关于白细胞端粒长度(LTL)和中间心血管表型与不良心血管结局的关联的证据尚无定论。这项研究评估了这些与心血管成像的关系,心电图,以及心源性猝死(SCD)的风险,冠状动脉事件,心力衰竭(HF)入院。我们对2006年至2010年间注册的英国生物银行参与者进行了横断面分析。使用定量聚合酶链反应测量LTL。使用电子健康记录来确定SCD的发生率,冠状动脉事件,和HF入场。使用心血管磁共振成像和机器学习进行心血管测量。LTL与SCD的关联,冠状动脉事件,以及HF入院和心脏磁共振成像,对33,043和19,554名参与者的心电图参数进行多因素回归分析。中位(四分位距)随访期为11.9(11.2-12.6)年。对2023年1月至5月的数据进行了分析。在403,382名没有冠状动脉疾病或HF的白人参与者中,男性181,637人(45.0%),平均年龄57.1岁。LTL与SCD风险呈独立负相关(LTL第三四分位数与第一四分位数:风险比[HR]:0.81,95%置信区间[CI]:0.72-0.92),冠状动脉事件(LTL第三四分位数与第一四分位数:HR:0.88,95%CI:0.84-0.92),和HF入院(LTL第四四分位数与第一四分位数:HR:0.84,95%CI:0.74-0.95)。LTL也独立地与心脏重塑正相关,特别是左心室质量指数,左心室收缩末期和舒张末期容积,左心室平均心肌壁厚度,左心室每搏输出量,并随心电图沿T轴的负度变化。横断面研究结果显示,中年时LTL与心脏大小和心功能呈正相关,但是心电图结果没有显示这些关联,这可以解释LTL与SCD风险之间的负相关,冠状动脉事件,和英国生物银行参与者的HF入学。
The evidence about the associations of leukocyte telomere length (LTL) and intermediary cardiovascular phenotypes with adverse cardiovascular outcomes is inconclusive. This study assessed these relationships with cardiovascular imaging, electrocardiography, and the risks of sudden cardiac death (SCD), coronary events, and heart failure (HF) admission. We conducted a cross-sectional analysis of UK Biobank participants enrolled between 2006 and 2010. LTL was measured using quantitative polymerase chain reactions. Electronic health records were used to determine the incidence of SCD, coronary events, and HF admission. Cardiovascular measurements were made using cardiovascular magnetic resonance imaging and machine learning. The associations of LTL with SCD, coronary events, and HF admission and cardiac magnetic resonance imaging, electrocardiogram parameters of 33,043 and 19,554 participants were evaluated by multivariate regression. The median (interquartile range) follow-up period was 11.9 (11.2-12.6) years. Data was analyzed from January to May 2023. Among the 403,382 white participants without coronary artery disease or HF, 181,637 (45.0%) were male with a mean age of 57.1 years old. LTL was independently negatively associated with a risk of SCD (LTL third quartile vs first quartile: hazard ratio [HR]: 0.81, 95% confidence interval [CI]: 0.72-0.92), coronary events (LTL third quartile vs first quartile: HR: 0.88, 95% CI: 0.84-0.92), and HF admission (LTL fourth quartile vs first quartile: HR: 0.84, 95% CI: 0.74-0.95). LTL was also independently positively associated with cardiac remodeling, specifically left ventricular mass index, left-ventricular-end systolic and diastolic volumes, mean left ventricular myocardial wall thickness, left ventricular stroke volume, and with electrocardiogram changes along the negative degree of T-axis. Cross-sectional study results showed that LTL was positively associated with heart size and cardiac function in middle age, but electrocardiography results did not show these associations, which could explain the negative association between LTL and risk of SCD, coronary events, and HF admission in UK Biobank participants.