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Arrhythmia and cardiomyopathy risk in Taiwan with complementary biobank evidence on thyroid genetic susceptibility:

Yi-Chang Lin1,2, Yao-Ching Huang3,4,5, Ya-Ting Yang6

  • 1Division of Cardiovascular Surgery, Department of Surgery, Tri-Service General Hospital, National Defense Medical University , Taipei, Taiwan.

Endocrine Connections
|July 17, 2026
PubMed

Insights

Arrhythmia increases cardiomyopathy risk, while thyroid genetic susceptibility, influenced by lifestyle, contributes to thyroid dysfunction. Integrated risk assessment may identify at-risk individuals.

Area of Science:

  • Cardiovascular Medicine
  • Endocrinology
  • Genetics

Background:

  • Arrhythmia-induced cardiomyopathy (AiCM) is a reversible cause of ventricular dysfunction, but not all patients with arrhythmia develop it.
  • Genetic susceptibility and endocrine factors, particularly thyroid dysfunction, may influence individual susceptibility to arrhythmia-related myocardial outcomes.

Purpose of the Study:

  • To investigate the association between arrhythmia and incident cardiomyopathy.
  • To explore the role of thyroid dysfunction, genetic susceptibility, and lifestyle factors in determining myocardial outcomes.

Main Methods:

  • A dual-cohort study using the National Health Insurance Research Database (NHIRD) and Taiwan Biobank (TWB).
  • Cox proportional hazards models analyzed arrhythmia and cardiomyopathy risk in NHIRD.
  • Multivariable regression and interaction models assessed thyroid dysfunction determinants using genome-wide data, thyroid-stimulating hormone (TSH), polygenic risk scores (PRS), lifestyle, and metabolic factors in TWB.

Main Results:

  • Arrhythmia significantly increased cardiomyopathy risk (aHR 2.49) in NHIRD, with atrial fibrillation being most strongly associated.
  • Higher thyroid PRS strongly predicted thyroid dysfunction (aOR 6.64) in TWB.
  • Genetic susceptibility to thyroid dysfunction was modified by diabetes, hyperlipidemia, and diet; genome-wide analysis revealed loci for TSH regulation.

Conclusions:

  • Arrhythmia is linked to increased cardiomyopathy risk, and thyroid genetic susceptibility is associated with thyroid dysfunction, influenced by metabolic and lifestyle factors.
  • Findings support an endocrine-cardiac interaction framework.
  • Integrated clinical and genetic risk assessment can identify individuals needing closer monitoring.
Abstract

Keywords:
arrhythmiacardiomyopathyendocrine geneticspolygenic risk score (PRS)precision medicinethyroid dysfunction

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