52 Genetic Loci Influencing Myocardial Mass

Pim van der Harst, Jessica van Setten, Niek Verweij, Georg Vogler, Lude Franke, Matthew T. Maurano, Xinchen Wang, Irene Mateo Leach, Mark Eijgelsheim, Nona Sotoodehnia, Caroline Hayward, Rossella Sorice, Osorio Meirelles, Leo-Pekka Lyytikäinen, Ozren Polašek, Toshiko Tanaka, Dan E. Arking, Sheila Ulivi, Stella Trompet, Martina Müller-Nurasyid, Albert V. Smith, Marcus Dörr, Kathleen F. Kerr, Jared W. Magnani, Fabiola Del Greco M., Weihua Zhang, Ilja M. Nolte, Claudia T. Silva, Sandosh Padmanabhan, Vinicius Tragante, Tõnu Esko, Gonçalo R. Abecasis, Michiel E. Adriaens, Karl Andersen, Phil Barnett, Joshua C. Bis, Rolf Bodmer, Brendan M. Buckley, Harry Campbell, Megan V. Cannon, Aravinda Chakravarti, Lin Y. Chen, Alessandro Delitala, Richard B. Devereux, Pieter A. Doevendans, Anna F. Dominiczak, Luigi Ferrucci, Ian Ford, Christian Gieger, Tamara B. Harris, Eric Haugen, Matthias Heinig, Dena G. Hernandez, Hans L. Hillege, Joel N. Hirschhorn, Albert Hofman, Norbert Hubner, Shih-Jen Hwang, Annamaria Iorio, Mika Kähönen, Manolis Kellis, Ivana Kolcic, Ishminder K. Kooner, Jaspal S. Kooner, Jan A. Kors, Edward G. Lakatta, Kasper Lage, Lenore J. Launer, Daniel Levy, Alicia Lundby, Peter W. Macfarlane, Dalit May, Thomas Meitinger, Andres Metspalu, Stefania Nappo, Silvia Naitza, Shane Neph, Alex S. Nord, Teresa Nutile, Peter M. Okin, Jesper V. Olsen, Ben A. Oostra, Josef M. Penninger, Len A. Pennacchio, Tune H. Pers, Siegfried Perz, Annette Peters, Yigal M. Pinto, Arne Pfeufer, Maria Grazia Pilia, Peter P. Pramstaller, Bram P. Prins, Olli T. Raitakari, Soumya Raychaudhuri, Ken M. Rice, Elizabeth J. Rossin, Jerome I. Rotter, Sebastian Schafer, David Schlessinger, Carsten O. Schmidt, Jobanpreet Sehmi, Herman H.W. Silljé, Gianfranco Sinagra, Moritz F. Sinner, Kamil Slowikowski, Elsayed Z. Soliman, Timothy D. Spector, Wilko Spiering, John A. Stamatoyannopoulos, Ronald P. Stolk, Konstantin Strauch, Sian-Tsung Tan, Kirill V. Tarasov, Bosco Trinh, Andre G. Uitterlinden, Malou van den Boogaard, Cornelia M. van Duijn, Wiek H. van Gilst, Jorma S. Viikari, Peter M. Visscher, Veronique Vitart, Uwe Völker, Melanie Waldenberger, Christian X. Weichenberger, Harm-Jan Westra, Cisca Wijmenga, Bruce H. Wolffenbuttel, Jian Yang, Connie R. Bezzina, Patricia B. Munroe, Harold Snieder, Alan F. Wright, Igor Rudan, Laurie A. Boyer, Folkert W. Asselbergs, Dirk J. van Veldhuisen, Bruno H. Stricker, Bruce M. Psaty, Marina Ciullo, Serena Sanna, Terho Lehtimäki, James F. Wilson, Stefania Bandinelli, Alvaro Alonso, Paolo Gasparini, J. Wouter Jukema, Stefan Kääb, Vilmundur Gudnason, Stephan B. Felix, Susan R. Heckbert, Rudolf A. de Boer, Christopher Newton-Cheh, Andrew A. Hicks, John C. Chambers, Yalda Jamshidi, Axel Visel, Vincent M. Christoffels, Aaron Isaacs, Nilesh J. Samani, Paul I.W. de Bakker

Myocardial mass is a key determinant of cardiac muscle function and hypertrophy. Myocardial depolarization leading to cardiac muscle contraction is reflected by the amplitude and duration of the QRS complex on the electrocardiogram (ECG). Abnormal QRS amplitude or duration reflect changes in myocardial mass and conduction, and are associated with increased risk of heart failure and death. This meta-analysis sought to gain insights into the genetic determinants of myocardial mass. We carried out a genome-wide association meta-analysis of 4 QRS traits in up to 73,518 individuals of European ancestry, followed by extensive biological and functional assessment. We identified 52 genomic loci, of which 32 are novel, that are reliably associated with 1 or more QRS phenotypes at p < 1 × 10(-8). These loci are enriched in regions of open chromatin, histone modifications, and transcription factor binding, suggesting that they represent regions of the genome that are actively transcribed in the human heart. Pathway analyses provided evidence that these loci play a role in cardiac hypertrophy. We further highlighted 67 candidate genes at the identified loci that are preferentially expressed in cardiac tissue and associated with cardiac abnormalities in Drosophila melanogaster and Mus musculus. We validated the regulatory function of a novel variant in the SCN5A/SCN10A locus in vitro and in vivo. Taken together, our findings provide new insights into genes and biological pathways controlling myocardial mass and may help identify novel therapeutic targets.