, Missouri
| | - Aldi T Kraja
- Division of Statistical Genomics, Department of Genetics, Washington University School of Medicine, St. Louis, Missouri
| | - Xiuqing Guo
- Genomic Outcomes, Pediatrics, Institute for Translational Genomics and Population Sciences, LA BioMed at Harbor-UCLA Medical Center, Torrance, California
| | - Nora Franceschini
- Epidemiology, University of North Carolina Gilling School of Global Public Health, Chapel Hill, North Carolina
| | - Ching-Yu Cheng
- Singapore Eye Research Institute, Singapore National Eye Centre, Singapore, Singapore
- Centre for Quantitative Medicine, Academic Medicine Research Institute, Ophthalmology & Visual Sciences Academic Clinical Program
- Department of Ophthalmology, Yong Loo Lin School of Medicine, National University of Singapore, Singapore, Singapore
| | - Xueling Sim
- Saw Swee Hock School of Public Health, National University of Singapore and National University Health System, Singapore, Singapore
| | - Dina Vojinovic
- Department of Epidemiology, Erasmus University Medical Center, Rotterdam, The Netherlands
| | - Jennifer E Huffman
- Medical Research Council Human Genetics Unit, Institute of Genetics and Molecular Medicine, Institute of Genetics and Molecular Medicine, University of Edinburgh, Edinburgh, United Kingdom
| | - Solomon K Musani
- Jackson Heart Study, Department of Medicine, University of Mississippi Medical Center, Jackson, Mississippi
| | - Changwei Li
- Epidemiology and Biostatistics, University of Georgia at Athens College of Public Health, Athens, Georgia
| | - Mary F Feitosa
- Division of Statistical Genomics, Department of Genetics, Washington University School of Medicine, St. Louis, Missouri
| | - Melissa A Richard
- Brown Foundation Institute of Molecular Medicine, The University of Texas Health Science Center at Houston, Houston, Texas
| | - Raymond Noordam
- Internal Medicine, Gerontology and Geriatrics, Leiden University Medical Center, Leiden, The Netherlands
| | - Hugues Aschard
- Department of Epidemiology, Harvard School of Public Health, Boston, Massachusetts
- Centre de Bioinformatique, Biostatistique et Biologie Intégrative
| | - Traci M Bartz
- Cardiovascular Health Research Unit, Biostatistics and Medicine, University of Washington, Seattle, Washington
| | - Lawrence F Bielak
- Epidemiology, School of Public Health, University of Michigan, Ann Arbor, Michigan
| | - Xuan Deng
- Biostatistics, Boston University School of Public Health, Boston, Massachusetts
| | - Rajkumar Dorajoo
- Genome Institute of Singapore, Agency for Science Technology and Research, Singapore, Singapore
| | - Kurt K Lohman
- Public Health Sciences, Biostatistical Sciences, Wake Forest University Health Sciences, Winston-Salem, North Carolina
| | - Alisa K Manning
- Clinical and Translational Epidemiology Unit, Massachusetts General Hospital, Boston, Massachusetts
- Department of Medicine, Harvard Medical School, Boston, Massachusetts
| | - Tuomo Rankinen
- Human Genomics Laboratory, Pennington Biomedical Research Center, Baton Rouge, Louisiana
| | - Albert V Smith
- Icelandic Heart Association, Kopavogur, Iceland
- Faculty of Medicine, University of Iceland, Reykjavik, Iceland
| | - Salman M Tajuddin
- Health Disparities Research Section, Laboratory of Epidemiology and Population Sciences, National Institute on Aging, National Institutes of Health, Baltimore, Maryland
| | - Evangelos Evangelou
- Department of Epidemiology and Biostatistics, Imperial College London, London, United Kingdom
- Department of Hygiene and Epidemiology, University of Ioannina Medical School, Ioannina, Greece
| | - Mariaelisa Graff
- Epidemiology, University of North Carolina Gilling School of Global Public Health, Chapel Hill, North Carolina
| | - Maris Alver
- Estonian Genome Center, University of Tartu, Tartu, Estonia
| | | | - Jin Fang Chai
- Saw Swee Hock School of Public Health, National University of Singapore and National University Health System, Singapore, Singapore
| | - Xu Chen
- Department of Medical Epidemiology and Biostatistics, Karolinska Institutet, Stockholm, Stockholm, Sweden
| | - Jasmin Divers
- Biostatistical Sciences, Public Health Sciences, Wake Forest School of Medicine, Winston-Salem, North Carolina
| | - Ilaria Gandin
- Department of Medical Sciences, University of Trieste, Trieste, Italy
| | - Chuan Gao
- Molecular Genetics and Genomics Program, Molecular Genetics and Genomics Program, Wake Forest School of Medicine, Winston-Salem, North Carolina
| | - Anuj Goel
- Division of Cardiovascular Medicine, Radcliffe Department of Medicine, University of Oxford, Oxford, Oxfordshire, United Kingdom
- Wellcome Centre for Human Genetics, University of Oxford, Oxford, Oxfordshire, United Kingdom
| | - Yanick Hagemeijer
- Department of Cardiology, University of Groningen, University Medical Center Groningen, Groningen, The Netherlands
| | - Sarah E Harris
- Centre for Cognitive Ageing and Cognitive Epidemiology, The University of Edinburgh, Edinburgh, United Kingdom
- Medical Genetics Section, University of Edinburgh Centre for Genomic and Experimental Medicine and MRC Institute of Genetics and Molecular Medicine, The University of Edinburgh, Edinburgh, United Kingdom
| | - Fernando P Hartwig
- Postgraduate Programme in Epidemiology, Federal University of Pelotas, Pelotas, RS, Brazil
- Medical Research Council Integrative Epidemiology Unit, University of Bristol, Bristol, United Kingdom
| | - Meian He
- Department of Occupational and Environmental Health and State Key Laboratory of Environmental Health for Incubating, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
| | | | - Fang-Chi Hsu
- Biostatistical Sciences, Public Health Sciences, Wake Forest School of Medicine, Winston-Salem, North Carolina
| | - Anne U Jackson
- Department of Biostatistics and Center for Statistical Genetics, University of Michigan, Ann Arbor, Michigan
| | | | - Pirjo Komulainen
- Foundation for Research in Health Exercise and Nutrition, Kuopio Research Institute of Exercise Medicine, Kuopio, Finland
| | - Brigitte Kühnel
- Research Unit of Molecular Epidemiology, Helmholtz Zentrum München, German Research Center for Environmental Health, Neuherberg, Germany
- Institute of Epidemiology, Helmholtz Zentrum München, German Research Center for Environmental Health, Neuherberg, Germany
| | - Federica Laguzzi
- Unit of Cardiovascular Epidemiology, Institute of Environmental Medicine, Karolinska Institutet, Stockholm, Sweden
| | - Joseph H Lee
- Sergievsky Center and Taub Institute, Columbia University Medical Center, New York, New York
| | - Jian'an Luan
- MRC Epidemiology Unit, University of Cambridge, Cambridge, United Kingdom
| | - Leo-Pekka Lyytikäinen
- Department of Clinical Chemistry, Fimlab Laboratories, Tampere, Finland
- Department of Clinical Chemistry, Finnish Cardiovascular Research Center – Tampere, Faculty of Medicine and Health Technology, Tampere University, Tampere, Finland
| | - Nana Matoba
- Laboratory for Statistical Analysis, Center for Integrative Medical Sciences, RIKEN, Yokohama, Japan
| | - Ilja M Nolte
- Department of Epidemiology, University of Groningen, University Medical Center Groningen, Groningen, The Netherlands
| | - Maik Pietzner
- Institute of Clinical Chemistry and Laboratory Medicine, University Medicine Greifswald, Greifswald, Germany
- DZHK
| | - Muhammad Riaz
- Department of Cardiovascular Sciences, University of Leicester, Leicester, United Kingdom
- NIHR Leicester Biomedical Research Centre, Glenfield Hospital, Leicester, United Kingdom
| | - M Abdullah Said
- Department of Cardiology, University of Groningen, University Medical Center Groningen, Groningen, The Netherlands
| | - Robert A Scott
- MRC Epidemiology Unit, University of Cambridge, Cambridge, United Kingdom
| | - Tamar Sofer
- Department of Medicine, Harvard Medical School, Boston, Massachusetts
- Division of Sleep and Circadian Disorders, Brigham and Women's Hospital, Boston, Massachusetts
| | - Alena Stančáková
- Institute of Clinical Medicine, Internal Medicine, University of Eastern Finland, Kuopio, Finland
| | - Fumihiko Takeuchi
- Department of Gene Diagnostics and Therapeutics, Research Institute, National Center for Global Health and Medicine, Tokyo, Japan
| | - Bamidele O Tayo
- Department of Public Health Sciences, Loyola University Chicago, Maywood, Illinois
| | - Peter J van der Most
- Department of Epidemiology, University of Groningen, University Medical Center Groningen, Groningen, The Netherlands
| | - Tibor V Varga
- Department of Clinical Sciences, Genetic and Molecular Epidemiology Unit, Lund University Diabetes Centre, Skåne University Hospital, Malmö, Sweden
| | - Yajuan Wang
- Department of Population and Quantitative Health and Sciences, Case Western Reserve University, Cleveland, Ohio
| | - Erin B Ware
- Survey Research Center, Institute for Social Research, University of Michigan, Ann Arbor, Michigan
| | - Wanqing Wen
- Division of Epidemiology, Department of Medicine, Vanderbilt University School of Medicine, Nashville, Tennessee
| | - Lisa R Yanek
- Division of General Internal Medicine, Department of Medicine, Johns Hopkins University School of Medicine, Baltimore, Maryland
| | - Weihua Zhang
- Department of Epidemiology and Biostatistics, Imperial College London, London, United Kingdom
- Department of Cardiology, Ealing Hospital, Middlesex, United Kingdom
| | - Jing Hua Zhao
- MRC Epidemiology Unit, University of Cambridge, Cambridge, United Kingdom
| | - Saima Afaq
- Department of Epidemiology and Biostatistics, Imperial College London, London, United Kingdom
| | - Najaf Amin
- Department of Epidemiology, Erasmus University Medical Center, Rotterdam, The Netherlands
| | - Marzyeh Amini
- Department of Epidemiology, University of Groningen, University Medical Center Groningen, Groningen, The Netherlands
| | - Dan E Arking
- McKusick-Nathans Institute of Genetic Medicine, Johns Hopkins University School of Medicine, Baltimore, Maryland
| | - Tin Aung
- Singapore Eye Research Institute, Singapore National Eye Centre, Singapore, Singapore
- Department of Ophthalmology, Yong Loo Lin School of Medicine, National University of Singapore, Singapore, Singapore
- Ophthalmology & Visual Sciences Academic Clinical Program
| | - Christie Ballantyne
- Section of Cardiovascular Research, Baylor College of Medicine, Houston, Texas
- Houston Methodist Debakey Heart and Vascular Center, Houston, Texas
| | - Eric Boerwinkle
- Department of Epidemiology, Human Genetics, and Environmental Sciences, The University of Texas School of Public Health, Houston, Texas
- Human Genome Sequencing Center, Baylor College of Medicine, Houston, Texas
| | - Ulrich Broeckel
- Section of Genomic Pediatrics, Department of Pediatrics, Medicine and Physiology, Medical College of Wisconsin, Milwaukee, Wisconsin
| | - Archie Campbell
- Centre for Genomic & Experimental Medicine, Institute of Genetics & Molecular Medicine, University of Edinburgh, Edinburgh, United Kingdom
| | | | - Sabanayagam Charumathi
- Singapore Eye Research Institute, Singapore National Eye Centre, Singapore, Singapore
- Centre for Quantitative Medicine, Academic Medicine Research Institute, Ophthalmology & Visual Sciences Academic Clinical Program
| | - Yii-Der Ida Chen
- Genomic Outcomes, Pediatrics, Institute for Translational Genomics and Population Sciences, LA BioMed at Harbor-UCLA Medical Center, Torrance, California
| | - John M Connell
- Ninewells Hospital & Medical School, University of Dundee, Dundee, Scotland, United Kingdom
| | - Ulf de Faire
- Unit of Cardiovascular Epidemiology, Institute of Environmental Medicine, Karolinska Institutet, Stockholm, Sweden
| | - Lisa de las Fuentes
- Division of Biostatistics, Washington University School of Medicine, St. Louis, Missouri
- Cardiovascular Division, Department of Medicine, Washington University, St. Louis, Missouri
| | - Renée de Mutsert
- Clinical Epidemiology, Leiden University Medical Center, Leiden, Netherlands
| | - H Janaka de Silva
- Department of Medicine, Faculty of Medicine, University of Kelaniya, Ragama, Sri Lanka
| | - Jingzhong Ding
- Center on Diabetes, Obesity, and Metabolism, Gerontology and Geriatric Medicine, Wake Forest University Health Sciences, Winston-Salem, North Carolina
| | - Anna F Dominiczak
- Institute of Cardiovascular and Medical Sciences, College of Medical, Veterinary and Life Sciences, University of Glasgow, Glasgow, Scotland, United Kingdom
| | - Qing Duan
- Department of Genetics, University of North Carolina, Chapel Hill, North Carolina
| | - Charles B Eaton
- Department of Family Medicine and Epidemiology, Alpert Medical School of Brown University, Providence, Rhode Island
| | - Ruben N Eppinga
- Department of Cardiology, University of Groningen, University Medical Center Groningen, Groningen, The Netherlands
| | - Jessica D Faul
- Survey Research Center, Institute for Social Research, University of Michigan, Ann Arbor, Michigan
| | - Virginia Fisher
- Biostatistics, Boston University School of Public Health, Boston, Massachusetts
| | - Terrence Forrester
- Tropical Metabolism Research Unit, Tropical Medicine Research Institute, University of the West Indies, Mona, Jamaica
| | - Oscar H Franco
- Department of Epidemiology, Erasmus University Medical Center, Rotterdam, The Netherlands
- Institute of Social and Preventive Medicine
| | - Yechiel Friedlander
- Braun School of Public Health, Hebrew University-Hadassah Medical Center, Jerusalem, Israel
| | - Mohsen Ghanbari
- Department of Epidemiology, Erasmus University Medical Center, Rotterdam, The Netherlands
- Department of Genetics, School of Medicine, Mashhad University of Medical Sciences, Mashhad, Iran
| | | | - Hans J Grabe
- Department Psychiatry and Psychotherapy, University Medicine Greifswald, Greifswald, Germany
| | - Megan L Grove
- 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, Texas
| | - C Charles Gu
- Division of Biostatistics, Washington University School of Medicine, St. Louis, Missouri
| | - Tamara B Harris
- Laboratory of Epidemiology and Population Sciences, National Institute on Aging, National Institutes of Health, Bethesda, Maryland
| | - Sami Heikkinen
- Institute of Clinical Medicine, Internal Medicine, University of Eastern Finland, Kuopio, Finland
- Institute of Biomedicine, School of Medicine, University of Eastern Finland, Kuopio Campus, Finland
| | - Chew-Kiat Heng
- Department of Paediatrics, Yong Loo Lin School of Medicine, National University of Singapore, Singapore, Singapore
- Khoo Teck Puat – National University Children's Medical Institute, National University Health System, Singapore, Singapore
| | - Makoto Hirata
- Laboratory of Genome Technology, Human Genome Center, Institute of Medical Science, The University of Tokyo, Minato-ku, Japan
| | - James E Hixson
- Department of Epidemiology, Human Genetics, and Environmental Sciences, The University of Texas School of Public Health, Houston, Texas
| | - Barbara V Howard
- MedStar Health Research Institute, Hyattsville, Maryland
- Center for Clinical and Translational Sciences and Department of Medicine, Georgetown-Howard Universities, Washington, District of Columbia
| | - M Arfan Ikram
- Department of Epidemiology, Erasmus University Medical Center, Rotterdam, The Netherlands
- Department of Radiology and Nuclear Medicine, Erasmus University Medical Center, Rotterdam, The Netherlands
- Department of Neurology, Erasmus University Medical Center, Rotterdam, The Netherlands
| | | | - David R Jacobs
- Division of Epidemiology & Community Health, School of Public Health, University of Minnesota, Minneapolis, Minnesota
| | - Craig Johnson
- Collaborative Health Studies Coordinating Center, University of Washington, Seattle, Washington
| | - Jost Bruno Jonas
- Department of Ophthalmology, Medical Faculty Mannheim, University Heidelberg, Mannheim, Germany
- Beijing Institute of Ophthalmology, Beijing Ophthalmology and Visual Science Key Lab, Beijing Tongren Eye Center, Capital Medical University, Beijing, China
| | - Candace M Kammerer
- Department of Human Genetics, Graduate School of Public Health, University of Pittsburgh, Pittsburgh, Pennsylvania
| | - Tomohiro Katsuya
- Department of Clinical Gene Therapy, Osaka University Graduate School of Medicine, Suita, Japan
- Department of Geriatric and General Medicine, Osaka University Graduate School of Medicine, Suita, Japan
| | - Chiea Chuen Khor
- Genome Institute of Singapore, Agency for Science Technology and Research, Singapore, Singapore
- Department of Biochemistry, National University of Singapore, Singapore, Singapore
| | - Tuomas O Kilpeläinen
- Novo Nordisk Foundation Center for Basic Metabolic Research, Section of Metabolic Genetics, Faculty of Health and Medical Sciences, University of Copenhagen, Copenhagen, Denmark
- Department of Environmental Medicine and Public Health, The Icahn School of Medicine at Mount Sinai, New York, New York
| | - Woon-Puay Koh
- Saw Swee Hock School of Public Health, National University of Singapore and National University Health System, Singapore, Singapore
- Duke-NUS Medical School, Singapore, Singapore
| | - Heikki A Koistinen
- Department of Health, National Institute for Health and Welfare, Helsinki, Finland
- Department of Medicine and Abdominal Center, Endocrinology, University of Helsinki and Helsinki University Central Hospital, Helsinki, Finland
- Minerva Foundation Institute for Medical Research, Helsinki, Finland
| | | | - Charles Kooperberg
- Fred Hutchinson Cancer Research Center, University of Washington School of Public Health, Seattle, Washington
| | - Jose E Krieger
- Laboratory of Genetics and Molecular Cardiology, Heart Institute
| | - Steve B Kritchevsky
- Sticht Center for Health Aging and Alzheimer's Prevention, Department of Internal Medicine, Wake Forest School of Medicine, Winston-Salem, North Carolina
| | - Michiaki Kubo
- Center for Integrative Medical Sciences, RIKEN, Yokohama, Japan
| | - Johanna Kuusisto
- Institute of Clinical Medicine, Internal Medicine, University of Eastern Finland, Kuopio, Finland
| | - Timo A Lakka
- Foundation for Research in Health Exercise and Nutrition, Kuopio Research Institute of Exercise Medicine, Kuopio, Finland
- Institute of Biomedicine, School of Medicine, University of Eastern Finland, Kuopio Campus, Finland
- Department of Clinical Physiology and Nuclear Medicine, Kuopio University Hospital, Kuopio, Finland
| | - Carl D Langefeld
- Biostatistical Sciences, Public Health Sciences, Wake Forest School of Medicine, Winston-Salem, North Carolina
| | - Claudia Langenberg
- MRC Epidemiology Unit, University of Cambridge, Cambridge, United Kingdom
| | - Lenore J Launer
- Laboratory of Epidemiology and Population Sciences, National Institute on Aging, National Institutes of Health, Bethesda, Maryland
| | - Benjamin Lehne
- Department of Epidemiology and Biostatistics, Imperial College London, London, United Kingdom
| | - Rozenn N Lemaitre
- Cardiovascular Health Research Unit, Medicine, University of Washington, Seattle, Washington
| | - Yize Li
- Division of Biostatistics, Washington University School of Medicine, St. Louis, Missouri
| | - Jingjing Liang
- Department of Population and Quantitative Health and Sciences, Case Western Reserve University, Cleveland, Ohio
| | - Jianjun Liu
- Genome Institute of Singapore, Agency for Science Technology and Research, Singapore, Singapore
- Department of Medicine, Yong Loo Lin School of Medicine, National University of Singapore, Singapore, Singapore
| | - Kiang Liu
- Epidemiology, Department of Preventive Medicine, Northwestern University Feinberg School of Medicine, Chicago, Illinois
| | - Marie Loh
- Department of Epidemiology and Biostatistics, Imperial College London, London, United Kingdom
- Translational Laboratory in Genetic Medicine, Agency for Science, Technology and Research, Singapore
| | - Tin Louie
- Department of Biostatistics, University of Washington, Seattle, Washington
| | - Reedik Mägi
- Estonian Genome Center, University of Tartu, Tartu, Estonia
| | - Ani W Manichaikul
- Biostatistics Section, Center for Public Health Genomics, University of Virginia, School of Medicine, West Complex, Charlottesville, Virginia
| | - Colin A McKenzie
- Tropical Metabolism Research Unit, Tropical Medicine Research Institute, University of the West Indies, Mona, Jamaica
| | - Thomas Meitinger
- Institute of Human Genetics, Helmholtz Zentrum München, German Research Center for Environmental Health, Neuherberg, Germany
- Institute of Human Genetics, Technische Universität München, Munich, Germany
| | | | - Yuri Milaneschi
- Department of Psychiatry, Amsterdam Neuroscience and Amsterdam Public Health Research Institute, Amsterdam University Medical Center, Amsterdam, The Netherlands
| | - Lili Milani
- Estonian Genome Center, University of Tartu, Tartu, Estonia
| | - Karen L Mohlke
- Department of Genetics, University of North Carolina, Chapel Hill, North Carolina
| | - Thomas H Mosley
- Geriatrics, Medicine, University of Mississippi Medical Center, Jackson, Mississippi
| | - Kenneth J Mukamal
- General Medicine & Primary Care, Medicine, Beth Israel Deaconess Medical Center, Boston, Massachusetts
| | - Mike A Nalls
- Data Tecnica International, Glen Echo, Maryland
- Laboratory of Neurogenetics, National Institute on Aging, Bethesda, Maryland
| | - Matthias Nauck
- Institute of Clinical Chemistry and Laboratory Medicine, University Medicine Greifswald, Greifswald, Germany
- DZHK
| | - Christopher P Nelson
- Department of Cardiovascular Sciences, University of Leicester, Leicester, United Kingdom
- NIHR Leicester Biomedical Research Centre, Glenfield Hospital, Leicester, United Kingdom
| | - Nona Sotoodehnia
- Cardiovascular Health Research Unit, Division of Cardiology, University of Washington, Seattle, Washington
| | - Jeff R O'Connell
- Division of Endocrinology, Diabetes, and Nutrition, University of Maryland School of Medicine, Baltimore, Maryland
- Program for Personalized and Genomic Medicine, University of Maryland School of Medicine, Baltimore, Maryland
| | | | - Raha Pazoki
- Department of Epidemiology and Biostatistics, Imperial College London, London, United Kingdom
| | - Nancy L Pedersen
- Department of Medical Epidemiology and Biostatistics, Karolinska Institutet, Stockholm, Stockholm, Sweden
| | - Annette Peters
- Institute of Epidemiology, Helmholtz Zentrum München, German Research Center for Environmental Health, Neuherberg, Germany
- DZHK
| | - Patricia A Peyser
- Epidemiology, School of Public Health, University of Michigan, Ann Arbor, Michigan
| | - Ozren Polasek
- Department of Public Health, Department of Medicine, University of Split, Split, Croatia
- Psychiatric Hospital “Sveti Ivan”, Zagreb, Croatia
- Gen-info Ltd, Zagreb, Croatia
| | - Neil Poulter
- School of Public Health, Imperial College London, London, United Kingdom
| | - Leslie J Raffel
- Division of Genetic and Genomic Medicine, Department of Pediatrics, University of California, Irvine, California
| | - Olli T Raitakari
- Department of Clinical Physiology and Nuclear Medicine, Turku University Hospital, Turku, Finland
- Research Centre of Applied and Preventive Cardiovascular Medicine, University of Turku, Turku, Finland
| | - Alex P Reiner
- Fred Hutchinson Cancer Research Center, University of Washington School of Public Health, Seattle, Washington
| | - Treva K Rice
- Division of Biostatistics, Washington University School of Medicine, St. Louis, Missouri
| | - Stephen S Rich
- Center for Public Health Genomics, University of Virginia, School of Medicine, West Complex, Charlottesville, Virginia
| | - Antonietta Robino
- Institute for Maternal and Child Health – IRCCS “Burlo Garofolo”, Trieste, Italy
| | - Jennifer G Robinson
- Department of Epidemiology and Medicine, University of Iowa, Iowa City, Iowa
| | - Lynda M Rose
- Preventive Medicine, Brigham and Women's Hospital, Boston, Massachusetts
| | - Igor Rudan
- Centre for Global Health Research, Usher Institute of Population Health Sciences and Informatics, University of Edinburgh, Edinburgh, United Kingdom
| | - Carsten O Schmidt
- Institute for Community Medicine, University Medicine Greifswald, Greifswald, Germany
| | - Pamela J Schreiner
- Division of Epidemiology & Community Health, School of Public Health, University of Minnesota, Minneapolis, Minnesota
| | - William R Scott
- Department of Epidemiology and Biostatistics, Imperial College London, London, United Kingdom
- National Heart and Lung Institute, Imperial College London, London, United Kingdom
| | - Peter Sever
- National Heart and Lung Institute, Imperial College London, London, United Kingdom
| | - Yuan Shi
- Singapore Eye Research Institute, Singapore National Eye Centre, Singapore, Singapore
| | - Stephen Sidney
- Division of Research, Kaiser Permanente of Northern California, Oakland, California
| | - Mario Sims
- Jackson Heart Study, Department of Medicine, University of Mississippi Medical Center, Jackson, Mississippi
| | - Blair H Smith
- Division of Population Health and Genomics, Ninewells Hospital and Medical School, University of Dundee, Dundee, United Kingdom
| | - Jennifer A Smith
- Epidemiology, School of Public Health, University of Michigan, Ann Arbor, Michigan
- Survey Research Center, Institute for Social Research, University of Michigan, Ann Arbor, Michigan
| | - Harold Snieder
- Department of Epidemiology, University of Groningen, University Medical Center Groningen, Groningen, The Netherlands
| | - John M Starr
- Centre for Cognitive Ageing and Cognitive Epidemiology, The University of Edinburgh, Edinburgh, United Kingdom
- Alzheimer Scotland Dementia Research Centre, The University of Edinburgh, Edinburgh, United Kingdom
| | - Konstantin Strauch
- Institute of Genetic Epidemiology, Helmholtz Zentrum München, German Research Center for Environmental Health, Neuherberg, Germany
- Chair of Genetic Epidemiology, IBE, Faculty of Medicine, LMU, Munich, Germany
| | - Nicholas Tan
- Singapore Eye Research Institute, Singapore National Eye Centre, Singapore, Singapore
- Department of Ophthalmology, Yong Loo Lin School of Medicine, National University of Singapore, Singapore, Singapore
| | - Kent D Taylor
- Genomic Outcomes, Pediatrics, Institute for Translational Genomics and Population Sciences, LA BioMed at Harbor-UCLA Medical Center, Torrance, California
| | - Yik Ying Teo
- Saw Swee Hock School of Public Health, National University of Singapore and National University Health System, Singapore, Singapore
- Genome Institute of Singapore, Agency for Science Technology and Research, Singapore, Singapore
- Life Sciences Institute, National University of Singapore, Singapore, Singapore
- NUS Graduate School for Integrative Science and Engineering, National University of Singapore, Singapore, Singapore
- Department of Statistics and Applied Probability, National University of Singapore, Singapore, Singapore
| | - Yih Chung Tham
- Singapore Eye Research Institute, Singapore National Eye Centre, Singapore, Singapore
| | - André G Uitterlinden
- Department of Epidemiology, Erasmus University Medical Center, Rotterdam, The Netherlands
- Department of Internal Medicine, Erasmus University Medical Center, Rotterdam, The Netherlands
| | - Diana van Heemst
- Internal Medicine, Gerontology and Geriatrics, Leiden University Medical Center, Leiden, The Netherlands
| | - Dragana Vuckovic
- Department of Medical Sciences, University of Trieste, Trieste, Italy
| | - Melanie Waldenberger
- Research Unit of Molecular Epidemiology, Helmholtz Zentrum München, German Research Center for Environmental Health, Neuherberg, Germany
- Institute of Epidemiology, Helmholtz Zentrum München, German Research Center for Environmental Health, Neuherberg, Germany
| | - Lihua Wang
- Division of Statistical Genomics, Department of Genetics, Washington University School of Medicine, St. Louis, Missouri
| | - Yujie Wang
- Epidemiology, University of North Carolina Gilling School of Global Public Health, Chapel Hill, North Carolina
| | - Zhe Wang
- 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, Texas
| | - Wen Bin Wei
- Beijing Tongren Eye Center, Beijing Tongren Hospital, Capital Medical University, Beijing, China
| | - Christine Williams
- Division of Statistical Genomics, Department of Genetics, Washington University School of Medicine, St. Louis, Missouri
| | - Gregory Wilson
- Jackson Heart Study, School of Public Health, Jackson State University, Jackson, Mississippi
| | - Mary K Wojczynski
- Division of Statistical Genomics, Department of Genetics, Washington University School of Medicine, St. Louis, Missouri
| | - Jie Yao
- Genomic Outcomes, Pediatrics, Institute for Translational Genomics and Population Sciences, LA BioMed at Harbor-UCLA Medical Center, Torrance, California
| | - Bing Yu
- 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, Texas
| | - Caizheng Yu
- Department of Occupational and Environmental Health and State Key Laboratory of Environmental Health for Incubating, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
| | - Jian-Min Yuan
- Department of Epidemiology, Graduate School of Public Health, University of Pittsburgh, Pittsburgh, Pennsylvania
- Division of Cancer Control and Population Sciences, UPMC Hillman Cancer, University of Pittsburgh, Pittsburgh, Pennsylvania
| | - Wei Zhao
- Epidemiology, School of Public Health, University of Michigan, Ann Arbor, Michigan
| | - Alan B Zonderman
- Behavioral Epidemiology Section, Laboratory of Epidemiology and Population Sciences, National Institute on Aging, National Institutes of Health, Baltimore, Maryland
| | - Diane M Becker
- Division of General Internal Medicine, Department of Medicine, Johns Hopkins University School of Medicine, Baltimore, Maryland
| | - Michael Boehnke
- Department of Biostatistics and Center for Statistical Genetics, University of Michigan, Ann Arbor, Michigan
| | - Donald W Bowden
- Biochemistry, Wake Forest School of Medicine, Winston-Salem, North Carolina
| | - John C Chambers
- Department of Epidemiology and Biostatistics, Imperial College London, London, United Kingdom
- Department of Cardiology, Ealing Hospital, Middlesex, United Kingdom
- Lee Kong Chian School of Medicine, Nanyang Technological University, Singapore, Singapore
- Imperial College Healthcare NHS Trust, London, United Kingdom
- MRC-PHE Centre for Environment and Health, Imperial College London, London, United Kingdom
- NIHR Imperial College Biomedical Research Centre, Imperial College London, London, United Kingdom
| | - Ian J Deary
- Centre for Cognitive Ageing and Cognitive Epidemiology, The University of Edinburgh, Edinburgh, United Kingdom
- Psychology, The University of Edinburgh, Edinburgh, United Kingdom
| | - Tõnu Esko
- Estonian Genome Center, University of Tartu, Tartu, Estonia
- Broad Institute of the Massachusetts Institute of Technology and Harvard University, Boston, Massachusetts
| | - Martin Farrall
- Division of Cardiovascular Medicine, Radcliffe Department of Medicine, University of Oxford, Oxford, Oxfordshire, United Kingdom
- Wellcome Centre for Human Genetics, University of Oxford, Oxford, Oxfordshire, United Kingdom
| | - Paul W Franks
- Department of Clinical Sciences, Genetic and Molecular Epidemiology Unit, Lund University Diabetes Centre, Skåne University Hospital, Malmö, Sweden
- Department of Nutrition, Harvard T. H. Chan School of Public Health, Harvard University, Boston, Massachusetts
- Department of Public Health & Clinical Medicine, Umeå University, Umeå, Västerbotten, Sweden
- OCDEM, Radcliffe Department of Medicine, University of Oxford, Oxford, United Kingdom
| | - Barry I Freedman
- Nephrology, Internal Medicine, Wake Forest School of Medicine, Winston-Salem, North Carolina
| | - Philippe Froguel
- CNRS UMR 8199, European Genomic Institute for Diabetes
- Department of Genomics of Common Disease, Imperial College London, London, United Kingdom
| | - Paolo Gasparini
- Department of Medical Sciences, University of Trieste, Trieste, Italy
- Institute for Maternal and Child Health – IRCCS “Burlo Garofolo”, Trieste, Italy
| | - Christian Gieger
- Research Unit of Molecular Epidemiology, Helmholtz Zentrum München, German Research Center for Environmental Health, Neuherberg, Germany
- German Center for Diabetes Research
| | - Bernardo L Horta
- Postgraduate Programme in Epidemiology, Federal University of Pelotas, Pelotas, RS, Brazil
| | - Yoichiro Kamatani
- Laboratory for Statistical Analysis, Center for Integrative Medical Sciences, RIKEN, Yokohama, Japan
| | - Norihiro Kato
- Department of Gene Diagnostics and Therapeutics, Research Institute, National Center for Global Health and Medicine, Tokyo, Japan
| | - Jaspal S Kooner
- Department of Cardiology, Ealing Hospital, Middlesex, United Kingdom
- National Heart and Lung Institute, Imperial College London, London, United Kingdom
- Imperial College Healthcare NHS Trust, London, United Kingdom
