Leucocyte telomere length and paroxysmal atrial fibrillation: A prospective cohort study and systematic review with meta‐analysis

Zhang, Nixiao; Fan, Chong; Gong, Mengqi; Li, Xue; Zhang, Weili; Li, Guangping; Tse, Gary; Liu, Tong

doi:10.1002/jcla.22599

Cited by 14 publications

(10 citation statements)

References 29 publications

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“…One of the consequences is fibrosis, characterized by increased turnover of the extracellular matrix, producing conduction abnormalities that provide the necessary substrate for arrhythmogenesis . A number of blood biomarkers and electrocardiographic predictors have been found in association with AF onset, development, and recurrence. Of these, galectin‐3 plays a key role in acute and chronic pro‐inflammatory responses and mediates activation of quiescent fibroblasts and synthesis of collagen .…”

Section: Discussionmentioning

confidence: 99%

Galectin‐3 and risk of atrial fibrillation: A systematic review and meta‐analysis

Gong

Cheung

Wang

et al. 2020

Clinical Laboratory Analysis

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Background Galectin‐3 is an inflammatory marker that is raised in myocardial fibrosis and inflammation. Recent studies have explored its role in predicting atrial fibrillation (AF) outcomes. The aim of this systematic review and meta‐analysis is to examine the association between serum concentration of galectin‐3 and AF. Methods PubMed, EMBASE, and the Cochrane Database were searched. A total of 280 studies were identified, of which 28 studies involving 10 830 patients were included in our meta‐analysis. Results Galectin‐3 is present at higher concentrations in patients with AF than those in sinus rhythm (mean difference [MD] = −0.68 ng/mL, 95% CI: −0.92, −0.44, Z = 5.61, P < .00001). Galectin‐3 levels were significantly higher in the persistent AF than in the paroxysmal AF group (MD = −0.94 ng/mL, 95% CI: −1.85, −0.03, Z = 2.04, P = .04). Higher galectin‐3 levels were associated with a 45% increase in the odds of developing AF (odds ratio [OR] = 1.45, 95% CI: 1.15, 1.83, Z = 3.11, P = .002) and risk of AF recurrence (hazard ratio [HR] =1.17, 95% CI: 1.06, 1.29, Z = 3.12, P = .002). Conclusions Our meta‐analysis found that galectin‐3 is significantly higher in patients with persistent AF than in those with paroxysmal AF, and can predict both AF development and recurrence after treatment.

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Section: Discussionmentioning

confidence: 99%

Galectin‐3 and risk of atrial fibrillation: A systematic review and meta‐analysis

Gong

Cheung

Wang

et al. 2020

Clinical Laboratory Analysis

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“…Additionally, although our MR study did not find evidence to support the associations between TL and heart failure or cardiac death, the ORs for these associations were both less than 1.0, suggesting that TL might be a potential risk factor for heart failure and cardiac death. Previous studies have shown inconsistent results in the associations of TL with heart failure, atrial fibrillation, and cardiac death (14,(51)(52)(53)(54)(55)(56)(57), indicating the need for further research.…”

Section: Discussionmentioning

confidence: 98%

Telomere length and the risk of cardiovascular diseases: A Mendelian randomization study

Deng

Li²,

Zhou³

et al. 2022

Front. Cardiovasc. Med.

