Genetic risk and atrial fibrillation in patients with heart failure

Kloosterman, Mariëlle; Santema, Bernadet T.; Roselli, Carolina; Nelson, Christopher P.; Koekemoer, Andrea; Romaine, Simon P. R.; Gelder, Isabelle C. Van; Lam, Carolyn S.P.; Artola, V; Lang, Chim C.; Ng, Leong L.; Metra, Marco; Anker, Stefan D.; Filippatos, Gerasimos; Dickstein, Kenneth; Ponikowski, Piotr; Harst, Pim van der; Meer, Peter van der; Veldhuisen, Dirk J. van; Benjamin, Emelia J.; Voors, Adriaan A.; Samani, Nilesh J.; Rienstra, Michiel

doi:10.1002/ejhf.1735

Cited by 18 publications

(15 citation statements)

References 28 publications

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“…section). 23,64,65 These improvements contributed to the accuracy of risk prediction in 2 ways. First, they improve the accuracy of the prediction of AF in the absence of clinical risk factors (eg, early-onset AF).…”

Section: Atrial Fibrillationmentioning

confidence: 99%

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Polygenic Risk Scores for Cardiovascular Disease: A Scientific Statement From the American Heart Association

O’Sullivan¹,

Raghavan²,

et al. 2022

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Cardiovascular disease is the leading contributor to years lost due to disability or premature death among adults. Current efforts focus on risk prediction and risk factor mitigation‚ which have been recognized for the past half-century. However, despite advances, risk prediction remains imprecise with persistently high rates of incident cardiovascular disease. Genetic characterization has been proposed as an approach to enable earlier and potentially tailored prevention. Rare mendelian pathogenic variants predisposing to cardiometabolic conditions have long been known to contribute to disease risk in some families. However, twin and familial aggregation studies imply that diverse cardiovascular conditions are heritable in the general population. Significant technological and methodological advances since the Human Genome Project are facilitating population-based comprehensive genetic profiling at decreasing costs. Genome-wide association studies from such endeavors continue to elucidate causal mechanisms for cardiovascular diseases. Systematic cataloging for cardiovascular risk alleles also enabled the development of polygenic risk scores. Genetic profiling is becoming widespread in large-scale research, including in health care–associated biobanks, randomized controlled trials, and direct-to-consumer profiling in tens of millions of people. Thus, individuals and their physicians are increasingly presented with polygenic risk scores for cardiovascular conditions in clinical encounters. In this scientific statement, we review the contemporary science, clinical considerations, and future challenges for polygenic risk scores for cardiovascular diseases. We selected 5 cardiometabolic diseases (coronary artery disease, hypercholesterolemia, type 2 diabetes, atrial fibrillation, and venous thromboembolic disease) and response to drug therapy and offer provisional guidance to health care professionals, researchers, policymakers, and patients.

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Section: Atrial Fibrillationmentioning

confidence: 99%

“…shown incremental predictive capabilities in addition to clinical risk factors. 20,23,[64][65][66][67][68][69] Proposed utility has been to refine the identification of individuals meriting close surveillance for AF development. 4.…”

Section: Atrial Fibrillation: Prss For Af Have Consistentlymentioning

confidence: 99%

Polygenic Risk Scores for Cardiovascular Disease: A Scientific Statement From the American Heart Association

O’Sullivan¹,

Raghavan²,

et al. 2022

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“…Atrial fibrillation (AF) is the most common arrhythmia in heart failure (HF) with a prevalence between 20-60% depending on the type and severity of HF. [1][2][3] Both AF and HF are strongly associated with ageing, share many other clinical risk factors such as obesity and hypertension, and can trigger each other. 2,3 Distinct differences are observed when comparing patients with HF with and without AF.…”

Section: Introductionmentioning

confidence: 99%

“…[1][2][3] Both AF and HF are strongly associated with ageing, share many other clinical risk factors such as obesity and hypertension, and can trigger each other. 2,3 Distinct differences are observed when comparing patients with HF with and without AF. We recently showed that patients with AF and HF are older, less often have an ischemic aetiology of HF, and have a distinct biomarker profile as compared with HF patients in sinus rhythm.…”

Section: Introductionmentioning

confidence: 99%

Pathophysiological pathways in patients with heart failure and atrial fibrillation

