Abstract
The QRS interval, from the beginning of the Q wave to the end of the S wave on an electrocardiogram, reflects ventricular depolarization and conduction time and is a risk factor for mortality, sudden death and heart failure. We performed a genome-wide association meta-analysis in 40,407 individuals of European descent from 14 studies, with further genotyping in 7,170 additional Europeans, and we identified 22 loci associated with QRS duration (P < 5 × 10−8). These loci map in or near genes in pathways with established roles in ventricular conduction such as sodium channels, transcription factors and calcium-handling proteins, but also point to previously unidentified biologic processes, such as kinase inhibitors and genes related to tumorigenesis. We demonstrate that SCN10A, a candidate gene at the most significantly associated locus in this study, is expressed in the mouse ventricular conduction system, and treatment with a selective SCN10A blocker prolongs QRS duration. These findings extend our current knowledge of ventricular depolarization and conduction.
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Contributions
Study concept and design: N.S., A.A., D.E.A., P.I.W.d.B., E.B., H.C., A.C., C.M.v.D., M.E., S.B.F., G.I.F., A.R.F., J.F., V.G., P.v.d.H., S.R.H., A.A.H., A.H., A.I., S.K., H.K.K., C.N.-C., B.A.O., A. Pfeufer, P.P.P., B.M.P., J.I.R., I.R., H.S., E.Z.S., B.H.C.S., A.G.U., A.V.S., U.V., H.V., T.J.W., J.F.W., A.F.W., N.J.S., Y.J.
Acquisition of data: A.A., D.E.A., L.H.v.d.B., R.A.d.B., E.B., M.J.C., A.C., J.M.C., A.F.D., M.D., C.M.v.D., R.S.N.F., A.R.F., L.F., S.G., H.J.M.G., T.B.H., P.v.d.H., C.H., G.v.H., A.I., W.H.L.K., N.K., J.A.K., A.K., L.L., M.L., F.-Y.L., I.M.L., G.t.M., P.B.M., G.N., C.N.-C., B.A.O., R.A.O., S. Perz, A. Pfeufer, A. Petersmann, O.P., B.M.P., J.Q., F.R., J.I.R., I.R., N.J.S., C.S., M.P.S.S., M.F.S., E.Z.S., B.H.C.S., A.T., A.G.U., D.J.v.V., C.B.V., R.K.W., C.W., J.F.W., J.C.M.W., D.L., T.D.S.
Statistical analysis and interpretation of data: A.A., D.E.A., T.A., P.I.W.d.B., N.S., E.B., A.C., L.A.C., M.E., K.E., G.I.F., A.R.F., L.F., J.F., C.F., S.A.G., W.H.v.G., S.G., V.G., P.v.d.H., C.H., S.R.H., A.I., T.J., W.H.L.K., X.L., K.D.M., I.M.L., M.M., I.M.N., S. Padmanabhan, A. Pfeufer, O.P., B.M.P., K.R., H.S., A.T., A.V.S., S.H.W., Y.A.W., N.J.S.
Drafting of the manuscript: N.S., A.A., D.E.A, F.W.A., P.I.W.d.B., M.D., C.M.v.D,. M.E., G.I.F., J.F., S.A.G., V.G., C.H., A.I., Y.J., S.K., J.W.M., I.M.N., O.P., N.J.S., H.S., C.N.-C., P.v.d.H.
Critical revision of the manuscript: A.A., D.E.A., T.A., F.W.A., J.C.B., R.A.d.B., E.B., H.C., M.J.C., A.C., J.M.C., L.A.C., A.F.D., M.D., C.M.v.D., M.E., K.E., S.B.F., G.I.F., A.R.F., J.F., W.H.v.G., V.G., T.B.H., P.v.d.H., C.H., S.R.H., G.v.H., A.A.H., A.H., A.I., Y.J., T.J., S.K., W.H.L.K., N.K., J.A.K., A.K., H.K.K., L.L., D.L., M.L., J.W.M., I.M.L., T.M., M.M., P.B.M., G.N., C.N.-C., I.M.N., C.J.O., B.A.O., S. Padmanabhan, S. Perz, A. Pfeufer, A. Petersmann, O.P., B.M.P., F.R., J.I.R., I.R., M.P.S.S., M.F.S., D.S.S., H.S., B.H.C.S., E.Z.S., A.T., A.G.U., D.J.v.V., U.V., H.V., T.J.W., H.-E.W., A.V.S., S.H.W., J.F.W., J.C.M.W., A.F.W.
Obtained funding: L.H.v.d.B., E.B., H.C., M.J.C., A.C., J.M.C., A.F.D., C.M.v.D., S.B.F., G.I.F., W.H.v.G., H.J.M.G., V.G., P.v.d.H., A.H., Y.J., S.K., H.K.K., L.L., P.B.M., G.N., C.N.-C., C.J.O., B.A.O., R.A.O., P.P.P., B.M.P., J.I.R., I.R., N.J.S., N.S., T.D.S., A.G.U., D.J.v.V., U.V., H.V., T.J.W., R.K.W., H.-E.W., C.W., J.F.W., A.F.W., D.L.
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A.C. is a paid member of the Scientific Advisory Board of Affymetrix, a role that is managed by the Committee on Conflict of Interest of the Johns Hopkins University School of Medicine.
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Sotoodehnia, N., Isaacs, A., de Bakker, P. et al. Common variants in 22 loci are associated with QRS duration and cardiac ventricular conduction. Nat Genet 42, 1068–1076 (2010). https://doi.org/10.1038/ng.716
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DOI: https://doi.org/10.1038/ng.716
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