Related Experiment Video
Updated: Jun 24, 2025
Estimating Bilateral Atrial Function by Cardiovascular Magnetic Resonance Feature Tracking in Patients with Paroxysmal Atrial Fibrillation
Published on: July 20, 2022
Causal Effect of Atrial Fibrillation on Heart Failure Risk in East Asian Ancestry: A Bidirectional Mendelian
Yibin Mei1, Fang Ye1, Xiaofen Yin2
1Department of Cardiology, Lishui People's Hospital, the Sixth Affiliated Hospital of Wenzhou Medical University, Lishui, Zhejiang, China;Department of Cardiology, First Affiliated Hospital of Lishui University School of Medicine, Lishui, Zhejiang, China.
Insights
Atrial fibrillation (AF) causally increases heart failure (HF) risk in East Asians. Heart failure does not increase AF risk, highlighting the importance of managing AF to prevent HF.
Area of Science:
- Cardiovascular Epidemiology
- Genetic Epidemiology
- Mendelian Randomization
Background:
- Atrial fibrillation (AF) and heart failure (HF) are common in East Asia.
- The causal link between AF and HF risk is not fully understood.
Purpose of the Study:
- To investigate the potential causal effect of atrial fibrillation on heart failure risk using Mendelian randomization.
Main Methods:
- Utilized genome-wide association study summary data from East Asian populations.
- Employed Mendelian randomization with inverse variance weighted (IVW) and sensitivity analyses.
- Conducted bidirectional MR to assess causality in both directions.
Main Results:
- Genetically predicted AF was causally associated with increased HF risk (OR=1.14, 95% CI: 1.10-1.19).
- Consistent findings across multiple MR methods with no significant heterogeneity or pleiotropy.
- No evidence of a causal effect of HF on AF risk.
Conclusions:
- Supports a unidirectional causal relationship: AF increases HF risk in East Asians.
- Highlights the importance of maintaining sinus rhythm to reduce HF risk.
- Further research needed to confirm findings and explore clinical implications.
Background:
Atrial fibrillation (AF) and heart failure (HF) are prevalent cardiovascular conditions in East Asia, with a complex interrelationship. The directionality of the causal impact of AF on HF risk remains uncertain. This study employs Mendelian randomization (MR) to investigate the potential causal effect of AF on HF.
Methods:
Utilizing summary data from genome-wide association studies (GWAS) within the Medical Research Council Integrative Epidemiology Unit open GWAS database, we analyzed 8180 AF cases and 28 612 controls, alongside 9413 HF cases and 203 040 controls, all of East Asian descent. We conducted MR analysis using the inverse variance weighted (IVW) method, complemented by various sensitivity analyses, including bidirectional MR to assess causality in the reverse direction.
Results:
Genetically predicted AF was found to be causally associated with an increased risk of HF in East Asian populations (odds ratio = 1.14, 95% CI: 1.10-1.19, P <.001) as per the IVW method. These findings were consistent across multiple MR methods. Sensitivity analyses revealed no significant heterogeneity or pleiotropy. Notably, bidirectional MR analysis showed no causal effect of HF on the risk of developing AF.
Conclusions:
The MR analysis supports a unidirectional causal relationship between AF and increased HF risk in East Asian individuals. The absence of a reverse causal effect reinforces the importance of maintaining sinus rhythm to mitigate HF risk. Further research is warranted to corroborate these findings and to explore their clinical implications in depth.
