Ischemic heart disease and cardiac arrhythmia are associated with increased cardiac aging

Ischemic heart disease (IHD) and cardiac arrhythmia (CA) patients experience alterations in cardiac structure and function which can speed up cardiac aging. Estimating biological heart age using cardiac magnetic resonance (CMR) and electrocardiogram (ECG)-derived phenotypes provides a biomarker for cardiac aging. We investigated the impact of IHD and CA on cardiac aging using biological age estimation biomarkers, and the role of age-related cardiac changes and vascular risk factors (VRF)s using data from United Kingdom Biobank. Cardiac age was estimated in prevalent IHD (n = 2,142) and CA (n = 1,683) subjects using a Bayesian ridge regression model with CMR radiomics and ECG features. Heart age gap (HAG), the difference between predicted and chronological heart age, was calculated. Mediation analysis explored CMR metrics as mediators in the HAG-cardiac disease association. The association of HAG and VRFs in each disease cohort was also analysed. IHD subjects had significantly increasing heart age (HAG: 1.55 years ± 5.66; p < 0.001), as did CA individuals (HAG: 1.57 years ± 5.77; p < 0.001). Conventional CMR metrics describing normal age-related changes partially mediated the effect of disease on HAG. High adiposity contributed most to increasing HAG in IHD, followed by hypertension. Hypertension had the greatest impact on cardiac aging, followed by high cholesterol in CA.