"Shape variations are more strongly related to cardiovascular risk factors, such as hypertension, hyperlipidemia, diabetes, smoking and obesity, and are predictive of major adverse cardiovascular events," says an international study.
Contrary to what universal symbolism has popularized, the heart is far from having a unique shape and as perfect as two semicircles joined by an inverted triangle at the bottom. It is no longer scientific news that there are hearts that are more rounded, more elongated, smaller or wider. But what science now seems to demonstrate is that the shape and size of each heart may also be related to the risk of certain cardiovascular diseases.
Did you know, for example, that a more spherical heart may be more susceptible to the risk of atrial fibrillation, a type of cardiac arrhythmia in which there are very irregular and usually fast heartbeats, with 80 to 160 beats per minute? And that smaller hearts are more associated with a higher risk of diabetes? Well, this is what an international study led by Spanish researchers, and published in the journal Nature Communications , shows, which used magnetic resonance images of more than 40 thousand people to create complete three-dimensional models of the hearts.
The scientists mapped 11 coordinates relating to different aspects of the heart's shape, from size, tilt, sphericity and thickness. This is a novel approach, as previous methods were limited to simple measurements, such as the volume of the ventricles or the size of the myocardium.
“This is the first time we have such a detailed three-dimensional representation of cardiac morphology,” highlights Julia Ramírez, from the University of Zaragoza, co-author of the study, quoted by the newspaper El País .
The study identified 45 regions of DNA linked to heart shape. Although many of these genes were already known, 14 of them had never been associated with the heart or any cardiac characteristic. “These genes represent new biology to explore,” says Patricia B. Munroe, a professor at Queen Mary University of London and one of the study’s authors.
The discovery of these 14 new genes related to cardiac morphology may open avenues for further investigations.
“We now know that it is possible to predict cardiac anomalies based on genetic information, which can be more cost-effective than MRI scans,” explains Julia Ramírez.
"Shape variations are more strongly related to cardiovascular risk factors such as hypertension, hyperlipidemia, diabetes, smoking and obesity, and more predictive of major adverse cardiovascular events than standard cardiac structural phenotypes. Genetic associations with cardiac shape variation may therefore provide insights not found in genetic analyses of standard cardiac structural phenotypes and may help in understanding the mechanisms underlying the development of CVD," the study says.
Although promising, the study is still far from practical applications. Ana García Álvarez, head of Cardiology at the Hospital Clínic de Barcelona, quoted by El País, praises the integrated approach of the work, but highlights that more studies are needed to understand how these discoveries can help prevent diseases.
“Genetics plays a role, but lifestyle is more decisive for cardiovascular health,” he emphasizes, highlighting that 80% of the impact on heart disease is related to environmental factors, such as diet, a sedentary lifestyle and smoking.
According to the World Health Organization, croupous diseases remain the leading cause of mortality worldwide.
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