- NIHR Imperial College Biomedical Research Centre, Imperial College London, London, United Kingdom
| | - Markku Laakso
- Institute of Clinical Medicine, Internal Medicine, University of Eastern Finland, Kuopio, Finland
| | - Karin Leander
- Unit of Cardiovascular Epidemiology, Institute of Environmental Medicine, Karolinska Institutet, Stockholm, Sweden
| | - Terho Lehtimäki
- Department of Clinical Chemistry, Fimlab Laboratories, Tampere, Finland
- Department of Clinical Chemistry, Finnish Cardiovascular Research Center – Tampere, Faculty of Medicine and Health Technology, Tampere University, Tampere, Finland
| | | | - Patrik K E Magnusson
- Department of Medical Epidemiology and Biostatistics, Karolinska Institutet, Stockholm, Stockholm, Sweden
| | - Brenda Penninx
- Department of Psychiatry, Amsterdam Neuroscience and Amsterdam Public Health Research Institute, Amsterdam University Medical Center, Amsterdam, The Netherlands
| | | | - Rainer Rauramaa
- Foundation for Research in Health Exercise and Nutrition, Kuopio Research Institute of Exercise Medicine, Kuopio, Finland
| | - Nilesh J Samani
- Department of Cardiovascular Sciences, University of Leicester, Leicester, United Kingdom
- NIHR Leicester Biomedical Research Centre, Glenfield Hospital, Leicester, United Kingdom
| | - James Scott
- National Heart and Lung Institute, Imperial College London, London, United Kingdom
| | - Xiao-Ou Shu
- Division of Epidemiology, Department of Medicine, Vanderbilt University School of Medicine, Nashville, Tennessee
| | - Pim van der Harst
- Department of Cardiology, University of Groningen, University Medical Center Groningen, Groningen, The Netherlands
- Department of Genetics, University of Groningen, University Medical Center Groningen, Groningen, The Netherlands
| | - Lynne E Wagenknecht
- Public Health Sciences, Wake Forest School of Medicine, Winston-Salem, North Carolina
| | - Ya Xing Wang
- Beijing Institute of Ophthalmology, Beijing Tongren Eye Center, Beijing Ophthalmology and Visual Science Key Lab, Beijing Tongren Hospital, Capital Medical University, Beijing, China
| | - Nicholas J Wareham
- MRC Epidemiology Unit, University of Cambridge, Cambridge, United Kingdom
| | - Hugh Watkins
- Division of Cardiovascular Medicine, Radcliffe Department of Medicine, University of Oxford, Oxford, Oxfordshire, United Kingdom
- Wellcome Centre for Human Genetics, University of Oxford, Oxford, Oxfordshire, United Kingdom
| | - David R Weir
- Survey Research Center, Institute for Social Research, University of Michigan, Ann Arbor, Michigan
| | | | - Wei Zheng
- Division of Epidemiology, Department of Medicine, Vanderbilt University School of Medicine, Nashville, Tennessee
| | - Paul Elliott
- Department of Epidemiology and Biostatistics, Imperial College London, London, United Kingdom
- MRC-PHE Centre for Environment and Health, Imperial College London, London, United Kingdom
- NIHR Imperial College Biomedical Research Centre, Imperial College London, London, United Kingdom
- Health Data Research UK
- UK Dementia Research Institute
| | - Kari E North
- Epidemiology, University of North Carolina Gilling School of Global Public Health, Chapel Hill, North Carolina
- Carolina Center of Genome Sciences, University of North Carolina, Chapel Hill, North Carolina
| | - Claude Bouchard
- Human Genomics Laboratory, Pennington Biomedical Research Center, Baton Rouge, Louisiana
| | - Michele K Evans
- Health Disparities Research Section, Laboratory of Epidemiology and Population Sciences, National Institute on Aging, National Institutes of Health, Baltimore, Maryland
| | - Vilmundur Gudnason
- Icelandic Heart Association, Kopavogur, Iceland
- Faculty of Medicine, University of Iceland, Reykjavik, Iceland
| | - Ching-Ti Liu
- Biostatistics, Boston University School of Public Health, Boston, Massachusetts
| | - Yongmei Liu
- Public Health Sciences, Epidemiology and Prevention, Wake Forest University Health Sciences, Winston-Salem, North Carolina
| | - Bruce M Psaty
- Cardiovascular Health Research Unit, Epidemiology, Medicine and Health Services, University of Washington, Seattle, Washington
- Kaiser Permanente Washington, Health Research Institute, Seattle, Washington
| | - Paul M Ridker
- Preventive Medicine, Brigham and Women's Hospital, Boston, Massachusetts
- Harvard Medical School, Boston, Massachusetts
| | - Rob M van Dam
- Saw Swee Hock School of Public Health, National University of Singapore and National University Health System, Singapore, Singapore
- Department of Nutrition, Harvard T. H. Chan School of Public Health, Harvard University, Boston, Massachusetts
- Department of Medicine, Yong Loo Lin School of Medicine, National University of Singapore, Singapore, Singapore
| | - Sharon L R Kardia
- Epidemiology, School of Public Health, University of Michigan, Ann Arbor, Michigan
| | - Xiaofeng Zhu
- Department of Population and Quantitative Health and Sciences, Case Western Reserve University, Cleveland, Ohio
| | - Charles N Rotimi
- Center for Research on Genomics and Global Health, National Human Genome Research Institute, National Institutes of Health, Bethesda, Maryland
| | - Dennis O Mook-Kanamori
- Clinical Epidemiology, Leiden University Medical Center, Leiden, Netherlands
- Public Health and Primary Care, Leiden University Medical Center, Leiden, Leiden
| | - Myriam Fornage
- 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, Texas
- Brown Foundation Institute of Molecular Medicine, The University of Texas Health Science Center at Houston, Houston, Texas
| | - Tanika N Kelly
- Epidemiology, Tulane University School of Public Health and Tropical Medicine, New Orleans, Louisiana
| | - Ervin R Fox
- Cardiology, Medicine, University of Mississippi Medical Center, Jackson, Mississippi
| | - Caroline Hayward
- Medical Research Council Human Genetics Unit, Institute of Genetics and Molecular Medicine, Institute of Genetics and Molecular Medicine, University of Edinburgh, Edinburgh, United Kingdom
| | - Cornelia M van Duijn
- Department of Epidemiology, Erasmus University Medical Center, Rotterdam, The Netherlands
| | - E Shyong Tai
- Saw Swee Hock School of Public Health, National University of Singapore and National University Health System, Singapore, Singapore
- Duke-NUS Medical School, Singapore, Singapore
- Department of Medicine, Yong Loo Lin School of Medicine, National University of Singapore, Singapore, Singapore
| | - Tien Yin Wong
- Singapore Eye Research Institute, Singapore National Eye Centre, Singapore, Singapore
- Department of Ophthalmology, Yong Loo Lin School of Medicine, National University of Singapore, Singapore, Singapore
- Ophthalmology & Visual Sciences Academic Clinical Program
| | - Jingmin Liu
- WHI CCC, Fred Hutchinson Cancer Research Center, Seattle, Washington
| | - Jerome I Rotter
- Genomic Outcomes, Pediatrics, Institute for Translational Genomics and Population Sciences, LA BioMed at Harbor-UCLA Medical Center, Torrance, California
| | - W James Gauderman
- Biostatistics, Preventive Medicine, University of Southern California, Los Angeles, California
| | - Michael A Province
- Division of Statistical Genomics, Department of Genetics, Washington University School of Medicine, St. Louis, Missouri
| | - Patricia B Munroe
- Clinical Pharmacology, William Harvey Research Institute, Barts and The London School of Medicine and Dentistry, Queen Mary University of London, London, United Kingdom
- NIHR Barts Cardiovascular Biomedical Research Unit, Queen Mary University of London, London, United Kingdom
| | - Kenneth Rice
- Department of Biostatistics, University of Washington, Seattle, Washington
| | - Daniel I Chasman
- Preventive Medicine, Brigham and Women's Hospital, Boston, Massachusetts
- Harvard Medical School, Boston, Massachusetts
| | - L Adrienne Cupples
- Biostatistics, Boston University School of Public Health, Boston, Massachusetts
- NHLBI Framingham Heart Study, Framingham, Massachusetts
| | - Dabeeru C Rao
- Division of Biostatistics, Washington University School of Medicine, St. Louis, Missouri
| | - Alanna C Morrison
- 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, Texas
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Bentley AR, Sung YJ, Brown MR, Winkler TW, Kraja AT, Ntalla I, Schwander K, Chasman DI, Lim E, Deng X, Guo X, Liu J, Lu Y, Cheng CY, Sim X, Vojinovic D, Huffman JE, Musani SK, Li C, Feitosa MF, Richard MA, Noordam R, Baker J, Chen G, Aschard H, Bartz TM, Ding J, Dorajoo R, Manning AK, Rankinen T, Smith AV, Tajuddin SM, Zhao W, Graff M, Alver M, Boissel M, Chai JF, Chen X, Divers J, Evangelou E, Gao C, Goel A, Hagemeijer Y, Harris SE, Hartwig FP, He M, Horimoto ARVR, Hsu FC, Hung YJ, Jackson AU, Kasturiratne A, Komulainen P, Kühnel B, Leander K, Lin KH, Luan J, Lyytikäinen LP, Matoba N, Nolte IM, Pietzner M, Prins B, Riaz M, Robino A, Said MA, Schupf N, Scott RA, Sofer T, Stancáková A, Takeuchi F, Tayo BO, van der Most PJ, Varga TV, Wang TD, Wang Y, Ware EB, Wen W, Xiang YB, Yanek LR, Zhang W, Zhao JH, Adeyemo A, Afaq S, Amin N, Amini M, Arking DE, Arzumanyan Z, Aung T, Ballantyne C, Barr RG, Bielak LF, Boerwinkle E, Bottinger EP, Broeckel U, Brown M, Cade BE, Campbell A, Canouil M, Charumathi S, Chen YDI, Christensen K, Concas MP, Connell JM, de Las Fuentes L, de Silva HJ, de Vries PS, Doumatey A, Duan Q, Eaton CB, Eppinga RN, Faul JD, Floyd JS, Forouhi NG, Forrester T, Friedlander Y, Gandin I, Gao H, Ghanbari M, Gharib SA, Gigante B, Giulianini F, Grabe HJ, Gu CC, Harris TB, Heikkinen S, Heng CK, Hirata M, Hixson JE, Ikram MA, Jia Y, Joehanes R, Johnson C, Jonas JB, Justice AE, Katsuya T, Khor CC, Kilpeläinen TO, Koh WP, Kolcic I, Kooperberg C, Krieger JE, Kritchevsky SB, Kubo M, Kuusisto J, Lakka TA, Langefeld CD, Langenberg C, Launer LJ, Lehne B, Lewis CE, Li Y, Liang J, Lin S, Liu CT, Liu J, Liu K, Loh M, Lohman KK, Louie T, Luzzi A, Mägi R, Mahajan A, Manichaikul AW, McKenzie CA, Meitinger T, Metspalu A, Milaneschi Y, Milani L, Mohlke KL, Momozawa Y, Morris AP, Murray AD, Nalls MA, Nauck M, Nelson CP, North KE, O'Connell JR, Palmer ND, Papanicolau GJ, Pedersen NL, Peters A, Peyser PA, Polasek O, Poulter N, Raitakari OT, Reiner AP, Renström F, Rice TK, Rich SS, Robinson JG, Rose LM, Rosendaal FR, Rudan I, Schmidt CO, Schreiner PJ, Scott WR, Sever P, Shi Y, Sidney S, Sims M, Smith JA, Snieder H, Starr JM, Strauch K, Stringham HM, Tan NYQ, Tang H, Taylor KD, Teo YY, Tham YC, Tiemeier H, Turner ST, Uitterlinden AG, van Heemst D, Waldenberger M, Wang H, Wang L, Wang L, Wei WB, Williams CA, Wilson G, Wojczynski MK, Yao J, Young K, Yu C, Yuan JM, Zhou J, Zonderman AB, Becker DM, Boehnke M, Bowden DW, Chambers JC, Cooper RS, de Faire U, Deary IJ, Elliott P, Esko T, Farrall M, Franks PW, Freedman BI, Froguel P, Gasparini P, Gieger C, Horta BL, Juang JMJ, Kamatani Y, Kammerer CM, Kato N, Kooner JS, Laakso M, Laurie CC, Lee IT, Lehtimäki T, Magnusson PKE, Oldehinkel AJ, Penninx BWJH, Pereira AC, Rauramaa R, Redline S, Samani NJ, Scott J, Shu XO, van der Harst P, Wagenknecht LE, Wang JS, Wang YX, Wareham NJ, Watkins H, Weir DR, Wickremasinghe AR, Wu T, Zeggini E, Zheng W, Bouchard C, Evans MK, Gudnason V, Kardia SLR, Liu Y, Psaty BM, Ridker PM, van Dam RM, Mook-Kanamori DO, Fornage M, Province MA, Kelly TN, Fox ER, Hayward C, van Duijn CM, Tai ES, Wong TY, Loos RJF, Franceschini N, Rotter JI, Zhu X, Bierut LJ, Gauderman WJ, Rice K, Munroe PB, Morrison AC, Rao DC, Rotimi CN, Cupples LA. Multi-ancestry genome-wide gene-smoking interaction study of 387,272 individuals identifies new loci associated with serum lipids. Nat Genet 2019; 51:636-648. [PMID: 30926973 PMCID: PMC6467258 DOI: 10.1038/s41588-019-0378-y] [Citation(s) in RCA: 82] [Impact Index Per Article: 16.4] [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: 01/08/2018] [Accepted: 02/07/2019] [Indexed: 12/08/2022]
Abstract
The concentrations of high- and low-density-lipoprotein cholesterol and triglycerides are influenced by smoking, but it is unknown whether genetic associations with lipids may be modified by smoking. We conducted a multi-ancestry genome-wide gene-smoking interaction study in 133,805 individuals with follow-up in an additional 253,467 individuals. Combined meta-analyses identified 13 new loci associated with lipids, some of which were detected only because association differed by smoking status. Additionally, we demonstrate the importance of including diverse populations, particularly in studies of interactions with lifestyle factors, where genomic and lifestyle differences by ancestry may contribute to novel findings.
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Affiliation(s)
- Amy R Bentley
- Center for Research on Genomics and Global Health, National Human Genome Research Institute, US National Institutes of Health, Bethesda, MD, USA.
| | - Yun J Sung
- Division of Biostatistics, Washington University School of Medicine, St. Louis, MO, USA
| | - Michael R Brown
- Human Genetics Center, Department of Epidemiology, Human Genetics, and Environmental Sciences, School of Public Health, University of Texas Health Science Center at Houston, Houston, TX, USA
| | - Thomas W Winkler
- Department of Genetic Epidemiology, University of Regensburg, Regensburg, Germany
| | - Aldi T Kraja
- Division of Statistical Genomics, Department of Genetics, Washington University School of Medicine, St. Louis, MO, USA
| | - Ioanna Ntalla
- Clinical Pharmacology, William Harvey Research Institute, Barts and The London School of Medicine and Dentistry, Queen Mary University of London, London, UK
| | - Karen Schwander
- Division of Biostatistics, Washington University School of Medicine, St. Louis, MO, USA
| | - Daniel I Chasman
- Division of Preventive Medicine, Brigham and Women's Hospital, Boston, MA, USA
- Harvard Medical School, Boston, MA, USA
| | - Elise Lim
- Department of Biostatistics, Boston University School of Public Health, Boston, MA, USA
| | - Xuan Deng
- Department of Biostatistics, Boston University School of Public Health, Boston, MA, USA
| | - Xiuqing Guo
- Institute for Translational Genomics and Population Sciences, Department of Pediatrics, Los Angeles Biomedical Research Institute at Harbor-UCLA Medical Center, Torrance, CA, USA
| | - Jingmin Liu
- Women's Health Initiative Clinical Coordinating Center, Fred Hutchinson Cancer Research Center, Seattle, WA, USA
| | - Yingchang Lu
- Charles Bronfman Institute for Personalized Medicine, Icahn School of Medicine at Mount Sinai, New York, NY, USA
| | - Ching-Yu Cheng
- Singapore Eye Research Institute, Singapore National Eye Centre, Singapore, Singapore
- Centre for Quantitative Medicine, Academic Medicine Research Institute, Ophthalmology and Visual Sciences Academic Clinical Program (Eye ACP), Duke-NUS Medical School, Singapore, Singapore
- Department of Ophthalmology, Yong Loo Lin School of Medicine, National University of Singapore, Singapore, Singapore
| | - Xueling Sim
- Saw Swee Hock School of Public Health, National University of Singapore and National University Health System, Singapore, Singapore
| | - Dina Vojinovic
- Department of Epidemiology, Erasmus University Medical Center, Rotterdam, the Netherlands
| | - Jennifer E Huffman
- Medical Research Council Human Genetics Unit, Institute of Genetics and Molecular Medicine, University of Edinburgh, Edinburgh, UK
| | - Solomon K Musani
- Jackson Heart Study, Department of Medicine, University of Mississippi Medical Center, Jackson, MS, USA
| | - Changwei Li
- Epidemiology and Biostatistics, University of Georgia at Athens College of Public Health, Athens, GA, USA
| | - Mary F Feitosa
- Division of Statistical Genomics, Department of Genetics, Washington University School of Medicine, St. Louis, MO, USA
| | - Melissa A Richard
- Brown Foundation Institute of Molecular Medicine, University of Texas Health Science Center at Houston, Houston, TX, USA
| | - Raymond Noordam
- Internal Medicine, Gerontology and Geriatrics, Leiden University Medical Center, Leiden, the Netherlands
| | - Jenna Baker
- Center for Research on Genomics and Global Health, National Human Genome Research Institute, US National Institutes of Health, Bethesda, MD, USA
| | - Guanjie Chen
- Center for Research on Genomics and Global Health, National Human Genome Research Institute, US National Institutes of Health, Bethesda, MD, USA
| | - Hugues Aschard
- Centre de Bioinformatique, Biostatistique, et Biologie Intégrative (C3BI), Institut Pasteur, Paris, France
- Department of Epidemiology, Harvard T. H. Chan School of Public Health, Boston, MA, USA
| | - Traci M Bartz
- Cardiovascular Health Research Unit, Department of Biostatistics, University of Washington, Seattle, WA, USA
- Cardiovascular Health Research Unit, Department of Medicine, University of Washington, Seattle, WA, USA
| | - Jingzhong Ding
- Center on Diabetes, Obesity, and Metabolism, Gerontology and Geriatric Medicine, Wake Forest University Health Sciences, Winston-Salem, NC, USA
| | - Rajkumar Dorajoo
- Genome Institute of Singapore, Agency for Science, Technology and Research, Singapore, Singapore
| | - Alisa K Manning
- Clinical and Translational Epidemiology Unit, Massachusetts General Hospital, Boston, MA, USA
- Department of Medicine, Harvard Medical School, Boston, MA, USA
| | - Tuomo Rankinen
- Human Genomics Laboratory, Pennington Biomedical Research Center, Baton Rouge, LA, USA
| | - Albert V Smith
- Icelandic Heart Association, Kopavogur, Iceland
- Faculty of Medicine, University of Iceland, Reykjavik, Iceland
| | - Salman M Tajuddin
- Health Disparities Research Section, Laboratory of Epidemiology and Population Sciences, National Institute on Aging, US National Institutes of Health, Baltimore, MD, USA
| | - Wei Zhao
- Department of Epidemiology, School of Public Health, University of Michigan, Ann Arbor, MI, USA
| | - Mariaelisa Graff
- Department of Epidemiology, Gillings School of Global Public Health, University of North Carolina at Chapel Hill, Chapel Hill, NC, USA
| | - Maris Alver
- Estonian Genome Center, Institute of Genomics, University of Tartu, Tartu, Estonia
| | - Mathilde Boissel
- CNRS UMR 8199, European Genomic Institute for Diabetes (EGID), Institut Pasteur de Lille, University of Lille, Lille, France
| | - Jin Fang Chai
- Saw Swee Hock School of Public Health, National University of Singapore and National University Health System, Singapore, Singapore
| | - Xu Chen
- Department of Medical Epidemiology and Biostatistics, Karolinska Institutet, Stockholm, Sweden
| | - Jasmin Divers
- Department of Biostatistics and Data Science, Division of Public Health Sciences, Wake Forest School of Medicine, Winston-Salem, NC, USA
| | - Evangelos Evangelou
- Department of Epidemiology and Biostatistics, School of Public Health, Imperial College, London, UK
- Department of Hygiene and Epidemiology, University of Ioannina Medical School, Ioannina, Greece
| | - Chuan Gao
- Molecular Genetics and Genomics Program, Wake Forest School of Medicine, Winston-Salem, NC, USA
| | - Anuj Goel
- Division of Cardiovascular Medicine, Radcliffe Department of Medicine, University of Oxford, Oxford, UK
- Wellcome Centre for Human Genetics, University of Oxford, Oxford, UK
| | - Yanick Hagemeijer
- University of Groningen, University Medical Center Groningen, Department of Cardiology, Groningen, the Netherlands
| | - Sarah E Harris
- Centre for Cognitive Ageing and Cognitive Epidemiology, University of Edinburgh, Edinburgh, UK
- Medical Genetics Section, Centre for Genomic and Experimental Medicine, University of Edinburgh, Edinburgh, UK
| | - Fernando P Hartwig
- Postgraduate Programme in Epidemiology, Federal University of Pelotas, Pelotas, Brazil
- Medical Research Council Integrative Epidemiology Unit, University of Bristol, Bristol, UK
| | - Meian He
- Department of Occupational and Environmental Health and State Key Laboratory of Environmental Health for Incubating, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
| | - Andrea R V R Horimoto
- Laboratory of Genetics and Molecular Cardiology, Heart Institute (InCor), University of São Paulo Medical School, São Paulo, Brazil
| | - Fang-Chi Hsu
- Department of Biostatistics and Data Science, Division of Public Health Sciences, Wake Forest School of Medicine, Winston-Salem, NC, USA
| | - Yi-Jen Hung
- Endocrinology and Metabolism, Tri-Service General Hospital, Taipei, Taiwan
- School of Medicine, National Defense Medical Center, Taipei, Taiwan
| | - Anne U Jackson
- Department of Biostatistics and Center for Statistical Genetics, University of Michigan, Ann Arbor, MI, USA
| | | | - Pirjo Komulainen
- Foundation for Research in Health, Exercise, and Nutrition, Kuopio Research Institute of Exercise Medicine, Kuopio, Finland
| | - Brigitte Kühnel
- Research Unit of Molecular Epidemiology, Helmholtz Zentrum München-German Research Center for Environmental Health, Neuherberg, Germany
- Institute of Epidemiology, Helmholtz Zentrum München-German Research Center for Environmental Health, Neuherberg, Germany
| | - Karin Leander
- Unit of Cardiovascular Epidemiology, Institute of Environmental Medicine, Karolinska Institutet, Stockholm, Sweden
| | - Keng-Hung Lin
- Ophthalmology, Taichung Veterans General Hospital, Taichung, Taiwan
| | - Jian'an Luan
- Medical Research Council Epidemiology Unit, University of Cambridge, Cambridge, UK
| | - Leo-Pekka Lyytikäinen
- Department of Clinical Chemistry, Fimlab Laboratories, Tampere, Finland
- Department of Clinical Chemistry, Finnish Cardiovascular Research Center-Tampere, Faculty of Medicine and Technology, Tampere University, Tampere, Finland
| | - Nana Matoba
- Laboratory for Statistical Analysis, RIKEN Center for Integrative Medical Sciences, Yokohama, Japan
| | - Ilja M Nolte
- University of Groningen, University Medical Center Groningen, Department of Epidemiology, Groningen, the Netherlands
| | - Maik Pietzner
- DZHK (German Centre for Cardiovascular Health), Partner Site Greifswald, Greifswald, Germany
- Institute of Clinical Chemistry and Laboratory Medicine, University Medicine Greifswald, Greifswald, Germany
| | - Bram Prins
- Human Genetics, Wellcome Trust Sanger Institute, Hinxton, UK
| | - Muhammad Riaz
- Department of Cardiovascular Sciences, University of Leicester, Leicester, UK
- NIHR Leicester Biomedical Research Centre, Glenfield Hospital, Leicester, UK
| | - Antonietta Robino
- Institute for Maternal and Child Health, IRCCS 'Burlo Garofolo', Trieste, Italy
| | - M Abdullah Said
- University of Groningen, University Medical Center Groningen, Department of Cardiology, Groningen, the Netherlands
| | - Nicole Schupf
- Taub Institute for Research on Alzheimer's Disease and the Aging Brain, Columbia University Medical Center, New York, NY, USA
| | - Robert A Scott
- Medical Research Council Epidemiology Unit, University of Cambridge, Cambridge, UK
| | - Tamar Sofer
- Department of Medicine, Harvard Medical School, Boston, MA, USA
- Division of Sleep and Circadian Disorders, Brigham and Women's Hospital, Boston, MA, USA
| | - Alena Stancáková
- Institute of Clinical Medicine, Internal Medicine, University of Eastern Finland, Kuopio, Finland
| | - Fumihiko Takeuchi
- Department of Gene Diagnostics and Therapeutics, Research Institute, National Center for Global Health and Medicine, Tokyo, Japan
| | - Bamidele O Tayo
- Department of Public Health Sciences, Loyola University Chicago, Maywood, IL, USA
| | - Peter J van der Most
- University of Groningen, University Medical Center Groningen, Department of Epidemiology, Groningen, the Netherlands
| | - Tibor V Varga
- Department of Clinical Sciences, Genetic and Molecular Epidemiology Unit, Lund University Diabetes Centre, Skåne University Hospital, Malmö, Sweden
| | - Tzung-Dau Wang
- Cardiovascular Center, National Taiwan University Hospital, Taipei, Taiwan
- National Taiwan University College of Medicine, Taipei, Taiwan
- Division of Cardiology, Department of Internal Medicine, National Taiwan University Hospital, Taipei, Taiwan
| | - Yajuan Wang
- Department of Population Quantitative and Health Sciences, Case Western Reserve University, Cleveland, OH, USA
| | - Erin B Ware
- Survey Research Center, Institute for Social Research, University of Michigan, Ann Arbor, MI, USA
| | - Wanqing Wen
- Division of Epidemiology, Department of Medicine, Vanderbilt University School of Medicine, Nashville, TN, USA
| | - Yong-Bing Xiang
- SKLORG and Department of Epidemiology, Shanghai Cancer Institute, Renji Hospital, Shanghai Jiaotong University School of Medicine, Shanghai, China
| | - Lisa R Yanek
- Division of General Internal Medicine, Department of Medicine, Johns Hopkins University School of Medicine, Baltimore, MD, USA
| | - Weihua Zhang
- MRC-PHE Centre for Environment and Health, School of Public Health, Imperial College, London, UK
- Department of Cardiology, Ealing Hospital, Middlesex, UK
| | - Jing Hua Zhao
- Medical Research Council Epidemiology Unit, University of Cambridge, Cambridge, UK
| | - Adebowale Adeyemo
- Center for Research on Genomics and Global Health, National Human Genome Research Institute, US National Institutes of Health, Bethesda, MD, USA
| | - Saima Afaq
- MRC-PHE Centre for Environment and Health, School of Public Health, Imperial College, London, UK
| | - Najaf Amin
- Department of Epidemiology, Erasmus University Medical Center, Rotterdam, the Netherlands
| | - Marzyeh Amini
- University of Groningen, University Medical Center Groningen, Department of Epidemiology, Groningen, the Netherlands
| | - Dan E Arking
- McKusick-Nathans Institute of Genetic Medicine, Johns Hopkins University School of Medicine, Baltimore, MD, USA
| | - Zorayr Arzumanyan
- Institute for Translational Genomics and Population Sciences, Department of Pediatrics, Los Angeles Biomedical Research Institute at Harbor-UCLA Medical Center, Torrance, CA, USA
| | - Tin Aung
- Singapore Eye Research Institute, Singapore National Eye Centre, Singapore, Singapore
- Department of Ophthalmology, Yong Loo Lin School of Medicine, National University of Singapore, Singapore, Singapore
- Ophthalmology and Visual Sciences Academic Clinical Program (Eye ACP), Duke-NUS Medical School, Singapore, Singapore
| | - Christie Ballantyne
- Section of Cardiovascular Research, Baylor College of Medicine, Houston, TX, USA
- Houston Methodist Debakey Heart and Vascular Center, Houston, TX, USA
| | - R Graham Barr
- Departments of Medicine and Epidemiology, Columbia University Medical Center, New York, NY, USA
| | - Lawrence F Bielak
- Department of Epidemiology, School of Public Health, University of Michigan, Ann Arbor, MI, USA
| | - Eric Boerwinkle
- Human Genetics Center, Department of Epidemiology, Human Genetics, and Environmental Sciences, School of Public Health, University of Texas Health Science Center at Houston, Houston, TX, USA
- Human Genome Sequencing Center, Baylor College of Medicine, Houston, TX, USA
| | - Erwin P Bottinger
- Charles Bronfman Institute for Personalized Medicine, Icahn School of Medicine at Mount Sinai, New York, NY, USA
| | - Ulrich Broeckel
- Section of Genomic Pediatrics, Departments of Pediatrics, Medicine, and Physiology, Medical College of Wisconsin, Milwaukee, WI, USA
| | - Morris Brown
- Clinical Pharmacology, William Harvey Research Institute, Barts and The London School of Medicine and Dentistry, Queen Mary University of London, London, UK
- NIHR Barts Cardiovascular Biomedical Research Centre, Queen Mary University of London, London, UK
| | - Brian E Cade
- Division of Sleep and Circadian Disorders, Brigham and Women's Hospital, Boston, MA, USA
| | - Archie Campbell
- Centre for Genomic and Experimental Medicine, Institute of Genetics and Molecular Medicine, University of Edinburgh, Edinburgh, UK
| | - Mickaël Canouil
- CNRS UMR 8199, European Genomic Institute for Diabetes (EGID), Institut Pasteur de Lille, University of Lille, Lille, France
| | - Sabanayagam Charumathi
- Singapore Eye Research Institute, Singapore National Eye Centre, Singapore, Singapore
- Centre for Quantitative Medicine, Academic Medicine Research Institute, Ophthalmology and Visual Sciences Academic Clinical Program (Eye ACP), Duke-NUS Medical School, Singapore, Singapore
| | - Yii-Der Ida Chen
- Institute for Translational Genomics and Population Sciences, Department of Pediatrics, Los Angeles Biomedical Research Institute at Harbor-UCLA Medical Center, Torrance, CA, USA
| | - Kaare Christensen
- Danish Aging Research Center, Institute of Public Health, University of Southern Denmark, Odense, Denmark
| | - Maria Pina Concas
- Institute for Maternal and Child Health, IRCCS 'Burlo Garofolo', Trieste, Italy
| | - John M Connell
- Ninewells Hospital and Medical School, University of Dundee, Dundee, UK
| | - Lisa de Las Fuentes
- Division of Biostatistics, Washington University School of Medicine, St. Louis, MO, USA
- Cardiovascular Division, Department of Medicine, Washington University School of Medicine, St. Louis, MO, USA
| | - H Janaka de Silva
- Department of Medicine, Faculty of Medicine, University of Kelaniya, Ragama, Sri Lanka
| | - Paul S de Vries
- Human Genetics Center, Department of Epidemiology, Human Genetics, and Environmental Sciences, School of Public Health, University of Texas Health Science Center at Houston, Houston, TX, USA
| | - Ayo Doumatey
- Center for Research on Genomics and Global Health, National Human Genome Research Institute, US National Institutes of Health, Bethesda, MD, USA
| | - Qing Duan
- Department of Genetics, University of North Carolina at Chapel Hill, Chapel Hill, NC, USA
| | - Charles B Eaton
- Department of Family Medicine and Epidemiology, Alpert Medical School of Brown University, Providence, RI, USA
| | - Ruben N Eppinga
- University of Groningen, University Medical Center Groningen, Department of Cardiology, Groningen, the Netherlands
| | - Jessica D Faul
- Survey Research Center, Institute for Social Research, University of Michigan, Ann Arbor, MI, USA
| | - James S Floyd
- Cardiovascular Health Research Unit, Department of Medicine, University of Washington, Seattle, WA, USA
- Department of Epidemiology, University of Washington, Seattle, WA, USA
| | - Nita G Forouhi
- Medical Research Council Epidemiology Unit, University of Cambridge, Cambridge, UK
| | - Terrence Forrester
- UWI Solutions for Developing Countries, University of the West Indies, Kingston, Jamaica
| | - Yechiel Friedlander
- Braun School of Public Health, Hebrew University-Hadassah Medical Center, Jerusalem, Israel
| | - Ilaria Gandin
- Department of Medical Sciences, University of Trieste, Trieste, Italy
| | - He Gao
- Department of Epidemiology and Biostatistics, School of Public Health, Imperial College, London, UK
| | - Mohsen Ghanbari
- Department of Epidemiology, Erasmus University Medical Center, Rotterdam, the Netherlands
- Department of Genetics, School of Medicine, Mashhad University of Medical Sciences, Mashhad, Iran
| | - Sina A Gharib
- Computational Medicine Core, Center for Lung Biology, UW Medicine Sleep Center, Department of Medicine, University of Washington, Seattle, WA, USA
| | - Bruna Gigante
- Unit of Cardiovascular Epidemiology, Institute of Environmental Medicine, Karolinska Institutet, Stockholm, Sweden
| | - Franco Giulianini
- Division of Preventive Medicine, Brigham and Women's Hospital, Boston, MA, USA
| | - Hans J Grabe
- Department of Psychiatry and Psychotherapy, University Medicine Greifswald, Greifswald, Germany
| | - C Charles Gu
- Division of Biostatistics, Washington University School of Medicine, St. Louis, MO, USA
| | - Tamara B Harris
- Laboratory of Epidemiology and Population Sciences, National Institute on Aging, US National Institutes of Health, Bethesda, MD, USA
| | - Sami Heikkinen
- Institute of Clinical Medicine, Internal Medicine, University of Eastern Finland, Kuopio, Finland
- Institute of Biomedicine, School of Medicine, University of Eastern Finland, Kuopio, Finland
| | - Chew-Kiat Heng
- Department of Paediatrics, Yong Loo Lin School of Medicine, National University of Singapore, Singapore, Singapore
- Khoo Teck Puat-National University Children's Medical Institute, National University Health System, Singapore, Singapore
| | - Makoto Hirata
- Laboratory of Genome Technology, Human Genome Center, Institute of Medical Science, University of Tokyo, Minato-ku, Japan
| | - James E Hixson
- Human Genetics Center, Department of Epidemiology, Human Genetics, and Environmental Sciences, School of Public Health, University of Texas Health Science Center at Houston, Houston, TX, USA
| | - M Arfan Ikram
- Department of Epidemiology, Erasmus University Medical Center, Rotterdam, the Netherlands
- Department of Radiology and Nuclear Medicine, Erasmus University Medical Center, Rotterdam, the Netherlands
- Department of Neurology, Erasmus University Medical Center, Rotterdam, the Netherlands
| | - Yucheng Jia
