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January 19, 2023
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Telomere attrition as a biomarker for atrial fibrillation
Zheng et al. analyzed 12 studies with more than 18,000 patients to determine whether there is a connection between leukocyte telomere length (LTL) and atrial fibrillation (AF).
Atrial fibrillation (AF) is the most common condition affecting heart rhythmicity. This condition is a predisposing factor for cardiovascular diseases, leading to increased morbidity and mortality risks. Prolonged exposure to cardiovascular risk factors, like hypertension, diabetes, and hypercholesterolemia, has been found to contribute significantly to AF. According to the literature, around 80% of AF patients are aged 65 years and above, meaning that the risk of the condition increases with age coupled with the abovementioned risk factors.
Telomeres, consisting of TTAGGG repeats, are specialized DNA-protein structures that lie at the end of the chromosome, protecting the genome from degradation. Under normal conditions, these telomeres shorten with every cell division. In addition, conditions like oxidative stress, inflammation, and environmental factors have been found to influence the rate of telomere attrition. Peripheral blood leukocyte telomere length (LTL) has been found to be a valuable marker for telomere length in other cells and has been suggested to be a useful indicator of biological age. Previously, research has shown that chronological age, irrespective of biological age, has been linked to AF risk. However, exploring the potential of LTL, a marker of biological aging on AF risk, has not been adequately investigated.
Recent observational studies have reported a link between leukocyte telomere shortening (LTS) and increased risk of AF. Contrarily, other studies have reported no similar associations. To determine whether there is a possible connection between LTL and the risk of AF, Zheng et al. performed a systematic review and meta-analysis of the available literature. Their analysis included 12 studies with more than 18,000 patients. Further analysis took place to determine the predictive value of LTL between different fibrillation types, AF definitions, and genders.
Results revealed that LTS was found to be a predictor of AF, as it was significantly associated with the condition. In addition, LTS significantly correlated with recurrent AF cases but not new-onset ones, highlighting the potential of LTS as a predictor of disease recurrence. Further analysis showed that LTS was a predictor of paroxysmal AF in addition to being an independent predictor for progression from paroxysmal AF to persistent AF. Results analysing gender and LTS-associated AF risk showed males to be at higher risk than females.
Based on the abovementioned results, the authors derived four main findings:
- Patients with LTS are more likely to develop AF.
- LTS acts as a predictor for AF recurrence.
- LTS and AF risk was more prominent in males.
- LTL attrition can predict disease progression.
The authors concluded that LTL shortening is a marker of biological aging that holds a significant value in predicting AF occurrence, recurrence, and progression. The predictive value is more prominent in males. Further research is needed to confirm the findings and explore the potential of LTS as a biomarker in AF patients.
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Atrial fibrillation (AF) is the most common condition affecting heart rhythmicity. This condition is a predisposing factor for cardiovascular diseases, leading to increased morbidity and mortality risks. Prolonged exposure to cardiovascular risk factors, like hypertension, diabetes, and hypercholesterolemia, has been found to contribute significantly to AF. According to the literature, around 80% of AF patients are aged 65 years and above, meaning that the risk of the condition increases with age coupled with the abovementioned risk factors.
Telomeres, consisting of TTAGGG repeats, are specialized DNA-protein structures that lie at the end of the chromosome, protecting the genome from degradation. Under normal conditions, these telomeres shorten with every cell division. In addition, conditions like oxidative stress, inflammation, and environmental factors have been found to influence the rate of telomere attrition. Peripheral blood leukocyte telomere length (LTL) has been found to be a valuable marker for telomere length in other cells and has been suggested to be a useful indicator of biological age. Previously, research has shown that chronological age, irrespective of biological age, has been linked to AF risk. However, exploring the potential of LTL, a marker of biological aging on AF risk, has not been adequately investigated.
Recent observational studies have reported a link between leukocyte telomere shortening (LTS) and increased risk of AF. Contrarily, other studies have reported no similar associations. To determine whether there is a possible connection between LTL and the risk of AF, Zheng et al. performed a systematic review and meta-analysis of the available literature. Their analysis included 12 studies with more than 18,000 patients. Further analysis took place to determine the predictive value of LTL between different fibrillation types, AF definitions, and genders.
Results revealed that LTS was found to be a predictor of AF, as it was significantly associated with the condition. In addition, LTS significantly correlated with recurrent AF cases but not new-onset ones, highlighting the potential of LTS as a predictor of disease recurrence. Further analysis showed that LTS was a predictor of paroxysmal AF in addition to being an independent predictor for progression from paroxysmal AF to persistent AF. Results analysing gender and LTS-associated AF risk showed males to be at higher risk than females.
Based on the abovementioned results, the authors derived four main findings:
- Patients with LTS are more likely to develop AF.
- LTS acts as a predictor for AF recurrence.
- LTS and AF risk was more prominent in males.
- LTL attrition can predict disease progression.
The authors concluded that LTL shortening is a marker of biological aging that holds a significant value in predicting AF occurrence, recurrence, and progression. The predictive value is more prominent in males. Further research is needed to confirm the findings and explore the potential of LTS as a biomarker in AF patients.
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Dr. Ana Baroni MD. Ph.D.
Scientific & Medical Advisor
Quality Garant
Ana has over 20 years of consultancy experience in longevity, regenerative and precision medicine. She has a multifaceted understanding of genomics, molecular biology, clinical biochemistry, nutrition, aging markers, hormones and physical training. This background allows her to bridge the gap between longevity basic sciences and evidence-based real interventions, putting them into the clinic, to enhance the healthy aging of people. She is co-founder of Origen.life, and Longevityzone. Board member at Breath of Health, BioOx and American Board of Clinical Nutrition. She is Director of International Medical Education of the American College of Integrative Medicine, Professor in IL3 Master of Longevity at Barcelona University and Professor of Nutrigenomics in Nutrition Grade in UNIR University.
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