PDF(Pubmed)
Abstract：
UNASSIGNED: Observational studies have shown that heart rate (HR), heart rate variability (HRV), P-wave terminal force, P-wave duration, T-wave amplitude and PR interval are associated with risk factors for atrial fibrillation (AF) or bradycardia. Arrhythmias are associated with many causes of hospitalization. However, observational studies are susceptible to confounding factors that have not yet been identified. The objective of this study was to clarify the causal relationships by Mendelian randomization analysis.
UNASSIGNED: We conducted a two-sample and multivariate Mendelian randomization (MVMR) analysis using genome-wide association study (GWAS) data from a European population to assess the total and direct causal effects of HR, three HRV traits, P-wave terminal force, P-wave duration, T-wave top amplitude in five-lead modes, and the PR interval on the risk of AF (N=191,205), bradycardia (N=463,010), and supraventricular tachycardia (SVT) (N=463,010).
UNASSIGNED: The results of the univariate MR analysis revealed the following significant causal effects: the higher the genetically predicted PR interval, the lower the risk of AF; the higher the HR and T-wave top amplitude (aVR leads and V3 + V4 + aVL leads), the lower the risk of bradycardia; and the higher HR and the lower PR interval, the higher the risk of SVT. The multivariate MR results indicated that the HRV_standard deviation of the normal-to-normal (SDNN) interval had an independent causal effect on the risk of AF [odds ratio (OR): 0.515; 95% confidence interval (CI): 0.278-0.954; P=0.03], and the T-wave top amplitude in the aVR leads (OR: 0.998; 95% CI: 0.996-0.999; P<0.001) and the HRV_SDNN (OR: 0.988; 95% CI: 0.976-1.000; P=0.045) had independent causal effects on the risk of bradycardia.
UNASSIGNED: The HRV_SDNN had an independent causal effect on AF, while the HRV_SDNN and T-wave top amplitude in the aVR leads had independent causal effects on bradycardia, which suggests that some of the electrocardiographic parameters have preventive effects on the incidence of AF and bradycardia.
UNASSIGNED: We conducted a two-sample and multivariate Mendelian randomization (MVMR) analysis using genome-wide association study (GWAS) data from a European population to assess the total and direct causal effects of HR, three HRV traits, P-wave terminal force, P-wave duration, T-wave top amplitude in five-lead modes, and the PR interval on the risk of AF (N=191,205), bradycardia (N=463,010), and supraventricular tachycardia (SVT) (N=463,010).
UNASSIGNED: The results of the univariate MR analysis revealed the following significant causal effects: the higher the genetically predicted PR interval, the lower the risk of AF; the higher the HR and T-wave top amplitude (aVR leads and V3 + V4 + aVL leads), the lower the risk of bradycardia; and the higher HR and the lower PR interval, the higher the risk of SVT. The multivariate MR results indicated that the HRV_standard deviation of the normal-to-normal (SDNN) interval had an independent causal effect on the risk of AF [odds ratio (OR): 0.515; 95% confidence interval (CI): 0.278-0.954; P=0.03], and the T-wave top amplitude in the aVR leads (OR: 0.998; 95% CI: 0.996-0.999; P<0.001) and the HRV_SDNN (OR: 0.988; 95% CI: 0.976-1.000; P=0.045) had independent causal effects on the risk of bradycardia.
UNASSIGNED: The HRV_SDNN had an independent causal effect on AF, while the HRV_SDNN and T-wave top amplitude in the aVR leads had independent causal effects on bradycardia, which suggests that some of the electrocardiographic parameters have preventive effects on the incidence of AF and bradycardia.
摘要：
■观察性研究表明，心率(HR)，心率变异性（HRV），P波终端力,P波持续时间,T波振幅和PR间期与心房颤动（AF）或心动过缓的危险因素有关。心律失常与许多住院原因有关。然而,观察性研究容易受到尚未确定的混杂因素的影响.本研究的目的是通过孟德尔随机化分析阐明因果关系。
■我们使用来自欧洲人群的全基因组关联研究（GWAS）数据进行了双样本和多变量孟德尔随机化（MVMR）分析，以评估HR的总体和直接因果关系。三个HRV性状，P波终端力,P波持续时间,五导联模式下的T波顶部振幅，和房颤风险的PR间期(N=191,205)，心动过缓（N=463,010），室上性心动过速（SVT）（N=463,010）。
■单变量MR分析的结果揭示了以下显着的因果效应：遗传预测的PR间隔越高，房颤风险越低;HR和T波顶振幅越高(aVR导联和V3+V4+aVL导联),心动过缓的风险越低；HR越高，PR间期越低，SVT的风险越高。多变量MR结果表明，正常到正常（SDNN）间隔的HRV_标准偏差对AF风险具有独立的因果关系[比值比（OR）：0.515；95％置信区间（CI）：0.278-0.954；P=0.03]，aVR导联的T波顶振幅（OR：0.998；95％CI：0.996-0.999；P<0.001）和HRV_SDNN（OR：0.988；95％CI：0.976-1.000；P=0.045）对心动过缓的风险具有独立的因果关系。
■HRV_SDNN对AF有独立的因果效应，而在aVR导联中HRV_SDNN和T波顶振幅对心动过缓有独立的因果效应,这表明某些心电图参数对房颤和心动过缓的发生具有预防作用。
■我们使用来自欧洲人群的全基因组关联研究（GWAS）数据进行了双样本和多变量孟德尔随机化（MVMR）分析，以评估HR的总体和直接因果关系。三个HRV性状，P波终端力,P波持续时间,五导联模式下的T波顶部振幅，和房颤风险的PR间期(N=191,205)，心动过缓（N=463,010），室上性心动过速（SVT）（N=463,010）。
■单变量MR分析的结果揭示了以下显着的因果效应：遗传预测的PR间隔越高，房颤风险越低;HR和T波顶振幅越高(aVR导联和V3+V4+aVL导联),心动过缓的风险越低；HR越高，PR间期越低，SVT的风险越高。多变量MR结果表明，正常到正常（SDNN）间隔的HRV_标准偏差对AF风险具有独立的因果关系[比值比（OR）：0.515；95％置信区间（CI）：0.278-0.954；P=0.03]，aVR导联的T波顶振幅（OR：0.998；95％CI：0.996-0.999；P<0.001）和HRV_SDNN（OR：0.988；95％CI：0.976-1.000；P=0.045）对心动过缓的风险具有独立的因果关系。
■HRV_SDNN对AF有独立的因果效应，而在aVR导联中HRV_SDNN和T波顶振幅对心动过缓有独立的因果效应,这表明某些心电图参数对房颤和心动过缓的发生具有预防作用。