Santema

Arita

Sama

et al. 2021

Cardiovascular Research

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Aims Atrial fibrillation (AF) and heart failure (HF) are two growing epidemics that frequently co-exist. We aimed to gain insights into underlying pathophysiological pathways in HF patients with AF by comparing circulating biomarkers using pathway overrepresentation analyses. Methods and Results From a panel of 92 biomarkers from different pathophysiological domains available in 1,620 patients with HF, we first tested which biomarkers were dysregulated in patients with HF and AF (n = 648) compared with patients in sinus rhythm (n = 972). Secondly, pathway overrepresentation analyses were performed to identify biological pathways linked to higher plasma concentrations of biomarkers in patients who had HF and AF. Findings were validated in an independent HF cohort (n = 1,219, 38% with AF). Patient with AF and HF were older, less often women, and less often had a history of coronary artery disease compared with those in sinus rhythm. In the index cohort, 24 biomarkers were upregulated in patients with AF and HF. In the validation cohort, 8 biomarkers were upregulated, which all overlapped with the 24 biomarkers found in the index cohort. The strongest up-regulated biomarkers in patients with AF were spondin-1 (fold change 1.18, p = 1.33x10−12), insulin-like growth factor-binding protein-1 (fold change 1.32, p = 1.08x10−8), and insulin-like growth factor-binding protein-7 (fold change 1.33, p = 1.35x10−18). Pathway overrepresentation analyses revealed that the presence of AF was associated with activation amyloid-beta metabolic processes, amyloid-beta formation, and amyloid precursor protein catabolic processes with a remarkable consistency observed in the validation cohort. Conclusion In two independent cohorts of patients with HF, the presence of AF was associated with activation of three pathways related to amyloid-beta. These hypothesis-generating results warrant confirmation in future studies. Translational Perspective Using an unbiased approach, we identified and validated dysregulation of three amyloid-beta related pathways in patients who had heart failure (HF) with concomitant atrial fibrillation (AF). Amyloid-beta depositions are a hallmark of Alzheimer’s disease, but might also play a role in pathophysiological processes outside the central nervous system. Biopsy studies are needed to confirm the pathophysiological role of amyloid-beta in patients with AF and HF. Diagnostic and therapeutic implications should be investigated in the light of potential pathophysiological overlap between the three aging-related epidemics: Alzheimer’s disease, AF and HF.

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“…В исследовании M. Kloosterman и соавт. среди пациентов, находящихся на гемодиализе, распространенность персистирующей ФП составила 23,4% [1]. По данным метаанализа D. Zimmerman и соавт., ФП обнаружена у 27% пациентов, находящихся на диализе, и у 13,9% пациентов регистрировалась постоянная ФП.…”

Section: Introductionunclassified

The effect of hemodialysis on echocardiographic parameters and on supraventricular cardiac arrhythmias

Likhachev-Mishchenko¹,

Корниенко²,

Хаишева

et al. 2020

Cardio. Som.

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Relevance. Supraventricular arrhythmias are frequent comorbid conditions in patients with end-stage renal failure undergoing dialysis. The prevalence of atrial fibrillation (AF) in this group of patients is higher than in the general population and is associated with increased mortality. Aim. To analyze the effect of a dialysis session on echocardiographic parameters and to assess their relationship with the occurrence of supraventricular arrhythmias and AF during hemodialysis. Material and methods. The study included 78 patients on hemodialysis. All patients underwent Holter electrocardiography monitoring, taking into account the heart rate before and after dialysis, the number and duration of AF episodes associated with the dialysis session. Using echocardiography, which was performed before and after the dialysis procedure, all patients were also evaluated for the presence of left ventricular (LV) hypertrophy, impaired systolic and diastolic function, as well as LV myocardial mass, sizes of the left atrium, its volume, volume of the right atrium and LV ejection fraction. Results. An analysis of the differences in echocardiographic parameters before and after dialysis showed a significantly larger volume of the left atrium, the volume of the right atrium, the width of the inferior vena cava, and the parameter P(early transmitral velocity) before dialysis compared with the state after dialysis. Also, AF paroxysms were recorded much more frequently after dialysis. The volume of the left atrium 32 mm and the right atrium 30 mm (limit values) were observed much more often in patients before dialysis. A relationship was found between an increased number of paroxysms of atrial fibrillation and a decrease in the volume of the right atrium 5 mm and the left atrium 7 mm after dialysis. No correlation was found between the mass of the LV and the volume of the left atrium. Conclusions. 1. The age and duration of dialysis therapy in hemodialysis patients are associated with an increased risk of atrial fibrillation. 2. A decrease in the volumes of the right and left atriums after the hemodialysis procedure has a positive correlation with paroxysmal AF. 3. The hemodialysis procedure leads to a decrease in the volumes of the right and left atriums, as well as the width of the inferior vena cava and a decrease in the speed of movement of the mitral valve in early diastole. 4. No relationship was found between the volume of the left atrium and the mass of the LV myocardium in patients on hemodialysis.

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Genetic risk and atrial fibrillation in patients with heart failure

Cited by 18 publications

References 28 publications

Polygenic Risk Scores for Cardiovascular Disease: A Scientific Statement From the American Heart Association

Polygenic Risk Scores for Cardiovascular Disease: A Scientific Statement From the American Heart Association

Pathophysiological pathways in patients with heart failure and atrial fibrillation

The effect of hemodialysis on echocardiographic parameters and on supraventricular cardiac arrhythmias

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