Telomere length and outcome in heart failure.
BACKGROUND
Telomeres are causally involved in senescence. Senescence is a potential factor in the pathogenesis and progression of heart failure. In heart failure telomeres are shorter, but the prognostic value associated with telomere length has not been defined.


METHODS
Telomere length was prospectively determined by quantitative polymerase chain reaction in 890 patients with New York Heart Association (NYHA) functional class II to IV heart failure. After 18 months, we examined the association between telomere length and the predefined primary end-point: time to death or hospitalization for heart failure.


RESULTS
Mean age of the patients was 71 years, 39% were women, 51% were in NYHA class II, and 49% were in class III/IV. A total of 344 patients reached the primary end-point (130 deaths and 214 hospitalizations). Patients with shorter telomeres were at an increased risk of reaching the primary end-point (hazard ratio 1.79; 95% confidence interval (CI) 1.21-2.63). In multivariate analysis shorter telomere length remained associated with a higher risk for death or hospitalization (hazard ratio, 1.74; 95% CI 1.07-2.95) after adjustment for age of heart failure onset, gender, hemoglobin, renal function, and N-terminal pro-B-type natriuretic peptide level, a history of stroke, atrial fibrillation, and diabetes.


CONCLUSIONS
Shorter length of telomeres predicts the occurrence of death or hospitalization in patients with chronic heart failure.
van der Harst
Pim
P
Department of Cardiology, University Medical Center Groningen, University of Groningen, Hanzeplein 1, 9700 RB Groningen, The Netherlands. p.van.der.harst@thorax.umcg.nl
de Boer
Rudolf A
RA
Samani
Nilesh J
NJ
Wong
Liza S M
LS
Huzen
Jardi
J
Codd
Veryan
V
Hillege
Hans L
HL
Voors
Adriaan A
AA
van Gilst
Wiek H
WH
Jaarsma
Tiny
T
van Veldhuisen
Dirk J
DJ
D000368:Aged; D000369:Aged, 80 and over; D001281:Atrial Fibrillation / Q000150:complications / Q000378:metabolism; D048909:Diabetes Complications / Q000378:metabolism; D005260:Female; D006333:Heart Failure / Q000401:mortality* / Q000503:physiopathology*; D006801:Humans; D008297:Male; D020097:Natriuretic Peptide, Brain / Q000378:metabolism; D011379:Prognosis; D020521:Stroke / Q000150:complications / Q000378:metabolism; D016615:Telomere / Q000235:genetics / Q000378:metabolism*
D020097:Natriuretic Peptide, Brain