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Updated: Jun 21, 2025

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Published on: July 14, 2021
Causal relationship between inflammatory markers and left ventricle geometry and function: A 2-sample Mendelian
Insights
This study found that higher C-reactive protein (CRP) levels causally reduce left ventricular (LV) mass. Interleukin-6 and myeloperoxidase did not show a causal link with cardiac structure or function.
Area of Science:
- Cardiovascular Genetics
- Inflammation and Heart Disease
- Mendelian Randomization Studies
Background:
- Inflammatory markers are linked to cardiovascular disease (CVD) risk and cardiac function.
- A direct causal link between specific inflammatory markers and cardiac structure/function remains unclear.
- Left ventricular (LV) parameters are critical indicators of cardiac health and prognosis.
Purpose of the Study:
- To investigate the potential causal relationship between key inflammatory markers and LV parameters.
- To utilize Mendelian randomization to assess causality, overcoming limitations of observational studies.
Main Methods:
- A two-sample Mendelian randomization (MR) study design was employed.
- Instrumental variables for C-reactive protein (CRP), interleukin-6 (IL-6), and myeloperoxidase (MPO) were derived from large genome-wide association studies (GWAS).
- LV parameters (mass, ejection fraction, volumes) were analyzed using summary statistics from UK Biobank cardiovascular magnetic resonance data (n=16,923).
Main Results:
- A significant causal association was found between genetically predicted higher CRP levels and reduced LV mass (β = -0.13 g, P = 0.046).
- No significant causal relationships were identified for IL-6 or MPO with any of the assessed LV parameters.
- Sensitivity analyses confirmed the robustness of findings, with no evidence of heterogeneity or pleiotropy.
Conclusions:
- Increased C-reactive protein levels appear to have a causal effect in reducing left ventricular mass.
- Interleukin-6 and myeloperoxidase do not demonstrate a causal influence on LV structure or function.
- Further research is warranted to validate these findings and explore underlying mechanisms.
Abstract:
Studies have shown that some inflammatory markers can predict the risk of cardiovascular disease (CVD) and affect the structure and function of the heart. However, a causal relationship between inflammatory markers and the cardiac structure and function has not yet been established. Thus, we conducted a 2-sample Mendelian randomization (MR) study to explore the potential causal relationship between inflammatory markers and prognostically-related left ventricular (LV) parameters. Instrumental variables (IVs) for C-reactive protein (CRP), interleukin-6 (IL-6), and myeloperoxidase (MPO) levels were selected from the databases of large genome-wide association studies (GWAS). Summary statistics for LV parameters, including LV mass, ejection fraction, end-diastolic and systolic volumes, and the ratio of LV mass to end-diastolic volume, were obtained from cardiovascular magnetic resonance studies of the UK Biobank (n = 16923). The inverse-variance weighted (IVW) method was the primary analytical method used, and was complemented with the MR-Egger, weighted median, simple mode, weighted mode, and MR pleiotropy residual sum and outlier (MR-PRESSO) methods. Sensitivity analysis was performed to evaluate the robustness of the results. CRP was significantly associated with the LV mass in the IVW method (β = -0.13 g [95% confidence interval [CI], 0.78 g-1.00 g], P = .046). A higher standard deviation of genetically-predicted CRP levels was associated with a 0.13 ± 0.06 g lower LV mass. No causal relationships of IL-6 and MPO with LV parameters were found. No evidence of heterogeneity and pleiotropy was detected. Sensitivity analyses confirmed the robustness of the results. Two-sample MR analysis revealed a causal association between increased CRP level and decreased LV mass, whereas IL-6 and MPO levels did not influence the LV parameters. However, further research is required to validate our findings.
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