- Institute for Translational Genomics and Population Sciences, Department of Pediatrics, Los Angeles Biomedical Research Institute at Harbor-UCLA Medical Center, Torrance, CA, USA
| | - Roby Joehanes
- Hebrew SeniorLife, Beth Israel Deaconess Medical Center, Harvard Medical School, Boston, MA, USA
- Framingham Heart Study, National Heart, Lung, and Blood Institute, US National Institutes of Health, Bethesda, MD, USA
| | - Craig Johnson
- Collaborative Health Studies Coordinating Center, University of Washington, Seattle, WA, USA
| | - Jost Bruno Jonas
- Department of Ophthalmology, Medical Faculty Mannheim, University of Heidelberg, Mannheim, Germany
- Beijing Institute of Ophthalmology, Beijing Ophthalmology and Visual Science Key Laboratory, Beijing Tongren Eye Center, Capital Medical University, Beijing, China
| | - Anne E Justice
- Department of Epidemiology, Gillings School of Global Public Health, University of North Carolina at Chapel Hill, Chapel Hill, NC, USA
| | - Tomohiro Katsuya
- Department of Clinical Gene Therapy, Osaka University Graduate School of Medicine, Suita, Japan
- Department of Geriatric and General Medicine, Osaka University Graduate School of Medicine, Suita, Japan
| | - Chiea Chuen Khor
- Genome Institute of Singapore, Agency for Science, Technology and Research, Singapore, Singapore
| | - Tuomas O Kilpeläinen
- Novo Nordisk Foundation Center for Basic Metabolic Research, Faculty of Health and Medical Sciences, University of Copenhagen, Copenhagen, Denmark
- Department of Environmental Medicine and Public Health, Icahn School of Medicine at Mount Sinai, New York, NY, USA
| | - Woon-Puay Koh
- Saw Swee Hock School of Public Health, National University of Singapore and National University Health System, Singapore, Singapore
- Duke-NUS Medical School, Singapore, Singapore
| | - Ivana Kolcic
- Department of Public Health, Department of Medicine, University of Split, Split, Croatia
| | - Charles Kooperberg
- Fred Hutchinson Cancer Research Center, University of Washington School of Public Health, Seattle, WA, USA
| | - Jose E Krieger
- Laboratory of Genetics and Molecular Cardiology, Heart Institute (InCor), University of São Paulo Medical School, São Paulo, Brazil
| | - Stephen B Kritchevsky
- Sticht Center for Healthy Aging and Alzheimer's Prevention, Department of Internal Medicine, Wake Forest School of Medicine, Winston-Salem, NC, USA
| | - Michiaki Kubo
- RIKEN Center for Integrative Medical Sciences, Yokohama, Japan
| | - Johanna Kuusisto
- Institute of Clinical Medicine, Internal Medicine, University of Eastern Finland, Kuopio, Finland
| | - Timo A Lakka
- Foundation for Research in Health, Exercise, and Nutrition, Kuopio Research Institute of Exercise Medicine, Kuopio, Finland
- Institute of Biomedicine, School of Medicine, University of Eastern Finland, Kuopio, Finland
- Department of Clinical Physiology and Nuclear Medicine, Kuopio University Hospital, Kuopio, Finland
| | - Carl D Langefeld
- Department of Biostatistics and Data Science, Division of Public Health Sciences, Wake Forest School of Medicine, Winston-Salem, NC, USA
| | - Claudia Langenberg
- Medical Research Council Epidemiology Unit, University of Cambridge, Cambridge, UK
| | - Lenore J Launer
- Laboratory of Epidemiology and Population Sciences, National Institute on Aging, US National Institutes of Health, Bethesda, MD, USA
| | - Benjamin Lehne
- Institute of Clinical Sciences, Department of Molecular Sciences, Imperial College, London, UK
| | - Cora E Lewis
- Department of Medicine, University of Alabama at Birmingham, Birmingham, AL, USA
| | - Yize Li
- Division of Biostatistics, Washington University School of Medicine, St. Louis, MO, USA
| | - Jingjing Liang
- Department of Population Quantitative and Health Sciences, Case Western Reserve University, Cleveland, OH, USA
| | - Shiow Lin
- Division of Statistical Genomics, Department of Genetics, Washington University School of Medicine, St. Louis, MO, USA
| | - Ching-Ti Liu
- Department of Biostatistics, Boston University School of Public Health, Boston, MA, USA
| | - Jianjun Liu
- Genome Institute of Singapore, Agency for Science, Technology and Research, Singapore, Singapore
- Department of Medicine, Yong Loo Lin School of Medicine, National University of Singapore, Singapore, Singapore
| | - Kiang Liu
- Epidemiology, Department of Preventive Medicine, Northwestern University Feinberg School of Medicine, Chicago, IL, USA
| | - Marie Loh
- MRC-PHE Centre for Environment and Health, School of Public Health, Imperial College, London, UK
- Translational Laboratory in Genetic Medicine, Agency for Science, Technology, and Research, Singapore, Singapore
- Department of Biochemistry, Yong Loo Lin School of Medicine, National University of Singapore, Singapore, Singapore
- Lee Kong Chian School of Medicine, Nanyang Technological University, Singapore, Singapore
| | - Kurt K Lohman
- Department of Biostatistics and Data Science, Division of Public Health Sciences, Wake Forest School of Medicine, Winston-Salem, NC, USA
| | - Tin Louie
- Department of Biostatistics, University of Washington, Seattle, WA, USA
| | - Anna Luzzi
- Institute for Translational Genomics and Population Sciences, Department of Pediatrics, Los Angeles Biomedical Research Institute at Harbor-UCLA Medical Center, Torrance, CA, USA
| | - Reedik Mägi
- Estonian Genome Center, Institute of Genomics, University of Tartu, Tartu, Estonia
| | - Anubha Mahajan
- Wellcome Centre for Human Genetics, University of Oxford, Oxford, UK
| | - Ani W Manichaikul
- Center for Public Health Genomics, University of Virginia, Charlottesville, VA, USA
| | - Colin A McKenzie
- Tropical Metabolism Research Unit, Caribbean Institute for Health Research, University of the West Indies, Mona, Jamaica
| | - Thomas Meitinger
- Institute of Human Genetics, Helmholtz Zentrum München-German Research Center for Environmental Health, Neuherberg, Germany
- Institute of Human Genetics, Technische Universität München, Munich, Germany
- Technische Universität München, Munich, Germany
| | - Andres Metspalu
- Estonian Genome Center, Institute of Genomics, University of Tartu, Tartu, Estonia
| | - Yuri Milaneschi
- Department of Psychiatry, Amsterdam Neuroscience and Amsterdam Public Health Research Institute, Amsterdam University Medical Center, Vrije Universiteit, Amsterdam, the Netherlands
| | - Lili Milani
- Estonian Genome Center, Institute of Genomics, University of Tartu, Tartu, Estonia
| | - Karen L Mohlke
- Department of Genetics, University of North Carolina at Chapel Hill, Chapel Hill, NC, USA
| | - Yukihide Momozawa
- Laboratory for Genotyping Development, RIKEN Center for Integrative Medical Sciences, Yokohama, Japan
| | - Andrew P Morris
- Wellcome Centre for Human Genetics, University of Oxford, Oxford, UK
- Department of Biostatistics, University of Liverpool, Liverpool, UK
| | - Alison D Murray
- Institute of Medical Sciences, Aberdeen Biomedical Imaging Centre, University of Aberdeen, Aberdeen, UK
| | - Mike A Nalls
- Data Tecnica International, Glen Echo, MD, USA
- Laboratory of Neurogenetics, National Institute on Aging, Bethesda, MD, USA
| | - Matthias Nauck
- DZHK (German Centre for Cardiovascular Health), Partner Site Greifswald, Greifswald, Germany
- Institute of Clinical Chemistry and Laboratory Medicine, University Medicine Greifswald, Greifswald, Germany
| | - Christopher P Nelson
- Department of Cardiovascular Sciences, University of Leicester, Leicester, UK
- NIHR Leicester Biomedical Research Centre, Glenfield Hospital, Leicester, UK
| | - Kari E North
- Department of Epidemiology, Gillings School of Global Public Health, University of North Carolina at Chapel Hill, Chapel Hill, NC, USA
| | - Jeffrey R O'Connell
- Division of Endocrinology, Diabetes, and Nutrition, University of Maryland School of Medicine, Baltimore, MD, USA
- Program for Personalized and Genomic Medicine, University of Maryland School of Medicine, Baltimore, MD, USA
| | | | - George J Papanicolau
- Epidemiology Branch, Division of Cardiovascular Sciences, National Heart, Lung, and Blood Institute, US National Institutes of Health, Bethesda, MD, USA
| | - Nancy L Pedersen
- Department of Medical Epidemiology and Biostatistics, Karolinska Institutet, Stockholm, Sweden
| | - Annette Peters
- Institute of Epidemiology, Helmholtz Zentrum München-German Research Center for Environmental Health, Neuherberg, Germany
- Epidemiology, Faculty of Medicine, Institute for Medical Information Processing, Biometry, and Epidemiology, Ludwig Maximilian University, Munich, Germany
| | - Patricia A Peyser
- Department of Epidemiology, School of Public Health, University of Michigan, Ann Arbor, MI, USA
| | - Ozren Polasek
- Department of Public Health, Department of Medicine, University of Split, Split, Croatia
- Psychiatric Hospital 'Sveti Ivan', Zagreb, Croatia
- Gen-info, Ltd, Zagreb, Croatia
| | - Neil Poulter
- School of Public Health, Imperial College, London, UK
| | - Olli T Raitakari
- Department of Clinical Physiology and Nuclear Medicine, Turku University Hospital, Turku, Finland
- Research Centre of Applied and Preventive Cardiovascular Medicine, University of Turku, Turku, Finland
| | - Alex P Reiner
- Fred Hutchinson Cancer Research Center, University of Washington School of Public Health, Seattle, WA, USA
| | - Frida Renström
- Department of Clinical Sciences, Genetic and Molecular Epidemiology Unit, Lund University Diabetes Centre, Skåne University Hospital, Malmö, Sweden
- Department of Biobank Research, Umeå University, Umeå, Sweden
| | - Treva K Rice
- Division of Biostatistics, Washington University School of Medicine, St. Louis, MO, USA
| | - Stephen S Rich
- Center for Public Health Genomics, University of Virginia, Charlottesville, VA, USA
| | - Jennifer G Robinson
- Department of Epidemiology and Medicine, University of Iowa, Iowa City, IA, USA
| | - Lynda M Rose
- Division of Preventive Medicine, Brigham and Women's Hospital, Boston, MA, USA
| | - Frits R Rosendaal
- Clinical Epidemiology, Leiden University Medical Center, Leiden, the Netherlands
| | - Igor Rudan
- Centre for Global Health Research, Usher Institute of Population Health Sciences and Informatics, University of Edinburgh, Edinburgh, UK
| | - Carsten O Schmidt
- Institute for Community Medicine, University Medicine Greifswald, Greifswald, Germany
| | - Pamela J Schreiner
- Division of Epidemiology and Community Health, School of Public Health, University of Minnesota, Minneapolis, MN, USA
| | - William R Scott
- Institute of Clinical Sciences, Department of Molecular Sciences, Imperial College, London, UK
- National Heart and Lung Institute, Imperial College, London, UK
| | - Peter Sever
- National Heart and Lung Institute, Imperial College, London, UK
| | - Yuan Shi
- Singapore Eye Research Institute, Singapore National Eye Centre, Singapore, Singapore
| | - Stephen Sidney
- Division of Research, Kaiser Permanente Northern California, Oakland, CA, USA
| | - Mario Sims
- Jackson Heart Study, Department of Medicine, University of Mississippi Medical Center, Jackson, MS, USA
| | - Jennifer A Smith
- Department of Epidemiology, School of Public Health, University of Michigan, Ann Arbor, MI, USA
- Survey Research Center, Institute for Social Research, University of Michigan, Ann Arbor, MI, USA
| | - Harold Snieder
- University of Groningen, University Medical Center Groningen, Department of Epidemiology, Groningen, the Netherlands
| | - John M Starr
- Centre for Cognitive Ageing and Cognitive Epidemiology, University of Edinburgh, Edinburgh, UK
- Alzheimer Scotland Dementia Research Centre, University of Edinburgh, Edinburgh, UK
| | - Konstantin Strauch
- Genetic Epidemiology, Faculty of Medicine, Institute for Medical Information Processing, Biometry, and Epidemiology, Ludwig Maximilian University, Munich, Germany
- Institute of Genetic Epidemiology, Helmholtz Zentrum München-German Research Center for Environmental Health, Neuherberg, Germany
| | - Heather M Stringham
- Department of Biostatistics and Center for Statistical Genetics, University of Michigan, Ann Arbor, MI, USA
| | - Nicholas Y Q Tan
- Singapore Eye Research Institute, Singapore National Eye Centre, Singapore, Singapore
| | - Hua Tang
- Department of Genetics, Stanford University, Stanford, CA, USA
| | - Kent D Taylor
- Institute for Translational Genomics and Population Sciences, Department of Pediatrics, Los Angeles Biomedical Research Institute at Harbor-UCLA Medical Center, Torrance, CA, USA
| | - Yik Ying Teo
- Saw Swee Hock School of Public Health, National University of Singapore and National University Health System, Singapore, Singapore
- Genome Institute of Singapore, Agency for Science, Technology and Research, Singapore, Singapore
- Department of Statistics and Applied Probability, National University of Singapore, Singapore, Singapore
- Life Sciences Institute, National University of Singapore, Singapore, Singapore
- NUS Graduate School for Integrative Science and Engineering, National University of Singapore, Singapore, Singapore
| | - Yih Chung Tham
- Singapore Eye Research Institute, Singapore National Eye Centre, Singapore, Singapore
| | - Henning Tiemeier
- Department of Epidemiology, Erasmus University Medical Center, Rotterdam, the Netherlands
- Department of Social and Behavioral Sciences, Harvard T. H. Chan School of Public Health, Boston, MA, USA
| | - Stephen T Turner
- Division of Nephrology and Hypertension, Mayo Clinic, Rochester, MN, USA
| | - André G Uitterlinden
- Department of Epidemiology, Erasmus University Medical Center, Rotterdam, the Netherlands
- Department of Internal Medicine, Erasmus University Medical Center, Rotterdam, the Netherlands
| | - Diana van Heemst
- Internal Medicine, Gerontology and Geriatrics, Leiden University Medical Center, Leiden, the Netherlands
| | - Melanie Waldenberger
- Research Unit of Molecular Epidemiology, Helmholtz Zentrum München-German Research Center for Environmental Health, Neuherberg, Germany
- Institute of Epidemiology, Helmholtz Zentrum München-German Research Center for Environmental Health, Neuherberg, Germany
| | - Heming Wang
- Department of Medicine, Harvard Medical School, Boston, MA, USA
- Division of Sleep and Circadian Disorders, Brigham and Women's Hospital, Boston, MA, USA
| | - Lan Wang
- Department of Biostatistics, Boston University School of Public Health, Boston, MA, USA
| | - Lihua Wang
- Division of Statistical Genomics, Department of Genetics, Washington University School of Medicine, St. Louis, MO, USA
| | - Wen Bin Wei
- Beijing Tongren Eye Center, Beijing Tongren Hospital, Capital Medical University, Beijing, China
| | - Christine A Williams
- Division of Statistical Genomics, Department of Genetics, Washington University School of Medicine, St. Louis, MO, USA
| | - Gregory Wilson
- Jackson Heart Study, School of Public Health, Jackson State University, Jackson, MS, USA
| | - Mary K Wojczynski
- Division of Statistical Genomics, Department of Genetics, Washington University School of Medicine, St. Louis, MO, USA
| | - Jie Yao
- Institute for Translational Genomics and Population Sciences, Department of Pediatrics, Los Angeles Biomedical Research Institute at Harbor-UCLA Medical Center, Torrance, CA, USA
| | - Kristin Young
- Department of Epidemiology, Gillings School of Global Public Health, University of North Carolina at Chapel Hill, Chapel Hill, NC, USA
| | - Caizheng Yu
- Department of Occupational and Environmental Health and State Key Laboratory of Environmental Health for Incubating, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
| | - Jian-Min Yuan
- Department of Epidemiology, Graduate School of Public Health, University of Pittsburgh, Pittsburgh, PA, USA
- Division of Cancer Control and Population Sciences, UPMC Hillman Cancer, University of Pittsburgh, Pittsburgh, PA, USA
| | - Jie Zhou
- Center for Research on Genomics and Global Health, National Human Genome Research Institute, US National Institutes of Health, Bethesda, MD, USA
| | - Alan B Zonderman
- Behavioral Epidemiology Section, Laboratory of Epidemiology and Population Sciences, National Institute on Aging, US National Institutes of Health, Baltimore, MD, USA
| | - Diane M Becker
- Division of General Internal Medicine, Department of Medicine, Johns Hopkins University School of Medicine, Baltimore, MD, USA
| | - Michael Boehnke
- Department of Biostatistics and Center for Statistical Genetics, University of Michigan, Ann Arbor, MI, USA
| | - Donald W Bowden
- Biochemistry, Wake Forest School of Medicine, Winston-Salem, NC, USA
| | - John C Chambers
- Department of Epidemiology and Biostatistics, School of Public Health, Imperial College, London, UK
- MRC-PHE Centre for Environment and Health, School of Public Health, Imperial College, London, UK
- Department of Cardiology, Ealing Hospital, Middlesex, UK
- Lee Kong Chian School of Medicine, Nanyang Technological University, Singapore, Singapore
- Imperial College Healthcare NHS Trust, London, UK
| | - Richard S Cooper
- Department of Public Health Sciences, Loyola University Chicago, Maywood, IL, USA
| | - Ulf de Faire
- Unit of Cardiovascular Epidemiology, Institute of Environmental Medicine, Karolinska Institutet, Stockholm, Sweden
| | - Ian J Deary
- Centre for Cognitive Ageing and Cognitive Epidemiology, University of Edinburgh, Edinburgh, UK
- Psychology, University of Edinburgh, Edinburgh, UK
| | - Paul Elliott
- MRC-PHE Centre for Environment and Health, School of Public Health, Imperial College, London, UK
| | - Tõnu Esko
- Estonian Genome Center, Institute of Genomics, University of Tartu, Tartu, Estonia
- Broad Institute of MIT and Harvard, Boston, MA, USA
| | - Martin Farrall
- Division of Cardiovascular Medicine, Radcliffe Department of Medicine, University of Oxford, Oxford, UK
- Wellcome Centre for Human Genetics, University of Oxford, Oxford, UK
| | - Paul W Franks
- Department of Clinical Sciences, Genetic and Molecular Epidemiology Unit, Lund University Diabetes Centre, Skåne University Hospital, Malmö, Sweden
- Department of Nutrition, Harvard T. H. Chan School of Public Health, Harvard University, Boston, MA, USA
- Department of Public Health and Clinical Medicine, Umeå University, Umeå, Sweden
- OCDEM, Radcliffe Department of Medicine, University of Oxford, Oxford, UK
| | - Barry I Freedman
- Nephrology, Internal Medicine, Wake Forest School of Medicine, Winston-Salem, NC, USA
| | - Philippe Froguel
- CNRS UMR 8199, European Genomic Institute for Diabetes (EGID), Institut Pasteur de Lille, University of Lille, Lille, France
- Department of Genomics of Common Disease, Imperial College, London, UK
| | - Paolo Gasparini
- Institute for Maternal and Child Health, IRCCS 'Burlo Garofolo', Trieste, Italy
- Department of Medical Sciences, University of Trieste, Trieste, Italy
| | - Christian Gieger
- Institute of Epidemiology, Helmholtz Zentrum München-German Research Center for Environmental Health, Neuherberg, Germany
- German Center for Diabetes Research (DZD), Neuherberg, Germany
| | - Bernardo L Horta
- Postgraduate Programme in Epidemiology, Federal University of Pelotas, Pelotas, Brazil
| | - Jyh-Ming Jimmy Juang
- National Taiwan University College of Medicine, Taipei, Taiwan
- Division of Cardiology, Department of Internal Medicine, National Taiwan University Hospital, Taipei, Taiwan
| | - Yoichiro Kamatani
- Laboratory for Statistical Analysis, RIKEN Center for Integrative Medical Sciences, Yokohama, Japan
| | - Candace M Kammerer
- Department of Human Genetics, Graduate School of Public Health, University of Pittsburgh, Pittsburgh, PA, USA
| | - Norihiro Kato
- Department of Gene Diagnostics and Therapeutics, Research Institute, National Center for Global Health and Medicine, Tokyo, Japan
| | - Jaspal S Kooner
- MRC-PHE Centre for Environment and Health, School of Public Health, Imperial College, London, UK
- Department of Cardiology, Ealing Hospital, Middlesex, UK
- National Heart and Lung Institute, Imperial College, London, UK
- Imperial College Healthcare NHS Trust, London, UK
| | - Markku Laakso
- Institute of Clinical Medicine, Internal Medicine, University of Eastern Finland, Kuopio, Finland
| | - Cathy C Laurie
- Department of Biostatistics, University of Washington, Seattle, WA, USA
| | - I-Te Lee
- Endocrinology and Metabolism, Internal Medicine, Taichung Veterans General Hospital, Taichung, Taiwan
- School of Medicine, Chung Shan Medical University, Taichung, Taiwan
- School of Medicine, National Yang-Ming University, Taipei, Taiwan
| | - Terho Lehtimäki
- Department of Clinical Chemistry, Fimlab Laboratories, Tampere, Finland
- Department of Clinical Chemistry, Finnish Cardiovascular Research Center-Tampere, Faculty of Medicine and Technology, Tampere University, Tampere, Finland
| | - Patrik K E Magnusson
- Department of Medical Epidemiology and Biostatistics, Karolinska Institutet, Stockholm, Sweden
| | - Albertine J Oldehinkel
- University of Groningen, University Medical Center Groningen, Department of Psychiatry, Groningen, the Netherlands
| | - Brenda W J H Penninx
- Department of Psychiatry, Amsterdam Neuroscience and Amsterdam Public Health Research Institute, Amsterdam University Medical Center, Vrije Universiteit, Amsterdam, the Netherlands
| | - Alexandre C Pereira
- Laboratory of Genetics and Molecular Cardiology, Heart Institute (InCor), University of São Paulo Medical School, São Paulo, Brazil
| | - Rainer Rauramaa
- Foundation for Research in Health, Exercise, and Nutrition, Kuopio Research Institute of Exercise Medicine, Kuopio, Finland
| | - Susan Redline
- Division of Sleep and Circadian Disorders, Brigham and Women's Hospital, Boston, MA, USA
| | - Nilesh J Samani
- Department of Cardiovascular Sciences, University of Leicester, Leicester, UK
- NIHR Leicester Biomedical Research Centre, Glenfield Hospital, Leicester, UK
| | - James Scott
- National Heart and Lung Institute, Imperial College, London, UK
| | - Xiao-Ou Shu
- Division of Epidemiology, Department of Medicine, Vanderbilt University School of Medicine, Nashville, TN, USA
| | - Pim van der Harst
- University of Groningen, University Medical Center Groningen, Department of Cardiology, Groningen, the Netherlands
- University of Groningen, University Medical Center Groningen, Department of Genetics, Groningen, the Netherlands
| | - Lynne E Wagenknecht
- Public Health Sciences, Wake Forest School of Medicine, Winston-Salem, NC, USA
| | - Jun-Sing Wang
- Endocrinology and Metabolism, Internal Medicine, Taichung Veterans General Hospital, Taichung, Taiwan
- School of Medicine, National Yang-Ming University, Taipei, Taiwan
| | - Ya Xing Wang
- Beijing Institute of Ophthalmology, Beijing Ophthalmology and Visual Science Key Laboratory, Beijing Tongren Eye Center, Capital Medical University, Beijing, China
| | - Nicholas J Wareham
- Medical Research Council Epidemiology Unit, University of Cambridge, Cambridge, UK
| | - Hugh Watkins
- Division of Cardiovascular Medicine, Radcliffe Department of Medicine, University of Oxford, Oxford, UK
- Wellcome Centre for Human Genetics, University of Oxford, Oxford, UK
| | - David R Weir
- Survey Research Center, Institute for Social Research, University of Michigan, Ann Arbor, MI, USA
| | | | - Tangchun Wu
- Department of Occupational and Environmental Health and State Key Laboratory of Environmental Health for Incubating, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
| | - Eleftheria Zeggini
- Human Genetics, Wellcome Trust Sanger Institute, Hinxton, UK
- Institute of Translational Genomics, Helmholtz Zentrum München-German Research Center for Environmental Health, Neuherberg, Germany
| | - Wei Zheng
- Division of Epidemiology, Department of Medicine, Vanderbilt University School of Medicine, Nashville, TN, USA
| | - Claude Bouchard
- Human Genomics Laboratory, Pennington Biomedical Research Center, Baton Rouge, LA, USA
| | - Michele K Evans
- Health Disparities Research Section, Laboratory of Epidemiology and Population Sciences, National Institute on Aging, US National Institutes of Health, Baltimore, MD, USA
| | - Vilmundur Gudnason
- Icelandic Heart Association, Kopavogur, Iceland
- Faculty of Medicine, University of Iceland, Reykjavik, Iceland
| | - Sharon L R Kardia
- Department of Epidemiology, School of Public Health, University of Michigan, Ann Arbor, MI, USA
| | - Yongmei Liu
- Public Health Sciences, Epidemiology and Prevention, Wake Forest University Health Sciences, Winston-Salem, NC, 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
- Department of Health Services, University of Washington, Seattle, WA, USA
- Kaiser Permanente Washington Health Research Institute, Seattle, WA, USA
| | - Paul M Ridker
- Division of Preventive Medicine, Brigham and Women's Hospital, Boston, MA, USA
- Harvard Medical School, Boston, MA, USA
| | - Rob M van Dam
- Saw Swee Hock School of Public Health, National University of Singapore and National University Health System, Singapore, Singapore
- Department of Medicine, Yong Loo Lin School of Medicine, National University of Singapore, Singapore, Singapore
| | - Dennis O Mook-Kanamori
- Clinical Epidemiology, Leiden University Medical Center, Leiden, the Netherlands
- Public Health and Primary Care, Leiden University Medical Center, Leiden, the Netherlands
| | - Myriam Fornage
- Human Genetics Center, Department of Epidemiology, Human Genetics, and Environmental Sciences, School of Public Health, University of Texas Health Science Center at Houston, Houston, TX, USA
- Brown Foundation Institute of Molecular Medicine, University of Texas Health Science Center at Houston, Houston, TX, USA
| | - Michael A Province
- Division of Statistical Genomics, Department of Genetics, Washington University School of Medicine, St. Louis, MO, USA
| | - Tanika N Kelly
- Epidemiology, Tulane University School of Public Health and Tropical Medicine, New Orleans, LA, USA
| | - Ervin R Fox
- Cardiology, Medicine, University of Mississippi Medical Center, Jackson, MS, USA
| | - Caroline Hayward
- Medical Research Council Human Genetics Unit, Institute of Genetics and Molecular Medicine, University of Edinburgh, Edinburgh, UK
| | - Cornelia M van Duijn
- Department of Epidemiology, Erasmus University Medical Center, Rotterdam, the Netherlands
- Nuffield Department of Population Health, University of Oxford, Oxford, UK
| | - E Shyong Tai
- Saw Swee Hock School of Public Health, National University of Singapore and National University Health System, Singapore, Singapore
- Duke-NUS Medical School, Singapore, Singapore
- Department of Medicine, Yong Loo Lin School of Medicine, National University of Singapore, Singapore, Singapore
| | - Tien Yin Wong
- Singapore Eye Research Institute, Singapore National Eye Centre, Singapore, Singapore
- Department of Ophthalmology, Yong Loo Lin School of Medicine, National University of Singapore, Singapore, Singapore
- Ophthalmology and Visual Sciences Academic Clinical Program (Eye ACP), Duke-NUS Medical School, Singapore, Singapore
| | - Ruth J F Loos
- Charles Bronfman Institute for Personalized Medicine, Icahn School of Medicine at Mount Sinai, New York, NY, USA
- Mindich Child Health Development Institute, Icahn School of Medicine at Mount Sinai, New York, NY, USA
| | - Nora Franceschini
- Department of Epidemiology, Gillings School of Global Public Health, University of North Carolina at Chapel Hill, Chapel Hill, NC, USA
| | - Jerome I Rotter
- Institute for Translational Genomics and Population Sciences, Department of Pediatrics, Los Angeles Biomedical Research Institute at Harbor-UCLA Medical Center, Torrance, CA, USA
| | - Xiaofeng Zhu
- Department of Population Quantitative and Health Sciences, Case Western Reserve University, Cleveland, OH, USA
| | - Laura J Bierut
- Psychiatry, Washington University School of Medicine, St. Louis, MO, USA
| | - W James Gauderman
- Biostatistics, Department of Preventive Medicine, University of Southern California, Los Angeles, CA, USA
| | - Kenneth Rice
- Department of Biostatistics, University of Washington, Seattle, WA, USA
| | - Patricia B Munroe
- Clinical Pharmacology, William Harvey Research Institute, Barts and The London School of Medicine and Dentistry, Queen Mary University of London, London, UK
- NIHR Barts Cardiovascular Biomedical Research Centre, Queen Mary University of London, London, UK
| | - Alanna C Morrison
- Human Genetics Center, Department of Epidemiology, Human Genetics, and Environmental Sciences, School of Public Health, University of Texas Health Science Center at Houston, Houston, TX, USA
| | - Dabeeru C Rao
- Division of Biostatistics, Washington University School of Medicine, St. Louis, MO, USA
| | - Charles N Rotimi
- Center for Research on Genomics and Global Health, National Human Genome Research Institute, US National Institutes of Health, Bethesda, MD, USA.
| | - L Adrienne Cupples
- Department of Biostatistics, Boston University School of Public Health, Boston, MA, USA.
- Framingham Heart Study, National Heart, Lung, and Blood Institute, US National Institutes of Health, Bethesda, MD, USA.
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Tavares LC, Duarte NE, Marcatto LR, Soares RAG, Krieger JE, Pereira AC, Santos PCJL. Impact of incorporating ABCB1 and CYP4F2 polymorphisms in a pharmacogenetics-guided warfarin dosing algorithm for the Brazilian population. Eur J Clin Pharmacol 2018; 74:1555-1566. [PMID: 30051215 DOI: 10.1007/s00228-018-2528-z] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/25/2018] [Accepted: 07/16/2018] [Indexed: 12/15/2022]
Abstract
PURPOSE Interpatient variation of warfarin dose requirements may be explained by genetic variations and general and clinical factors. In this scenario, diverse population-calibrated dosing algorithms, which incorporate the main warfarin dosing influencers, have been widely proposed for predicting supposed warfarin maintenance dose, in order to prevent and reduce adverse events. The aim of the present study was to evaluate the impact of the inclusion of ABCB1 c.3435C>T and CYP4F2 c.1297G>A polymorphisms as additional covariates in a previously developed pharmacogenetic-based warfarin dosing algorithm calibrated for the Brazilian population. METHODS Two independent cohorts of patients treated with warfarin (n = 832 and n = 133) were included for derivation and replication of the algorithm, respectively. Genotyping of ABCB1 c.3435C>T and CYP4F2 c.1297G>A polymorphisms was performed by polymerase chain reaction followed by melting curve analysis and TaqMan® assay, respectively. A multiple linear regression was performed for the warfarin stable doses as a dependent variable, considering clinical, general, and genetic data as covariates. RESULTS The inclusion of ABCB1 and CYP4F2 polymorphisms was able to improve the algorithm's coefficient of determination (R2) by 2.6%. In addition, the partial determination coefficients of these variants revealed that they explained 3.6% of the warfarin dose variability. We also observed a marginal improvement of the linear correlation between observed and predicted doses (from 59.7 to 61.4%). CONCLUSION Although our study indicates that the contribution of the combined ABCB1 and CYP4F2 genotypes in explaining the overall variability in warfarin dose is not very large, we demonstrated that these pharmacogenomic data are statistically significant. However, the clinical relevance and cost-effective impact of incorporating additional variants in warfarin dosing algorithms should be carefully evaluated.
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Affiliation(s)
- Letícia C Tavares
- Laboratory of Genetics and Molecular Cardiology, Heart Institute (InCor), Faculdade de Medicina FMUSP, Universidade de Sao Paulo, São Paulo, SP, Brazil
| | - Nubia E Duarte
- Department of Mathematic and Statistics, Universidad Nacional de Colombia, Manizales, Caldas, Colombia
| | - Leiliane R Marcatto
- Laboratory of Genetics and Molecular Cardiology, Heart Institute (InCor), Faculdade de Medicina FMUSP, Universidade de Sao Paulo, São Paulo, SP, Brazil
| | - Renata A G Soares
- Laboratory of Genetics and Molecular Cardiology, Heart Institute (InCor), Faculdade de Medicina FMUSP, Universidade de Sao Paulo, São Paulo, SP, Brazil
| | - Jose E Krieger
- Laboratory of Genetics and Molecular Cardiology, Heart Institute (InCor), Faculdade de Medicina FMUSP, Universidade de Sao Paulo, São Paulo, SP, Brazil
| | - Alexandre C Pereira
- Laboratory of Genetics and Molecular Cardiology, Heart Institute (InCor), Faculdade de Medicina FMUSP, Universidade de Sao Paulo, São Paulo, SP, Brazil
| | - Paulo Caleb Junior Lima Santos
- Laboratory of Genetics and Molecular Cardiology, Heart Institute (InCor), Faculdade de Medicina FMUSP, Universidade de Sao Paulo, São Paulo, SP, Brazil.
- Department of Pharmacology, Escola Paulista de Medicina, Universidade Federal de Sao Paulo UNIFESP, São Paulo, SP, Brazil.
