Key result
Higher KDMAge biological age acceleration linked to ~55% greater mortality risk per SD in HFpEF.
Why the study?
Accelerated biological aging is linked to adverse cardiovascular events, but its role in heart failure with preserved ejection fraction remains unclear.
Does biological aging acceleration predict mortality and left ventricular dysfunction in patients with HFpEF?
Cohort (n=1,727)
No
Does biological aging acceleration predict mortality and left ventricular dysfunction in patients with HFpEF?
Accelerated biological aging is significantly associated with increased all-cause and cardiovascular mortality, as well as left ventricular dysfunction, in patients with HFpEF.
May refine mortality risk stratification in HFpEF; leaves open whether targeting biological aging improves outcomes.
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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Xu et al. (2025) conducted a cohort in Heart failure with preserved ejection fraction (HFpEF) (n=1,727). Biological age acceleration (KDMAge) vs. Lower biological age acceleration was evaluated on All-cause mortality (HR 1.55, 95% CI 1.40-1.72, p=<0.001). Per 1-SD increase in KDMAge biological age acceleration was associated with a significantly higher risk of all-cause mortality (HR 1.55) in patients with heart failure with preserved ejection fraction.
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