Biological aging, left ventricular dysfunction and mortality in patients with heart failure with preserved ejection fraction.

Xinghao Xu, Zihao Huang, Xingfeng Xu, Menghui Liu, Rihua Huang, Zhenyu Xiong, Yue Guo, Shaozhao Zhang, Ziwei Zhou, Ziyue Tang, Xinxue Liao, Xiaodong Zhuang

Department of Cardiology, The First Affiliated Hospital of Sun Yat-Sen University, Guangzhou, China.Department of Cardiology, The First Affiliated Hospital of Sun Yat-Sen University, Guangzhou, China. · pubmed

Paper

Abstract

Accelerated biological aging (BA) is linked to adverse cardiovascular events, but its role in heart failure with preserved ejection fraction (HFpEF) remains unclear. We analyzed 1,727 HFpEF patients from RED-CARPET Study (ChiCTR2000039901), assessing BA using Klemera-Doubal and PhenoAge methods. During a median 4.9-year follow-up, 321 all-cause and 180 cardiovascular deaths occurred. After full adjustment, per 1-SD increase in BA acceleration showed significantly higher risk of all-cause mortality (KDMAge HR 1.55, 95% CI 1.40-1.72; PhenoAge HR 1.24, 95% CI 1.11-1.40) and cardiovascular mortality (KDMAge HR 1.47, 95% CI 1.28-1.69; PhenoAge HR 1.21, 95% CI 1.04-1.41). BA acceleration was also significantly related to increased left ventricular mass index (LVMI), relative wall thickness, and E/e' ratio. Mediation analysis revealed that both LVMI and the E/e' ratio partially mediated the relationship between BA acceleration and mortality. These findings suggest BA acceleration may serve as a key prognostic marker in patients with HFpEF.

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Research summary

Accelerated biological aging is associated with increased mortality risk in patients with heart failure with preserved ejection fraction. The study addresses biological aging as a potential prognostic marker, which aligns with longevity research by exploring the underlying mechanisms of aging and their impact on health outcomes.

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