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41
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Dezan MR, Oliveira VB, Gomes ÇN, Luz F, Gallucci AJ, Bonifácio SL, Alencar CS, Sabino EC, Pereira AC, Krieger JE, Rocha V, Mendrone-Junior A, Dinardo CL. High frequency of variant RHD genotypes among donors and patients of mixed origin with serologic weak-D phenotype. J Clin Lab Anal 2018; 32:e22596. [PMID: 29943480 DOI: 10.1002/jcla.22596] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/04/2018] [Accepted: 05/31/2018] [Indexed: 12/26/2022] Open
Abstract
BACKGROUND The current transfusion policy recommended for individuals with serologic weak-D phenotype is based on data derived from European-descent populations. Data referring to the distribution of RH alleles underlying weak-D phenotype among people of mixed origin are yet incomplete, and the applicability of European-based transfusion guidelines to this specific population is questionable. GOAL To evaluate the distribution of RHD variant genotype among individuals with serologic weak-D phenotype of both African and European descent. METHODS Donors and patients of mixed origin and with serologic weak-D phenotype were selected for the study. They were investigated using conventional RHD-PCR assays and RHD whole-coding region direct sequencing. RESULTS One hundred and six donors and 58 patients were included. There were 47 donors and 29 patients with partial-D genotype (47/106, 44.3%, and 29/58, 50%, respectively). RHD*DAR and RHD*weak D type 38 represented the most common altered RHD alleles among donors (joint frequency of 39.6%), while weak D types 1-3 accounted for 10.4% of the total D variant samples. RHD*DAR was the most common allele identified in the patient group (frequency of 31%), and weak D types 1-3 represented 29.3% of the total. CONCLUSION The frequency of partial D among mixed individuals with serologic weak-D phenotype is high. They should be managed as D-negative patients until molecular tests are complete.
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Affiliation(s)
- Marcia Regina Dezan
- Immunohematology, Fundação Pró-Sangue Hemocentro de São PauloSão Paulo, São Paulo, Brazil
| | - Valéria B Oliveira
- Immunohematology, Fundação Pró-Sangue Hemocentro de São PauloSão Paulo, São Paulo, Brazil
| | - Çarolina Nunes Gomes
- Immunohematology, Fundação Pró-Sangue Hemocentro de São PauloSão Paulo, São Paulo, Brazil
| | - Fabio Luz
- Immunohematology, Fundação Pró-Sangue Hemocentro de São PauloSão Paulo, São Paulo, Brazil
| | - Antônio J Gallucci
- Immunohematology, Fundação Pró-Sangue Hemocentro de São PauloSão Paulo, São Paulo, Brazil
| | - Silvia L Bonifácio
- Immunohematology, Fundação Pró-Sangue Hemocentro de São PauloSão Paulo, São Paulo, Brazil
| | - Cecília Salete Alencar
- Laboratório de Medicina Laboratorial, Divisão de Laboratório Central Hospital das Clinicas, Faculdade de Medicina, Universidade de São Paulo, São Paulo, Brazil
| | - Ester C Sabino
- Institute of Tropical Medicine, Universidade de São Paulo, São Paulo, Brazil
| | - Alexandre C Pereira
- Laboratory of Genetics and Molecular Cardiology, Heart Institute (InCor), São Paulo, Brazil
| | - Jose E Krieger
- Laboratory of Genetics and Molecular Cardiology, Heart Institute (InCor), São Paulo, Brazil
| | - Vanderson Rocha
- Immunohematology, Fundação Pró-Sangue Hemocentro de São PauloSão Paulo, São Paulo, Brazil.,Discipline of Hematology, University of São Paulo School of Medicine, São Paulo, Brazil.,Churchill Hospital, NHSBT, Oxford University, Oxford, UK
| | | | - Carla L Dinardo
- Immunohematology, Fundação Pró-Sangue Hemocentro de São PauloSão Paulo, São Paulo, Brazil.,Laboratório de Medicina Laboratorial, Divisão de Laboratório Central Hospital das Clinicas, Faculdade de Medicina, Universidade de São Paulo, São Paulo, Brazil
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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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Tavares LC, Marcatto LR, Soares RAG, Krieger JE, Pereira AC, Santos PCJL. Association Between ABCB1 Polymorphism and Stable Warfarin Dose Requirements in Brazilian Patients. Front Pharmacol 2018; 9:542. [PMID: 29875668 PMCID: PMC5975540 DOI: 10.3389/fphar.2018.00542] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.0] [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: 03/15/2018] [Accepted: 05/04/2018] [Indexed: 11/13/2022] Open
Abstract
The ideal dose of the oral anticoagulant warfarin varies widely among patients, mainly due to genetic factors. Genetic variations that impact warfarin pharmacokinetics and the vitamin K cycle are plausible candidates for being associated with warfarin dose requirements. Therefore, the aim of this study was to assess whether polymorphisms in the ABCB1 and CYP4F2 genes were associated with stable warfarin dose requirements in Brazilian patients. This retrospective study included samples from 309 individuals. Genotyping of ABCB1 c.3435C>T and CYP4F2 c.1297G>A were performed by polymerase chain reaction followed by melting curve analysis (HRM-PCR) and TaqMan® genotyping assay, respectively. Stable doses were adjusted in a linear multiple regression model for age, gender, body mass index, self-reported race, use of amiodarone, CYP2C9 (*2 and *3), VKORC1 c.1639G>A, and ABCB1 c.3435C>T or CYP4F2 c.1297G>A. By performing a univariate analysis of variance, we found that the warfarin patients who carry ABCB1 c.3435T variant alleles (CT and TT genotypes) need fewer warfarin stable doses in comparison with the individuals that are CC wild-type: 2.5 (p = 0.003) and 4.3 (p < 0.001) mg/week less, respectively, for the overall group of patients on stable anticoagulation therapeutics (n = 309); and 5.5 (p = 0.006) and 10.2 (p < 0.001) mg/week less, respectively, for the self-declared non-white stable subgroup (n = 76). No statistically significant differences in dose requirements were observed according to CYP4F2 genotypes. In conclusion, our results suggest ABCB1 c.3435C>T variant may influence warfarin dose requirements in Brazilian patients, when associated with other genotypic, demographic and clinical factors.
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Affiliation(s)
- Letícia C Tavares
- Laboratory of Genetics and Molecular Cardiology, Heart Institute (InCor), Faculdade de Medicina FMUSP, Universidade de São Paulo, São Paulo, Brazil
| | - Leiliane R Marcatto
- Laboratory of Genetics and Molecular Cardiology, Heart Institute (InCor), Faculdade de Medicina FMUSP, Universidade de São Paulo, São Paulo, Brazil
| | - Renata A G Soares
- Laboratory of Genetics and Molecular Cardiology, Heart Institute (InCor), Faculdade de Medicina FMUSP, Universidade de São Paulo, São Paulo, Brazil
| | - Jose E Krieger
- Laboratory of Genetics and Molecular Cardiology, Heart Institute (InCor), Faculdade de Medicina FMUSP, Universidade de São Paulo, São Paulo, Brazil
| | - Alexandre C Pereira
- Laboratory of Genetics and Molecular Cardiology, Heart Institute (InCor), Faculdade de Medicina FMUSP, Universidade de São Paulo, São Paulo, Brazil
| | - Paulo C J L Santos
- Laboratory of Genetics and Molecular Cardiology, Heart Institute (InCor), Faculdade de Medicina FMUSP, Universidade de São Paulo, São Paulo, Brazil.,Department of Pharmacology, Universidade Federal de São Paulo UNIFESP, São Paulo, Brazil
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Abstract
PURPOSE OF THE REVIEW Blood pressure regulation in humans has long been known to be a genetically determined trait. The identification of causal genetic modulators for this trait has been unfulfilling at the least. Despite the recent advances of genome-wide genetic studies, loci associated with hypertension or blood pressure still explain a very low percentage of the overall variation of blood pressure in the general population. This has precluded the translation of discoveries in the genetics of human hypertension to clinical use. Here, we propose the combined use of resistant hypertension as a trait for mapping genetic determinants in humans and the integration of new large-scale technologies to approach in model systems the multidimensional nature of the problem. RECENT FINDINGS New large-scale efforts in the genetic and genomic arenas are paving the way for an increased and granular understanding of genetic determinants of hypertension. New technologies for whole genome sequence and large-scale forward genetic screens can help prioritize gene and gene-pathways for downstream characterization and large-scale population studies, and guided pharmacological design can be used to drive discoveries to the translational application through better risk stratification and new therapeutic approaches. Although significant challenges remain in the mapping and identification of genetic determinants of hypertension, new large-scale technological approaches have been proposed to surpass some of the shortcomings that have limited progress in the area for the last three decades. The incorporation of these technologies to hypertension research may significantly help in the understanding of inter-individual blood pressure variation and the deployment of new phenotyping and treatment approaches for the condition.
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Affiliation(s)
- Samantha K Teixeira
- Laboratorio de Genetica e Cardiologia Molecular, Faculdade Medicina da Universidade de São Paulo, Instituto do Coracao (InCor) HC.FMUSP, Av Dr Eneas C Aguiar 44, São Paulo, SP, 05403-000, Brazil
| | - Alexandre C Pereira
- Laboratorio de Genetica e Cardiologia Molecular, Faculdade Medicina da Universidade de São Paulo, Instituto do Coracao (InCor) HC.FMUSP, Av Dr Eneas C Aguiar 44, São Paulo, SP, 05403-000, Brazil
| | - Jose E Krieger
- Laboratorio de Genetica e Cardiologia Molecular, Faculdade Medicina da Universidade de São Paulo, Instituto do Coracao (InCor) HC.FMUSP, Av Dr Eneas C Aguiar 44, São Paulo, SP, 05403-000, Brazil.
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Nadruz W, Gioli-Pereira L, Bernardez-Pereira S, Marcondes-Braga FG, Fernandes-Silva MM, Silvestre OM, Sposito AC, Ribeiro AL, Bacal F, Fernandes F, Krieger JE, Mansur AJ, Pereira AC. Temporal trends in the contribution of Chagas cardiomyopathy to mortality among patients with heart failure. Heart 2018. [PMID: 29523589 DOI: 10.1136/heartjnl-2017-312869] [Citation(s) in RCA: 15] [Impact Index Per Article: 2.5] [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: 12/23/2022] Open
Abstract
BACKGROUND Chagas cardiomyopathy (ChC) prevalence is decreasing in Brazil and medical therapies for heart failure (HF) have improved in the last decade. Whether these changes modified the prognosis of ChC relative to non-Chagas cardiomyopathies (NChC) remains unknown. This study evaluated the temporal trends in population attributable risk (PAR) of ChC for 2-year mortality among patients with HF enrolled at years 2002-2004 (era 1) and 2012-2014 (era 2) in a Brazilian university hospital. METHODS We prospectively studied 362 (15% with ChC) and 582 (18% with ChC) HF patients with ejection fraction ≤50% in eras 1 and 2, respectively and estimated the PAR of ChC for 2-year mortality. RESULTS There were 145 deaths (29 in ChC) in era 1 and 85 deaths (26 in ChC) in era 2. In multivariable Cox-regression analysis adjusted for age, sex, ejection fraction, heart rate, body mass index, hypertension, diabetes mellitus, systolic blood pressure and ischaemic/valvar aetiology, ChC was associated with higher risk of death in era 1 (HR (95% CI)=1.92 (1.00 to 3.71), p=0.05) and era 2 (HR (95% CI)=3.51 (1.94 to 6.36), p<0.001). In fully adjusted analysis, the PAR of ChC for mortality increased twofold from era 1 (PAR (95% CI)=11.0 (2.8 to 18.5)%) to era 2 (PAR (95% CI)=21.9 (16.5 to 26.9)%; p=0.023 versus era 1). CONCLUSION Although the absolute death rates decreased over time in the ChC and NChC groups, the PAR of ChC for mortality increased among patients with HF, driven by increases in the HR associated with ChC. Our results highlight the need for additional efforts aiming to prevent and treat ChC.
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Affiliation(s)
- Wilson Nadruz
- Department of Internal Medicine, University of Campinas, Campinas, Brazil
| | | | | | | | - Miguel M Fernandes-Silva
- Medicine Department, Pontifícia Universidade Católica do Paraná, Curitiba, Brazil.,Research Department, Quanta Diagnósticos e Terapia, Curitiba, Brazil
| | - Odilson M Silvestre
- Department of Internal Medicine, Federal University of Acre, Rio Branco, Brazil
| | - Andrei C Sposito
- Department of Internal Medicine, University of Campinas, Campinas, Brazil
| | - Antonio L Ribeiro
- Department of Internal Medicine, Federal University of Minas Gerais, Belo Horizonte, Brazil
| | - Fernando Bacal
- Heart Institute (InCor), University of Sao Paulo Medical School, Sao Paulo, Brazil
| | - Fabio Fernandes
- Heart Institute (InCor), University of Sao Paulo Medical School, Sao Paulo, Brazil
| | - Jose E Krieger
- Heart Institute (InCor), University of Sao Paulo Medical School, Sao Paulo, Brazil
| | - Alfredo J Mansur
- Heart Institute (InCor), University of Sao Paulo Medical School, Sao Paulo, Brazil
| | - Alexandre C Pereira
- Heart Institute (InCor), University of Sao Paulo Medical School, Sao Paulo, Brazil
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46
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Sung YJ, Winkler TW, de Las Fuentes L, Bentley AR, Brown MR, Kraja AT, Schwander K, Ntalla I, Guo X, Franceschini N, Lu Y, Cheng CY, Sim X, Vojinovic D, Marten J, Musani SK, Li C, Feitosa MF, Kilpeläinen TO, Richard MA, Noordam R, Aslibekyan S, Aschard H, Bartz TM, Dorajoo R, Liu Y, Manning AK, Rankinen T, Smith AV, Tajuddin SM, Tayo BO, Warren HR, Zhao W, Zhou Y, Matoba N, Sofer T, Alver M, Amini M, Boissel M, Chai JF, Chen X, Divers J, Gandin I, Gao C, Giulianini F, Goel A, Harris SE, Hartwig FP, Horimoto ARVR, Hsu FC, Jackson AU, Kähönen M, Kasturiratne A, Kühnel B, Leander K, Lee WJ, Lin KH, 'an Luan J, McKenzie CA, Meian H, Nelson CP, Rauramaa R, Schupf N, Scott RA, Sheu WHH, Stančáková A, Takeuchi F, van der Most PJ, Varga TV, Wang H, Wang Y, Ware EB, Weiss S, Wen W, Yanek LR, Zhang W, Zhao JH, Afaq S, Alfred T, Amin N, Arking D, Aung T, Barr RG, Bielak LF, Boerwinkle E, Bottinger EP, Braund PS, Brody JA, Broeckel U, Cabrera CP, Cade B, Caizheng Y, Campbell A, Canouil M, Chakravarti A, Chauhan G, Christensen K, Cocca M, Collins FS, Connell JM, de Mutsert R, de Silva HJ, Debette S, Dörr M, Duan Q, Eaton CB, Ehret G, Evangelou E, Faul JD, Fisher VA, Forouhi NG, Franco OH, Friedlander Y, Gao H, Gigante B, Graff M, Gu CC, Gu D, Gupta P, Hagenaars SP, Harris TB, He J, Heikkinen S, Heng CK, Hirata M, Hofman A, Howard BV, Hunt S, Irvin MR, Jia Y, Joehanes R, Justice AE, Katsuya T, Kaufman J, Kerrison ND, Khor CC, Koh WP, Koistinen HA, Komulainen P, Kooperberg C, Krieger JE, Kubo M, Kuusisto J, Langefeld CD, Langenberg C, Launer LJ, Lehne B, Lewis CE, Li Y, Lim SH, Lin S, Liu CT, Liu J, Liu J, Liu K, Liu Y, Loh M, Lohman KK, Long J, Louie T, Mägi R, Mahajan A, Meitinger T, Metspalu A, Milani L, Momozawa Y, Morris AP, Mosley TH, Munson P, Murray AD, Nalls MA, Nasri U, Norris JM, North K, Ogunniyi A, Padmanabhan S, Palmas WR, Palmer ND, Pankow JS, Pedersen NL, Peters A, Peyser PA, Polasek O, Raitakari OT, Renström F, Rice TK, Ridker PM, Robino A, Robinson JG, Rose LM, Rudan I, Sabanayagam C, Salako BL, Sandow K, Schmidt CO, Schreiner PJ, Scott WR, Seshadri S, Sever P, Sitlani CM, Smith JA, Snieder H, Starr JM, Strauch K, Tang H, Taylor KD, Teo YY, Tham YC, Uitterlinden AG, Waldenberger M, Wang L, Wang YX, Wei WB, Williams C, Wilson G, Wojczynski MK, Yao J, Yuan JM, Zonderman AB, Becker DM, Boehnke M, Bowden DW, Chambers JC, Chen YDI, de Faire U, Deary IJ, Esko T, Farrall M, Forrester T, Franks PW, Freedman BI, Froguel P, Gasparini P, Gieger C, Horta BL, Hung YJ, Jonas JB, Kato N, Kooner JS, Laakso M, Lehtimäki T, Liang KW, Magnusson PKE, Newman AB, Oldehinkel AJ, Pereira AC, Redline S, Rettig R, Samani NJ, Scott J, Shu XO, van der Harst P, Wagenknecht LE, Wareham NJ, Watkins H, Weir DR, Wickremasinghe AR, Wu T, Zheng W, Kamatani Y, Laurie CC, Bouchard C, Cooper RS, Evans MK, Gudnason V, Kardia SLR, Kritchevsky SB, Levy D, O'Connell JR, Psaty BM, van Dam RM, Sims M, Arnett DK, Mook-Kanamori DO, Kelly TN, Fox ER, Hayward C, Fornage M, Rotimi CN, Province MA, van Duijn CM, Tai ES, Wong TY, Loos RJF, Reiner AP, Rotter JI, Zhu X, Bierut LJ, Gauderman WJ, Caulfield MJ, Elliott P, Rice K, Munroe PB, Morrison AC, Cupples LA, Rao DC, Chasman DI. A Large-Scale Multi-ancestry Genome-wide Study Accounting for Smoking Behavior Identifies Multiple Significant Loci for Blood Pressure. Am J Hum Genet 2018; 102:375-400. [PMID: 29455858 PMCID: PMC5985266 DOI: 10.1016/j.ajhg.2018.01.015] [Citation(s) in RCA: 88] [Impact Index Per Article: 14.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/10/2017] [Accepted: 01/18/2018] [Indexed: 12/18/2022] Open
Abstract
Genome-wide association analysis advanced understanding of blood pressure (BP), a major risk factor for vascular conditions such as coronary heart disease and stroke. Accounting for smoking behavior may help identify BP loci and extend our knowledge of its genetic architecture. We performed genome-wide association meta-analyses of systolic and diastolic BP incorporating gene-smoking interactions in 610,091 individuals. Stage 1 analysis examined ∼18.8 million SNPs and small insertion/deletion variants in 129,913 individuals from four ancestries (European, African, Asian, and Hispanic) with follow-up analysis of promising variants in 480,178 additional individuals from five ancestries. We identified 15 loci that were genome-wide significant (p < 5 × 10-8) in stage 1 and formally replicated in stage 2. A combined stage 1 and 2 meta-analysis identified 66 additional genome-wide significant loci (13, 35, and 18 loci in European, African, and trans-ancestry, respectively). A total of 56 known BP loci were also identified by our results (p < 5 × 10-8). Of the newly identified loci, ten showed significant interaction with smoking status, but none of them were replicated in stage 2. Several loci were identified in African ancestry, highlighting the importance of genetic studies in diverse populations. The identified loci show strong evidence for regulatory features and support shared pathophysiology with cardiometabolic and addiction traits. They also highlight a role in BP regulation for biological candidates such as modulators of vascular structure and function (CDKN1B, BCAR1-CFDP1, PXDN, EEA1), ciliopathies (SDCCAG8, RPGRIP1L), telomere maintenance (TNKS, PINX1, AKTIP), and central dopaminergic signaling (MSRA, EBF2).
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Affiliation(s)
- Yun J Sung
- Division of Biostatistics, Washington University School of Medicine, St. Louis, MO 63110, USA.
| | - Thomas W Winkler
- Department of Genetic Epidemiology, University of Regensburg, Regensburg 93051, Germany
| | - Lisa de Las Fuentes
- Cardiovascular Division, Department of Medicine, Washington University, St. Louis, MO 63110, USA
| | - Amy R Bentley
- Center for Research on Genomics and Global Health, National Human Genome Research Institute, NIH, Bethesda, MD 20892, USA
| | - Michael R Brown
- Department of Epidemiology, Human Genetics, and Environmental Sciences, The University of Texas School of Public Health, Houston, TX 77030, USA
| | - Aldi T Kraja
- Division of Statistical Genomics, Department of Genetics, Washington University School of Medicine, St. Louis, MO 63108, USA
| | - Karen Schwander
- Division of Biostatistics, Washington University School of Medicine, St. Louis, MO 63110, USA
| | - Ioanna Ntalla
- William Harvey Research Institute, Clinical Pharmacology, Queen Mary University of London, London EC1M 6BQ, UK
| | - Xiuqing Guo
- Genomic Outcomes, Department of Pediatrics, LABioMed at Harbor-UCLA Medical Center, Torrance, CA 90502, USA
| | - Nora Franceschini
- Department of Epidemiology, University of North Carolina Gillings School of Global Public Health, Chapel Hill, NC 27514, USA
| | - Yingchang Lu
- Icahn School of Medicine at Mount Sinai, The Charles Bronfman Institute for Personalized Medicine, New York, NY 10029, USA
| | - Ching-Yu Cheng
- Singapore Eye Research Institute, Singapore National Eye Centre, Singapore, Singapore 169856, Singapore; Ophthalmology & Visual Sciences Academic Clinical Program (Eye ACP), Duke-NUS Medical School, Singapore, Singapore 169857, Singapore; Department of Ophthalmology, Yong Loo Lin School of Medicine, National University of Singapore, Singapore, Singapore 117597, Singapore
| | - Xueling Sim
- Saw Swee Hock School of Public Health, National University Health System and National University of Singapore, Singapore, Singapore 117549, Singapore
| | - Dina Vojinovic
- Department of Epidemiology, Erasmus University Medical Center, Rotterdam, the Netherlands
| | - Jonathan Marten
- Medical Research Council Human Genetics Unit, Institute of Genetics & Molecular Medicine, University of Edinburgh, Edinburgh EH4 2XU, UK
| | - Solomon K Musani
- Jackson Heart Study, Department of Medicine, University of Mississippi Medical Center, Jackson, MS 39213, USA
| | - Changwei Li
- Department of Epidemiology and Biostatistics, University of Giorgia at Athens College of Public Health, Athens, GA 30602, USA
| | - Mary F Feitosa
- Division of Statistical Genomics, Department of Genetics, Washington University School of Medicine, St. Louis, MO 63108, USA
| | - Tuomas O Kilpeläinen
- Section of Metabolic Genetics, Novo Nordisk Foundation Center for Basic Metabolic Research, Faculty of Health and Medical Sciences, University of Copenhagen, Copenhagen 2100, Denmark; Department of Environmental Medicine and Public Health, The Icahn School of Medicine at Mount Sinai, New York, NY 10029, USA
| | - Melissa A Richard
- Brown Foundation Institute of Molecular Medicine, University of Texas Health Science Center at Houston, Houston, TX 77030, USA
| | - Raymond Noordam
- Department of Internal Medicine, Section of Gerontology and Geriatrics, Leiden University Medical Center, Leiden 2300RC, the Netherlands
| | - Stella Aslibekyan
- Department of Epidemiology, University of Alabama at Birmingham, Birmingham, AL 35294, USA
| | - Hugues Aschard
- Department of Epidemiology, Harvard School of Public Health, Boston, MA 02115, USA; Centre de Bioinformatique Biostatistique et Biologie Integrative (C3BI), Institut Pasteur, Paris 75015, France
| | - Traci M Bartz
- Cardiovascular Health Research Unit, Biostatistics and Medicine, University of Washington, Seattle, WA 98101, USA
| | - Rajkumar Dorajoo
- Genome Institute of Singapore, Agency for Science Technology and Research, Singapore 138672, Singapore
| | - Yongmei Liu
- Division of Biostatistical Sciences, Department of Public Health Sciences, Wake Forest School of Medicine, Winston-Salem, NC 27157, USA
| | - Alisa K Manning
- Center for Human Genetics Research, Massachusetts General Hospital, Boston, MA 02114, USA; Program in Medical and Population Genetics, Broad Institute of MIT and Harvard, Cambridge, MA 02142, USA
| | - Tuomo Rankinen
- Human Genomics Laboratory, Pennington Biomedical Research Center, Baton Rouge, LA 70808, USA
| | - Albert Vernon Smith
- Icelandic Heart Association, Kopavogur 201, Iceland; Faculty of Medicine, University of Iceland, Reykjavik 101, Iceland
| | - Salman M Tajuddin
- Health Disparities Research Section, Laboratory of Epidemiology and Population Sciences, National Institute on Aging, NIH, Baltimore, MD 21224, USA
| | - Bamidele O Tayo
- Department of Public Health Sciences, Loyola University Chicago, Maywood, IL 60153, USA
| | - Helen R Warren
- William Harvey Research Institute, Clinical Pharmacology, Queen Mary University of London, London EC1M 6BQ, UK; NIHR Cardiovascular Biomedical Research Unit, Barts and The London School of Medicine and Dentistry, Queen Mary University of London, London EC1M 6BQ, UK
| | - Wei Zhao
- School of Public Health, Department of Epidemiology, University of Michigan, Ann Arbor, MI 48109, USA
| | - Yanhua Zhou
- Department of Biostatistics, Boston University School of Public Health, Boston, MA 02118, USA
| | - Nana Matoba
- Laboratory for Statistical Analysis, Center for Integrative Medical Sciences, RIKEN, Yokohama 230-0045, Japan
| | - Tamar Sofer
- Department of Biostatistics, University of Washington, Seattle, WA 98105, USA
| | - Maris Alver
- Estonian Genome Center, University of Tartu, Tartu 51010, Estonia
| | - Marzyeh Amini
- Department of Epidemiology, University of Groningen, University Medical Center Groningen, Groningen 9700 RB, the Netherlands
| | - Mathilde Boissel
- CNRS UMR 8199, European Genomic Institute for Diabetes (EGID), Institut Pasteur de Lille, University of Lille, Lille 59000, France
| | - Jin Fang Chai
- Saw Swee Hock School of Public Health, National University of Singapore, Singapore 117549, Singapore
| | - Xu Chen
- Department of Medical Epidemiology and Biostatistics, Karolinska Institutet, Stockholm 17177, Sweden
| | - Jasmin Divers
- Division of Biostatistical Sciences, Department of Public Health Sciences, Wake Forest School of Medicine, Winston-Salem, NC 27157, USA
| | - Ilaria Gandin
- Department of Medical Sciences, University of Trieste, Trieste 34137, Italy
| | - Chuan Gao
- Department of Molecular Genetics and Genomics Program, Wake Forest School of Medicine, Winston-Salem, NC 27157, USA
| | - Franco Giulianini
- Division of Preventive Medicine, Department of Medicine, Brigham and Women's Hospital, Boston, MA 02215, USA
| | - Anuj Goel
- Division of Cardiovascular Medicine, Radcliffe Department of Medicine, University of Oxford, Oxford, Oxfordshire OX3 9DU, UK; Wellcome Centre for Human Genetics, University of Oxford, Oxford OX3 7BN, UK
| | - Sarah E Harris
- Centre for Cognitive Ageing and Cognitive Epidemiology, The University of Edinburgh, Edinburgh EH8 9JZ, UK; Medical Genetics Section, University of Edinburgh Centre for Genomic and Experimental Medicine and MRC Institute of Genetics and Molecular Medicine, The University of Edinburgh, Edinburgh EH4 2XU, UK
| | - Fernando Pires Hartwig
- Postgraduate Program in Epidemiology, Federal University of Pelotas, Pelotas, RS 96020220, Brazil
| | - Andrea R V R Horimoto
- Lab Genetics and Molecular Cardiology, Department of Cardiology, Heart Institute, University of Sao Paulo, Sao Paulo, Brazil
| | - Fang-Chi Hsu
- Division of Biostatistical Sciences, Department of Public Health Sciences, Wake Forest School of Medicine, Winston-Salem, NC 27157, USA
| | - Anne U Jackson
- Department of Biostatistics and Center for Statistical Genetics, University of Michigan, Ann Arbor, MI 48109, USA
| | - Mika Kähönen
- Department of Clinical Physiology, Faculty of Medicine and Life Sciences, University of Tampere, Tampere 33014, Finland; Department of Clinical Physiology, Tampere University Hospital, Tampere, Finland
| | | | - Brigitte Kühnel
- Research Unit of Molecular Epidemiology, Helmholtz Zentrum München, German Research Center for Environmental Health, Neuherberg 85764, Germany; Institute of Epidemiology II, Helmholtz Zentrum München, German Research Center for Environmental Health, Neuherberg 85764, Germany
| | - Karin Leander
- Institute of Environmental Medicine, Karolinska Institutet, Stockholm 17177, Sweden
| | - Wen-Jane Lee
- Department of Medical Research, Taichung Veterans General Hospital, Department of Social Work, Tunghai University, Taichung 40705, Taiwan
| | - Keng-Hung Lin
- Department of Opthalmology, Taichung Veterans General Hospital, Taichung 40705, Taiwan
| | - Jian 'an Luan
- MRC Epidemiology Unit, University of Cambridge, Cambridge CB2 0QQ, UK
| | - Colin A McKenzie
- Tropical Metabolism Research Unit, Tropical Medicine Research Institute, University of the West Indies, Mona JMAAW15, Jamaica
| | - He Meian
- Department of Occupational and Environmental Health and State Key Laboratory of Environmental Health for Incubating, School of Public Health, Tongji Medical College Huazhong University of Science and Technology, Wuhan, China
| | - Christopher P Nelson
- Department of Cardiovascular Sciences, University of Leicester, Leicester LE3 9QP, UK; NIHR Leicester Cardiovascular Biomedical Research Unit, Glenfield Hospital, Leicester LE3 9QP, UK
| | - Rainer Rauramaa
- Foundation for Research in Health Exercise and Nutrition, Kuopio Research Institute of Exercise Medicine, Kuopio 70100, Finland
| | - Nicole Schupf
- Taub Institute for Research on Alzheimer disease and the Aging Brain, Department of Epidemiology, Columbia University Mailman School of Public Health, New York, NY 10032, USA
| | - Robert A Scott
- MRC Epidemiology Unit, University of Cambridge, Cambridge CB2 0QQ, UK
| | - Wayne H H Sheu
- Endocrinology and Metabolism, Department of Internal Medicine, Taichung Veterans General Hospital, Taichung 40705, Taiwan; School of Medicine, National Yang-ming University, Taipei, Taiwan; School of Medicine, National Defense Medical Center, Taipei, Taiwan; Institute of Medical Technology, National Chung-Hsing University, Taichung 40705, Taiwan
| | - Alena Stančáková
- Institute of Clinical Medicine, Internal Medicine, University of Eastern Finland, Kuopio 70210, Finland
| | - Fumihiko Takeuchi
- Department of Gene Diagnostics and Therapeutics, Research Institute, National Center for Global Health and Medicine, Tokyo 1628655, Japan
| | - Peter J van der Most
- Department of Epidemiology, University of Groningen, University Medical Center Groningen, Groningen 9700 RB, the Netherlands
| | - Tibor V Varga
- Genetic and Molecular Epidemiology Unit, Department of Clinical Sciences, Lund University, Malmö, Skåne 205 02, Sweden
| | - Heming Wang
- Department of Epidemiology and Biostatistics, Case Western Reserve University, Cleveland, OH 44106, USA
| | - Yajuan Wang
- Department of Epidemiology and Biostatistics, Case Western Reserve University, Cleveland, OH 44106, USA
| | - Erin B Ware
- School of Public Health, Department of Epidemiology, University of Michigan, Ann Arbor, MI 48109, USA; Institute for Social Research, Research Center for Group Dynamics, University of Michigan, Ann Arbor, MI 48104, USA
| | - Stefan Weiss
- Interfaculty Institute for Genetics and Functional Genomics, University Medicine and Ernst-Moritz Arndt University Greifswald, Greifswald 17487, Germany; DZHK (German Center for Cardiovascular Research), partner site Greifswald, Greifswald 17475, Germany
| | - Wanqing Wen
- Division of Epidemiology, Department of Medicine, Vanderbilt University School of Medicine, Nashville, TN 37203, USA
| | - Lisa R Yanek
- General Internal Medicine, GeneSTAR Research Program, Department of Medicine, Johns Hopkins University School of Medicine, Baltimore, MD 21287, USA
| | - Weihua Zhang
- Department of Epidemiology and Biostatistics, Imperial College London, London W2 1PG, UK; Department of Cardiology, Ealing Hospital, Middlesex UB1 3HW, UK
| | - Jing Hua Zhao
- MRC Epidemiology Unit, University of Cambridge, Cambridge CB2 0QQ, UK
| | - Saima Afaq
- Department of Epidemiology and Biostatistics, Imperial College London, London W2 1PG, UK
| | - Tamuno Alfred
- Icahn School of Medicine at Mount Sinai, The Charles Bronfman Institute for Personalized Medicine, New York, NY 10029, USA
| | - Najaf Amin
- Department of Epidemiology, Erasmus University Medical Center, Rotterdam, the Netherlands
| | - Dan Arking
- McKusick-Nathans Institute of Genetic Medicine, Johns Hopkins University School of Medicine, Baltimore, MD 21205, USA
| | - Tin Aung
- Singapore Eye Research Institute, Singapore National Eye Centre, Singapore, Singapore 169856, Singapore; Ophthalmology & Visual Sciences Academic Clinical Program (Eye ACP), Duke-NUS Medical School, Singapore, Singapore 169857, Singapore; Department of Ophthalmology, Yong Loo Lin School of Medicine, National University of Singapore, Singapore, Singapore 117597, Singapore
| | - R Graham Barr
- Departments of Medicine and Epidemiology, Columbia University Medical Center, New York, NY 10032, USA
| | - Lawrence F Bielak
- School of Public Health, Department of Epidemiology, University of Michigan, Ann Arbor, MI 48109, USA
| | - Eric Boerwinkle
- Human Genetics Center, The University of Texas School of Public Health, Houston, TX 77030, USA; Institute of Molecular Medicine, The University of Texas Health Science Center, Houston, TX 77030, USA
| | - Erwin P Bottinger
- Icahn School of Medicine at Mount Sinai, The Charles Bronfman Institute for Personalized Medicine, New York, NY 10029, USA
| | - Peter S Braund
- Department of Cardiovascular Sciences, University of Leicester, Leicester LE3 9QP, UK; NIHR Leicester Cardiovascular Biomedical Research Unit, Glenfield Hospital, Leicester LE3 9QP, UK
| | - Jennifer A Brody
- Cardiovascular Health Research Unit, Medicine, University of Washington, Seattle, WA 98101, USA
| | - Ulrich Broeckel
- Section of Genomic Pediatrics, Department of Pediatrics, Medicine and Physiology, Medical College of Wisconsin, Milwaukee, WI 53226, USA
| | - Claudia P Cabrera
