Genome-wide association and Mendelian randomisation analysis provide insights into the pathogenesis of heart failure

Nat Commun. 2020 Jan 9;11(1):163. doi: 10.1038/s41467-019-13690-5.

Abstract

Heart failure (HF) is a leading cause of morbidity and mortality worldwide. A small proportion of HF cases are attributable to monogenic cardiomyopathies and existing genome-wide association studies (GWAS) have yielded only limited insights, leaving the observed heritability of HF largely unexplained. We report results from a GWAS meta-analysis of HF comprising 47,309 cases and 930,014 controls. Twelve independent variants at 11 genomic loci are associated with HF, all of which demonstrate one or more associations with coronary artery disease (CAD), atrial fibrillation, or reduced left ventricular function, suggesting shared genetic aetiology. Functional analysis of non-CAD-associated loci implicate genes involved in cardiac development (MYOZ1, SYNPO2L), protein homoeostasis (BAG3), and cellular senescence (CDKN1A). Mendelian randomisation analysis supports causal roles for several HF risk factors, and demonstrates CAD-independent effects for atrial fibrillation, body mass index, and hypertension. These findings extend our knowledge of the pathways underlying HF and may inform new therapeutic strategies.

Publication types

  • Meta-Analysis

MeSH terms

  • Adaptor Proteins, Signal Transducing / genetics
  • Apoptosis Regulatory Proteins / genetics
  • Atrial Fibrillation / genetics*
  • Cardiomyopathies / genetics*
  • Cardiomyopathies / pathology
  • Carrier Proteins / genetics
  • Case-Control Studies
  • Coronary Artery Disease / genetics*
  • Cyclin-Dependent Kinase Inhibitor p21 / genetics
  • Genome-Wide Association Study
  • Heart Failure / genetics*
  • Heart Failure / pathology*
  • Humans
  • Mendelian Randomization Analysis
  • Microfilament Proteins / genetics
  • Muscle Proteins / genetics
  • Risk Factors
  • Ventricular Function, Left / genetics*

Substances

  • Adaptor Proteins, Signal Transducing
  • Apoptosis Regulatory Proteins
  • BAG3 protein, human
  • CDKN1A protein, human
  • Carrier Proteins
  • Cyclin-Dependent Kinase Inhibitor p21
  • MYOZ1 protein, human
  • Microfilament Proteins
  • Muscle Proteins
  • SYNPO2L protein, human