Genetic variants, pathophysiological pathways, and oral anticoagulation in patients with hypertrophic cardiomyopathy and atrial fibrillation

Shengnan Wang; He Chen; Chunju Liu; Mengxian Wu; Wanlei Sun; Shenjian Liu; Yan Zheng; Wenfeng He

doi:10.3389/fcvm.2023.1023394

Genetic variants, pathophysiological pathways, and oral anticoagulation in patients with hypertrophic cardiomyopathy and atrial fibrillation

Front Cardiovasc Med. 2023 Apr 17:10:1023394. doi: 10.3389/fcvm.2023.1023394. eCollection 2023.

Authors

Shengnan Wang¹, He Chen², Chunju Liu³, Mengxian Wu³, Wanlei Sun⁴, Shenjian Liu², Yan Zheng^{1

2}, Wenfeng He^{1

2}

Affiliations

¹ Department of Medical Genetics, The Second Affiliated Hospital of Nanchang University, Nanchang, China.
² Jiangxi Key Laboratory of Molecular Medicine, The Second Affiliated Hospital of Nanchang University, Nanchang, China.
³ Department of Clinical Laboratory, Affiliated Hospital of Jiangxi University of Traditional Chinese Medicine, Nanchang, China.
⁴ Department of Clinical Laboratory, The Second Affiliated Hospital of Nanchang University, Nanchang, China.

Abstract

Atrial fibrillation (AF) is commonly prevalent in patients with hypertrophic cardiomyopathy (HCM). However, whether the prevalence and incidence of AF are different between genotype-positive vs. genotype-negative patients with HCM remains controversial. Recent evidence has indicated that AF is often the first presentation of genetic HCM patients in the absence of a cardiomyopathy phenotype, implying the importance of genetic testing in this population with early-onset AF. However, the association of the identified sarcomere gene variants with HCM occurrence in the future remains unclear. How the identification of these cardiomyopathy gene variants should influence the use of anticoagulation therapy for a patient with early-onset AF is still undefined. In this review, we sought to assess the genetic variants, pathophysiological pathways, and oral anticoagulation in patients with HCM and AF.

Keywords: anticoagulation; atrial fibrillation; genotype; hypertrophic cardiomyopathy; mechanism.

Publication types

Review

Grants and funding

National Natural Science Foundation of China [31960146]; Natural Science Foundation of Jiangxi Province [20181BAB205013]; Science and Technology Research Project of Jiangxi Education Department [GJJ170096].