- William Harvey Research Institute, Clinical Pharmacology, Queen Mary University of London, London EC1M 6BQ, UK; NIHR Cardiovascular Biomedical Research Unit, Barts and The London School of Medicine and Dentistry, Queen Mary University of London, London EC1M 6BQ, UK
| | - Brian Cade
- Sleep Medicine and Circadian Disorders, Brigham and Women's Hospital, Boston, MA 02115, USA
| | - Yu Caizheng
- Department of Occupational and Environmental Health and State Key Laboratory of Environmental Health for Incubating, School of Public Health, Tongji Medical College Huazhong University of Science and Technology, Wuhan, China
| | - Archie Campbell
- Centre for Genomic & Experimental Medicine, Institute of Genetics & Molecular Medicine, University of Edinburgh, Edinburgh EH4 2XU, UK
| | - Mickaël Canouil
- CNRS UMR 8199, European Genomic Institute for Diabetes (EGID), Institut Pasteur de Lille, University of Lille, Lille 59000, France
| | - Aravinda Chakravarti
- Center for Complex Disease Genomics, McKusick-Nathans Institute of Genetic Medicine, Johns Hopkins University School of Medicine, Baltimore, MD 21205, USA
| | - Ganesh Chauhan
- Centre for Brain Research, Indian Institute of Schience, Bangalore 560012, India
| | - Kaare Christensen
- The Danish Aging Research Center, Institute of Public Health, University of Southern Denmark, Odense, Denmark
| | - Massimiliano Cocca
- Department of Medical Sciences, University of Trieste, Trieste 34137, Italy
| | - Francis S Collins
- Medical Genomics and Metabolic Genetics Branch, National Human Genome Research Institute, NIH, Bethesda, MD 20892, USA
| | - John M Connell
- Ninewells Hospital & Medical School, University of Dundee, Dundee DD1 9SY, UK
| | - Renée de Mutsert
- Department of Clinical Epidemiology, Leiden University Medical Center, Leiden 2300RC, the Netherlands
| | | | - Stephanie Debette
- Inserm U1219 Neuroepidemiology, University of Bordeaux, Bordeaux, France; Department of Neurology, University Hospital, Bordeaux, France; Boston University School of Medicine, Boston, MA 02118, USA
| | - Marcus Dörr
- DZHK (German Center for Cardiovascular Research), partner site Greifswald, Greifswald 17475, Germany; Department of Internal Medicine B, University Medicine Greifswald, Greifswald 17475, Germany
| | - Qing Duan
- Department of Genetics, University of North Carolina, Chapel Hill, NC 27514, USA
| | - Charles B Eaton
- Department of Family Medicine and Epidemiology, Alpert Medical School of Brown University, Providence, RI 02860, USA
| | - Georg Ehret
- Center for Complex Disease Genomics, McKusick-Nathans Institute of Genetic Medicine, Johns Hopkins University School of Medicine, Baltimore, MD 21205, USA; Division of Cardiology, Department of Specialties of Medicine, Geneva University Hospital, Geneva 1211, Switzerland
| | - Evangelos Evangelou
- Department of Epidemiology and Biostatistics, Imperial College London, London W2 1PG, UK; Department of Hygiene and Epidemiology, University of Ioannina Medical School, Ioannina 45110, Greece
| | - Jessica D Faul
- Institute for Social Research, Survey Research Center, University of Michigan, Ann Arbor, MI 48104, USA
| | - Virginia A Fisher
- Department of Biostatistics, Boston University School of Public Health, Boston, MA 02118, USA
| | - Nita G Forouhi
- MRC Epidemiology Unit, University of Cambridge, Cambridge CB2 0QQ, UK
| | - Oscar H Franco
- Department of Epidemiology, Erasmus University Medical Center, Rotterdam, the Netherlands
| | - Yechiel Friedlander
- Braun School of Public Health, Hebrew University-Hadassah Medical Center, Jerusalem 91120, Israel
| | - He Gao
- Department of Epidemiology and Biostatistics, Imperial College London, London W2 1PG, UK; MRC-PHE Centre for Environment and Health, Department of Epidemiology & Biostatistics, School of Public Health, Imperial College London, London, UK
| | - Bruna Gigante
- Institute of Environmental Medicine, Karolinska Institutet, Stockholm 17177, Sweden
| | - Misa Graff
- Department of Epidemiology, University of North Carolina Gillings School of Global Public Health, Chapel Hill, NC 27514, USA
| | - C Charles Gu
- Division of Biostatistics, Washington University School of Medicine, St. Louis, MO 63110, USA
| | - Dongfeng Gu
- Department of Epidemiology, State Key Laboratory of Cardiovascular Disease, Fuwai Hospital, National Center for Cardiovascular Diseases, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China
| | - Preeti Gupta
- Singapore Eye Research Institute, Singapore National Eye Centre, Singapore, Singapore 169856, Singapore
| | - Saskia P Hagenaars
- Centre for Cognitive Ageing and Cognitive Epidemiology, The University of Edinburgh, Edinburgh EH8 9JZ, UK; Department of Psychology, The University of Edinburgh, Edinburgh EH8 9JZ, UK
| | - Tamara B Harris
- Laboratory of Epidemiology and Population Sciences, National Institute on Aging, NIH, Bethesda, MD 20892, USA
| | - Jiang He
- Department of Epidemiology, Tulane University School of Public Health and Tropical Medicine, New Orleans, LA 70112, USA; Department of Medicine, Tulane University School of Medicine, New Orleans, LA 70112, USA
| | - Sami Heikkinen
- University of Eastern Finland, Institute of Biomedicine, Kuopio 70211, Finland
| | - Chew-Kiat Heng
- Department of Paediatrics, Yong Loo Lin School of Medicine, National University of Singapore, Singapore 119228, Singapore; Khoo Teck Puat - National University Children's Medical Institute, National University Health System, Singapore 119228, Singapore
| | - Makoto Hirata
- Laboratory of Genome Technology, Human Genome Center, Institute of Medical Science, The University of Tokyo, Minato-ku 108-8639, Japan
| | - Albert Hofman
- Department of Epidemiology, Erasmus University Medical Center, Rotterdam, the Netherlands
| | - Barbara V Howard
- MedStar Health Research Institute, Hyattsville, MD 20782, USA; Center for Clinical and Translational Sciences and Department of Medicine, Georgetown-Howard Universities, Washington, DC 20057, USA
| | - Steven Hunt
- Cardiovascular Genetics, Department of Internal Medicine, University of Utah, Salt Lake City, UT 84108, USA; Weill Cornell Medicine in Qatar, Doha, Qatar
| | - Marguerite R Irvin
- Department of Epidemiology, University of Alabama at Birmingham, Birmingham, AL 35294, USA
| | - Yucheng Jia
- Genomic Outcomes, Department of Pediatrics, LABioMed at Harbor-UCLA Medical Center, Torrance, CA 90502, USA
| | - Roby Joehanes
- Hebrew SeniorLife, Beth Israel Deaconess Medical Center, Harvard Medical School, Boston, MA 02131, USA; Framingham Heart Study, National Heart, Lung, and Blood Institute, NIH, Bethesda, MD 20982, USA
| | - Anne E Justice
- Department of Epidemiology, University of North Carolina Gillings School of Global Public Health, Chapel Hill, NC 27514, USA
| | - Tomohiro Katsuya
- Department of Clinical Gene Therapy, Osaka University Graduate School of Medicine, Suita 5650871, Japan; Department of Geriatric and General Medicine, Osaka University Graduate School of Medicine, Suita 5650871, Japan
| | - Joel Kaufman
- Epidemiology, Department of Occupational and Environmental Medicine Program, University of Washington, Seattle, WA 98105, USA
| | - Nicola D Kerrison
- MRC Epidemiology Unit, University of Cambridge, Cambridge CB2 0QQ, UK
| | - Chiea Chuen Khor
- Genome Institute of Singapore, Agency for Science Technology and Research, Singapore 138672, Singapore; Department of Biochemistry, National University of Singapore, Singapore 117596, Singapore
| | - Woon-Puay Koh
- Saw Swee Hock School of Public Health, National University of Singapore, Singapore 117549, Singapore; Duke-NUS Medical School, Singapore 169857, Singapore
| | - Heikki A Koistinen
- Department of Health, National Institute for Health and Welfare, Helsinki 00271, Finland; Department of Medicine and Abdominal Center: Endocrinology, University of Helsinki and Helsinki University Central Hospital, Helsinki 00029, Finland
| | - Pirjo Komulainen
- Foundation for Research in Health Exercise and Nutrition, Kuopio Research Institute of Exercise Medicine, Kuopio 70100, Finland
| | - Charles Kooperberg
- Fred Hutchinson Cancer Research Center, University of Washington School of Public Health, Seattle, WA 98109, USA
| | - Jose E Krieger
- Lab Genetics and Molecular Cardiology, Department of Cardiology, Heart Institute, University of Sao Paulo, Sao Paulo, Brazil
| | - Michiaki Kubo
- Center for Integrative Medical Sciences, RIKEN, Yokohama 230-0045, Japan
| | - Johanna Kuusisto
- Institute of Clinical Medicine, Internal Medicine, University of Eastern Finland and Kuopio University Hospital, Kuopio 70210, Finland
| | - Carl D Langefeld
- Division of Biostatistical Sciences, Department of Public Health Sciences, Wake Forest School of Medicine, Winston-Salem, NC 27157, USA
| | | | - Lenore J Launer
- Laboratory of Epidemiology and Population Sciences, National Institute on Aging, NIH, Bethesda, MD 20892, USA
| | - Benjamin Lehne
- Department of Epidemiology and Biostatistics, Imperial College London, London W2 1PG, UK
| | - Cora E Lewis
- Department of Medicine, University of Alabama at Birmingham, Birmingham, AL 35205, USA
| | - Yize Li
- Division of Biostatistics, Washington University School of Medicine, St. Louis, MO 63110, USA
| | - Sing Hui Lim
- Singapore Eye Research Institute, Singapore National Eye Centre, Singapore, Singapore 169856, Singapore
| | - Shiow Lin
- Division of Statistical Genomics, Department of Genetics, Washington University School of Medicine, St. Louis, MO 63108, USA
| | - Ching-Ti Liu
- Department of Biostatistics, Boston University School of Public Health, Boston, MA 02118, USA
| | - Jianjun Liu
- Saw Swee Hock School of Public Health, National University Health System and National University of Singapore, Singapore, Singapore 117549, Singapore; Genome Institute of Singapore, Agency for Science Technology and Research, Singapore 138672, Singapore
| | - Jingmin Liu
- WHI CCC, Fred Hutchinson Cancer Research Center, Seattle, WA 98115, USA
| | - Kiang Liu
- Preventive Medicine, Northwestern University Feinberg School of Medicine, Chicago, IL 60611, USA
| | - Yeheng Liu
- Genomic Outcomes, Department of Pediatrics, LABioMed at Harbor-UCLA Medical Center, Torrance, CA 90502, USA
| | - Marie Loh
- Department of Epidemiology and Biostatistics, Imperial College London, London W2 1PG, UK; Translational Laboratory in Genetic Medicine, Agency for Science, Technology and Research 138648, Singapore
| | - Kurt K Lohman
- Division of Biostatistical Sciences, Department of Public Health Sciences, Wake Forest School of Medicine, Winston-Salem, NC 27157, USA
| | - Jirong Long
- Division of Epidemiology, Department of Medicine, Vanderbilt University School of Medicine, Nashville, TN 37203, USA
| | - Tin Louie
- Department of Biostatistics, University of Washington, Seattle, WA 98105, USA
| | - Reedik Mägi
- Estonian Genome Center, University of Tartu, Tartu 51010, Estonia
| | - Anubha Mahajan
- Wellcome Centre for Human Genetics, University of Oxford, Oxford OX3 7BN, UK
| | - Thomas Meitinger
- Institute of Human Genetics, Helmholtz Zentrum München, German Research Center for Environmental Health, Neuherberg 85764, Germany; Institute of Human Genetics, Technische Universität München, Munich 80333, Germany
| | - Andres Metspalu
- Estonian Genome Center, University of Tartu, Tartu 51010, Estonia
| | - Lili Milani
- Estonian Genome Center, University of Tartu, Tartu 51010, Estonia
| | - Yukihide Momozawa
- Laboratory for Genotyping Development, Center for Integrative Medical Sciences, RIKEN, Yokohama 230-0045, Japan
| | - Andrew P Morris
- Wellcome Centre for Human Genetics, University of Oxford, Oxford OX3 7BN, UK; Department of Biostatistics, University of Liverpool, Liverpool L69 3GL, UK
| | - Thomas H Mosley
- Geriatrics, Department of Medicine, University of Mississippi Medical Center, Jackson, MS 39216, USA
| | - Peter Munson
- Mathematical and Statistical Computing Laboratory, Center for Information Technology, NIH, Bethesda, MD 20892, USA
| | - Alison D Murray
- The Institute of Medical Sciences, Aberdeen Biomedical Imaging Centre, University of Aberdeen, Aberdeen AB25 2ZD, UK
| | - Mike A Nalls
- Data Tecnica International, Glen Echo, MD 20812, USA; Laboratory of Neurogenetics, National Institute on Aging, Bethesda, MD 20892, USA
| | - Ubaydah Nasri
- Genomic Outcomes, Department of Pediatrics, LABioMed at Harbor-UCLA Medical Center, Torrance, CA 90502, USA
| | - Jill M Norris
- Department of Epidemiology, Colorado School of Public Health, Aurora, CO 80045, USA
| | - Kari North
- Department of Epidemiology, University of North Carolina Gillings School of Global Public Health, Chapel Hill, NC 27514, USA
| | | | - Sandosh Padmanabhan
- Institute of Cardiovascular and Medical Sciences, University of Glasgow, Glasgow G12 8TA, UK
| | - Walter R Palmas
- Internal Medicine, Department of Medicine, Columbia University, New York, NY 10032, USA
| | - Nicholette D Palmer
- Department of Biochemistry, Wake Forest School of Medicine, Winston-Salem, NC 27157, USA
| | - James S Pankow
- Division of Epidemiology and Community Health, University of Minnesota School of Public Health, Minneapolis, MN 55454, USA
| | - Nancy L Pedersen
- Department of Medical Epidemiology and Biostatistics, Karolinska Institutet, Stockholm 17177, Sweden
| | - Annette Peters
- Institute of Epidemiology II, Helmholtz Zentrum München, German Research Center for Environmental Health, Neuherberg 85764, Germany; DZHK (German Centre for Cardiovascular Research), partner site Munich Heart Alliance, Neuherberg 85764, Germany
| | - Patricia A Peyser
- School of Public Health, Department of Epidemiology, University of Michigan, Ann Arbor, MI 48109, USA
| | - Ozren Polasek
- Faculty of Medicine, University of Split, Split, Croatia
| | - 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 20520, Finland
| | - Frida Renström
- Genetic and Molecular Epidemiology Unit, Department of Clinical Sciences, Lund University, Malmö, Skåne 205 02, Sweden; Department of Biobank Research, Umeå University, Umeå, Västerbotten 901 87, Sweden
| | - Treva K Rice
- Division of Biostatistics, Washington University School of Medicine, St. Louis, MO 63110, USA
| | - Paul M Ridker
- Division of Preventive Medicine, Department of Medicine, Brigham and Women's Hospital, Boston, MA 02215, USA
| | | | - Jennifer G Robinson
- Department of Epidemiology and Medicine, University of Iowa, Iowa City, IA 52242, USA
| | - Lynda M Rose
- Division of Preventive Medicine, Department of Medicine, Brigham and Women's Hospital, Boston, MA 02215, USA
| | - Igor Rudan
- Usher Institute of Population Health Sciences and Informatics, University of Edinburgh, Edinburgh EH8 9AG, UK
| | - Charumathi Sabanayagam
- Singapore Eye Research Institute, Singapore National Eye Centre, Singapore, Singapore 169856, Singapore; Ophthalmology & Visual Sciences Academic Clinical Program (Eye ACP), Duke-NUS Medical School, Singapore, Singapore 169857, Singapore
| | | | - Kevin Sandow
- Genomic Outcomes, Department of Pediatrics, LABioMed at Harbor-UCLA Medical Center, Torrance, CA 90502, USA
| | - Carsten O Schmidt
- DZHK (German Center for Cardiovascular Research), partner site Greifswald, Greifswald 17475, Germany; Institute for Community Medicine, University Medicine Greifswald, Greifswald 17475, Germany
| | - Pamela J Schreiner
- Division of Epidemiology and Community Health, University of Minnesota School of Public Health, Minneapolis, MN 55454, USA
| | - William R Scott
- Department of Epidemiology and Biostatistics, Imperial College London, London W2 1PG, UK; National Heart and Lung Institute, Imperial College London, London W12 0NN, UK
| | - Sudha Seshadri
- Framingham Heart Study, National Heart, Lung, and Blood Institute, NIH, Bethesda, MD 20982, USA; Department of Neurology, Boston University School of Medicine, Boston, MA 02118, USA
| | - Peter Sever
- International Centre for Circulatory Health, Imperial College London, London W2 1PG, UK
| | - Colleen M Sitlani
- Cardiovascular Health Research Unit, Medicine, University of Washington, Seattle, WA 98101, USA
| | - Jennifer A Smith
- School of Public Health, Department of Epidemiology, University of Michigan, Ann Arbor, MI 48109, USA
| | - Harold Snieder
- Department of Epidemiology, University of Groningen, University Medical Center Groningen, Groningen 9700 RB, the Netherlands
| | - John M Starr
- Centre for Cognitive Ageing and Cognitive Epidemiology, The University of Edinburgh, Edinburgh EH8 9JZ, UK; Alzheimer Scotland Dementia Research Centre, The University of Edinburgh, Edinburgh EH8 9JZ, UK
| | - Konstantin Strauch
- Institute of Genetic Epidemiology, Helmholtz Zentrum München, German Research Center for Environmental Health, Neuherberg 85764, Germany; Chair of Genetic Epidemiology, IBE, Faculty of Medicine, LMU Munich, Munich 81377, Germany
| | - Hua Tang
- Department of Genetics, Stanford University, Stanford, CA 94305, USA
| | - Kent D Taylor
- Genomic Outcomes, Department of Pediatrics, LABioMed at Harbor-UCLA Medical Center, Torrance, CA 90502, USA
| | - Yik Ying Teo
- Saw Swee Hock School of Public Health, National University Health System and National University of Singapore, Singapore, Singapore 117549, Singapore; Genome Institute of Singapore, Agency for Science Technology and Research, Singapore 138672, Singapore; Life Sciences Institute, National University of Singapore, Singapore, Singapore 117456, Singapore; NUS Graduate School for Integrative Science and Engineering, National University of Singapore, Singapore 117456, Singapore; Department of Statistics and Applied Probability, National University of Singapore, Singapore 117546, Singapore
| | - Yih Chung Tham
- Singapore Eye Research Institute, Singapore National Eye Centre, Singapore, Singapore 169856, Singapore
| | - André G Uitterlinden
- Department of Internal Medicine, Erasmus University Medical Center, Rotterdam, the Netherlands
| | - Melanie Waldenberger
- Research Unit of Molecular Epidemiology, Helmholtz Zentrum München, German Research Center for Environmental Health, Neuherberg 85764, Germany; Institute of Epidemiology II, Helmholtz Zentrum München, German Research Center for Environmental Health, Neuherberg 85764, Germany
| | - Lihua Wang
- Division of Statistical Genomics, Department of Genetics, Washington University School of Medicine, St. Louis, MO 63108, USA
| | - Ya X Wang
- Beijing Institute of Ophthalmology, Beijing Ophthalmology and Visual Science Key Lab, Beijing Tongren Eye Center, Capital Medical University, Beijing, China 100730, China
| | - Wen Bin Wei
- Beijing Tongren Eye Center, Beijing Tongren Hospital, Capital Medical University, Beijing 100730, China
| | - Christine Williams
- Division of Statistical Genomics, Department of Genetics, Washington University School of Medicine, St. Louis, MO 63108, USA
| | - Gregory Wilson
- Jackson Heart Study, Department of Public Health, Jackson State University, Jackson, MS 39213, USA
| | - Mary K Wojczynski
- Division of Statistical Genomics, Department of Genetics, Washington University School of Medicine, St. Louis, MO 63108, USA
| | - Jie Yao
- Genomic Outcomes, Department of Pediatrics, LABioMed at Harbor-UCLA Medical Center, Torrance, CA 90502, USA
| | - Jian-Min Yuan
- Department of Epidemiology, Graduate School of Public Health, University of Pittsburgh, Pittsburgh, PA 15261, USA; Division of Cancer Control and Population Sciences, University of Pittsburgh Cancer Institute, Pittsburgh, PA 15232, USA
| | - Alan B Zonderman
- Behavioral Epidemiology Section, Laboratory of Epidemiology and Population Sciences, National Institute on Aging, NIH, Baltimore, MD 21224, USA
| | - Diane M Becker
- General Internal Medicine, GeneSTAR Research Program, Department of Medicine, Johns Hopkins University School of Medicine, Baltimore, MD 21287, USA
| | - Michael Boehnke
- Department of Biostatistics and Center for Statistical Genetics, University of Michigan, Ann Arbor, MI 48109, USA
| | - Donald W Bowden
- Department of Biochemistry, Wake Forest School of Medicine, Winston-Salem, NC 27157, USA
| | - John C Chambers
- Department of Epidemiology and Biostatistics, Imperial College London, London W2 1PG, UK; Department of Cardiology, Ealing Hospital, Middlesex UB1 3HW, UK
| | - Yii-Der Ida Chen
- Genomic Outcomes, Department of Pediatrics, LABioMed at Harbor-UCLA Medical Center, Torrance, CA 90502, USA
| | - Ulf de Faire
- Institute of Environmental Medicine, Karolinska Institutet, Stockholm 17177, Sweden
| | - Ian J Deary
- Centre for Cognitive Ageing and Cognitive Epidemiology, The University of Edinburgh, Edinburgh EH8 9JZ, UK; Department of Psychology, The University of Edinburgh, Edinburgh EH8 9JZ, UK
| | - Tõnu Esko
- Estonian Genome Center, University of Tartu, Tartu 51010, Estonia; Broad Institute of the Massachusetts Institute of Technology and Harvard University, Boston, MA 02142, USA
| | - Martin Farrall
- Division of Cardiovascular Medicine, Radcliffe Department of Medicine, University of Oxford, Oxford, Oxfordshire OX3 9DU, UK; Wellcome Centre for Human Genetics, University of Oxford, Oxford OX3 7BN, UK
| | - Terrence Forrester
- Tropical Metabolism Research Unit, Tropical Medicine Research Institute, University of the West Indies, Mona JMAAW15, Jamaica
| | - Paul W Franks
- Genetic and Molecular Epidemiology Unit, Department of Clinical Sciences, Lund University, Malmö, Skåne 205 02, Sweden; Harvard T.H. Chan School of Public Health, Department of Nutrition, Harvard University, Boston, MA 02115, USA; Department of Public Health & Clinical Medicine, Umeå University, Umeå, Västerbotten 901 85, Sweden
| | - Barry I Freedman
- Division of Nephrology, Department of Internal Medicine, Wake Forest School of Medicine, Winston-Salem, NC 27157, USA
| | - Philippe Froguel
- CNRS UMR 8199, European Genomic Institute for Diabetes (EGID), Institut Pasteur de Lille, University of Lille, Lille 59000, France; Department of Genomics of Common Disease, Imperial College London, London W12 0NN, UK
| | - Paolo Gasparini
- Department of Medical Sciences, University of Trieste, Trieste 34137, Italy; Division Experimental Genetics, Sidra, Doha 26999, Qatar
| | - Christian Gieger
- Research Unit of Molecular Epidemiology, Helmholtz Zentrum München, German Research Center for Environmental Health, Neuherberg 85764, Germany; German Center for Diabetes Research (DZD e.V.), Neuherberg 85764, Germany
| | - Bernardo Lessa Horta
- Postgraduate Program in Epidemiology, Federal University of Pelotas, Pelotas, RS 96020220, Brazil
| | - Yi-Jen Hung
- Endocrinology and Metabolism, Tri-Service General Hospital, National Defense Medical Center, Taipei City, Taipei 11490, Taiwan
| | - Jost B Jonas
- Beijing Tongren Eye Center, Beijing Tongren Hospital, Capital Medical University, Beijing 100730, China; Department of Ophthalmology, Medical Faculty Mannheim, University Heidelberg, Mannheim 68167, Germany
| | - Norihiro Kato
- Department of Gene Diagnostics and Therapeutics, Research Institute, National Center for Global Health and Medicine, Tokyo 1628655, Japan
| | - Jaspal S Kooner
- Department of Cardiology, Ealing Hospital, Middlesex UB1 3HW, UK; National Heart and Lung Institute, Imperial College London, London W12 0NN, UK
| | - Markku Laakso
- Institute of Clinical Medicine, Internal Medicine, University of Eastern Finland and Kuopio University Hospital, Kuopio 70210, Finland
| | - Terho Lehtimäki
- Department of Clinical Chemistry, Fimlab Laboratories, Tampere 33520, Finland; Department of Clinical Chemistry, Finnish Cardiovascular Research Center - Tampere, Faculty of Medicine and Lifes Sciences, University of Tampere, Tampere 33014, Finland
| | - Kae-Woei Liang
- School of Medicine, National Yang-ming University, Taipei, Taiwan; Cardiovascular Center, Taichung Veterans General Hospital, Taichung 40705, Taiwan; Department of Medicine, China Medical University, Taichung 40705, Taiwan
| | - Patrik K E Magnusson
- Department of Medical Epidemiology and Biostatistics, Karolinska Institutet, Stockholm 17177, Sweden
| | - Anne B Newman
- Department of Epidemiology, Graduate School of Public Health, University of Pittsburgh, Pittsburgh, PA 15261, USA
| | - Albertine J Oldehinkel
- Department of Psychiatry, University of Groningen, University Medical Center Groningen, Groningen 9700 RB, the Netherlands
| | - Alexandre C Pereira
- Lab Genetics and Molecular Cardiology, Department of Cardiology, Heart Institute, University of Sao Paulo, Sao Paulo, Brazil; Genetics, Harvard Medical School, Boston, MA 02115, USA
| | - Susan Redline
- Sleep Medicine and Circadian Disorders, Brigham and Women's Hospital, Boston, MA 02115, USA
| | - Rainer Rettig
- DZHK (German Center for Cardiovascular Research), partner site Greifswald, Greifswald 17475, Germany; Institute of Physiology, University Medicine Greifswald, Greifswald 17495, Germany
| | - Nilesh J Samani
- Department of Cardiovascular Sciences, University of Leicester, Leicester LE3 9QP, UK; NIHR Leicester Cardiovascular Biomedical Research Unit, Glenfield Hospital, Leicester LE3 9QP, UK
| | - James Scott
- National Heart and Lung Institute, Imperial College London, London W12 0NN, UK
| | - Xiao-Ou Shu
- Division of Epidemiology, Department of Medicine, Vanderbilt University School of Medicine, Nashville, TN 37203, USA
| | - Pim van der Harst
- Department of Cardiology, University of Groningen, University Medical Center Groningen, Groningen 9700 RB, the Netherlands
| | - Lynne E Wagenknecht
- Department of Public Health Sciences, Wake Forest School of Medicine, Winston-Salem, NC 27157, USA
| | | | - Hugh Watkins
- Division of Cardiovascular Medicine, Radcliffe Department of Medicine, University of Oxford, Oxford, Oxfordshire OX3 9DU, UK; Wellcome Centre for Human Genetics, University of Oxford, Oxford OX3 7BN, UK
| | - David R Weir
- Institute for Social Research, Survey Research Center, University of Michigan, Ann Arbor, MI 48104, USA
| | | | - Tangchun Wu
- Department of Occupational and Environmental Health and State Key Laboratory of Environmental Health for Incubating, School of Public Health, Tongji Medical College Huazhong University of Science and Technology, Wuhan, China
| | - Wei Zheng
- Division of Epidemiology, Department of Medicine, Vanderbilt University School of Medicine, Nashville, TN 37203, USA
| | - Yoichiro Kamatani
- Laboratory for Statistical Analysis, Center for Integrative Medical Sciences, RIKEN, Yokohama 230-0045, Japan
| | - Cathy C Laurie
- Department of Biostatistics, University of Washington, Seattle, WA 98105, USA
| | - Claude Bouchard
- Human Genomics Laboratory, Pennington Biomedical Research Center, Baton Rouge, LA 70808, USA
| | - Richard S Cooper
- Department of Public Health Sciences, Loyola University Chicago, Maywood, IL 60153, USA
| | - Michele K Evans
- Health Disparities Research Section, Laboratory of Epidemiology and Population Sciences, National Institute on Aging, NIH, Baltimore, MD 21224, USA
| | - Vilmundur Gudnason
- Icelandic Heart Association, Kopavogur 201, Iceland; Faculty of Medicine, University of Iceland, Reykjavik 101, Iceland
| | - Sharon L R Kardia
- School of Public Health, Department of Epidemiology, University of Michigan, Ann Arbor, MI 48109, USA
| | - Stephen B Kritchevsky
- Sticht Center for Health Aging and Alzheimer's Prevention, Department of Internal Medicine, Wake Forest School of Medicine, Winston-Salem, NC 27157, USA
| | - Daniel Levy
- Framingham Heart Study, National Heart, Lung, and Blood Institute, NIH, Bethesda, MD 20982, USA; Population Sciences Branch, Division of Intramural Research, National Heart, Lung, and Blood Institute, NIH, Bethesda, MD 20892, USA
| | - Jeff R O'Connell
- Division of Endocrinology, Diabetes, and Nutrition, University of Maryland School of Medicine, Baltimore, MD 21201, USA; Program for Personalized and Genomic Medicine, University of Maryland School of Medicine, Baltimore, MD 21201, USA
| | - Bruce M Psaty
- Cardiovascular Health Research Unit, Epidemiology, Medicine and Health Services, University of Washington, Seattle, WA 98101, USA; Kaiser Permanente Washington, Health Research Institute, Seattle, WA 98101, USA
| | - Rob M van Dam
- Saw Swee Hock School of Public Health, National University of Singapore, Singapore 117549, Singapore; Department of Medicine, Yong Loo Lin School of Medicine, National University of Singapore, Singapore 119228, Singapore
| | - Mario Sims
- Jackson Heart Study, Department of Medicine, University of Mississippi Medical Center, Jackson, MS 39213, USA
| | - Donna K Arnett
- Dean's Office, University of Kentucky College of Public Health, Lexington, KY 40536, USA
| | - Dennis O Mook-Kanamori
- Department of Clinical Epidemiology, Leiden University Medical Center, Leiden 2300RC, the Netherlands; Department of Public Health and Primary Care, Leiden University Medical Center, Leiden 2300RC, the Netherlands
| | - Tanika N Kelly
- Department of Epidemiology, Tulane University School of Public Health and Tropical Medicine, New Orleans, LA 70112, USA
| | - Ervin R Fox
- Cardiology, Department of Medicine, University of Mississippi Medical Center, Jackson, MS 39216, USA
| | - Caroline Hayward
- Medical Research Council Human Genetics Unit, Institute of Genetics & Molecular Medicine, University of Edinburgh, Edinburgh EH4 2XU, UK
| | - Myriam Fornage
- Brown Foundation Institute of Molecular Medicine, University of Texas Health Science Center at Houston, Houston, TX 77030, USA
| | - Charles N Rotimi
- Center for Research on Genomics and Global Health, National Human Genome Research Institute, NIH, Bethesda, MD 20892, USA
| | - Michael A Province
- Division of Statistical Genomics, Department of Genetics, Washington University School of Medicine, St. Louis, MO 63108, USA
| | - Cornelia M van Duijn
- Department of Epidemiology, Erasmus University Medical Center, Rotterdam, the Netherlands
| | - E Shyong Tai
- Saw Swee Hock School of Public Health, National University Health System and National University of Singapore, Singapore, Singapore 117549, Singapore; Duke-NUS Medical School, Singapore 169857, Singapore; Department of Medicine, Yong Loo Lin School of Medicine, National University of Singapore, Singapore 119228, Singapore
| | - Tien Yin Wong
- Singapore Eye Research Institute, Singapore National Eye Centre, Singapore, Singapore 169856, Singapore; Ophthalmology & Visual Sciences Academic Clinical Program (Eye ACP), Duke-NUS Medical School, Singapore, Singapore 169857, Singapore; Department of Ophthalmology, Yong Loo Lin School of Medicine, National University of Singapore, Singapore, Singapore 117597, Singapore
| | - Ruth J F Loos
- Icahn School of Medicine at Mount Sinai, The Charles Bronfman Institute for Personalized Medicine, New York, NY 10029, USA; Icahn School of Medicine at Mount Sinai, The Mindich Child Health and Development Institute, New York, NY 10029, USA
| | - Alex P Reiner
- Fred Hutchinson Cancer Research Center, University of Washington School of Public Health, Seattle, WA 98109, USA
| | - Jerome I Rotter
- Genomic Outcomes, Department of Pediatrics, LABioMed at Harbor-UCLA Medical Center, Torrance, CA 90502, USA; Genomic Outcomes, Department of Medicine, LABioMed at Harbor-UCLA Medical Center, Torrance, CA 90502, USA
| | - Xiaofeng Zhu
- Department of Epidemiology and Biostatistics, Case Western Reserve University, Cleveland, OH 44106, USA
| | - Laura J Bierut
- Department of Psychiatry, Washington University School of Medicine, St. Louis, MO 63110, USA
| | - W James Gauderman
- Division of Biostatistics, Department of Preventive Medicine, University of Southern California, Los Angeles, CA 90032, USA
| | - Mark J Caulfield
- William Harvey Research Institute, Clinical Pharmacology, Queen Mary University of London, London EC1M 6BQ, UK; NIHR Cardiovascular Biomedical Research Unit, Barts and The London School of Medicine and Dentistry, Queen Mary University of London, London EC1M 6BQ, UK
| | - Paul Elliott
- Department of Epidemiology and Biostatistics, Imperial College London, London W2 1PG, UK; MRC-PHE Centre for Environment and Health, Department of Epidemiology & Biostatistics, School of Public Health, Imperial College London, London, UK
| | - Kenneth Rice
- Department of Biostatistics, University of Washington, Seattle, WA 98105, USA
| | - Patricia B Munroe
- William Harvey Research Institute, Clinical Pharmacology, Queen Mary University of London, London EC1M 6BQ, UK; NIHR Barts Cardiovascular Biomedical Research Unit, Queen Mary University of London, London EC1M 6BQ, UK
| | - Alanna C Morrison
- Department of Epidemiology, Human Genetics, and Environmental Sciences, The University of Texas School of Public Health, Houston, TX 77030, USA
| | - L Adrienne Cupples
- Department of Biostatistics, Boston University School of Public Health, Boston, MA 02118, USA; Framingham Heart Study, National Heart, Lung, and Blood Institute, NIH, Bethesda, MD 20982, USA
| | - Dabeeru C Rao
- Division of Biostatistics, Washington University School of Medicine, St. Louis, MO 63110, USA
| | - Daniel I Chasman
- Division of Preventive Medicine, Department of Medicine, Brigham and Women's Hospital, Boston, MA 02215, USA.
