Common variants at ten loci influence QT interval duration in the QTGEN Study

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QT interval duration, reflecting myocardial repolarization on the electrocardiogram, is a heritable risk factor for sudden cardiac death and drug-induced arrhythmias. We conducted a meta-analysis of three genome-wide association studies in 13,685 individuals of European ancestry from the Framingham Heart Study, the Rotterdam Study and the Cardiovascular Health Study, as part of the QTGEN consortium. We observed associations at P < 5 × 10−8 with variants in NOS1AP, KCNQ1, KCNE1, KCNH2 and SCN5A, known to be involved in myocardial repolarization and mendelian long-QT syndromes. Associations were found at five newly identified loci, including 16q21 near NDRG4 and GINS3, 6q22 near PLN, 1p36 near RNF207, 16p13 near LITAF and 17q12 near LIG3 and RFFL. Collectively, the 14 independent variants at these 10 loci explain 5.4–6.5% of the variation in QT interval. These results, together with an accompanying paper, offer insights into myocardial repolarization and suggest candidate genes that could predispose to sudden cardiac death and drug-induced arrhythmias.

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Figure 1: QT interval association results for 2,543,686 imputed SNPs in 13,685 individuals from three cohorts.
Figure 2: Regional association plots for one megabase surrounding each associated locus.


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The Framingham Heart Study work was conducted in part using data and resources from the Framingham Heart Study of the National Heart Lung and Blood Institute of the National Institutes of Health and Boston University School of Medicine (contract #N01-HC-25195) , its contract with Affymetrix for genotyping services (contract #N02-HL-6-4278), and the Doris Duke Charitable Foundation (C.N.-C.) and Burroughs Wellcome Fund (C.N.-C.). The Framingham analyses reflect intellectual input and resource development from the Framingham Heart Study investigators participating in the SNP Health Association Resource (SHARe) project. A portion of this research utilized the Linux Cluster for Genetic Analysis (LinGA-II) funded by the Robert Dawson Evans Endowment of the Department of Medicine at Boston University School of Medicine and Boston Medical Center. The measurement of ECG intervals in Framingham Heart Study generation 1 and 2 samples was done by eResearchTechnology and supported by an unrestricted grant from Pfizer. The measurement of ECG intervals in the Framingham Heart Study generation 3 sample was completed by A. Hirji and S. Kovvali using AMPS software provided through an unrestricted academic license by Analyzing Medical Parameters for Solutions (A.M.P.S., LLC). The Rotterdam Study is funded by Erasmus Medical Center and Erasmus University, Rotterdam, Netherlands Organization for the Health Research and Development (ZonMw), the Research Institute for Diseases in the Elderly (RIDE), the Ministry of Education, Culture and Science, the Ministry for Health, Welfare and Sports, the European Commission (DG XII), and the Municipality of Rotterdam. The generation and management of GWAS genotype data for the Rotterdam Study is supported by the Netherlands Organisation of Scientific Research NWO Investments (#175.010.2005.011, 911-03-012). This study is funded by the Research Institute for Diseases in the Elderly (014-93-015; RIDE2), and the Netherlands Genomics Initiative (NGI)/Netherlands Organisation for Scientific Research (NWO) project #050-060-810. The CHS research reported in this article was supported by contract numbers N01-HC-85079 through N01-HC-85086, N01-HC-35129, N01 HC-15103, N01 HC-55222, N01-HC-75150, N01-HC-45133, grant numbers U01 HL080295 and R01 HL087652 from the National Heart, Lung, and Blood Institute, with additional contribution from the National Institute of Neurological Disorders and Stroke. DNA handling and genotyping was supported in part by National Center for Research Resources grant M01RR00069 to the Cedars-Sinai General Clinical Research Center Genotyping core and National Institute of Diabetes and Digestive and Kidney Diseases grant DK063491 to the Southern California Diabetes Endocrinology Research Center. A full list of principal CHS investigators and institutions can be found at The authors acknowledge the essential role of the CHARGE (Cohorts for Heart and Aging Research in Genome Epidemiology) Consortium in development and support of this manuscript. CHARGE members include the Netherland's Rotterdam Study, the NHLBI's Atherosclerosis Risk in Communities (ARIC) Study, Cardiovascular Health Study (CHS) and Framingham Heart Study (FHS), and the NIA's Iceland Age, Gene/Environment Susceptibility (AGES) Study. C.N.-C. is supported by US National Institutes of Health grant K23-HL-080025, a Doris Duke Charitable Foundation Clinical Scientist Development Award, and a Burroughs Wellcome Fund Career Award for Medical Scientists. M.E. is funded by the Netherlands Heart Foundation (#2007B221). J.I.R. is supported by the Cedars-Sinai Board of Governors' Chair in Medical Genetics. The authors wish to thank the following people: G. Crawford and C. Guiducci (Broad Institute of Harvard and Massachusetts Institute of Technology) who completed the Sequenom-based technical validation genotyping of the Framingham Heart Study samples; P. Arp and M. Jhamai (Erasmus Medical Center) for Illumina array genotyping and Taqman-based technical validation genotyping of the Rotterdam Study samples; and Dr. M. Moorhouse, M. Verkerk and S. Bervoets (Erasmus Medical Center) for database management in the Rotterdam Study; and the study participants, the staff from the Rotterdam Study and the participating general practitioners and pharmacists. The QTGEN consortium would like to thank the QTSCD consortium for the opportunity to exchange top results pre-publication.

Author information

Framingham Heart Study: M.G.L., C.N.-C., P.A.N., C.J.O., X.Y.

Rotterdam Study: M.E., K.E., A.H., J.A.K., F.R., B.H.Ch.S., A.G.U., J.C.M.W.

Cardiovascular Health Study: J.C.B., S.R.H., T.L., K.M., C.N.-C., B.M.P., K.M.R., J.I.R., N.L.S., N.S.

Broad Institute of Harvard and Massachusetts Institute of Technology: P.I.W.dB., C.N.-C.

Design of QTGEN study: P.I.W.dB., M.E., M.G.L., T.L., C.N.-C., C.J.O., B.M.P., K.M.R., B.H.Ch.S. Genotyping: Affymetrix, C.N.-C., F.R., J.I.R., A.G.U. Statistical analysis and informatics: J.C.B., P.I.W.dB., M.E., K.E., T.L., K.M., C.N.-C., K.M.R., F.R., A.G.U., X.Y. Drafting of manuscript: C.N.-C. Critical revision of manuscript: J.C.B., P.I.W.dB., M.E., K.E., S.R.H., A.H., J.A.K., P.A.N., B.M.P., K.M.R., J.I.R., N.L.S., N.S., B.H.Ch.S., J.C.M.W.

Correspondence to Christopher Newton-Cheh or Bruno H Ch Stricker.

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