Kuo-Li Pan1,2, Ya-Wen Hsiao3, Yenn-Jiang Lin3,4, Li-Wei Lo3,4, Yu-Feng Hu3,4, Fa-Po Chung3,4, Yung-Nan Tsai3,4, Tze-Fan Chao3,4, Jo-Nan Liao3,4, Chin-Yu Lin3,4, Shih-Jie Jhuo5, Chung-Hsing Lin6, Allamsetty Suresh7, Rohit Walia8, Abigail Louise D Te9, Shinya Yamada10, Yao-Ting Chang3,4, Shih-Lin Chang3,4, Shih-Ann Chen3,4. 1. Division of Cardiology, Chang Gung Memorial Hospital. 2. School of Traditional Chinese Medicine, College of Medicine, Chang Gung University. 3. Division of Cardiology, Department of Medicine, Taipei Veterans General Hospital. 4. School of Medicine, Faculty of Medicine, National Yang-Ming University. 5. Division of Cardiology, Kaohsiung Medical University Hospital. 6. Division of Cardiology, Department of Internal Medicine, Shuang Ho Hospital, Taipei Medical University. 7. Department of Cardiology, Nizam's Institute of Medical Sciences. 8. Division of Cardiology, Medanta Heart Institute, Medanta The Medicity. 9. Heart Institute, St. Luke's Medical Center. 10. Department of Cardiology and Hematology, Fukushima Medical University.
Abstract
BACKGROUND: Telomere length is a biologic aging marker. This study investigated leukocyte telomere length (LTL) as a new biomarker to predict recurrence after paroxysmal atrial fibrillation (PAF) ablation.Methods and Results: A total of 131 participants (26 healthy individuals and 105 symptomatic PAF patients) were enrolled. PAF patients (54.1±10.8 years) who received catheter ablation therapy were divided into 2 groups: recurrent AF (n=25) and no recurrent AF after catheter ablation (n=80). Peripheral blood mononuclear cells were collected from all subjects to measure LTL. Under 50 years old, LTL in healthy individuals (n=17) was longer than in PAF patients (n=31; 7.34±0.58 kbp vs. 6.44±0.91 kbp, P=0.01). In PAF patients, LTL was positively correlated with left atrial bipolar voltage (R=0.497, P<0.001), and negatively correlated with biatrial scar area (R=-0.570, P<0.001) and left atrial diameter (R=-0.214, P=0.028). LTL was shorter in the patients with recurrent AF than in those without recurrent AF after catheter ablation (5.68±0.82 kbp vs. 6.66±0.71 kbp; P<0.001). On receiver operating characteristic curve analysis, LTL cut-off <6.14 kbp had a specificity of 0.68 and sensitivity of 0.79 to predict recurrent AF after catheter ablation. CONCLUSIONS: Young PAF patients (≤50 years) had shorter LTL. Shorter LTL was associated with a degenerative atrial substrate and recurrence after catheter ablation in younger PAF patients.
BACKGROUND: Telomere length is a biologic aging marker. This study investigated leukocyte telomere length (LTL) as a new biomarker to predict recurrence after paroxysmal atrial fibrillation (PAF) ablation.Methods and Results: A total of 131 participants (26 healthy individuals and 105 symptomatic PAF patients) were enrolled. PAF patients (54.1±10.8 years) who received catheter ablation therapy were divided into 2 groups: recurrent AF (n=25) and no recurrent AF after catheter ablation (n=80). Peripheral blood mononuclear cells were collected from all subjects to measure LTL. Under 50 years old, LTL in healthy individuals (n=17) was longer than in PAF patients (n=31; 7.34±0.58 kbp vs. 6.44±0.91 kbp, P=0.01). In PAF patients, LTL was positively correlated with left atrial bipolar voltage (R=0.497, P<0.001), and negatively correlated with biatrial scar area (R=-0.570, P<0.001) and left atrial diameter (R=-0.214, P=0.028). LTL was shorter in the patients with recurrent AF than in those without recurrent AF after catheter ablation (5.68±0.82 kbp vs. 6.66±0.71 kbp; P<0.001). On receiver operating characteristic curve analysis, LTL cut-off <6.14 kbp had a specificity of 0.68 and sensitivity of 0.79 to predict recurrent AF after catheter ablation. CONCLUSIONS: Young PAF patients (≤50 years) had shorter LTL. Shorter LTL was associated with a degenerative atrial substrate and recurrence after catheter ablation in younger PAF patients.