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Miyakawa AA, Girão-Silva T, Krieger JE, Edelman ER. Rapamycin activates TGF receptor independently of its ligand: implications for endothelial dysfunction. Clin Sci (Lond) 2018; 132:437-447. [PMID: 29343616 PMCID: PMC6301009 DOI: 10.1042/cs20171457] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/15/2017] [Revised: 01/12/2018] [Accepted: 01/16/2018] [Indexed: 01/06/2023]
Abstract
Rapamycin, the macrolide immunosuppressant and active pharmaceutic in drug-eluting stents (DES), has a well-recognized antiproliferative action that involves inhibition of the mTOR pathway after binding to the cytosolic protein FKBP12. TGF receptor-type I (TGFRI) spontaneous activation is inhibited by the association with FKBP12. We hypothesized that rapamycin, in addition to inhibition of mTOR signaling, activates TGFRI independent of TGFβ. Human umbilical vein endothelial cells (HUVECs) were treated with rapamycin (10 nmol/l) and/or TGFβ RI kinase inhibitor (TGFRIi, 100 nmol/l) for 24 h. Rapamycin induced SMAD phosphorylation (SMAD1, SMAD2, and SMAD5) and PAI-1 up-regulation, which was specifically abrogated by SMAD2 knockdown. TGFRIi efficiently blocked phosphorylation of SMAD2, but not SMAD1/5. Interestingly, the inhibitor did not alter cell proliferation arrest induced by rapamycin. Active TGFβ secretion was not affected by the treatment. Neutralizing TGFβ experiments did not influence SMAD2 phosphorylation or PAI-1 expression indicating that activation of this pathway is independent of the ligand. In addition, rapamycin induction of endothelial-to-mesenchymal transition (EndMT) was potentiated by IL-1β and efficiently blocked by TGFRIi. In vivo, the prothrombogenic effects of rapamycin and up-regulation of PAI-1 in murine carotid arteries were reduced by TGFRIi treatment. In conclusion, we provide evidence that rapamycin activates TGF receptor independent of its ligand TGFβ, in concert with promotion of PAI-1 expression and changes in endothelial phenotype. These undesirable effects, the prothrombogenic state, and activation of EndMT are SMAD2-dependent and independent of the therapeutic rapamycin-induced cell proliferation arrest.
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Affiliation(s)
- Ayumi A Miyakawa
- Cardiovascular Division, Department of Medicine, Brigham and Women's Hospital, Harvard Medical School, Boston, MA 02115, U.S.A.
- Institute for Medical Engineering and Science, Massachusetts Institute of Technology, Cambridge, MA 02139, U.S.A
- Laboratory of Genetics and Molecular Cardiology, Heart Institute (InCor, HCFMUSP), Sao Paulo, SP 054003, Brazil
| | - Thais Girão-Silva
- Laboratory of Genetics and Molecular Cardiology, Heart Institute (InCor, HCFMUSP), Sao Paulo, SP 054003, Brazil
| | - Jose E Krieger
- Laboratory of Genetics and Molecular Cardiology, Heart Institute (InCor, HCFMUSP), Sao Paulo, SP 054003, Brazil
| | - Elazer R Edelman
- Cardiovascular Division, Department of Medicine, Brigham and Women's Hospital, Harvard Medical School, Boston, MA 02115, U.S.A
- Institute for Medical Engineering and Science, Massachusetts Institute of Technology, Cambridge, MA 02139, U.S.A
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48
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Krieger EM, Drager LF, Giorgi DMA, Pereira AC, Barreto-Filho JAS, Nogueira AR, Mill JG, Lotufo PA, Amodeo C, Batista MC, Bodanese LC, Carvalho ACC, Castro I, Chaves H, Costa EAS, Feitosa GS, Franco RJS, Fuchs FD, Guimarães AC, Jardim PC, Machado CA, Magalhães ME, Mion D, Nascimento RM, Nobre F, Nóbrega AC, Ribeiro ALP, Rodrigues-Sobrinho CR, Sanjuliani AF, Teixeira MDCB, Krieger JE. Spironolactone Versus Clonidine as a Fourth-Drug Therapy for Resistant Hypertension: The ReHOT Randomized Study (Resistant Hypertension Optimal Treatment). Hypertension 2018; 71:681-690. [PMID: 29463627 DOI: 10.1161/hypertensionaha.117.10662] [Citation(s) in RCA: 89] [Impact Index Per Article: 14.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/02/2017] [Revised: 12/17/2017] [Accepted: 01/22/2018] [Indexed: 01/12/2023]
Abstract
The aim of this study is to compare spironolactone versus clonidine as the fourth drug in patients with resistant hypertension in a multicenter, randomized trial. Medical therapy adherence was checked by pill counting. Patients with resistant hypertension (no office and ambulatory blood pressure [BP] monitoring control, despite treatment with 3 drugs, including a diuretic, for 12 weeks) were randomized to an additional 12-week treatment with spironolactone (12.5-50 mg QD) or clonidine (0.1-0.3 mg BID). The primary end point was BP control during office (<140/90 mm Hg) and 24-h ambulatory (<130/80 mm Hg) BP monitoring. Secondary end points included BP control from each method and absolute BP reduction. From 1597 patients recruited, 11.7% (187 patients) fulfilled the resistant hypertension criteria. Compared with the spironolactone group (n=95), the clonidine group (n=92) presented similar rates of achieving the primary end point (20.5% versus 20.8%, respectively; relative risk, 1.01 [0.55-1.88]; P=1.00). Secondary end point analysis showed similar office BP (33.3% versus 29.3%) and ambulatory BP monitoring (44% versus 46.2%) control for spironolactone and clonidine, respectively. However, spironolactone promoted greater decrease in 24-h systolic and diastolic BP and diastolic daytime ambulatory BP than clonidine. Per-protocol analysis (limited to patients with ≥80% adherence to spironolactone/clonidine treatment) showed similar results regarding the primary end point. In conclusion, clonidine was not superior to spironolactone in true resistant hypertensive patients, but the overall BP control was low (≈21%). Considering easier posology and greater decrease in secondary end points, spironolactone is preferable for the fourth-drug therapy. CLINICAL TRIAL REGISTRATION URL: http://www.clinicaltrials.gov. Unique identifier: NCT01643434.
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Affiliation(s)
- Eduardo M Krieger
- From the Hypertension Unit, Heart Institute-InCor (E.M.K., L.F.D., D.M.A.G.), Hypertension Unit, Renal Division (L.F.D., D.M.), and Laboratory of Genetics and Molecular Medicine, Heart Institute-InCor (A.C.P., J.E.K.), University of Sao Paulo Medical School, Brazil; Division of Cardiology, Federal University of Sergipe, Brazil (J.A.S.B.-F.); Department of Clinical Research, Hospital Universitario Clementino Fraga Filho, Brazil (A.R.N.); Department of Physiological Sciences, Federal University of Espírito Santo, Brazil (J.G.M.); Division of Internal Medicine, Center for Clinical and Epidemiological Research, University Hospital (P.A.L.) and Ribeirao Preto Medical School (F.N.), University of Sao Paulo, Brazil; Department of Hypertension and Nephrology, Dante Pazzanese Institute of Cardiology, Sao Paulo, Brazil (C.A.); Division of Nephrology, Department of Medicine (M.C.B.) and Department of Cardiology (A.C.C.C.), Universidade Federal de São Paulo, Brazil; Pontificia Universidade Catolica do Rio Grande do Sul, Porto Alegre, Brazil (L.C.B.); Institute of Cardiology, University Cardiology Foundation, Porto Alegre, Brazil (I.C.); Department of Clinical Medicine, Federal University of Pernambuco, Recife, Brazil (H.C.); Department of Cardiology, Universidade Federal do Para, Belem, Brazil (E.A.S.C.); Escola Bahiana de Medicina e Saude Pública, Salvador, Brazil (G.S.F.); Division of Nephrology, Department of Internal Medicine, Botucatu Medical School, Sao Paulo State University, Brazil (R.J.S.F.); Division of Cardiology, Hospital de Clinicas de Porto Alegre, Federal University of Rio Grande do Sul, Brazil (F.D.F.); Federal University of Bahia, Salvador, Brazil (A.C.G.); Faculty of Medicine, Federal University of Goias, Goiânia, Brazil (P.C.J.); Department of Cardiology, School of Medicine, Federal University of Sao Paulo, Brazil (C.A.M.); Serviço de Cardiologia do Hospital Universitario Pedro Ernesto da Universidade do Estado do Rio de Janeiro, Brazil (M.E.M.); Department of Medicine, Ouro Preto Federal University, Brazil (R.M.N.); Hospital Universitario Antonio Pedro, Universidade Federal Fluminense, Rio de Janeiro, Brazil (A.C.N.); Department of Internal Medicine, Federal University of Minas Gerais, Belo Horizonte, Brazil (A.L.P.R.); Department of Cardiology, Federal University of Ceara, Fortaleza, Brazil (C.R.-S.); Discipline of Clinical and Experimental Pathophysiology, Rio de Janeiro State University, Brazil (A.F.S.); and Universidade Estadual de Ciencias da Saude de Alagoas, Maceio, Brazil (M.d.C.B.T.).
| | - Luciano F Drager
- From the Hypertension Unit, Heart Institute-InCor (E.M.K., L.F.D., D.M.A.G.), Hypertension Unit, Renal Division (L.F.D., D.M.), and Laboratory of Genetics and Molecular Medicine, Heart Institute-InCor (A.C.P., J.E.K.), University of Sao Paulo Medical School, Brazil; Division of Cardiology, Federal University of Sergipe, Brazil (J.A.S.B.-F.); Department of Clinical Research, Hospital Universitario Clementino Fraga Filho, Brazil (A.R.N.); Department of Physiological Sciences, Federal University of Espírito Santo, Brazil (J.G.M.); Division of Internal Medicine, Center for Clinical and Epidemiological Research, University Hospital (P.A.L.) and Ribeirao Preto Medical School (F.N.), University of Sao Paulo, Brazil; Department of Hypertension and Nephrology, Dante Pazzanese Institute of Cardiology, Sao Paulo, Brazil (C.A.); Division of Nephrology, Department of Medicine (M.C.B.) and Department of Cardiology (A.C.C.C.), Universidade Federal de São Paulo, Brazil; Pontificia Universidade Catolica do Rio Grande do Sul, Porto Alegre, Brazil (L.C.B.); Institute of Cardiology, University Cardiology Foundation, Porto Alegre, Brazil (I.C.); Department of Clinical Medicine, Federal University of Pernambuco, Recife, Brazil (H.C.); Department of Cardiology, Universidade Federal do Para, Belem, Brazil (E.A.S.C.); Escola Bahiana de Medicina e Saude Pública, Salvador, Brazil (G.S.F.); Division of Nephrology, Department of Internal Medicine, Botucatu Medical School, Sao Paulo State University, Brazil (R.J.S.F.); Division of Cardiology, Hospital de Clinicas de Porto Alegre, Federal University of Rio Grande do Sul, Brazil (F.D.F.); Federal University of Bahia, Salvador, Brazil (A.C.G.); Faculty of Medicine, Federal University of Goias, Goiânia, Brazil (P.C.J.); Department of Cardiology, School of Medicine, Federal University of Sao Paulo, Brazil (C.A.M.); Serviço de Cardiologia do Hospital Universitario Pedro Ernesto da Universidade do Estado do Rio de Janeiro, Brazil (M.E.M.); Department of Medicine, Ouro Preto Federal University, Brazil (R.M.N.); Hospital Universitario Antonio Pedro, Universidade Federal Fluminense, Rio de Janeiro, Brazil (A.C.N.); Department of Internal Medicine, Federal University of Minas Gerais, Belo Horizonte, Brazil (A.L.P.R.); Department of Cardiology, Federal University of Ceara, Fortaleza, Brazil (C.R.-S.); Discipline of Clinical and Experimental Pathophysiology, Rio de Janeiro State University, Brazil (A.F.S.); and Universidade Estadual de Ciencias da Saude de Alagoas, Maceio, Brazil (M.d.C.B.T.)
| | - Dante M A Giorgi
- From the Hypertension Unit, Heart Institute-InCor (E.M.K., L.F.D., D.M.A.G.), Hypertension Unit, Renal Division (L.F.D., D.M.), and Laboratory of Genetics and Molecular Medicine, Heart Institute-InCor (A.C.P., J.E.K.), University of Sao Paulo Medical School, Brazil; Division of Cardiology, Federal University of Sergipe, Brazil (J.A.S.B.-F.); Department of Clinical Research, Hospital Universitario Clementino Fraga Filho, Brazil (A.R.N.); Department of Physiological Sciences, Federal University of Espírito Santo, Brazil (J.G.M.); Division of Internal Medicine, Center for Clinical and Epidemiological Research, University Hospital (P.A.L.) and Ribeirao Preto Medical School (F.N.), University of Sao Paulo, Brazil; Department of Hypertension and Nephrology, Dante Pazzanese Institute of Cardiology, Sao Paulo, Brazil (C.A.); Division of Nephrology, Department of Medicine (M.C.B.) and Department of Cardiology (A.C.C.C.), Universidade Federal de São Paulo, Brazil; Pontificia Universidade Catolica do Rio Grande do Sul, Porto Alegre, Brazil (L.C.B.); Institute of Cardiology, University Cardiology Foundation, Porto Alegre, Brazil (I.C.); Department of Clinical Medicine, Federal University of Pernambuco, Recife, Brazil (H.C.); Department of Cardiology, Universidade Federal do Para, Belem, Brazil (E.A.S.C.); Escola Bahiana de Medicina e Saude Pública, Salvador, Brazil (G.S.F.); Division of Nephrology, Department of Internal Medicine, Botucatu Medical School, Sao Paulo State University, Brazil (R.J.S.F.); Division of Cardiology, Hospital de Clinicas de Porto Alegre, Federal University of Rio Grande do Sul, Brazil (F.D.F.); Federal University of Bahia, Salvador, Brazil (A.C.G.); Faculty of Medicine, Federal University of Goias, Goiânia, Brazil (P.C.J.); Department of Cardiology, School of Medicine, Federal University of Sao Paulo, Brazil (C.A.M.); Serviço de Cardiologia do Hospital Universitario Pedro Ernesto da Universidade do Estado do Rio de Janeiro, Brazil (M.E.M.); Department of Medicine, Ouro Preto Federal University, Brazil (R.M.N.); Hospital Universitario Antonio Pedro, Universidade Federal Fluminense, Rio de Janeiro, Brazil (A.C.N.); Department of Internal Medicine, Federal University of Minas Gerais, Belo Horizonte, Brazil (A.L.P.R.); Department of Cardiology, Federal University of Ceara, Fortaleza, Brazil (C.R.-S.); Discipline of Clinical and Experimental Pathophysiology, Rio de Janeiro State University, Brazil (A.F.S.); and Universidade Estadual de Ciencias da Saude de Alagoas, Maceio, Brazil (M.d.C.B.T.)
| | - Alexandre C Pereira
- From the Hypertension Unit, Heart Institute-InCor (E.M.K., L.F.D., D.M.A.G.), Hypertension Unit, Renal Division (L.F.D., D.M.), and Laboratory of Genetics and Molecular Medicine, Heart Institute-InCor (A.C.P., J.E.K.), University of Sao Paulo Medical School, Brazil; Division of Cardiology, Federal University of Sergipe, Brazil (J.A.S.B.-F.); Department of Clinical Research, Hospital Universitario Clementino Fraga Filho, Brazil (A.R.N.); Department of Physiological Sciences, Federal University of Espírito Santo, Brazil (J.G.M.); Division of Internal Medicine, Center for Clinical and Epidemiological Research, University Hospital (P.A.L.) and Ribeirao Preto Medical School (F.N.), University of Sao Paulo, Brazil; Department of Hypertension and Nephrology, Dante Pazzanese Institute of Cardiology, Sao Paulo, Brazil (C.A.); Division of Nephrology, Department of Medicine (M.C.B.) and Department of Cardiology (A.C.C.C.), Universidade Federal de São Paulo, Brazil; Pontificia Universidade Catolica do Rio Grande do Sul, Porto Alegre, Brazil (L.C.B.); Institute of Cardiology, University Cardiology Foundation, Porto Alegre, Brazil (I.C.); Department of Clinical Medicine, Federal University of Pernambuco, Recife, Brazil (H.C.); Department of Cardiology, Universidade Federal do Para, Belem, Brazil (E.A.S.C.); Escola Bahiana de Medicina e Saude Pública, Salvador, Brazil (G.S.F.); Division of Nephrology, Department of Internal Medicine, Botucatu Medical School, Sao Paulo State University, Brazil (R.J.S.F.); Division of Cardiology, Hospital de Clinicas de Porto Alegre, Federal University of Rio Grande do Sul, Brazil (F.D.F.); Federal University of Bahia, Salvador, Brazil (A.C.G.); Faculty of Medicine, Federal University of Goias, Goiânia, Brazil (P.C.J.); Department of Cardiology, School of Medicine, Federal University of Sao Paulo, Brazil (C.A.M.); Serviço de Cardiologia do Hospital Universitario Pedro Ernesto da Universidade do Estado do Rio de Janeiro, Brazil (M.E.M.); Department of Medicine, Ouro Preto Federal University, Brazil (R.M.N.); Hospital Universitario Antonio Pedro, Universidade Federal Fluminense, Rio de Janeiro, Brazil (A.C.N.); Department of Internal Medicine, Federal University of Minas Gerais, Belo Horizonte, Brazil (A.L.P.R.); Department of Cardiology, Federal University of Ceara, Fortaleza, Brazil (C.R.-S.); Discipline of Clinical and Experimental Pathophysiology, Rio de Janeiro State University, Brazil (A.F.S.); and Universidade Estadual de Ciencias da Saude de Alagoas, Maceio, Brazil (M.d.C.B.T.)
| | - José Augusto Soares Barreto-Filho
- From the Hypertension Unit, Heart Institute-InCor (E.M.K., L.F.D., D.M.A.G.), Hypertension Unit, Renal Division (L.F.D., D.M.), and Laboratory of Genetics and Molecular Medicine, Heart Institute-InCor (A.C.P., J.E.K.), University of Sao Paulo Medical School, Brazil; Division of Cardiology, Federal University of Sergipe, Brazil (J.A.S.B.-F.); Department of Clinical Research, Hospital Universitario Clementino Fraga Filho, Brazil (A.R.N.); Department of Physiological Sciences, Federal University of Espírito Santo, Brazil (J.G.M.); Division of Internal Medicine, Center for Clinical and Epidemiological Research, University Hospital (P.A.L.) and Ribeirao Preto Medical School (F.N.), University of Sao Paulo, Brazil; Department of Hypertension and Nephrology, Dante Pazzanese Institute of Cardiology, Sao Paulo, Brazil (C.A.); Division of Nephrology, Department of Medicine (M.C.B.) and Department of Cardiology (A.C.C.C.), Universidade Federal de São Paulo, Brazil; Pontificia Universidade Catolica do Rio Grande do Sul, Porto Alegre, Brazil (L.C.B.); Institute of Cardiology, University Cardiology Foundation, Porto Alegre, Brazil (I.C.); Department of Clinical Medicine, Federal University of Pernambuco, Recife, Brazil (H.C.); Department of Cardiology, Universidade Federal do Para, Belem, Brazil (E.A.S.C.); Escola Bahiana de Medicina e Saude Pública, Salvador, Brazil (G.S.F.); Division of Nephrology, Department of Internal Medicine, Botucatu Medical School, Sao Paulo State University, Brazil (R.J.S.F.); Division of Cardiology, Hospital de Clinicas de Porto Alegre, Federal University of Rio Grande do Sul, Brazil (F.D.F.); Federal University of Bahia, Salvador, Brazil (A.C.G.); Faculty of Medicine, Federal University of Goias, Goiânia, Brazil (P.C.J.); Department of Cardiology, School of Medicine, Federal University of Sao Paulo, Brazil (C.A.M.); Serviço de Cardiologia do Hospital Universitario Pedro Ernesto da Universidade do Estado do Rio de Janeiro, Brazil (M.E.M.); Department of Medicine, Ouro Preto Federal University, Brazil (R.M.N.); Hospital Universitario Antonio Pedro, Universidade Federal Fluminense, Rio de Janeiro, Brazil (A.C.N.); Department of Internal Medicine, Federal University of Minas Gerais, Belo Horizonte, Brazil (A.L.P.R.); Department of Cardiology, Federal University of Ceara, Fortaleza, Brazil (C.R.-S.); Discipline of Clinical and Experimental Pathophysiology, Rio de Janeiro State University, Brazil (A.F.S.); and Universidade Estadual de Ciencias da Saude de Alagoas, Maceio, Brazil (M.d.C.B.T.)
| | - Armando R Nogueira
- From the Hypertension Unit, Heart Institute-InCor (E.M.K., L.F.D., D.M.A.G.), Hypertension Unit, Renal Division (L.F.D., D.M.), and Laboratory of Genetics and Molecular Medicine, Heart Institute-InCor (A.C.P., J.E.K.), University of Sao Paulo Medical School, Brazil; Division of Cardiology, Federal University of Sergipe, Brazil (J.A.S.B.-F.); Department of Clinical Research, Hospital Universitario Clementino Fraga Filho, Brazil (A.R.N.); Department of Physiological Sciences, Federal University of Espírito Santo, Brazil (J.G.M.); Division of Internal Medicine, Center for Clinical and Epidemiological Research, University Hospital (P.A.L.) and Ribeirao Preto Medical School (F.N.), University of Sao Paulo, Brazil; Department of Hypertension and Nephrology, Dante Pazzanese Institute of Cardiology, Sao Paulo, Brazil (C.A.); Division of Nephrology, Department of Medicine (M.C.B.) and Department of Cardiology (A.C.C.C.), Universidade Federal de São Paulo, Brazil; Pontificia Universidade Catolica do Rio Grande do Sul, Porto Alegre, Brazil (L.C.B.); Institute of Cardiology, University Cardiology Foundation, Porto Alegre, Brazil (I.C.); Department of Clinical Medicine, Federal University of Pernambuco, Recife, Brazil (H.C.); Department of Cardiology, Universidade Federal do Para, Belem, Brazil (E.A.S.C.); Escola Bahiana de Medicina e Saude Pública, Salvador, Brazil (G.S.F.); Division of Nephrology, Department of Internal Medicine, Botucatu Medical School, Sao Paulo State University, Brazil (R.J.S.F.); Division of Cardiology, Hospital de Clinicas de Porto Alegre, Federal University of Rio Grande do Sul, Brazil (F.D.F.); Federal University of Bahia, Salvador, Brazil (A.C.G.); Faculty of Medicine, Federal University of Goias, Goiânia, Brazil (P.C.J.); Department of Cardiology, School of Medicine, Federal University of Sao Paulo, Brazil (C.A.M.); Serviço de Cardiologia do Hospital Universitario Pedro Ernesto da Universidade do Estado do Rio de Janeiro, Brazil (M.E.M.); Department of Medicine, Ouro Preto Federal University, Brazil (R.M.N.); Hospital Universitario Antonio Pedro, Universidade Federal Fluminense, Rio de Janeiro, Brazil (A.C.N.); Department of Internal Medicine, Federal University of Minas Gerais, Belo Horizonte, Brazil (A.L.P.R.); Department of Cardiology, Federal University of Ceara, Fortaleza, Brazil (C.R.-S.); Discipline of Clinical and Experimental Pathophysiology, Rio de Janeiro State University, Brazil (A.F.S.); and Universidade Estadual de Ciencias da Saude de Alagoas, Maceio, Brazil (M.d.C.B.T.)
| | - José Geraldo Mill
- From the Hypertension Unit, Heart Institute-InCor (E.M.K., L.F.D., D.M.A.G.), Hypertension Unit, Renal Division (L.F.D., D.M.), and Laboratory of Genetics and Molecular Medicine, Heart Institute-InCor (A.C.P., J.E.K.), University of Sao Paulo Medical School, Brazil; Division of Cardiology, Federal University of Sergipe, Brazil (J.A.S.B.-F.); Department of Clinical Research, Hospital Universitario Clementino Fraga Filho, Brazil (A.R.N.); Department of Physiological Sciences, Federal University of Espírito Santo, Brazil (J.G.M.); Division of Internal Medicine, Center for Clinical and Epidemiological Research, University Hospital (P.A.L.) and Ribeirao Preto Medical School (F.N.), University of Sao Paulo, Brazil; Department of Hypertension and Nephrology, Dante Pazzanese Institute of Cardiology, Sao Paulo, Brazil (C.A.); Division of Nephrology, Department of Medicine (M.C.B.) and Department of Cardiology (A.C.C.C.), Universidade Federal de São Paulo, Brazil; Pontificia Universidade Catolica do Rio Grande do Sul, Porto Alegre, Brazil (L.C.B.); Institute of Cardiology, University Cardiology Foundation, Porto Alegre, Brazil (I.C.); Department of Clinical Medicine, Federal University of Pernambuco, Recife, Brazil (H.C.); Department of Cardiology, Universidade Federal do Para, Belem, Brazil (E.A.S.C.); Escola Bahiana de Medicina e Saude Pública, Salvador, Brazil (G.S.F.); Division of Nephrology, Department of Internal Medicine, Botucatu Medical School, Sao Paulo State University, Brazil (R.J.S.F.); Division of Cardiology, Hospital de Clinicas de Porto Alegre, Federal University of Rio Grande do Sul, Brazil (F.D.F.); Federal University of Bahia, Salvador, Brazil (A.C.G.); Faculty of Medicine, Federal University of Goias, Goiânia, Brazil (P.C.J.); Department of Cardiology, School of Medicine, Federal University of Sao Paulo, Brazil (C.A.M.); Serviço de Cardiologia do Hospital Universitario Pedro Ernesto da Universidade do Estado do Rio de Janeiro, Brazil (M.E.M.); Department of Medicine, Ouro Preto Federal University, Brazil (R.M.N.); Hospital Universitario Antonio Pedro, Universidade Federal Fluminense, Rio de Janeiro, Brazil (A.C.N.); Department of Internal Medicine, Federal University of Minas Gerais, Belo Horizonte, Brazil (A.L.P.R.); Department of Cardiology, Federal University of Ceara, Fortaleza, Brazil (C.R.-S.); Discipline of Clinical and Experimental Pathophysiology, Rio de Janeiro State University, Brazil (A.F.S.); and Universidade Estadual de Ciencias da Saude de Alagoas, Maceio, Brazil (M.d.C.B.T.)
| | - Paulo A Lotufo
- From the Hypertension Unit, Heart Institute-InCor (E.M.K., L.F.D., D.M.A.G.), Hypertension Unit, Renal Division (L.F.D., D.M.), and Laboratory of Genetics and Molecular Medicine, Heart Institute-InCor (A.C.P., J.E.K.), University of Sao Paulo Medical School, Brazil; Division of Cardiology, Federal University of Sergipe, Brazil (J.A.S.B.-F.); Department of Clinical Research, Hospital Universitario Clementino Fraga Filho, Brazil (A.R.N.); Department of Physiological Sciences, Federal University of Espírito Santo, Brazil (J.G.M.); Division of Internal Medicine, Center for Clinical and Epidemiological Research, University Hospital (P.A.L.) and Ribeirao Preto Medical School (F.N.), University of Sao Paulo, Brazil; Department of Hypertension and Nephrology, Dante Pazzanese Institute of Cardiology, Sao Paulo, Brazil (C.A.); Division of Nephrology, Department of Medicine (M.C.B.) and Department of Cardiology (A.C.C.C.), Universidade Federal de São Paulo, Brazil; Pontificia Universidade Catolica do Rio Grande do Sul, Porto Alegre, Brazil (L.C.B.); Institute of Cardiology, University Cardiology Foundation, Porto Alegre, Brazil (I.C.); Department of Clinical Medicine, Federal University of Pernambuco, Recife, Brazil (H.C.); Department of Cardiology, Universidade Federal do Para, Belem, Brazil (E.A.S.C.); Escola Bahiana de Medicina e Saude Pública, Salvador, Brazil (G.S.F.); Division of Nephrology, Department of Internal Medicine, Botucatu Medical School, Sao Paulo State University, Brazil (R.J.S.F.); Division of Cardiology, Hospital de Clinicas de Porto Alegre, Federal University of Rio Grande do Sul, Brazil (F.D.F.); Federal University of Bahia, Salvador, Brazil (A.C.G.); Faculty of Medicine, Federal University of Goias, Goiânia, Brazil (P.C.J.); Department of Cardiology, School of Medicine, Federal University of Sao Paulo, Brazil (C.A.M.); Serviço de Cardiologia do Hospital Universitario Pedro Ernesto da Universidade do Estado do Rio de Janeiro, Brazil (M.E.M.); Department of Medicine, Ouro Preto Federal University, Brazil (R.M.N.); Hospital Universitario Antonio Pedro, Universidade Federal Fluminense, Rio de Janeiro, Brazil (A.C.N.); Department of Internal Medicine, Federal University of Minas Gerais, Belo Horizonte, Brazil (A.L.P.R.); Department of Cardiology, Federal University of Ceara, Fortaleza, Brazil (C.R.-S.); Discipline of Clinical and Experimental Pathophysiology, Rio de Janeiro State University, Brazil (A.F.S.); and Universidade Estadual de Ciencias da Saude de Alagoas, Maceio, Brazil (M.d.C.B.T.)
| | - Celso Amodeo
- From the Hypertension Unit, Heart Institute-InCor (E.M.K., L.F.D., D.M.A.G.), Hypertension Unit, Renal Division (L.F.D., D.M.), and Laboratory of Genetics and Molecular Medicine, Heart Institute-InCor (A.C.P., J.E.K.), University of Sao Paulo Medical School, Brazil; Division of Cardiology, Federal University of Sergipe, Brazil (J.A.S.B.-F.); Department of Clinical Research, Hospital Universitario Clementino Fraga Filho, Brazil (A.R.N.); Department of Physiological Sciences, Federal University of Espírito Santo, Brazil (J.G.M.); Division of Internal Medicine, Center for Clinical and Epidemiological Research, University Hospital (P.A.L.) and Ribeirao Preto Medical School (F.N.), University of Sao Paulo, Brazil; Department of Hypertension and Nephrology, Dante Pazzanese Institute of Cardiology, Sao Paulo, Brazil (C.A.); Division of Nephrology, Department of Medicine (M.C.B.) and Department of Cardiology (A.C.C.C.), Universidade Federal de São Paulo, Brazil; Pontificia Universidade Catolica do Rio Grande do Sul, Porto Alegre, Brazil (L.C.B.); Institute of Cardiology, University Cardiology Foundation, Porto Alegre, Brazil (I.C.); Department of Clinical Medicine, Federal University of Pernambuco, Recife, Brazil (H.C.); Department of Cardiology, Universidade Federal do Para, Belem, Brazil (E.A.S.C.); Escola Bahiana de Medicina e Saude Pública, Salvador, Brazil (G.S.F.); Division of Nephrology, Department of Internal Medicine, Botucatu Medical School, Sao Paulo State University, Brazil (R.J.S.F.); Division of Cardiology, Hospital de Clinicas de Porto Alegre, Federal University of Rio Grande do Sul, Brazil (F.D.F.); Federal University of Bahia, Salvador, Brazil (A.C.G.); Faculty of Medicine, Federal University of Goias, Goiânia, Brazil (P.C.J.); Department of Cardiology, School of Medicine, Federal University of Sao Paulo, Brazil (C.A.M.); Serviço de Cardiologia do Hospital Universitario Pedro Ernesto da Universidade do Estado do Rio de Janeiro, Brazil (M.E.M.); Department of Medicine, Ouro Preto Federal University, Brazil (R.M.N.); Hospital Universitario Antonio Pedro, Universidade Federal Fluminense, Rio de Janeiro, Brazil (A.C.N.); Department of Internal Medicine, Federal University of Minas Gerais, Belo Horizonte, Brazil (A.L.P.R.); Department of Cardiology, Federal University of Ceara, Fortaleza, Brazil (C.R.-S.); Discipline of Clinical and Experimental Pathophysiology, Rio de Janeiro State University, Brazil (A.F.S.); and Universidade Estadual de Ciencias da Saude de Alagoas, Maceio, Brazil (M.d.C.B.T.)
