Evidence map›Paper›PMID 39689933›Full record

ArticleHeart (British Cardiac Society)2025

Leucocyte telomere length and conduction system ageing.

Stefan van Duijvenboden, Christopher P Nelson, Zahra Raisi-Estabragh, Julia Ramirez, Michele Orini, Qingning Wang, Nay Aung, Veryan Codd, Svetlana Stoma, Elias Allara and 7 more

Abstract read
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In one paragraph

Article in Heart (British Cardiac Society), 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 3 papers.

0numbers the graph read from it
0cells of the map it votes in
3citing papers in PubMed
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

3 citing papers in PubMed.

  1. Article
  2. Review
  3. Article
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

17 authors.

Stefan van Duijvenboden *Nuffield Department of Population Health, University of Oxford, Oxford, UK stefan.vanduijvenboden@ndph.ox.ac.uk.ORCID 0000-0001-8897-558X
Christopher P Nelson *Department of Cardiovascular Sciences, University of Leicester, Leicester, UK.
Zahra Raisi-EstabraghWilliam Harvey Research Institute, Barts and The London Faculty of Medicine and Dentistry, Queen Mary University of London, London, UK.ORCID 0000-0002-7757-5465
Julia RamirezWilliam Harvey Research Institute, Barts and The London Faculty of Medicine and Dentistry, Queen Mary University of London, London, UK.
Michele OriniInstitute of Cardiovascular Science, UCL, London, UK.ORCID 0000-0001-5773-0344
Qingning WangDepartment of Cardiovascular Sciences, University of Leicester, Leicester, UK.
Nay AungWilliam Harvey Research Institute, Barts and The London Faculty of Medicine and Dentistry, Queen Mary University of London, London, UK.
Veryan CoddDepartment of Cardiovascular Sciences, University of Leicester, Leicester, UK.
Svetlana StomaDepartment of Cardiovascular Sciences, University of Leicester, Leicester, UK.
Elias AllaraDepartment of Public Health and Primary Care, University of Cambridge, Cambridge, UK.
Angela M WoodDepartment of Public Health and Primary Care, University of Cambridge, Cambridge, UK.ORCID 0000-0002-7937-304X
Emanuele Di AngelantonioDepartment of Public Health and Primary Care, University of Cambridge, Cambridge, UK.
John DaneshDepartment of Public Health and Primary Care, University of Cambridge, Cambridge, UK.
Nicholas C HarveyMRC Lifecourse Epidemiology Unit, University of Southampton, Southampton, Hampshire, UK.
Steffen E PetersenWilliam Harvey Research Institute, Barts and The London Faculty of Medicine and Dentistry, Queen Mary University of London, London, UK.ORCID 0000-0003-4622-5160
Patricia B MunroeWilliam Harvey Research Institute, Barts and The London Faculty of Medicine and Dentistry, Queen Mary University of London, London, UK.
Nilesh J SamaniDepartment of Cardiovascular Sciences, University of Leicester, Leicester, UK.

Funding

British Heart Foundation FS/17/81/33318, RG/18/13/33946British Heart Foundation MR/M012816/1Medical Research Council MC_PC_21001, MR/N025083/1Medical Research Council MC_PC_21003Medical Research Council MC_UP_A620_1015Medical Research Council MC_UU_12011/2Wellcome Trust
6 · The paper itself

Abstract

backgroundDeterioration of the cardiac conduction system is an important manifestation of cardiac ageing. Cellular ageing is accompanied by telomere shortening and telomere length (TL) is often regarded as a marker of biological ageing, potentially adding information regarding conduction disease over and above chronological age. We therefore sought to evaluate the association between leucocyte telomere length (LTL) on two related, but distinct aspects of the cardiac conduction system: ECG measures of conduction (PR interval and QRS duration) and incident pacemaker implantation in a large population-based cohort.

methodsIn the UK Biobank, we measured PR interval and QRS duration from signal-averaged ECG waveforms in 59 868 and 62 266 participants, respectively. Incident pacemaker implantation was ascertained using hospital episode data from 420 071 participants. Associations with LTL were evaluated in (Cox) multivariable regression analyses adjusted for potential confounders. Putative causal effects of LTL were investigated by mendelian randomisation (MR).

resultsMean PR interval and QRS duration were 144.2 ms (± 20.4) and 92.3 ms (± 7.8), respectively, and there were 7169 (1.7%) incident pacemaker implantations, during a median follow-up period of 13.6 (IQR 1.5) years. LTL was significantly associated with PR interval (0.19 ms (95% CI: 0.03 to 0.35), per 1 SD shorter LTL, p=0.021), but not QRS duration. After adjusting for age, sex and cardiovascular risk factors, shorter LTL remained associated with an increased risk for incident pacemaker implantation (HR per SD decrease in LTL: 1.03 (95% CI: 1.01 to 1.06), p=0.012). MR analysis showed a trend towards an association of shorter LTL with longer PR interval and higher risk of pacemaker implantation but was likely to be underpowered.

conclusionsShorter LTL was significantly, and possibly causally, associated with prolongation of atrioventricular conduction and pacemaker implantation, independent of traditional cardiovascular risk factors. Our findings support further research to explore the role of ageing on cardiac conduction beyond chronological age.

Indexed as

AgingHeart Conduction SystemLeukocytesTelomereTelomere ShorteningAgedAged, 80 and overElectrocardiographyFemaleHumansMaleMendelian Randomization AnalysisMiddle AgedPacemaker, ArtificialRisk FactorsUnited KingdomElectrophysiologyEpidemiologyGenetics

Identifiers

PMID39689933
PMCPMC12015050

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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.