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Updated: Jun 9, 2025

Investigating the Pathogenesis of MYH7 Mutation Gly823Glu in Familial Hypertrophic Cardiomyopathy using a Mouse Model
Published on: August 8, 2022
Association between cardiovascular risk factors and dilated and hypertrophic cardiomyopathy: Mendelian randomization
Chenchao Zou1, Huaxi Zou2, Ying Jiang2
1Department of Cardiac Surgery, The Second Affiliated Hospital of Nanchang University, Nanchang, Jiangxi, 330006, China; Department of Cardiac Surgery, The First Affiliated Hospital of Nanchang University, Nanchang, Jiangxi, 330006, China.
Insights
Smoking and obesity are causally linked to an increased risk of dilated cardiomyopathy. This genetic study provides new insights into heart failure causes.
Area of Science:
- Cardiovascular Genetics
- Epidemiology
- Mendelian Randomization
Background:
- Dilated cardiomyopathy (DCM) is a primary cause of heart failure.
- Hypertrophic cardiomyopathy (HCM) is a leading cause of sudden cardiac death in young adults.
- Observational studies on cardiovascular risk factors (smoking, alcohol, obesity) and cardiomyopathies are limited and prone to bias.
Purpose of the Study:
- To investigate the causal associations between common cardiovascular risk factors and dilated and hypertrophic cardiomyopathies using a Mendelian randomization approach.
- To leverage large-scale genetic data for robust causal inference.
Main Methods:
- A two-sample Mendelian randomization analysis was conducted.
- Genetic variants for body mass index, smoking, and alcohol consumption served as instrumental variables.
- Genome-wide association study (GWAS) meta-analysis data from European populations were utilized for DCM (355,318 samples) and HCM (489,727 samples).
Main Results:
- A genetic predisposition for smoking showed a significant association with an increased risk of dilated cardiomyopathy (OR = 1.33; 95% CI: 1.07-1.67).
- A genetic predisposition for obesity was significantly associated with an increased risk of dilated cardiomyopathy (OR = 1.62; 95% CI: 1.30-2.02).
- No significant associations were found for other investigated risk factors or for hypertrophic cardiomyopathy.
Conclusions:
- This study provides evidence for a causal relationship between smoking and obesity and an elevated risk of developing dilated cardiomyopathy.
- Findings highlight smoking and obesity as significant modifiable risk factors for dilated cardiomyopathy.
Background And Aim:
Dilated cardiomyopathy is a major cause of heart failure, and hypertrophic cardiomyopathy is a common cause of sudden cardiac death in young adults. Epidemiological studies reporting the association between these cardiomyopathies and common cardiovascular risk factors, including smoking, alcohol, and obesity, are limited, and the published studies are mostly observational, making them vulnerable to bias.
Methods And Results:
We performed a two-sample Mendelian randomization analysis to assess whether cardiovascular risk factors were causally associated with dilated and hypertrophic cardiomyopathies. Independent genetic variants associated with body mass index, smoking, and alcohol were selected as instrumental variables, with two sets of instrumental variables utilized for alcohol. Dilated cardiomyopathy data on 355,318 samples and hypertrophic cardiomyopathy data on 489,727 samples were obtained from a European population-based genome-wide association study (GWAS) meta-analysis. The large GWAS data sample size improved the statistical power. Our results showed significant associations between a genetic predisposition for smoking and the risk of dilated cardiomyopathy (odds ratio (OR) = 1.33; 95 % confidence level (CI): 1.07-1.67; p = 0.012) and between a genetic predisposition for obesity and the risk of dilated cardiomyopathy (OR = 1.62; 95 % CI, 1.30-2.02; p = 1.51 × 10-5). The results of the other associations were not significant.
Conclusions:
This study suggests that smoking and obesity are causally associated with an increased risk of dilated cardiomyopathy.
Related Concept Videos
Cardiomyopathy III: Hypertrophic Cardiomyopathy
Cardiomyopathy II: Dilated Cardiomyopathy
Cardiomyopathy I: Introduction and Classification
Coronary Artery Disease I: Introduction
Cardiomyopathy IV: Restrictive Cardiomyopathy
Heart Failure II: Pathophysiology