| | - Marcelo C Batista
- From the Hypertension Unit, Heart Institute-InCor (E.M.K., L.F.D., D.M.A.G.), Hypertension Unit, Renal Division (L.F.D., D.M.), and Laboratory of Genetics and Molecular Medicine, Heart Institute-InCor (A.C.P., J.E.K.), University of Sao Paulo Medical School, Brazil; Division of Cardiology, Federal University of Sergipe, Brazil (J.A.S.B.-F.); Department of Clinical Research, Hospital Universitario Clementino Fraga Filho, Brazil (A.R.N.); Department of Physiological Sciences, Federal University of Espírito Santo, Brazil (J.G.M.); Division of Internal Medicine, Center for Clinical and Epidemiological Research, University Hospital (P.A.L.) and Ribeirao Preto Medical School (F.N.), University of Sao Paulo, Brazil; Department of Hypertension and Nephrology, Dante Pazzanese Institute of Cardiology, Sao Paulo, Brazil (C.A.); Division of Nephrology, Department of Medicine (M.C.B.) and Department of Cardiology (A.C.C.C.), Universidade Federal de São Paulo, Brazil; Pontificia Universidade Catolica do Rio Grande do Sul, Porto Alegre, Brazil (L.C.B.); Institute of Cardiology, University Cardiology Foundation, Porto Alegre, Brazil (I.C.); Department of Clinical Medicine, Federal University of Pernambuco, Recife, Brazil (H.C.); Department of Cardiology, Universidade Federal do Para, Belem, Brazil (E.A.S.C.); Escola Bahiana de Medicina e Saude Pública, Salvador, Brazil (G.S.F.); Division of Nephrology, Department of Internal Medicine, Botucatu Medical School, Sao Paulo State University, Brazil (R.J.S.F.); Division of Cardiology, Hospital de Clinicas de Porto Alegre, Federal University of Rio Grande do Sul, Brazil (F.D.F.); Federal University of Bahia, Salvador, Brazil (A.C.G.); Faculty of Medicine, Federal University of Goias, Goiânia, Brazil (P.C.J.); Department of Cardiology, School of Medicine, Federal University of Sao Paulo, Brazil (C.A.M.); Serviço de Cardiologia do Hospital Universitario Pedro Ernesto da Universidade do Estado do Rio de Janeiro, Brazil (M.E.M.); Department of Medicine, Ouro Preto Federal University, Brazil (R.M.N.); Hospital Universitario Antonio Pedro, Universidade Federal Fluminense, Rio de Janeiro, Brazil (A.C.N.); Department of Internal Medicine, Federal University of Minas Gerais, Belo Horizonte, Brazil (A.L.P.R.); Department of Cardiology, Federal University of Ceara, Fortaleza, Brazil (C.R.-S.); Discipline of Clinical and Experimental Pathophysiology, Rio de Janeiro State University, Brazil (A.F.S.); and Universidade Estadual de Ciencias da Saude de Alagoas, Maceio, Brazil (M.d.C.B.T.)
| | - Luiz C Bodanese
- From the Hypertension Unit, Heart Institute-InCor (E.M.K., L.F.D., D.M.A.G.), Hypertension Unit, Renal Division (L.F.D., D.M.), and Laboratory of Genetics and Molecular Medicine, Heart Institute-InCor (A.C.P., J.E.K.), University of Sao Paulo Medical School, Brazil; Division of Cardiology, Federal University of Sergipe, Brazil (J.A.S.B.-F.); Department of Clinical Research, Hospital Universitario Clementino Fraga Filho, Brazil (A.R.N.); Department of Physiological Sciences, Federal University of Espírito Santo, Brazil (J.G.M.); Division of Internal Medicine, Center for Clinical and Epidemiological Research, University Hospital (P.A.L.) and Ribeirao Preto Medical School (F.N.), University of Sao Paulo, Brazil; Department of Hypertension and Nephrology, Dante Pazzanese Institute of Cardiology, Sao Paulo, Brazil (C.A.); Division of Nephrology, Department of Medicine (M.C.B.) and Department of Cardiology (A.C.C.C.), Universidade Federal de São Paulo, Brazil; Pontificia Universidade Catolica do Rio Grande do Sul, Porto Alegre, Brazil (L.C.B.); Institute of Cardiology, University Cardiology Foundation, Porto Alegre, Brazil (I.C.); Department of Clinical Medicine, Federal University of Pernambuco, Recife, Brazil (H.C.); Department of Cardiology, Universidade Federal do Para, Belem, Brazil (E.A.S.C.); Escola Bahiana de Medicina e Saude Pública, Salvador, Brazil (G.S.F.); Division of Nephrology, Department of Internal Medicine, Botucatu Medical School, Sao Paulo State University, Brazil (R.J.S.F.); Division of Cardiology, Hospital de Clinicas de Porto Alegre, Federal University of Rio Grande do Sul, Brazil (F.D.F.); Federal University of Bahia, Salvador, Brazil (A.C.G.); Faculty of Medicine, Federal University of Goias, Goiânia, Brazil (P.C.J.); Department of Cardiology, School of Medicine, Federal University of Sao Paulo, Brazil (C.A.M.); Serviço de Cardiologia do Hospital Universitario Pedro Ernesto da Universidade do Estado do Rio de Janeiro, Brazil (M.E.M.); Department of Medicine, Ouro Preto Federal University, Brazil (R.M.N.); Hospital Universitario Antonio Pedro, Universidade Federal Fluminense, Rio de Janeiro, Brazil (A.C.N.); Department of Internal Medicine, Federal University of Minas Gerais, Belo Horizonte, Brazil (A.L.P.R.); Department of Cardiology, Federal University of Ceara, Fortaleza, Brazil (C.R.-S.); Discipline of Clinical and Experimental Pathophysiology, Rio de Janeiro State University, Brazil (A.F.S.); and Universidade Estadual de Ciencias da Saude de Alagoas, Maceio, Brazil (M.d.C.B.T.)
| | - Antônio C C Carvalho
- From the Hypertension Unit, Heart Institute-InCor (E.M.K., L.F.D., D.M.A.G.), Hypertension Unit, Renal Division (L.F.D., D.M.), and Laboratory of Genetics and Molecular Medicine, Heart Institute-InCor (A.C.P., J.E.K.), University of Sao Paulo Medical School, Brazil; Division of Cardiology, Federal University of Sergipe, Brazil (J.A.S.B.-F.); Department of Clinical Research, Hospital Universitario Clementino Fraga Filho, Brazil (A.R.N.); Department of Physiological Sciences, Federal University of Espírito Santo, Brazil (J.G.M.); Division of Internal Medicine, Center for Clinical and Epidemiological Research, University Hospital (P.A.L.) and Ribeirao Preto Medical School (F.N.), University of Sao Paulo, Brazil; Department of Hypertension and Nephrology, Dante Pazzanese Institute of Cardiology, Sao Paulo, Brazil (C.A.); Division of Nephrology, Department of Medicine (M.C.B.) and Department of Cardiology (A.C.C.C.), Universidade Federal de São Paulo, Brazil; Pontificia Universidade Catolica do Rio Grande do Sul, Porto Alegre, Brazil (L.C.B.); Institute of Cardiology, University Cardiology Foundation, Porto Alegre, Brazil (I.C.); Department of Clinical Medicine, Federal University of Pernambuco, Recife, Brazil (H.C.); Department of Cardiology, Universidade Federal do Para, Belem, Brazil (E.A.S.C.); Escola Bahiana de Medicina e Saude Pública, Salvador, Brazil (G.S.F.); Division of Nephrology, Department of Internal Medicine, Botucatu Medical School, Sao Paulo State University, Brazil (R.J.S.F.); Division of Cardiology, Hospital de Clinicas de Porto Alegre, Federal University of Rio Grande do Sul, Brazil (F.D.F.); Federal University of Bahia, Salvador, Brazil (A.C.G.); Faculty of Medicine, Federal University of Goias, Goiânia, Brazil (P.C.J.); Department of Cardiology, School of Medicine, Federal University of Sao Paulo, Brazil (C.A.M.); Serviço de Cardiologia do Hospital Universitario Pedro Ernesto da Universidade do Estado do Rio de Janeiro, Brazil (M.E.M.); Department of Medicine, Ouro Preto Federal University, Brazil (R.M.N.); Hospital Universitario Antonio Pedro, Universidade Federal Fluminense, Rio de Janeiro, Brazil (A.C.N.); Department of Internal Medicine, Federal University of Minas Gerais, Belo Horizonte, Brazil (A.L.P.R.); Department of Cardiology, Federal University of Ceara, Fortaleza, Brazil (C.R.-S.); Discipline of Clinical and Experimental Pathophysiology, Rio de Janeiro State University, Brazil (A.F.S.); and Universidade Estadual de Ciencias da Saude de Alagoas, Maceio, Brazil (M.d.C.B.T.)
| | - Iran Castro
- From the Hypertension Unit, Heart Institute-InCor (E.M.K., L.F.D., D.M.A.G.), Hypertension Unit, Renal Division (L.F.D., D.M.), and Laboratory of Genetics and Molecular Medicine, Heart Institute-InCor (A.C.P., J.E.K.), University of Sao Paulo Medical School, Brazil; Division of Cardiology, Federal University of Sergipe, Brazil (J.A.S.B.-F.); Department of Clinical Research, Hospital Universitario Clementino Fraga Filho, Brazil (A.R.N.); Department of Physiological Sciences, Federal University of Espírito Santo, Brazil (J.G.M.); Division of Internal Medicine, Center for Clinical and Epidemiological Research, University Hospital (P.A.L.) and Ribeirao Preto Medical School (F.N.), University of Sao Paulo, Brazil; Department of Hypertension and Nephrology, Dante Pazzanese Institute of Cardiology, Sao Paulo, Brazil (C.A.); Division of Nephrology, Department of Medicine (M.C.B.) and Department of Cardiology (A.C.C.C.), Universidade Federal de São Paulo, Brazil; Pontificia Universidade Catolica do Rio Grande do Sul, Porto Alegre, Brazil (L.C.B.); Institute of Cardiology, University Cardiology Foundation, Porto Alegre, Brazil (I.C.); Department of Clinical Medicine, Federal University of Pernambuco, Recife, Brazil (H.C.); Department of Cardiology, Universidade Federal do Para, Belem, Brazil (E.A.S.C.); Escola Bahiana de Medicina e Saude Pública, Salvador, Brazil (G.S.F.); Division of Nephrology, Department of Internal Medicine, Botucatu Medical School, Sao Paulo State University, Brazil (R.J.S.F.); Division of Cardiology, Hospital de Clinicas de Porto Alegre, Federal University of Rio Grande do Sul, Brazil (F.D.F.); Federal University of Bahia, Salvador, Brazil (A.C.G.); Faculty of Medicine, Federal University of Goias, Goiânia, Brazil (P.C.J.); Department of Cardiology, School of Medicine, Federal University of Sao Paulo, Brazil (C.A.M.); Serviço de Cardiologia do Hospital Universitario Pedro Ernesto da Universidade do Estado do Rio de Janeiro, Brazil (M.E.M.); Department of Medicine, Ouro Preto Federal University, Brazil (R.M.N.); Hospital Universitario Antonio Pedro, Universidade Federal Fluminense, Rio de Janeiro, Brazil (A.C.N.); Department of Internal Medicine, Federal University of Minas Gerais, Belo Horizonte, Brazil (A.L.P.R.); Department of Cardiology, Federal University of Ceara, Fortaleza, Brazil (C.R.-S.); Discipline of Clinical and Experimental Pathophysiology, Rio de Janeiro State University, Brazil (A.F.S.); and Universidade Estadual de Ciencias da Saude de Alagoas, Maceio, Brazil (M.d.C.B.T.)
| | - Hilton Chaves
- From the Hypertension Unit, Heart Institute-InCor (E.M.K., L.F.D., D.M.A.G.), Hypertension Unit, Renal Division (L.F.D., D.M.), and Laboratory of Genetics and Molecular Medicine, Heart Institute-InCor (A.C.P., J.E.K.), University of Sao Paulo Medical School, Brazil; Division of Cardiology, Federal University of Sergipe, Brazil (J.A.S.B.-F.); Department of Clinical Research, Hospital Universitario Clementino Fraga Filho, Brazil (A.R.N.); Department of Physiological Sciences, Federal University of Espírito Santo, Brazil (J.G.M.); Division of Internal Medicine, Center for Clinical and Epidemiological Research, University Hospital (P.A.L.) and Ribeirao Preto Medical School (F.N.), University of Sao Paulo, Brazil; Department of Hypertension and Nephrology, Dante Pazzanese Institute of Cardiology, Sao Paulo, Brazil (C.A.); Division of Nephrology, Department of Medicine (M.C.B.) and Department of Cardiology (A.C.C.C.), Universidade Federal de São Paulo, Brazil; Pontificia Universidade Catolica do Rio Grande do Sul, Porto Alegre, Brazil (L.C.B.); Institute of Cardiology, University Cardiology Foundation, Porto Alegre, Brazil (I.C.); Department of Clinical Medicine, Federal University of Pernambuco, Recife, Brazil (H.C.); Department of Cardiology, Universidade Federal do Para, Belem, Brazil (E.A.S.C.); Escola Bahiana de Medicina e Saude Pública, Salvador, Brazil (G.S.F.); Division of Nephrology, Department of Internal Medicine, Botucatu Medical School, Sao Paulo State University, Brazil (R.J.S.F.); Division of Cardiology, Hospital de Clinicas de Porto Alegre, Federal University of Rio Grande do Sul, Brazil (F.D.F.); Federal University of Bahia, Salvador, Brazil (A.C.G.); Faculty of Medicine, Federal University of Goias, Goiânia, Brazil (P.C.J.); Department of Cardiology, School of Medicine, Federal University of Sao Paulo, Brazil (C.A.M.); Serviço de Cardiologia do Hospital Universitario Pedro Ernesto da Universidade do Estado do Rio de Janeiro, Brazil (M.E.M.); Department of Medicine, Ouro Preto Federal University, Brazil (R.M.N.); Hospital Universitario Antonio Pedro, Universidade Federal Fluminense, Rio de Janeiro, Brazil (A.C.N.); Department of Internal Medicine, Federal University of Minas Gerais, Belo Horizonte, Brazil (A.L.P.R.); Department of Cardiology, Federal University of Ceara, Fortaleza, Brazil (C.R.-S.); Discipline of Clinical and Experimental Pathophysiology, Rio de Janeiro State University, Brazil (A.F.S.); and Universidade Estadual de Ciencias da Saude de Alagoas, Maceio, Brazil (M.d.C.B.T.)
| | - Eduardo A S Costa
- From the Hypertension Unit, Heart Institute-InCor (E.M.K., L.F.D., D.M.A.G.), Hypertension Unit, Renal Division (L.F.D., D.M.), and Laboratory of Genetics and Molecular Medicine, Heart Institute-InCor (A.C.P., J.E.K.), University of Sao Paulo Medical School, Brazil; Division of Cardiology, Federal University of Sergipe, Brazil (J.A.S.B.-F.); Department of Clinical Research, Hospital Universitario Clementino Fraga Filho, Brazil (A.R.N.); Department of Physiological Sciences, Federal University of Espírito Santo, Brazil (J.G.M.); Division of Internal Medicine, Center for Clinical and Epidemiological Research, University Hospital (P.A.L.) and Ribeirao Preto Medical School (F.N.), University of Sao Paulo, Brazil; Department of Hypertension and Nephrology, Dante Pazzanese Institute of Cardiology, Sao Paulo, Brazil (C.A.); Division of Nephrology, Department of Medicine (M.C.B.) and Department of Cardiology (A.C.C.C.), Universidade Federal de São Paulo, Brazil; Pontificia Universidade Catolica do Rio Grande do Sul, Porto Alegre, Brazil (L.C.B.); Institute of Cardiology, University Cardiology Foundation, Porto Alegre, Brazil (I.C.); Department of Clinical Medicine, Federal University of Pernambuco, Recife, Brazil (H.C.); Department of Cardiology, Universidade Federal do Para, Belem, Brazil (E.A.S.C.); Escola Bahiana de Medicina e Saude Pública, Salvador, Brazil (G.S.F.); Division of Nephrology, Department of Internal Medicine, Botucatu Medical School, Sao Paulo State University, Brazil (R.J.S.F.); Division of Cardiology, Hospital de Clinicas de Porto Alegre, Federal University of Rio Grande do Sul, Brazil (F.D.F.); Federal University of Bahia, Salvador, Brazil (A.C.G.); Faculty of Medicine, Federal University of Goias, Goiânia, Brazil (P.C.J.); Department of Cardiology, School of Medicine, Federal University of Sao Paulo, Brazil (C.A.M.); Serviço de Cardiologia do Hospital Universitario Pedro Ernesto da Universidade do Estado do Rio de Janeiro, Brazil (M.E.M.); Department of Medicine, Ouro Preto Federal University, Brazil (R.M.N.); Hospital Universitario Antonio Pedro, Universidade Federal Fluminense, Rio de Janeiro, Brazil (A.C.N.); Department of Internal Medicine, Federal University of Minas Gerais, Belo Horizonte, Brazil (A.L.P.R.); Department of Cardiology, Federal University of Ceara, Fortaleza, Brazil (C.R.-S.); Discipline of Clinical and Experimental Pathophysiology, Rio de Janeiro State University, Brazil (A.F.S.); and Universidade Estadual de Ciencias da Saude de Alagoas, Maceio, Brazil (M.d.C.B.T.)
| | - Gilson S Feitosa
- From the Hypertension Unit, Heart Institute-InCor (E.M.K., L.F.D., D.M.A.G.), Hypertension Unit, Renal Division (L.F.D., D.M.), and Laboratory of Genetics and Molecular Medicine, Heart Institute-InCor (A.C.P., J.E.K.), University of Sao Paulo Medical School, Brazil; Division of Cardiology, Federal University of Sergipe, Brazil (J.A.S.B.-F.); Department of Clinical Research, Hospital Universitario Clementino Fraga Filho, Brazil (A.R.N.); Department of Physiological Sciences, Federal University of Espírito Santo, Brazil (J.G.M.); Division of Internal Medicine, Center for Clinical and Epidemiological Research, University Hospital (P.A.L.) and Ribeirao Preto Medical School (F.N.), University of Sao Paulo, Brazil; Department of Hypertension and Nephrology, Dante Pazzanese Institute of Cardiology, Sao Paulo, Brazil (C.A.); Division of Nephrology, Department of Medicine (M.C.B.) and Department of Cardiology (A.C.C.C.), Universidade Federal de São Paulo, Brazil; Pontificia Universidade Catolica do Rio Grande do Sul, Porto Alegre, Brazil (L.C.B.); Institute of Cardiology, University Cardiology Foundation, Porto Alegre, Brazil (I.C.); Department of Clinical Medicine, Federal University of Pernambuco, Recife, Brazil (H.C.); Department of Cardiology, Universidade Federal do Para, Belem, Brazil (E.A.S.C.); Escola Bahiana de Medicina e Saude Pública, Salvador, Brazil (G.S.F.); Division of Nephrology, Department of Internal Medicine, Botucatu Medical School, Sao Paulo State University, Brazil (R.J.S.F.); Division of Cardiology, Hospital de Clinicas de Porto Alegre, Federal University of Rio Grande do Sul, Brazil (F.D.F.); Federal University of Bahia, Salvador, Brazil (A.C.G.); Faculty of Medicine, Federal University of Goias, Goiânia, Brazil (P.C.J.); Department of Cardiology, School of Medicine, Federal University of Sao Paulo, Brazil (C.A.M.); Serviço de Cardiologia do Hospital Universitario Pedro Ernesto da Universidade do Estado do Rio de Janeiro, Brazil (M.E.M.); Department of Medicine, Ouro Preto Federal University, Brazil (R.M.N.); Hospital Universitario Antonio Pedro, Universidade Federal Fluminense, Rio de Janeiro, Brazil (A.C.N.); Department of Internal Medicine, Federal University of Minas Gerais, Belo Horizonte, Brazil (A.L.P.R.); Department of Cardiology, Federal University of Ceara, Fortaleza, Brazil (C.R.-S.); Discipline of Clinical and Experimental Pathophysiology, Rio de Janeiro State University, Brazil (A.F.S.); and Universidade Estadual de Ciencias da Saude de Alagoas, Maceio, Brazil (M.d.C.B.T.)
| | - Roberto J S Franco
- From the Hypertension Unit, Heart Institute-InCor (E.M.K., L.F.D., D.M.A.G.), Hypertension Unit, Renal Division (L.F.D., D.M.), and Laboratory of Genetics and Molecular Medicine, Heart Institute-InCor (A.C.P., J.E.K.), University of Sao Paulo Medical School, Brazil; Division of Cardiology, Federal University of Sergipe, Brazil (J.A.S.B.-F.); Department of Clinical Research, Hospital Universitario Clementino Fraga Filho, Brazil (A.R.N.); Department of Physiological Sciences, Federal University of Espírito Santo, Brazil (J.G.M.); Division of Internal Medicine, Center for Clinical and Epidemiological Research, University Hospital (P.A.L.) and Ribeirao Preto Medical School (F.N.), University of Sao Paulo, Brazil; Department of Hypertension and Nephrology, Dante Pazzanese Institute of Cardiology, Sao Paulo, Brazil (C.A.); Division of Nephrology, Department of Medicine (M.C.B.) and Department of Cardiology (A.C.C.C.), Universidade Federal de São Paulo, Brazil; Pontificia Universidade Catolica do Rio Grande do Sul, Porto Alegre, Brazil (L.C.B.); Institute of Cardiology, University Cardiology Foundation, Porto Alegre, Brazil (I.C.); Department of Clinical Medicine, Federal University of Pernambuco, Recife, Brazil (H.C.); Department of Cardiology, Universidade Federal do Para, Belem, Brazil (E.A.S.C.); Escola Bahiana de Medicina e Saude Pública, Salvador, Brazil (G.S.F.); Division of Nephrology, Department of Internal Medicine, Botucatu Medical School, Sao Paulo State University, Brazil (R.J.S.F.); Division of Cardiology, Hospital de Clinicas de Porto Alegre, Federal University of Rio Grande do Sul, Brazil (F.D.F.); Federal University of Bahia, Salvador, Brazil (A.C.G.); Faculty of Medicine, Federal University of Goias, Goiânia, Brazil (P.C.J.); Department of Cardiology, School of Medicine, Federal University of Sao Paulo, Brazil (C.A.M.); Serviço de Cardiologia do Hospital Universitario Pedro Ernesto da Universidade do Estado do Rio de Janeiro, Brazil (M.E.M.); Department of Medicine, Ouro Preto Federal University, Brazil (R.M.N.); Hospital Universitario Antonio Pedro, Universidade Federal Fluminense, Rio de Janeiro, Brazil (A.C.N.); Department of Internal Medicine, Federal University of Minas Gerais, Belo Horizonte, Brazil (A.L.P.R.); Department of Cardiology, Federal University of Ceara, Fortaleza, Brazil (C.R.-S.); Discipline of Clinical and Experimental Pathophysiology, Rio de Janeiro State University, Brazil (A.F.S.); and Universidade Estadual de Ciencias da Saude de Alagoas, Maceio, Brazil (M.d.C.B.T.)
| | - Flávio D Fuchs
- From the Hypertension Unit, Heart Institute-InCor (E.M.K., L.F.D., D.M.A.G.), Hypertension Unit, Renal Division (L.F.D., D.M.), and Laboratory of Genetics and Molecular Medicine, Heart Institute-InCor (A.C.P., J.E.K.), University of Sao Paulo Medical School, Brazil; Division of Cardiology, Federal University of Sergipe, Brazil (J.A.S.B.-F.); Department of Clinical Research, Hospital Universitario Clementino Fraga Filho, Brazil (A.R.N.); Department of Physiological Sciences, Federal University of Espírito Santo, Brazil (J.G.M.); Division of Internal Medicine, Center for Clinical and Epidemiological Research, University Hospital (P.A.L.) and Ribeirao Preto Medical School (F.N.), University of Sao Paulo, Brazil; Department of Hypertension and Nephrology, Dante Pazzanese Institute of Cardiology, Sao Paulo, Brazil (C.A.); Division of Nephrology, Department of Medicine (M.C.B.) and Department of Cardiology (A.C.C.C.), Universidade Federal de São Paulo, Brazil; Pontificia Universidade Catolica do Rio Grande do Sul, Porto Alegre, Brazil (L.C.B.); Institute of Cardiology, University Cardiology Foundation, Porto Alegre, Brazil (I.C.); Department of Clinical Medicine, Federal University of Pernambuco, Recife, Brazil (H.C.); Department of Cardiology, Universidade Federal do Para, Belem, Brazil (E.A.S.C.); Escola Bahiana de Medicina e Saude Pública, Salvador, Brazil (G.S.F.); Division of Nephrology, Department of Internal Medicine, Botucatu Medical School, Sao Paulo State University, Brazil (R.J.S.F.); Division of Cardiology, Hospital de Clinicas de Porto Alegre, Federal University of Rio Grande do Sul, Brazil (F.D.F.); Federal University of Bahia, Salvador, Brazil (A.C.G.); Faculty of Medicine, Federal University of Goias, Goiânia, Brazil (P.C.J.); Department of Cardiology, School of Medicine, Federal University of Sao Paulo, Brazil (C.A.M.); Serviço de Cardiologia do Hospital Universitario Pedro Ernesto da Universidade do Estado do Rio de Janeiro, Brazil (M.E.M.); Department of Medicine, Ouro Preto Federal University, Brazil (R.M.N.); Hospital Universitario Antonio Pedro, Universidade Federal Fluminense, Rio de Janeiro, Brazil (A.C.N.); Department of Internal Medicine, Federal University of Minas Gerais, Belo Horizonte, Brazil (A.L.P.R.); Department of Cardiology, Federal University of Ceara, Fortaleza, Brazil (C.R.-S.); Discipline of Clinical and Experimental Pathophysiology, Rio de Janeiro State University, Brazil (A.F.S.); and Universidade Estadual de Ciencias da Saude de Alagoas, Maceio, Brazil (M.d.C.B.T.)
| | - Armênio C Guimarães
- From the Hypertension Unit, Heart Institute-InCor (E.M.K., L.F.D., D.M.A.G.), Hypertension Unit, Renal Division (L.F.D., D.M.), and Laboratory of Genetics and Molecular Medicine, Heart Institute-InCor (A.C.P., J.E.K.), University of Sao Paulo Medical School, Brazil; Division of Cardiology, Federal University of Sergipe, Brazil (J.A.S.B.-F.); Department of Clinical Research, Hospital Universitario Clementino Fraga Filho, Brazil (A.R.N.); Department of Physiological Sciences, Federal University of Espírito Santo, Brazil (J.G.M.); Division of Internal Medicine, Center for Clinical and Epidemiological Research, University Hospital (P.A.L.) and Ribeirao Preto Medical School (F.N.), University of Sao Paulo, Brazil; Department of Hypertension and Nephrology, Dante Pazzanese Institute of Cardiology, Sao Paulo, Brazil (C.A.); Division of Nephrology, Department of Medicine (M.C.B.) and Department of Cardiology (A.C.C.C.), Universidade Federal de São Paulo, Brazil; Pontificia Universidade Catolica do Rio Grande do Sul, Porto Alegre, Brazil (L.C.B.); Institute of Cardiology, University Cardiology Foundation, Porto Alegre, Brazil (I.C.); Department of Clinical Medicine, Federal University of Pernambuco, Recife, Brazil (H.C.); Department of Cardiology, Universidade Federal do Para, Belem, Brazil (E.A.S.C.); Escola Bahiana de Medicina e Saude Pública, Salvador, Brazil (G.S.F.); Division of Nephrology, Department of Internal Medicine, Botucatu Medical School, Sao Paulo State University, Brazil (R.J.S.F.); Division of Cardiology, Hospital de Clinicas de Porto Alegre, Federal University of Rio Grande do Sul, Brazil (F.D.F.); Federal University of Bahia, Salvador, Brazil (A.C.G.); Faculty of Medicine, Federal University of Goias, Goiânia, Brazil (P.C.J.); Department of Cardiology, School of Medicine, Federal University of Sao Paulo, Brazil (C.A.M.); Serviço de Cardiologia do Hospital Universitario Pedro Ernesto da Universidade do Estado do Rio de Janeiro, Brazil (M.E.M.); Department of Medicine, Ouro Preto Federal University, Brazil (R.M.N.); Hospital Universitario Antonio Pedro, Universidade Federal Fluminense, Rio de Janeiro, Brazil (A.C.N.); Department of Internal Medicine, Federal University of Minas Gerais, Belo Horizonte, Brazil (A.L.P.R.); Department of Cardiology, Federal University of Ceara, Fortaleza, Brazil (C.R.-S.); Discipline of Clinical and Experimental Pathophysiology, Rio de Janeiro State University, Brazil (A.F.S.); and Universidade Estadual de Ciencias da Saude de Alagoas, Maceio, Brazil (M.d.C.B.T.)
| | - Paulo C Jardim
- From the Hypertension Unit, Heart Institute-InCor (E.M.K., L.F.D., D.M.A.G.), Hypertension Unit, Renal Division (L.F.D., D.M.), and Laboratory of Genetics and Molecular Medicine, Heart Institute-InCor (A.C.P., J.E.K.), University of Sao Paulo Medical School, Brazil; Division of Cardiology, Federal University of Sergipe, Brazil (J.A.S.B.-F.); Department of Clinical Research, Hospital Universitario Clementino Fraga Filho, Brazil (A.R.N.); Department of Physiological Sciences, Federal University of Espírito Santo, Brazil (J.G.M.); Division of Internal Medicine, Center for Clinical and Epidemiological Research, University Hospital (P.A.L.) and Ribeirao Preto Medical School (F.N.), University of Sao Paulo, Brazil; Department of Hypertension and Nephrology, Dante Pazzanese Institute of Cardiology, Sao Paulo, Brazil (C.A.); Division of Nephrology, Department of Medicine (M.C.B.) and Department of Cardiology (A.C.C.C.), Universidade Federal de São Paulo, Brazil; Pontificia Universidade Catolica do Rio Grande do Sul, Porto Alegre, Brazil (L.C.B.); Institute of Cardiology, University Cardiology Foundation, Porto Alegre, Brazil (I.C.); Department of Clinical Medicine, Federal University of Pernambuco, Recife, Brazil (H.C.); Department of Cardiology, Universidade Federal do Para, Belem, Brazil (E.A.S.C.); Escola Bahiana de Medicina e Saude Pública, Salvador, Brazil (G.S.F.); Division of Nephrology, Department of Internal Medicine, Botucatu Medical School, Sao Paulo State University, Brazil (R.J.S.F.); Division of Cardiology, Hospital de Clinicas de Porto Alegre, Federal University of Rio Grande do Sul, Brazil (F.D.F.); Federal University of Bahia, Salvador, Brazil (A.C.G.); Faculty of Medicine, Federal University of Goias, Goiânia, Brazil (P.C.J.); Department of Cardiology, School of Medicine, Federal University of Sao Paulo, Brazil (C.A.M.); Serviço de Cardiologia do Hospital Universitario Pedro Ernesto da Universidade do Estado do Rio de Janeiro, Brazil (M.E.M.); Department of Medicine, Ouro Preto Federal University, Brazil (R.M.N.); Hospital Universitario Antonio Pedro, Universidade Federal Fluminense, Rio de Janeiro, Brazil (A.C.N.); Department of Internal Medicine, Federal University of Minas Gerais, Belo Horizonte, Brazil (A.L.P.R.); Department of Cardiology, Federal University of Ceara, Fortaleza, Brazil (C.R.-S.); Discipline of Clinical and Experimental Pathophysiology, Rio de Janeiro State University, Brazil (A.F.S.); and Universidade Estadual de Ciencias da Saude de Alagoas, Maceio, Brazil (M.d.C.B.T.)
| | - Carlos A Machado
- From the Hypertension Unit, Heart Institute-InCor (E.M.K., L.F.D., D.M.A.G.), Hypertension Unit, Renal Division (L.F.D., D.M.), and Laboratory of Genetics and Molecular Medicine, Heart Institute-InCor (A.C.P., J.E.K.), University of Sao Paulo Medical School, Brazil; Division of Cardiology, Federal University of Sergipe, Brazil (J.A.S.B.-F.); Department of Clinical Research, Hospital Universitario Clementino Fraga Filho, Brazil (A.R.N.); Department of Physiological Sciences, Federal University of Espírito Santo, Brazil (J.G.M.); Division of Internal Medicine, Center for Clinical and Epidemiological Research, University Hospital (P.A.L.) and Ribeirao Preto Medical School (F.N.), University of Sao Paulo, Brazil; Department of Hypertension and Nephrology, Dante Pazzanese Institute of Cardiology, Sao Paulo, Brazil (C.A.); Division of Nephrology, Department of Medicine (M.C.B.) and Department of Cardiology (A.C.C.C.), Universidade Federal de São Paulo, Brazil; Pontificia Universidade Catolica do Rio Grande do Sul, Porto Alegre, Brazil (L.C.B.); Institute of Cardiology, University Cardiology Foundation, Porto Alegre, Brazil (I.C.); Department of Clinical Medicine, Federal University of Pernambuco, Recife, Brazil (H.C.); Department of Cardiology, Universidade Federal do Para, Belem, Brazil (E.A.S.C.); Escola Bahiana de Medicina e Saude Pública, Salvador, Brazil (G.S.F.); Division of Nephrology, Department of Internal Medicine, Botucatu Medical School, Sao Paulo State University, Brazil (R.J.S.F.); Division of Cardiology, Hospital de Clinicas de Porto Alegre, Federal University of Rio Grande do Sul, Brazil (F.D.F.); Federal University of Bahia, Salvador, Brazil (A.C.G.); Faculty of Medicine, Federal University of Goias, Goiânia, Brazil (P.C.J.); Department of Cardiology, School of Medicine, Federal University of Sao Paulo, Brazil (C.A.M.); Serviço de Cardiologia do Hospital Universitario Pedro Ernesto da Universidade do Estado do Rio de Janeiro, Brazil (M.E.M.); Department of Medicine, Ouro Preto Federal University, Brazil (R.M.N.); Hospital Universitario Antonio Pedro, Universidade Federal Fluminense, Rio de Janeiro, Brazil (A.C.N.); Department of Internal Medicine, Federal University of Minas Gerais, Belo Horizonte, Brazil (A.L.P.R.); Department of Cardiology, Federal University of Ceara, Fortaleza, Brazil (C.R.-S.); Discipline of Clinical and Experimental Pathophysiology, Rio de Janeiro State University, Brazil (A.F.S.); and Universidade Estadual de Ciencias da Saude de Alagoas, Maceio, Brazil (M.d.C.B.T.)
