PR interval genome-wide association meta-analysis identifies 50 loci associated with atrial and atrioventricular electrical activity.
van Setten J., Brody JA., Jamshidi Y., Swenson BR., Butler AM., Campbell H., Del Greco FM., Evans DS., Gibson Q., Gudbjartsson DF., Kerr KF., Krijthe BP., Lyytikäinen L-P., Müller C., Müller-Nurasyid M., Nolte IM., Padmanabhan S., Ritchie MD., Robino A., Smith AV., Steri M., Tanaka T., Teumer A., Trompet S., Ulivi S., Verweij N., Yin X., Arnar DO., Asselbergs FW., Bader JS., Barnard J., Bis J., Blankenberg S., Boerwinkle E., Bradford Y., Buckley BM., Chung MK., Crawford D., den Hoed M., Denny JC., Dominiczak AF., Ehret GB., Eijgelsheim M., Ellinor PT., Felix SB., Franco OH., Franke L., Harris TB., Holm H., Ilaria G., Iorio A., Kähönen M., Kolcic I., Kors JA., Lakatta EG., Launer LJ., Lin H., Lin HJ., Loos RJF., Lubitz SA., Macfarlane PW., Magnani JW., Leach IM., Meitinger T., Mitchell BD., Munzel T., Papanicolaou GJ., Peters A., Pfeufer A., Pramstaller PP., Raitakari OT., Rotter JI., Rudan I., Samani NJ., Schlessinger D., Silva Aldana CT., Sinner MF., Smith JD., Snieder H., Soliman EZ., Spector TD., Stott DJ., Strauch K., Tarasov KV., Thorsteinsdottir U., Uitterlinden AG., Van Wagoner DR., Völker U., Völzke H., Waldenberger M., Jan Westra H., Wild PS., Zeller T., Alonso A., Avery CL., Bandinelli S., Benjamin EJ., Cucca F., Dörr M., Ferrucci L., Gasparini P., Gudnason V., Hayward C., Heckbert SR., Hicks AA., Jukema JW., Kääb S., Lehtimäki T., Liu Y., Munroe PB., Parsa A., Polasek O., Psaty BM., Roden DM., Schnabel RB., Sinagra G., Stefansson K., Stricker BH., van der Harst P., van Duijn CM., Wilson JF., Gharib SA., de Bakker PIW., Isaacs A., Arking DE., Sotoodehnia N.
Electrocardiographic PR interval measures atrio-ventricular depolarization and conduction, and abnormal PR interval is a risk factor for atrial fibrillation and heart block. Our genome-wide association study of over 92,000 European-descent individuals identifies 44 PR interval loci (34 novel). Examination of these loci reveals known and previously not-yet-reported biological processes involved in cardiac atrial electrical activity. Genes in these loci are over-represented in cardiac disease processes including heart block and atrial fibrillation. Variants in over half of the 44 loci were associated with atrial or blood transcript expression levels, or were in high linkage disequilibrium with missense variants. Six additional loci were identified either by meta-analysis of ~105,000 African and European-descent individuals and/or by pleiotropic analyses combining PR interval with heart rate, QRS interval, and atrial fibrillation. These findings implicate developmental pathways, and identify transcription factors, ion-channel genes, and cell-junction/cell-signaling proteins in atrio-ventricular conduction, identifying potential targets for drug development.