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Lin H, Kwan AC, Castro-Diehl C, Short MI, Xanthakis V, Yola IM, Salto G, Mitchell GF, Larson MG, Vasan RS, Cheng S. Sex-specific differences in the genetic and environmental effects on cardiac phenotypic variation assessed by echocardiography. Sci Rep 2023; 13:5786. [PMID: 37031215 PMCID: PMC10082757 DOI: 10.1038/s41598-023-32577-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/02/2022] [Accepted: 03/29/2023] [Indexed: 04/10/2023] Open
Abstract
The drivers of sexual dimorphism in heart failure phenotypes are currently poorly understood. Divergent phenotypes may result from differences in heritability and genetic versus environmental influences on the interplay of cardiac structure and function. To assess sex-specific heritability and genetic versus environmental contributions to variation and inter-relations between echocardiography traits in a large community-based cohort. We studied Framingham Heart Study participants of Offspring Cohort examination 8 (2005-2008) and Third Generation Cohort examination 1 (2002-2005). Five cardiac traits and six functional traits were measured using standardized echocardiography. Sequential Oligogenic Linkage Analysis Routines (SOLAR) software was used to perform singular and bivariate quantitative trait linkage analysis. In our study of 5674 participants (age 49 ± 15 years; 54% women), heritability for all traits was significant for both men and women. There were no significant differences in traits between men and women. Within inter-trait correlations, there were two genetic, and four environmental trait pairs with sex-based differences. Within both significant genetic trait pairs, men had a positive relation, and women had no significant relation. We observed significant sex-based differences in inter-trait genetic and environmental correlations between cardiac structure and function. These findings highlight potential pathways of sex-based divergent heart failure phenotypes.
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Affiliation(s)
- Honghuang Lin
- Department of Medicine, University of Massachusetts Chan Medical School, Worcester, MA, USA
- Framingham Heart Study, Framingham, MA, USA
| | - Alan C Kwan
- Department of Cardiology, Cedars-Sinai Medical Center, 127 S. San Vicente Blvd, Suite A3100, Los Angeles, CA, 90048, USA
| | - Cecilia Castro-Diehl
- Section of Preventive Medicine and Epidemiology, Department of Medicine, Boston University School of Medicine, Boston, MA, USA
| | - Meghan I Short
- Glenn Biggs Institute for Alzheimer's & Neurodegenerative Diseases, University of Texas Health San Antonio, San Antonio, TX, USA
- Department of Biostatistics, Boston University School of Public Heath, Boston, MA, USA
| | - Vanessa Xanthakis
- Framingham Heart Study, Framingham, MA, USA
- Section of Preventive Medicine and Epidemiology, Department of Medicine, Boston University School of Medicine, Boston, MA, USA
- Department of Biostatistics, Boston University School of Public Heath, Boston, MA, USA
| | - Ibrahim M Yola
- Section of Preventive Medicine and Epidemiology, Department of Medicine, Boston University School of Medicine, Boston, MA, USA
| | - Gerran Salto
- Department of Cardiology, Cedars-Sinai Medical Center, 127 S. San Vicente Blvd, Suite A3100, Los Angeles, CA, 90048, USA
| | | | - Martin G Larson
- Framingham Heart Study, Framingham, MA, USA
- Department of Biostatistics, Boston University School of Public Heath, Boston, MA, USA
| | - Ramachandran S Vasan
- Framingham Heart Study, Framingham, MA, USA
- Section of Preventive Medicine and Epidemiology, Department of Medicine, Boston University School of Medicine, Boston, MA, USA
- Section of Cardiovascular Medicine, Department of Medicine, Boston University School of Medicine, Boston, MA, USA
- Department of Epidemiology, Boston University School of Public Heath, Boston, MA, USA
- Center for Computing and Data Sciences, Boston University, Boston, MA, USA
| | - Susan Cheng
- Framingham Heart Study, Framingham, MA, USA.
- Department of Cardiology, Cedars-Sinai Medical Center, 127 S. San Vicente Blvd, Suite A3100, Los Angeles, CA, 90048, USA.
