The effects of psychiatric disorders on the risk of chronic heart failure: a univariable and multivariable Mendelian randomization study

Yang Chen; Wenke Peng; Min Pang; Botao Zhu; Huixing Liu; Die Hu; Yonghong Luo; Shuai Wang; Sha Wu; Jia He; Yang Yang; Daoquan Peng

doi:10.3389/fpubh.2024.1306150

The effects of psychiatric disorders on the risk of chronic heart failure: a univariable and multivariable Mendelian randomization study

Front Public Health. 2024 Jan 17:12:1306150. doi: 10.3389/fpubh.2024.1306150. eCollection 2024.

Authors

Yang Chen^{1

2}, Wenke Peng^{1

2}, Min Pang^{1

2}, Botao Zhu^{1

2}, Huixing Liu^{1

2}, Die Hu^{1

2}, Yonghong Luo^{1

2}, Shuai Wang^{1

2}, Sha Wu^{1

2}, Jia He^{1

2}, Yang Yang^{1

2}, Daoquan Peng^{1

2}

Affiliations

¹ Department of Cardiovascular Medicine, The Second Xiangya Hospital, Central South University, Changsha, China.
² Research Institute of Blood Lipid and Atherosclerosis, Central South University, Changsha, China.

Abstract

Background: Substantial evidence suggests an association between psychiatric disorders and chronic heart failure. However, further investigation is needed to confirm the causal relationship between these psychiatric disorders and chronic heart failure. To address this, we evaluated the potential effects of five psychiatric disorders on chronic heart failure using two-sample Mendelian Randomization (MR).

Methods: We selected single nucleotide polymorphisms (SNPs) associated with chronic heart failure and five psychiatric disorders (Attention-Deficit Hyperactivity Disorder (ADHD), Autism Spectrum Disorder (ASD), Major Depression, Bipolar Disorder and Schizophrenia (SCZ)). Univariable (UVMR) and multivariable two-sample Mendelian Randomization (MVMR) were employed to assess causality between these conditions. Ever smoked and alcohol consumption were controlled for mediating effects in the multivariable MR. The inverse variance weighting (IVW) and Wald ratio estimator methods served as the primary analytical methods for estimating potential causal effects. MR-Egger and weighted median analyses were also conducted to validate the results. Sensitivity analyses included the funnel plot, leave-one-out, and MR-Egger intercept tests. Additionally, potential mediators were investigated through risk factor analyses.

Results: Genetically predicted heart failure was significantly associated with ADHD (odds ratio (OR), 1.12; 95% CI, 1.04-1.20; p = 0.001), ASD (OR, 1.29; 95% CI, 1.07-1.56; p = 0.008), bipolar disorder (OR, 0.89; 95% CI, 0.83-0.96; p = 0.001), major depression (OR, 1.15; 95% CI, 1.03-1.29; p = 0.015), SCZ (OR, 1.04; 95% CI, 1.00-1.07; p = 0.024). Several risk factors for heart failure are implicated in the above cause-and-effect relationship, including ever smoked and alcohol consumption.

Conclusion: Our study demonstrated ADHD, ASD, SCZ and major depression may have a causal relationship with an increased risk of heart failure. In contrast, bipolar disorder was associated with a reduced risk of heart failure, which could potentially be mediated by ever smoked and alcohol consumption. Therefore, prevention strategies for heart failure should also incorporate mental health considerations, and vice versa.

Keywords: causal relationship; chronic heart failure; multivariable Mendelian randomization; psychological disorders; univariable Mendelian.

Publication types

Research Support, Non-U.S. Gov't

MeSH terms

Autism Spectrum Disorder*
Chronic Disease
Heart Failure* / epidemiology
Heart Failure* / genetics
Humans
Mendelian Randomization Analysis
Mental Disorders* / epidemiology
Mental Disorders* / genetics
Mental Health

Grants and funding

The author(s) declare financial support was received for the research, authorship, and/or publication of this article. This work was supported by National Natural Science Foundation of China (No.81870336 to DP) & National Natural Science Foundation of China (No.82100496 to DH).