Influence of circadian rhythm-induced cardiac remodeling on cardiovascular diseases:A Mendelian randomization study
Wang Bingfu
Song Yulong
Fan Yujian
Zhao Zhiqiang
Abstract：Objective To discuss the role of cardiac remodeling in influence of circadian rhythm on cardiovascular diseases.Methods The causal relationship between circadian rhythm and 6 types of cardiovascular diseases[coronary heart disease(CHD),heart failure(HF),atrial fibrillation(AF),dilated cardiomyopathy(DCM),hypertrophic cardiomyopathy(HCM)and valvular heart disease(VHD)]was analyzed by using Mendelian randomization.The mediating effect of cardiac structure in the relationship between circadian rhythm and cardiovascular diseases was identified through mediation analysis.Results Daytime napping could increase the risk of 5 types of cardiovascular diseases(CHD,HF,AF,DCM and VHD),while reduce HCM risk.Short sleep duration could elevate risks of CHD,HF and AF,whereas prolonged sleep duration could reduce risks of these three diseases.Sleep fragmentation and an increase in the number of sleep fragments were correlated to a higher HF risk.Obstructive sleep apnea syndrome(OSAS)raised risks of HF and AF.Additionally,a morning chronotype and high wake-up sensitivity might lead to an increased risk of HF or CHD.In mediation analysis,both OSAS and prolonged sleep duration could affect HF occurrence by altering cardiac volume.Short sleep duration could increase HF risk through reduced ascending aortic compliance and decreased ejection fraction.In addition,OSAS,increased number of sleep episodes,short sleep duration and morning chronotype could induce an increase in myocardial wall thickness and impair cardiac short-axis strain and circumferential strain,thereby increasing risks of HF,CHD or AF.Conclusion This study reveals a causal relationship between circadian rhythm and cardiovascular diseases(mainly including CHD,HF and AF),and identifies that the anterior wall and septum of intermediate ring and apical ring are the cardiac structures most susceptible to the influence of circadian rhythm.This suggests that adjusting circadian rhythm to improve cardiac remodeling may become an effective strategy for the prevention and management of cardiovascular diseases.
Keywords：Circadian rhythmCardiovascular diseasesHeart remodelingMendelian randomizationMediation analysis
Publication Date：2025-09-20
Online Publishing Date：2025-11-04(First online date of this platform, not the publication date of the document)
Pages：6( 1039-1043,1054 )