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

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

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

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

Yang Chen et al. Front Public Health. .

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.

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Conflict of interest statement

The authors declare that the research was conducted in the absence of any commercial or financial relationships that could be construed as a potential conflict of interest.

Figures

Figure 1
Figure 1
Directed a cyclic graph model of the causal effect between psychiatric disorders and heart failure.
Figure 2
Figure 2
Mendelian randomization (MR) association between genetically predicted psychiatric disorders and heart failure. Odds ratios (ORs) are scaled to the risk of heart failure for genetically predicted psychiatric disorders. HF, heart failure; CI, confidence interval.
Figure 3
Figure 3
Multivariable Mendelian randomization analysis of the effect of psychiatric disorders on heart failure. OR, Odds ratio; CI, confidence interval.
See this image and copyright information in PMC

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