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BackgroundThe causal direction and magnitude of the associations between telomere length (TL) and cardiovascular diseases (CVDs) remain uncertain due to susceptibility of reverse causation and confounding. This study aimed to investigate the associations between TL and CVDs using Mendelian randomization (MR).Materials and methodsIn this two-sample MR study, we identified 154 independent TL-associated genetic variants from a genome-wide association study (GWAS) consisting of 472,174 individuals (aged 40–69) in the UK Biobank. Summary level data of CVDs were obtained from different GWASs datasets. Methods of inverse variance weighted (IVW), Mendelian Randomization-Egger (MR-Egger), Mendelian Randomization robust adjusted profile score (MR-RAPS), maximum likelihood estimation, weighted mode, penalized weighted mode methods, and Mendelian randomization pleiotropy residual sum and outlier test (MR-PRESSO) were conducted to investigate the associations between TL and CVDs.ResultsOur findings indicated that longer TL was significantly associated with decreased risk of coronary atherosclerosis [odds ratio (OR), 0.85; 95% confidence interval (CI), 0.75–0.95; P = 4.36E-03], myocardial infarction (OR, 0.72; 95% CI, 0.63–0.83; P = 2.31E-06), ischemic heart disease (OR, 0.87; 95% CI, 0.78–0.97; P = 1.01E-02), stroke (OR, 0.87; 95% CI, 0.79–0.95; P = 1.60E-03), but an increased risk of hypertension (OR, 1.12; 95% CI, 1.02–1.23; P = 2.00E-02). However, there was no significant association between TL and heart failure (OR, 0.94; 95% CI, 0.87–1.01; P = 1.10E-01), atrial fibrillation (OR, 1.01; 95% CI, 0.93–1.11; P = 7.50E-01), or cardiac death (OR, 0.95; 95% CI, 0.82–1.10; P = 4.80E-01). Both raw and outlier corrected estimates from MR-PRESSO were consistent with those of IVW results. The sensitivity analyses showed no evidence of pleiotropy (MR-Egger intercept, P > 0.05), while Cochran’s Q test and MR-Egger suggested different degrees of heterogeneity.ConclusionOur MR study suggested that longer telomeres were associated with decreased risk of several CVDs, including coronary atherosclerosis, myocardial infarction, ischemic heart disease, and stroke, as well as an increased risk of hypertension. Future studies are still warranted to validate the results and investigate the mechanisms underlying these associations.

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“…Even though we did not find a relevant association between ECG measures and telomere length, it remains unresolved if telomere length is relevant for the pathophysiology of selected age-dependent conditions. At least for AF, a relation with telomere length has been suggested, but the results remain conflicting [33][34][35].…”

Section: Discussionmentioning

confidence: 99%

Common electrocardiogram measures are not associated with telomere length

Falkenhausen

Freudling

Waldenberger

et al. 2022

Aging

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Aims: Aging is accompanied by telomere shortening. Increased telomere shortening is considered a marker of premature aging. Cardiac aging results in the development of cardiac pathologies. Electrocardiogram (ECG) measures reflect cardiac excitation, conduction, and repolarization. ECG measures also prolong with aging and are associated with cardiac pathologies including atrial fibrillation. As premature prolongation of ECG measures is observed, we hypothesized that such prolongation may be associated with telomere length. Methods and Results: We studied the large, community-based KORA F4 Study. Of 3,080 participants enrolled between 2006 and 2007 with detailed information on demographic, anthropometric, clinical, and ECG characteristics, 2,575 presented with available data on leukocyte telomere length. Telomere length was determined by real-time quantitative PCR and expressed relative to a single copy gene. We fitted multivariable adjusted linear regression models to associate the ECG measures RR-interval, PR-interval, QRS-duration, and heart rate corrected QTc with telomere length. In our cohort, the mean age was 54.9±12.9 years and 46.6% were men. Increased age was associated with shorter telomere length (p<0.01), and men had shorter telomere length than women (p<0.05). In unadjusted models, heart rate (p=0.023), PR-interval (p<0.01), and QTc-interval (p<0.01) were significantly associated with shorter telomere length. However, no significant associations remained after accounting for age, sex, and covariates. Conclusions: ECG measures are age-dependent, but not associated with shortened telomere length as a marker of biological aging. Further research is warranted to clarify if shortened telomeres are associated with clinical cardiac pathologies including atrial fibrillation.

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Leucocyte telomere length and paroxysmal atrial fibrillation: A prospective cohort study and systematic review with meta‐analysis

Cited by 14 publications

References 29 publications

Galectin‐3 and risk of atrial fibrillation: A systematic review and meta‐analysis

Galectin‐3 and risk of atrial fibrillation: A systematic review and meta‐analysis

Telomere length and the risk of cardiovascular diseases: A Mendelian randomization study

Common electrocardiogram measures are not associated with telomere length

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