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Holmström L, Juntunen S, Vähätalo J, Pakanen L, Kaikkonen K, Haukilahti A, Kenttä T, Tikkanen J, Viitasalo V, Perkiömäki J, Huikuri H, Myerburg RJ, Junttila J. Plaque histology and myocardial disease in sudden coronary death: the Fingesture study. Eur Heart J 2022; 43:4923-4930. [PMID: 36172703 PMCID: PMC9748531 DOI: 10.1093/eurheartj/ehac533] [Citation(s) in RCA: 16] [Impact Index Per Article: 8.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/14/2022] [Revised: 07/18/2022] [Accepted: 09/13/2022] [Indexed: 01/12/2023] Open
Abstract
AIMS At least 50% of deaths due to coronary artery disease (CAD) are sudden cardiac deaths (SCDs), but the role of acute plaque complications on the incidence of sudden death in CAD is somewhat unclear. The present study aimed to investigate plaque histology and concomitant myocardial disease in sudden coronary death. METHODS AND RESULTS The study population is derived from the Fingesture study, which has collected data from 5869 consecutive autopsy-verified SCD victims in Northern Finland (population ≈600 000) between 1998 and 2017. In this substudy, histological examination of culprit lesions was performed in 600 SCD victims whose death was due to CAD. Determination of the cause of death was based on the combination of medical records, police reports, and autopsy data. Plaque histology was classified as either (i) plaque rupture or erosion, (ii) intraplaque haemorrhage, or (iii) stable plaque. The mean age of the study subjects was 64.9 ± 11.2 years, and 82% were male. Twenty-four per cent had plaque rupture or plaque erosion, 24% had an intraplaque haemorrhage, and 52% had a stable plaque. Myocardial hypertrophy was present in 78% and myocardial fibrosis in 93% of victims. The presence of myocardial hypertrophy or fibrosis was not associated with specific plaque histology. CONCLUSION Less than half of sudden deaths due to CAD had evidence of acute plaque complication, an observation which is contrary to historical perceptions. The prevalence of concomitant myocardial disease was high and independent of associated plaque morphology.
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Affiliation(s)
- Lauri Holmström
- Corresponding author. Tel: +358 8 3154464, Fax: +358 8 3155599,
| | | | - Juha Vähätalo
- Research Unit of Internal Medicine, Medical Research Center Oulu, University of Oulu and Oulu University Hospital, PO Box 5000, 90014 Oulu, Finland
| | - Lasse Pakanen
- Forensic Medicine Unit, Finnish Institute for Health and Welfare (THL), PO Box 310, 90101 Oulu, Finland,Department of Forensic Medicine, Research Unit of Internal Medicine, Medical Research Center Oulu, University of Oulu, PO Box 5000, 90014 Oulu, Finland
| | - Kari Kaikkonen
- Research Unit of Internal Medicine, Medical Research Center Oulu, University of Oulu and Oulu University Hospital, PO Box 5000, 90014 Oulu, Finland
| | - Anette Haukilahti
- Research Unit of Internal Medicine, Medical Research Center Oulu, University of Oulu and Oulu University Hospital, PO Box 5000, 90014 Oulu, Finland
| | - Tuomas Kenttä
- Research Unit of Internal Medicine, Medical Research Center Oulu, University of Oulu and Oulu University Hospital, PO Box 5000, 90014 Oulu, Finland
| | - Jani Tikkanen
- Research Unit of Internal Medicine, Medical Research Center Oulu, University of Oulu and Oulu University Hospital, PO Box 5000, 90014 Oulu, Finland
| | - Ville Viitasalo
- Research Unit of Internal Medicine, Medical Research Center Oulu, University of Oulu and Oulu University Hospital, PO Box 5000, 90014 Oulu, Finland
| | - Juha Perkiömäki
- Research Unit of Internal Medicine, Medical Research Center Oulu, University of Oulu and Oulu University Hospital, PO Box 5000, 90014 Oulu, Finland
| | - Heikki Huikuri
- Research Unit of Internal Medicine, Medical Research Center Oulu, University of Oulu and Oulu University Hospital, PO Box 5000, 90014 Oulu, Finland
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