Relationships between heart failure, depression, and anxiety: A Mendelian randomization study

Area of Science:

• Cardiovascular Medicine
• Psychiatry
• Genetic Epidemiology

Background:

• Observational studies suggest a link between heart failure (HF) and increased risk of depression and anxiety.
• These observational studies may be limited by confounding factors, necessitating investigation into causal relationships.

Purpose of the Study:

• To investigate the potential causal relationship between heart failure and the incidence of depressive disorders and anxiety.
• To utilize Mendelian randomization to overcome limitations of previous observational studies.

Main Methods:

• Two-sample Mendelian randomization analysis using genetic instruments for HF, depression, and anxiety.
• Inverse-variance weighted (IVW) as the primary method, with MR-Egger regression and weighted median as secondary approaches.
• Assessed robustness and horizontal pleiotropy using Cochran Q test, MR-Egger intercept, and leave-one-out analyses.

Main Results:

• No significant causal association was found between heart failure and the incidence of major depressive disorder or major depression using the IVW method.
• Results for heart failure and anxiety were inconsistent across different consortia, but a combined analysis supported a causal relationship.
• The combined effect analysis indicated a causal effect of heart failure on the risk of anxiety (OR=1.52, P<.001).

Conclusions:

• The study provides no evidence to support a causal association between heart failure and depression.
• Findings suggest a potential causal effect of heart failure on the increased risk of anxiety.
• Further research is warranted to elucidate the mechanisms underlying the HF-anxiety link.