| | - Maria E Magalhães
- From the Hypertension Unit, Heart Institute-InCor (E.M.K., L.F.D., D.M.A.G.), Hypertension Unit, Renal Division (L.F.D., D.M.), and Laboratory of Genetics and Molecular Medicine, Heart Institute-InCor (A.C.P., J.E.K.), University of Sao Paulo Medical School, Brazil; Division of Cardiology, Federal University of Sergipe, Brazil (J.A.S.B.-F.); Department of Clinical Research, Hospital Universitario Clementino Fraga Filho, Brazil (A.R.N.); Department of Physiological Sciences, Federal University of Espírito Santo, Brazil (J.G.M.); Division of Internal Medicine, Center for Clinical and Epidemiological Research, University Hospital (P.A.L.) and Ribeirao Preto Medical School (F.N.), University of Sao Paulo, Brazil; Department of Hypertension and Nephrology, Dante Pazzanese Institute of Cardiology, Sao Paulo, Brazil (C.A.); Division of Nephrology, Department of Medicine (M.C.B.) and Department of Cardiology (A.C.C.C.), Universidade Federal de São Paulo, Brazil; Pontificia Universidade Catolica do Rio Grande do Sul, Porto Alegre, Brazil (L.C.B.); Institute of Cardiology, University Cardiology Foundation, Porto Alegre, Brazil (I.C.); Department of Clinical Medicine, Federal University of Pernambuco, Recife, Brazil (H.C.); Department of Cardiology, Universidade Federal do Para, Belem, Brazil (E.A.S.C.); Escola Bahiana de Medicina e Saude Pública, Salvador, Brazil (G.S.F.); Division of Nephrology, Department of Internal Medicine, Botucatu Medical School, Sao Paulo State University, Brazil (R.J.S.F.); Division of Cardiology, Hospital de Clinicas de Porto Alegre, Federal University of Rio Grande do Sul, Brazil (F.D.F.); Federal University of Bahia, Salvador, Brazil (A.C.G.); Faculty of Medicine, Federal University of Goias, Goiânia, Brazil (P.C.J.); Department of Cardiology, School of Medicine, Federal University of Sao Paulo, Brazil (C.A.M.); Serviço de Cardiologia do Hospital Universitario Pedro Ernesto da Universidade do Estado do Rio de Janeiro, Brazil (M.E.M.); Department of Medicine, Ouro Preto Federal University, Brazil (R.M.N.); Hospital Universitario Antonio Pedro, Universidade Federal Fluminense, Rio de Janeiro, Brazil (A.C.N.); Department of Internal Medicine, Federal University of Minas Gerais, Belo Horizonte, Brazil (A.L.P.R.); Department of Cardiology, Federal University of Ceara, Fortaleza, Brazil (C.R.-S.); Discipline of Clinical and Experimental Pathophysiology, Rio de Janeiro State University, Brazil (A.F.S.); and Universidade Estadual de Ciencias da Saude de Alagoas, Maceio, Brazil (M.d.C.B.T.)
| | - Décio Mion
- From the Hypertension Unit, Heart Institute-InCor (E.M.K., L.F.D., D.M.A.G.), Hypertension Unit, Renal Division (L.F.D., D.M.), and Laboratory of Genetics and Molecular Medicine, Heart Institute-InCor (A.C.P., J.E.K.), University of Sao Paulo Medical School, Brazil; Division of Cardiology, Federal University of Sergipe, Brazil (J.A.S.B.-F.); Department of Clinical Research, Hospital Universitario Clementino Fraga Filho, Brazil (A.R.N.); Department of Physiological Sciences, Federal University of Espírito Santo, Brazil (J.G.M.); Division of Internal Medicine, Center for Clinical and Epidemiological Research, University Hospital (P.A.L.) and Ribeirao Preto Medical School (F.N.), University of Sao Paulo, Brazil; Department of Hypertension and Nephrology, Dante Pazzanese Institute of Cardiology, Sao Paulo, Brazil (C.A.); Division of Nephrology, Department of Medicine (M.C.B.) and Department of Cardiology (A.C.C.C.), Universidade Federal de São Paulo, Brazil; Pontificia Universidade Catolica do Rio Grande do Sul, Porto Alegre, Brazil (L.C.B.); Institute of Cardiology, University Cardiology Foundation, Porto Alegre, Brazil (I.C.); Department of Clinical Medicine, Federal University of Pernambuco, Recife, Brazil (H.C.); Department of Cardiology, Universidade Federal do Para, Belem, Brazil (E.A.S.C.); Escola Bahiana de Medicina e Saude Pública, Salvador, Brazil (G.S.F.); Division of Nephrology, Department of Internal Medicine, Botucatu Medical School, Sao Paulo State University, Brazil (R.J.S.F.); Division of Cardiology, Hospital de Clinicas de Porto Alegre, Federal University of Rio Grande do Sul, Brazil (F.D.F.); Federal University of Bahia, Salvador, Brazil (A.C.G.); Faculty of Medicine, Federal University of Goias, Goiânia, Brazil (P.C.J.); Department of Cardiology, School of Medicine, Federal University of Sao Paulo, Brazil (C.A.M.); Serviço de Cardiologia do Hospital Universitario Pedro Ernesto da Universidade do Estado do Rio de Janeiro, Brazil (M.E.M.); Department of Medicine, Ouro Preto Federal University, Brazil (R.M.N.); Hospital Universitario Antonio Pedro, Universidade Federal Fluminense, Rio de Janeiro, Brazil (A.C.N.); Department of Internal Medicine, Federal University of Minas Gerais, Belo Horizonte, Brazil (A.L.P.R.); Department of Cardiology, Federal University of Ceara, Fortaleza, Brazil (C.R.-S.); Discipline of Clinical and Experimental Pathophysiology, Rio de Janeiro State University, Brazil (A.F.S.); and Universidade Estadual de Ciencias da Saude de Alagoas, Maceio, Brazil (M.d.C.B.T.)
| | - Raimundo M Nascimento
- From the Hypertension Unit, Heart Institute-InCor (E.M.K., L.F.D., D.M.A.G.), Hypertension Unit, Renal Division (L.F.D., D.M.), and Laboratory of Genetics and Molecular Medicine, Heart Institute-InCor (A.C.P., J.E.K.), University of Sao Paulo Medical School, Brazil; Division of Cardiology, Federal University of Sergipe, Brazil (J.A.S.B.-F.); Department of Clinical Research, Hospital Universitario Clementino Fraga Filho, Brazil (A.R.N.); Department of Physiological Sciences, Federal University of Espírito Santo, Brazil (J.G.M.); Division of Internal Medicine, Center for Clinical and Epidemiological Research, University Hospital (P.A.L.) and Ribeirao Preto Medical School (F.N.), University of Sao Paulo, Brazil; Department of Hypertension and Nephrology, Dante Pazzanese Institute of Cardiology, Sao Paulo, Brazil (C.A.); Division of Nephrology, Department of Medicine (M.C.B.) and Department of Cardiology (A.C.C.C.), Universidade Federal de São Paulo, Brazil; Pontificia Universidade Catolica do Rio Grande do Sul, Porto Alegre, Brazil (L.C.B.); Institute of Cardiology, University Cardiology Foundation, Porto Alegre, Brazil (I.C.); Department of Clinical Medicine, Federal University of Pernambuco, Recife, Brazil (H.C.); Department of Cardiology, Universidade Federal do Para, Belem, Brazil (E.A.S.C.); Escola Bahiana de Medicina e Saude Pública, Salvador, Brazil (G.S.F.); Division of Nephrology, Department of Internal Medicine, Botucatu Medical School, Sao Paulo State University, Brazil (R.J.S.F.); Division of Cardiology, Hospital de Clinicas de Porto Alegre, Federal University of Rio Grande do Sul, Brazil (F.D.F.); Federal University of Bahia, Salvador, Brazil (A.C.G.); Faculty of Medicine, Federal University of Goias, Goiânia, Brazil (P.C.J.); Department of Cardiology, School of Medicine, Federal University of Sao Paulo, Brazil (C.A.M.); Serviço de Cardiologia do Hospital Universitario Pedro Ernesto da Universidade do Estado do Rio de Janeiro, Brazil (M.E.M.); Department of Medicine, Ouro Preto Federal University, Brazil (R.M.N.); Hospital Universitario Antonio Pedro, Universidade Federal Fluminense, Rio de Janeiro, Brazil (A.C.N.); Department of Internal Medicine, Federal University of Minas Gerais, Belo Horizonte, Brazil (A.L.P.R.); Department of Cardiology, Federal University of Ceara, Fortaleza, Brazil (C.R.-S.); Discipline of Clinical and Experimental Pathophysiology, Rio de Janeiro State University, Brazil (A.F.S.); and Universidade Estadual de Ciencias da Saude de Alagoas, Maceio, Brazil (M.d.C.B.T.)
| | - Fernando Nobre
- From the Hypertension Unit, Heart Institute-InCor (E.M.K., L.F.D., D.M.A.G.), Hypertension Unit, Renal Division (L.F.D., D.M.), and Laboratory of Genetics and Molecular Medicine, Heart Institute-InCor (A.C.P., J.E.K.), University of Sao Paulo Medical School, Brazil; Division of Cardiology, Federal University of Sergipe, Brazil (J.A.S.B.-F.); Department of Clinical Research, Hospital Universitario Clementino Fraga Filho, Brazil (A.R.N.); Department of Physiological Sciences, Federal University of Espírito Santo, Brazil (J.G.M.); Division of Internal Medicine, Center for Clinical and Epidemiological Research, University Hospital (P.A.L.) and Ribeirao Preto Medical School (F.N.), University of Sao Paulo, Brazil; Department of Hypertension and Nephrology, Dante Pazzanese Institute of Cardiology, Sao Paulo, Brazil (C.A.); Division of Nephrology, Department of Medicine (M.C.B.) and Department of Cardiology (A.C.C.C.), Universidade Federal de São Paulo, Brazil; Pontificia Universidade Catolica do Rio Grande do Sul, Porto Alegre, Brazil (L.C.B.); Institute of Cardiology, University Cardiology Foundation, Porto Alegre, Brazil (I.C.); Department of Clinical Medicine, Federal University of Pernambuco, Recife, Brazil (H.C.); Department of Cardiology, Universidade Federal do Para, Belem, Brazil (E.A.S.C.); Escola Bahiana de Medicina e Saude Pública, Salvador, Brazil (G.S.F.); Division of Nephrology, Department of Internal Medicine, Botucatu Medical School, Sao Paulo State University, Brazil (R.J.S.F.); Division of Cardiology, Hospital de Clinicas de Porto Alegre, Federal University of Rio Grande do Sul, Brazil (F.D.F.); Federal University of Bahia, Salvador, Brazil (A.C.G.); Faculty of Medicine, Federal University of Goias, Goiânia, Brazil (P.C.J.); Department of Cardiology, School of Medicine, Federal University of Sao Paulo, Brazil (C.A.M.); Serviço de Cardiologia do Hospital Universitario Pedro Ernesto da Universidade do Estado do Rio de Janeiro, Brazil (M.E.M.); Department of Medicine, Ouro Preto Federal University, Brazil (R.M.N.); Hospital Universitario Antonio Pedro, Universidade Federal Fluminense, Rio de Janeiro, Brazil (A.C.N.); Department of Internal Medicine, Federal University of Minas Gerais, Belo Horizonte, Brazil (A.L.P.R.); Department of Cardiology, Federal University of Ceara, Fortaleza, Brazil (C.R.-S.); Discipline of Clinical and Experimental Pathophysiology, Rio de Janeiro State University, Brazil (A.F.S.); and Universidade Estadual de Ciencias da Saude de Alagoas, Maceio, Brazil (M.d.C.B.T.)
| | - Antônio C Nóbrega
- From the Hypertension Unit, Heart Institute-InCor (E.M.K., L.F.D., D.M.A.G.), Hypertension Unit, Renal Division (L.F.D., D.M.), and Laboratory of Genetics and Molecular Medicine, Heart Institute-InCor (A.C.P., J.E.K.), University of Sao Paulo Medical School, Brazil; Division of Cardiology, Federal University of Sergipe, Brazil (J.A.S.B.-F.); Department of Clinical Research, Hospital Universitario Clementino Fraga Filho, Brazil (A.R.N.); Department of Physiological Sciences, Federal University of Espírito Santo, Brazil (J.G.M.); Division of Internal Medicine, Center for Clinical and Epidemiological Research, University Hospital (P.A.L.) and Ribeirao Preto Medical School (F.N.), University of Sao Paulo, Brazil; Department of Hypertension and Nephrology, Dante Pazzanese Institute of Cardiology, Sao Paulo, Brazil (C.A.); Division of Nephrology, Department of Medicine (M.C.B.) and Department of Cardiology (A.C.C.C.), Universidade Federal de São Paulo, Brazil; Pontificia Universidade Catolica do Rio Grande do Sul, Porto Alegre, Brazil (L.C.B.); Institute of Cardiology, University Cardiology Foundation, Porto Alegre, Brazil (I.C.); Department of Clinical Medicine, Federal University of Pernambuco, Recife, Brazil (H.C.); Department of Cardiology, Universidade Federal do Para, Belem, Brazil (E.A.S.C.); Escola Bahiana de Medicina e Saude Pública, Salvador, Brazil (G.S.F.); Division of Nephrology, Department of Internal Medicine, Botucatu Medical School, Sao Paulo State University, Brazil (R.J.S.F.); Division of Cardiology, Hospital de Clinicas de Porto Alegre, Federal University of Rio Grande do Sul, Brazil (F.D.F.); Federal University of Bahia, Salvador, Brazil (A.C.G.); Faculty of Medicine, Federal University of Goias, Goiânia, Brazil (P.C.J.); Department of Cardiology, School of Medicine, Federal University of Sao Paulo, Brazil (C.A.M.); Serviço de Cardiologia do Hospital Universitario Pedro Ernesto da Universidade do Estado do Rio de Janeiro, Brazil (M.E.M.); Department of Medicine, Ouro Preto Federal University, Brazil (R.M.N.); Hospital Universitario Antonio Pedro, Universidade Federal Fluminense, Rio de Janeiro, Brazil (A.C.N.); Department of Internal Medicine, Federal University of Minas Gerais, Belo Horizonte, Brazil (A.L.P.R.); Department of Cardiology, Federal University of Ceara, Fortaleza, Brazil (C.R.-S.); Discipline of Clinical and Experimental Pathophysiology, Rio de Janeiro State University, Brazil (A.F.S.); and Universidade Estadual de Ciencias da Saude de Alagoas, Maceio, Brazil (M.d.C.B.T.)
| | - Antônio L P Ribeiro
- From the Hypertension Unit, Heart Institute-InCor (E.M.K., L.F.D., D.M.A.G.), Hypertension Unit, Renal Division (L.F.D., D.M.), and Laboratory of Genetics and Molecular Medicine, Heart Institute-InCor (A.C.P., J.E.K.), University of Sao Paulo Medical School, Brazil; Division of Cardiology, Federal University of Sergipe, Brazil (J.A.S.B.-F.); Department of Clinical Research, Hospital Universitario Clementino Fraga Filho, Brazil (A.R.N.); Department of Physiological Sciences, Federal University of Espírito Santo, Brazil (J.G.M.); Division of Internal Medicine, Center for Clinical and Epidemiological Research, University Hospital (P.A.L.) and Ribeirao Preto Medical School (F.N.), University of Sao Paulo, Brazil; Department of Hypertension and Nephrology, Dante Pazzanese Institute of Cardiology, Sao Paulo, Brazil (C.A.); Division of Nephrology, Department of Medicine (M.C.B.) and Department of Cardiology (A.C.C.C.), Universidade Federal de São Paulo, Brazil; Pontificia Universidade Catolica do Rio Grande do Sul, Porto Alegre, Brazil (L.C.B.); Institute of Cardiology, University Cardiology Foundation, Porto Alegre, Brazil (I.C.); Department of Clinical Medicine, Federal University of Pernambuco, Recife, Brazil (H.C.); Department of Cardiology, Universidade Federal do Para, Belem, Brazil (E.A.S.C.); Escola Bahiana de Medicina e Saude Pública, Salvador, Brazil (G.S.F.); Division of Nephrology, Department of Internal Medicine, Botucatu Medical School, Sao Paulo State University, Brazil (R.J.S.F.); Division of Cardiology, Hospital de Clinicas de Porto Alegre, Federal University of Rio Grande do Sul, Brazil (F.D.F.); Federal University of Bahia, Salvador, Brazil (A.C.G.); Faculty of Medicine, Federal University of Goias, Goiânia, Brazil (P.C.J.); Department of Cardiology, School of Medicine, Federal University of Sao Paulo, Brazil (C.A.M.); Serviço de Cardiologia do Hospital Universitario Pedro Ernesto da Universidade do Estado do Rio de Janeiro, Brazil (M.E.M.); Department of Medicine, Ouro Preto Federal University, Brazil (R.M.N.); Hospital Universitario Antonio Pedro, Universidade Federal Fluminense, Rio de Janeiro, Brazil (A.C.N.); Department of Internal Medicine, Federal University of Minas Gerais, Belo Horizonte, Brazil (A.L.P.R.); Department of Cardiology, Federal University of Ceara, Fortaleza, Brazil (C.R.-S.); Discipline of Clinical and Experimental Pathophysiology, Rio de Janeiro State University, Brazil (A.F.S.); and Universidade Estadual de Ciencias da Saude de Alagoas, Maceio, Brazil (M.d.C.B.T.)
| | - Carlos R Rodrigues-Sobrinho
- From the Hypertension Unit, Heart Institute-InCor (E.M.K., L.F.D., D.M.A.G.), Hypertension Unit, Renal Division (L.F.D., D.M.), and Laboratory of Genetics and Molecular Medicine, Heart Institute-InCor (A.C.P., J.E.K.), University of Sao Paulo Medical School, Brazil; Division of Cardiology, Federal University of Sergipe, Brazil (J.A.S.B.-F.); Department of Clinical Research, Hospital Universitario Clementino Fraga Filho, Brazil (A.R.N.); Department of Physiological Sciences, Federal University of Espírito Santo, Brazil (J.G.M.); Division of Internal Medicine, Center for Clinical and Epidemiological Research, University Hospital (P.A.L.) and Ribeirao Preto Medical School (F.N.), University of Sao Paulo, Brazil; Department of Hypertension and Nephrology, Dante Pazzanese Institute of Cardiology, Sao Paulo, Brazil (C.A.); Division of Nephrology, Department of Medicine (M.C.B.) and Department of Cardiology (A.C.C.C.), Universidade Federal de São Paulo, Brazil; Pontificia Universidade Catolica do Rio Grande do Sul, Porto Alegre, Brazil (L.C.B.); Institute of Cardiology, University Cardiology Foundation, Porto Alegre, Brazil (I.C.); Department of Clinical Medicine, Federal University of Pernambuco, Recife, Brazil (H.C.); Department of Cardiology, Universidade Federal do Para, Belem, Brazil (E.A.S.C.); Escola Bahiana de Medicina e Saude Pública, Salvador, Brazil (G.S.F.); Division of Nephrology, Department of Internal Medicine, Botucatu Medical School, Sao Paulo State University, Brazil (R.J.S.F.); Division of Cardiology, Hospital de Clinicas de Porto Alegre, Federal University of Rio Grande do Sul, Brazil (F.D.F.); Federal University of Bahia, Salvador, Brazil (A.C.G.); Faculty of Medicine, Federal University of Goias, Goiânia, Brazil (P.C.J.); Department of Cardiology, School of Medicine, Federal University of Sao Paulo, Brazil (C.A.M.); Serviço de Cardiologia do Hospital Universitario Pedro Ernesto da Universidade do Estado do Rio de Janeiro, Brazil (M.E.M.); Department of Medicine, Ouro Preto Federal University, Brazil (R.M.N.); Hospital Universitario Antonio Pedro, Universidade Federal Fluminense, Rio de Janeiro, Brazil (A.C.N.); Department of Internal Medicine, Federal University of Minas Gerais, Belo Horizonte, Brazil (A.L.P.R.); Department of Cardiology, Federal University of Ceara, Fortaleza, Brazil (C.R.-S.); Discipline of Clinical and Experimental Pathophysiology, Rio de Janeiro State University, Brazil (A.F.S.); and Universidade Estadual de Ciencias da Saude de Alagoas, Maceio, Brazil (M.d.C.B.T.)
| | - Antônio F Sanjuliani
- From the Hypertension Unit, Heart Institute-InCor (E.M.K., L.F.D., D.M.A.G.), Hypertension Unit, Renal Division (L.F.D., D.M.), and Laboratory of Genetics and Molecular Medicine, Heart Institute-InCor (A.C.P., J.E.K.), University of Sao Paulo Medical School, Brazil; Division of Cardiology, Federal University of Sergipe, Brazil (J.A.S.B.-F.); Department of Clinical Research, Hospital Universitario Clementino Fraga Filho, Brazil (A.R.N.); Department of Physiological Sciences, Federal University of Espírito Santo, Brazil (J.G.M.); Division of Internal Medicine, Center for Clinical and Epidemiological Research, University Hospital (P.A.L.) and Ribeirao Preto Medical School (F.N.), University of Sao Paulo, Brazil; Department of Hypertension and Nephrology, Dante Pazzanese Institute of Cardiology, Sao Paulo, Brazil (C.A.); Division of Nephrology, Department of Medicine (M.C.B.) and Department of Cardiology (A.C.C.C.), Universidade Federal de São Paulo, Brazil; Pontificia Universidade Catolica do Rio Grande do Sul, Porto Alegre, Brazil (L.C.B.); Institute of Cardiology, University Cardiology Foundation, Porto Alegre, Brazil (I.C.); Department of Clinical Medicine, Federal University of Pernambuco, Recife, Brazil (H.C.); Department of Cardiology, Universidade Federal do Para, Belem, Brazil (E.A.S.C.); Escola Bahiana de Medicina e Saude Pública, Salvador, Brazil (G.S.F.); Division of Nephrology, Department of Internal Medicine, Botucatu Medical School, Sao Paulo State University, Brazil (R.J.S.F.); Division of Cardiology, Hospital de Clinicas de Porto Alegre, Federal University of Rio Grande do Sul, Brazil (F.D.F.); Federal University of Bahia, Salvador, Brazil (A.C.G.); Faculty of Medicine, Federal University of Goias, Goiânia, Brazil (P.C.J.); Department of Cardiology, School of Medicine, Federal University of Sao Paulo, Brazil (C.A.M.); Serviço de Cardiologia do Hospital Universitario Pedro Ernesto da Universidade do Estado do Rio de Janeiro, Brazil (M.E.M.); Department of Medicine, Ouro Preto Federal University, Brazil (R.M.N.); Hospital Universitario Antonio Pedro, Universidade Federal Fluminense, Rio de Janeiro, Brazil (A.C.N.); Department of Internal Medicine, Federal University of Minas Gerais, Belo Horizonte, Brazil (A.L.P.R.); Department of Cardiology, Federal University of Ceara, Fortaleza, Brazil (C.R.-S.); Discipline of Clinical and Experimental Pathophysiology, Rio de Janeiro State University, Brazil (A.F.S.); and Universidade Estadual de Ciencias da Saude de Alagoas, Maceio, Brazil (M.d.C.B.T.)
| | - Maria do Carmo B Teixeira
- From the Hypertension Unit, Heart Institute-InCor (E.M.K., L.F.D., D.M.A.G.), Hypertension Unit, Renal Division (L.F.D., D.M.), and Laboratory of Genetics and Molecular Medicine, Heart Institute-InCor (A.C.P., J.E.K.), University of Sao Paulo Medical School, Brazil; Division of Cardiology, Federal University of Sergipe, Brazil (J.A.S.B.-F.); Department of Clinical Research, Hospital Universitario Clementino Fraga Filho, Brazil (A.R.N.); Department of Physiological Sciences, Federal University of Espírito Santo, Brazil (J.G.M.); Division of Internal Medicine, Center for Clinical and Epidemiological Research, University Hospital (P.A.L.) and Ribeirao Preto Medical School (F.N.), University of Sao Paulo, Brazil; Department of Hypertension and Nephrology, Dante Pazzanese Institute of Cardiology, Sao Paulo, Brazil (C.A.); Division of Nephrology, Department of Medicine (M.C.B.) and Department of Cardiology (A.C.C.C.), Universidade Federal de São Paulo, Brazil; Pontificia Universidade Catolica do Rio Grande do Sul, Porto Alegre, Brazil (L.C.B.); Institute of Cardiology, University Cardiology Foundation, Porto Alegre, Brazil (I.C.); Department of Clinical Medicine, Federal University of Pernambuco, Recife, Brazil (H.C.); Department of Cardiology, Universidade Federal do Para, Belem, Brazil (E.A.S.C.); Escola Bahiana de Medicina e Saude Pública, Salvador, Brazil (G.S.F.); Division of Nephrology, Department of Internal Medicine, Botucatu Medical School, Sao Paulo State University, Brazil (R.J.S.F.); Division of Cardiology, Hospital de Clinicas de Porto Alegre, Federal University of Rio Grande do Sul, Brazil (F.D.F.); Federal University of Bahia, Salvador, Brazil (A.C.G.); Faculty of Medicine, Federal University of Goias, Goiânia, Brazil (P.C.J.); Department of Cardiology, School of Medicine, Federal University of Sao Paulo, Brazil (C.A.M.); Serviço de Cardiologia do Hospital Universitario Pedro Ernesto da Universidade do Estado do Rio de Janeiro, Brazil (M.E.M.); Department of Medicine, Ouro Preto Federal University, Brazil (R.M.N.); Hospital Universitario Antonio Pedro, Universidade Federal Fluminense, Rio de Janeiro, Brazil (A.C.N.); Department of Internal Medicine, Federal University of Minas Gerais, Belo Horizonte, Brazil (A.L.P.R.); Department of Cardiology, Federal University of Ceara, Fortaleza, Brazil (C.R.-S.); Discipline of Clinical and Experimental Pathophysiology, Rio de Janeiro State University, Brazil (A.F.S.); and Universidade Estadual de Ciencias da Saude de Alagoas, Maceio, Brazil (M.d.C.B.T.)
| | - Jose E Krieger
- From the Hypertension Unit, Heart Institute-InCor (E.M.K., L.F.D., D.M.A.G.), Hypertension Unit, Renal Division (L.F.D., D.M.), and Laboratory of Genetics and Molecular Medicine, Heart Institute-InCor (A.C.P., J.E.K.), University of Sao Paulo Medical School, Brazil; Division of Cardiology, Federal University of Sergipe, Brazil (J.A.S.B.-F.); Department of Clinical Research, Hospital Universitario Clementino Fraga Filho, Brazil (A.R.N.); Department of Physiological Sciences, Federal University of Espírito Santo, Brazil (J.G.M.); Division of Internal Medicine, Center for Clinical and Epidemiological Research, University Hospital (P.A.L.) and Ribeirao Preto Medical School (F.N.), University of Sao Paulo, Brazil; Department of Hypertension and Nephrology, Dante Pazzanese Institute of Cardiology, Sao Paulo, Brazil (C.A.); Division of Nephrology, Department of Medicine (M.C.B.) and Department of Cardiology (A.C.C.C.), Universidade Federal de São Paulo, Brazil; Pontificia Universidade Catolica do Rio Grande do Sul, Porto Alegre, Brazil (L.C.B.); Institute of Cardiology, University Cardiology Foundation, Porto Alegre, Brazil (I.C.); Department of Clinical Medicine, Federal University of Pernambuco, Recife, Brazil (H.C.); Department of Cardiology, Universidade Federal do Para, Belem, Brazil (E.A.S.C.); Escola Bahiana de Medicina e Saude Pública, Salvador, Brazil (G.S.F.); Division of Nephrology, Department of Internal Medicine, Botucatu Medical School, Sao Paulo State University, Brazil (R.J.S.F.); Division of Cardiology, Hospital de Clinicas de Porto Alegre, Federal University of Rio Grande do Sul, Brazil (F.D.F.); Federal University of Bahia, Salvador, Brazil (A.C.G.); Faculty of Medicine, Federal University of Goias, Goiânia, Brazil (P.C.J.); Department of Cardiology, School of Medicine, Federal University of Sao Paulo, Brazil (C.A.M.); Serviço de Cardiologia do Hospital Universitario Pedro Ernesto da Universidade do Estado do Rio de Janeiro, Brazil (M.E.M.); Department of Medicine, Ouro Preto Federal University, Brazil (R.M.N.); Hospital Universitario Antonio Pedro, Universidade Federal Fluminense, Rio de Janeiro, Brazil (A.C.N.); Department of Internal Medicine, Federal University of Minas Gerais, Belo Horizonte, Brazil (A.L.P.R.); Department of Cardiology, Federal University of Ceara, Fortaleza, Brazil (C.R.-S.); Discipline of Clinical and Experimental Pathophysiology, Rio de Janeiro State University, Brazil (A.F.S.); and Universidade Estadual de Ciencias da Saude de Alagoas, Maceio, Brazil (M.d.C.B.T.)
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49
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Dezan MR, Guardalini LGO, Pessoa E, Ribeiro IH, Oliveira VB, Luz F, Novac DR, Gallucci A, Bonifácio S, Gomes F, Levi JE, Pereira AC, Krieger JE, Mendrone-Junior A, Rocha V, Dinardo CL. Evaluation of the applicability and effectiveness of a molecular strategy for identifying weak D and DEL phenotype among D- blood donors of mixed origin exhibiting high frequency ofRHD*Ψ. Transfusion 2017; 58:317-322. [DOI: 10.1111/trf.14425] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/03/2017] [Revised: 09/01/2017] [Accepted: 10/22/2017] [Indexed: 01/28/2023]
Affiliation(s)
| | | | - Elaine Pessoa
- Immunohematology Division; Fundação Pró-Sangue, Hemocentro de São Paulo
| | | | | | - Fabio Luz
- Immunohematology Division; Fundação Pró-Sangue, Hemocentro de São Paulo
| | | | - António Gallucci
- Immunohematology Division; Fundação Pró-Sangue, Hemocentro de São Paulo
| | - Silvia Bonifácio
- Immunohematology Division; Fundação Pró-Sangue, Hemocentro de São Paulo
| | - Francisco Gomes
- Immunohematology Division; Fundação Pró-Sangue, Hemocentro de São Paulo
| | - José E. Levi
- Immunohematology Division; Fundação Pró-Sangue, Hemocentro de São Paulo
| | - Alexandre C. Pereira
- Laboratory of Genetics and Molecular Cardiology; Heart Institute (InCor), University of São Paulo School of Medicine
| | - Jose E. Krieger
- Laboratory of Genetics and Molecular Cardiology; Heart Institute (InCor), University of São Paulo School of Medicine
| | | | - Vanderson Rocha
- Immunohematology Division; Fundação Pró-Sangue, Hemocentro de São Paulo
- Discipline of Hematology; University of São Paulo School of Medicine; São Paulo Brazil
| | - Carla Luana Dinardo
- Immunohematology Division; Fundação Pró-Sangue, Hemocentro de São Paulo
- Laboratory of Genetics and Molecular Cardiology; Heart Institute (InCor), University of São Paulo School of Medicine
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50
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Oliveira VB, Dezan MR, Gomes FCA, Menosi Gualandro SF, Krieger JE, Pereira AC, Marsiglia JD, Levi JE, Rocha V, Mendrone-Junior A, Sabino EC, Dinardo CL. -318C/T polymorphism of the CTLA-4 gene is an independent risk factor for RBC alloimmunization among sickle cell disease patients. Int J Immunogenet 2017; 44:219-224. [PMID: 28815969 DOI: 10.1111/iji.12334] [Citation(s) in RCA: 15] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/22/2017] [Revised: 05/23/2017] [Accepted: 07/20/2017] [Indexed: 02/06/2023]
Abstract
Cytotoxic T-lymphocyte-associated antigen 4 (CTLA-4) molecule is expressed on T-lymphocyte membrane and negatively influences the antigen-presenting process. Reduced expression of CTLA-4 due to gene polymorphisms is associated with increased risk of autoimmune disorders, whose physiopathology is similar to that of post-transfusion red blood cell (RBC) alloimmunization. Our goal was to evaluate if polymorphisms of CTLA-4 gene that affect protein expression are associated with RBC alloimmunization. This was a case-control study in which 134 sickle cell disease (SCD) patients and 253 non-SCD patients were included. All patients were genotyped for the polymorphisms 49A/G and -318C/T of CTLA-4 gene. The genotype frequency of -318C/T differed significantly between alloimmunized and nonalloimmunized SCD patients, irrespective of clinical confounders (p = .016). SCD patients heterozygous for -318T allele presented higher risk of alloantibody development (OR: 5.4, CI: 1.15-25.6). In conclusion, the polymorphism -318C/T of CTLA-4 gene is associated with RBC alloimmunization among SCD patients. This highlights the role played by CTLA-4 on post-transfusion alloantibody development.
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Affiliation(s)
- V B Oliveira
- Fundação Pró-Sangue Hemocentro de São Paulo, São Paulo, São Paulo, Brazil
| | - M R Dezan
- Fundação Pró-Sangue Hemocentro de São Paulo, São Paulo, São Paulo, Brazil
| | - F C A Gomes
- Fundação Pró-Sangue Hemocentro de São Paulo, São Paulo, São Paulo, Brazil
| | - S F Menosi Gualandro
- Discipline of Hematology, University of São Paulo School of Medicine, São Paulo, São Paulo, Brazil
| | - J E Krieger
- Laboratory of Genetics and Molecular Cardiology, Heart Institute (InCor), University of São Paulo School of Medicine, São Paulo, São Paulo, Brazil
| | - A C Pereira
- Laboratory of Genetics and Molecular Cardiology, Heart Institute (InCor), University of São Paulo School of Medicine, São Paulo, São Paulo, Brazil
| | - J D Marsiglia
- Laboratory of Genetics and Molecular Cardiology, Heart Institute (InCor), University of São Paulo School of Medicine, São Paulo, São Paulo, Brazil
| | - J E Levi
- Fundação Pró-Sangue Hemocentro de São Paulo, São Paulo, São Paulo, Brazil
| | - V Rocha
- Discipline of Hematology, University of São Paulo School of Medicine, São Paulo, São Paulo, Brazil
| | - A Mendrone-Junior
- Fundação Pró-Sangue Hemocentro de São Paulo, São Paulo, São Paulo, Brazil
| | - E C Sabino
- Institute of Tropical Medicine, University of São Paulo, São Paulo, São Paulo, Brazil
| | - C L Dinardo
- Fundação Pró-Sangue Hemocentro de São Paulo, São Paulo, São Paulo, Brazil
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