1. Cardiac-Referenced Leukocyte Telomere Length and Outcomes After Cardiovascular Surgery
- Author
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Stephanie A. Fox, Michael W.A. Chu, Linrui Guo, Fuyan Li, Brittany Balint, John Michael Arpino, Oula Akawi, Bob Kiaii, Caroline O'Neil, Jorge A. Wong, J. Geoffrey Pickering, Hao Yin, Alanna Watson, A. Dave Nagpal, and Mackenzie A. Quantz
- Subjects
bp, base pair ,0301 basic medicine ,medicine.medical_specialty ,CLINICAL RESEARCH ,Population ,Disease ,030204 cardiovascular system & hematology ,law.invention ,surgery ,03 medical and health sciences ,PCR, polymerase chain reaction ,0302 clinical medicine ,telomere shortening ,law ,medicine ,In patient ,Atrium (heart) ,education ,risk ,education.field_of_study ,business.industry ,Atrial tissue ,TL, telomere length ,ΔTLRA-L, right atrium-leukocyte TL difference ,HR, hazard ratio ,ICU, intensive care unit ,Intensive care unit ,Surgery ,Telomere ,CI, confidence interval ,OR, odds ratio ,030104 developmental biology ,medicine.anatomical_structure ,Right atrium ,Cardiology and Cardiovascular Medicine ,business ,atrium - Abstract
Visual Abstract, Highlights • Short leukocyte telomeres have been associated with adverse cardiovascular outcomes in population studies, but this relationship has not translated to patient care. The authors report a telomere length autologous referencing strategy that has the potential to mark biological aging and to identify high-risk individuals. • Among 163 patients who underwent cardiovascular surgery, telomeres in leukocytes and skeletal muscle displayed age-related shortening, whereas the telomere length in the cardiac right atrium was stable during 6 decades of life. • The magnitude of the telomere length gap between cardiac atrial tissue and leukocytes was associated with post-operative complications and length of stay in the intensive care unit. • This study provided proof of concept that a single-time, internally referenced assessment of leukocyte telomere shortening behavior could inform acute risks in patients with cardiovascular disease., Summary Leukocyte telomere shortening reflects stress burdens and has been associated with cardiac events. However, the patient-specific clinical value of telomere assessment remains unknown. Moreover, telomere shortening cannot be inferred from a single telomere length assessment. The authors investigated and developed a novel strategy for gauging leukocyte telomere shortening using autologous cardiac atrial referencing. Using multitissue assessments from 163 patients who underwent cardiovascular surgery, we determined that the cardiac atrium-leukocyte telomere length difference predicted post-operative complexity. This constituted the first evidence that a single-time assessment of telomere dynamics might be salient to acute cardiac care.
- Published
- 2018