肺动脉高压与心房颤动/心房扑动因果关系的两样本孟德尔随机化研究

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CausalRelationshipbetweenPumonaryHypertensionandAtialFiblationandFuteraTwosampleMendelianandomzationStudy HOURuiling，ZHANG Qiong，WANG Peili，ZHANG Jie，ZHANG He

XiyuanHospital，ChinaAcademyofChineseMedical Sciences，Beijing10oo91，China

Corresponding Author ZHANG He， E-mail： zhhe1112 @ 163.com; ZHANG Jie，E-mail： zhangjie_by @ 163.com

AbstractObjective：Toivestigatecausalrelationshipbetweenpulmonaryhypertensionandatrialflrilationfutterbytwoample Mendelianrandomization（MR）analysis.Methods：Two-waytwo-sampleMRanalyseswereperformedusingpubliclyavailablegenome wideassociationstudyGWA）pooleddatasetswithinversevarianceweighting（vW），weightedmedian-Egerregresiople mode，andweightedmode，withIVWastheprimarymethodofanalysis.M-Eggerregressonwasusedforhorizontalmultivariatetesting. Cochran'sQstatiticasusedtoquantifytheheterogeeityofinstrumentalvariablesandsensityanalysiswasperformedusingthe leave-one-outmethod（LOM）.Results：Theresultsof theoutcomeMRanalysisshowedthattherewerecausalrelationshipbetween pulmonary hypertension and increased risk of atrial fibrillation/flutter（IVW：OR i=0.999 P=0.974 ），however，itwasnoteworthy thatatrial fibrillation/flutter was causally associated with an increased risk of PH in reverse MR（IVW：OF i=1.506 P=0.001 ;weighted median：OR ∘leddash 1.612， P=0.026 .InthebidirectionalMRanalysisofpulmonaryarterialhypertensionandatrialfibriltion/atrialflutter，therewasno horizontalpleiotropyoreterogeneityinteinstrumentalvarables.Sensityanalysisusingtheleaveonoutmethdrevealdthathe MRanalysisresultswererobust.Conlusion：Althoughsomeobservational studieshave suggestedaposibleassociationbetween pulmonryartealhpresndrafiliotraluulsftaasstatpmoayrtahsi mayffectatrloroieait moreresarchisededtootiexplorintecusalelatioshipetweepumonaryarteralhypertensionndatriafibltiue ywordspulmonaryarterial hypertension;atrialfibrilation;atrialfluttr; Mendelianrandomization;causalrelations

肺动脉高压（pulmonaryarterialhypertension，PAH）是以肺血管重塑、肺动脉压力持续升高，肺循环阻力增加，右心负荷增大，致右心衰竭为特征的恶性心肺疾病[1]，其发病率为每年 2.0/100 万 ～7.6/100 万[2]心房颤动（atrialfibrillation，AF）及心房扑动（atrialflutter，AFL）是最常见的室上性心律失常（supraventriculararrhythmia，SVA），AF发病率较高，且逐年上升，目前全世界成人AF的患病率为 2%～4% ，严重影响病人生活质量，显著增加死亡风险，是重要的公共卫生问题[3-4]。（剩余10956字）