Letter to the Editor
Copyright ©The Author(s) 2024. Published by Baishideng Publishing Group Inc. All rights reserved.
World J Psychiatry. Dec 19, 2024; 14(12): 1988-1991
Published online Dec 19, 2024. doi: 10.5498/wjp.v14.i12.1988
Heart abnormality associates with a wide spectrum of psychiatric disorders: Evidence from Mendelian randomization analyses
Xue-Shi Chen, Zi-Yan Song, Xuan-Long Chen, Yi-Ming Bo, Li-Liang Li
Xue-Shi Chen, Zi-Yan Song, Xuan-Long Chen, Yi-Ming Bo, Li-Liang Li, Department of Forensic Medicine, School of Basic Medical Sciences, Fudan University, Shanghai 200032, China
Co-first authors: Xue-Shi Chen and Zi-Yan Song.
Author contributions: Chen XS and Song ZY contributed equally to this study; Chen XS gathered literatures, drew the figure and drafted the manuscript; Song ZY gathered literatures and conducted data analysis; Chen XL and Bo YM designed the table; Li LL conceived the original idea and edited the manuscript; All authors participated fully in this work, taking public responsibility for its content, and provided final approval of the version that was submitted.
Supported by the National Natural Science Foundation of China, No. 82070285, No. 82322033 and No. 82470265.
Conflict-of-interest statement: The authors declare that they have no conflict of interest.
Open-Access: This article is an open-access article that was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution NonCommercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: https://creativecommons.org/Licenses/by-nc/4.0/
Corresponding author: Li-Liang Li, MD, PhD, Associate Professor, Teacher, Department of Forensic Medicine, School of Basic Medical Sciences, Fudan University, No. 131 Dongan Road, Shanghai 200032, China. liliangli11@fudan.edu.cn
Received: September 5, 2024
Revised: November 1, 2024
Accepted: November 8, 2024
Published online: December 19, 2024
Processing time: 83 Days and 2.6 Hours
Abstract

Psychiatric disorders and heart abnormality are closely interconnected. Previous knowledge has been well-established that psychiatric disorders can lead to increased cardiovascular morbidity and even sudden cardiac death. Conversely, whether heart abnormality contributes to psychiatric disorders remains rarely studied. The work by Zhang et al pointed out that chronic heart failure had effects on the anxiety and depression (AD) severity, and indices including left ventricular ejection fraction, N-terminal pro-brain natriuretic peptide and interleukin-6 were independent risk factors for AD severity. In addition to the aforementioned AD, we herein find that heart failure might additionally impact the development of autism spectrum disorder and post-traumatic stress disorder (albeit P > 0.05), and significantly protects against the presence of attention deficit hyperactivity disorder (ADHD), [odds ratio (OR) = 0.61, P = 0.0071] by using a Mendelian randomization analysis. Bradycardia is also a protective factor for ADHD (OR = 0.61, P = 0.0095), whereas hypertrophic cardiomyopathy is a mild risk factor for schizophrenia (OR = 1.02, P = 0.032). These data suggest a wide spectrum of psychiatric disorders secondary to heart abnormality, and we highlight more psychiatric care that should be paid to patients with heart abnormality.

Keywords: Psychiatric disorders; Schizophrenia; Heart abnormality; Heart failure; Mendelian randomization analyses

Core Tip: Numerous studies have reported the effects of psychiatric disorders on heart dysfunction. Little attention has been paid to the effects of heart abnormality on psychiatric status. We highlight that in addition to the impact on anxiety and depression, heart failure might further contribute to increased risks of autism spectrum disorder and post-traumatic stress disorder, and protects from the development of attention deficit hyperactivity disorder (ADHD). Furthermore, bradycardia is a protective factor for ADHD, and hypertrophic cardiomyopathy may significantly contribute to the presence of schizophrenia. Heart abnormality is associated with a wide spectrum of psychiatric disorders.