Genetic variants associated with syncope implicate neural and autonomic processes

DBDS Genomic Consortium, Hildur M Aegisdottir, Rosa B Thorolfsdottir, Gardar Sveinbjornsson, Olafur A Stefansson, Bjarni Gunnarsson, Vinicius Tragante, Gudmar Thorleifsson, Lilja Stefansdottir, Thorgeir E Thorgeirsson, Egil Ferkingstad, Patrick Sulem, Gudmundur Norddahl, Gudrun Rutsdottir, Karina Banasik, Alex Hoerby Christensen, Christina Mikkelsen, Ole Birger Pedersen, Søren Brunak, Mie Topholm BruunChristian Erikstrup, Rikke Louise Jacobsen, Kaspar Rene Nielsen, Erik Sørensen, Michael L Frigge, Kristjan E Hjorleifsson, Erna V Ivarsdottir, Anna Helgadottir, Solveig Gretarsdottir, Valgerdur Steinthorsdottir, Asmundur Oddsson, Hannes P Eggertsson, Gisli H Halldorsson, David A Jones, Jeffrey L Anderson, Kirk U Knowlton, Lincoln D Nadauld, Magnus Haraldsson, Gudmundur Thorgeirsson, Henning Bundgaard, David O Arnar, Unnur Thorsteinsdottir, Daniel F Gudbjartsson, Sisse R Ostrowski, Hilma Holm*, Kari Stefansson

*Corresponding author af dette arbejde

Publikation: Bidrag til tidsskriftArtikelForskningpeer review

Abstract

AIMS: Syncope is a common and clinically challenging condition. In this study, the genetics of syncope were investigated to seek knowledge about its pathophysiology and prognostic implications.

METHODS AND RESULTS: This genome-wide association meta-analysis included 56 071 syncope cases and 890 790 controls from deCODE genetics (Iceland), UK Biobank (United Kingdom), and Copenhagen Hospital Biobank Cardiovascular Study/Danish Blood Donor Study (Denmark), with a follow-up assessment of variants in 22 412 cases and 286 003 controls from Intermountain (Utah, USA) and FinnGen (Finland). The study yielded 18 independent syncope variants, 17 of which were novel. One of the variants, p.Ser140Thr in PTPRN2, affected syncope only when maternally inherited. Another variant associated with a vasovagal reaction during blood donation and five others with heart rate and/or blood pressure regulation, with variable directions of effects. None of the 18 associations could be attributed to cardiovascular or other disorders. Annotation with regard to regulatory elements indicated that the syncope variants were preferentially located in neural-specific regulatory regions. Mendelian randomization analysis supported a causal effect of coronary artery disease on syncope. A polygenic score (PGS) for syncope captured genetic correlation with cardiovascular disorders, diabetes, depression, and shortened lifespan. However, a score based solely on the 18 syncope variants performed similarly to the PGS in detecting syncope risk but did not associate with other disorders.

CONCLUSION: The results demonstrate that syncope has a distinct genetic architecture that implicates neural regulatory processes and a complex relationship with heart rate and blood pressure regulation. A shared genetic background with poor cardiovascular health was observed, supporting the importance of a thorough assessment of individuals presenting with syncope.

OriginalsprogEngelsk
Sider (fra-til)1070-1080
Antal sider11
TidsskriftEuropean heart journal
Vol/bind44
Udgave nummer12
Tidlig onlinedato7 feb. 2023
DOI
StatusUdgivet - 21 mar. 2023

Bibliografisk note

© The Author(s) 2023. Published by Oxford University Press on behalf of the European Society of Cardiology. All rights reserved. For permissions, please e-mail: [email protected].

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