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Assmus, Birgit; Cremer, Sebastian; Kirschbaum, Klara; Culmann, David; Kiefer, Katharina; Dorsheimer, Lena; Rasper, Tina; Abou-El-Ardat, Khalil; Herrmann, Eva; Berkowitsch, Alexander; Hoffmann, Jedrzej; Seeger, Florian; Mas-Peiro, Silvia; Rieger, Michael A; Dimmeler, Stefanie; Zeiher, Andreas M

Clonal haematopoiesis in chronic ischaemic heart failure: prognostic role of clone size for DNMT3A- and TET2-driver gene mutations

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  • Medientyp: E-Artikel
  • Titel: Clonal haematopoiesis in chronic ischaemic heart failure: prognostic role of clone size for DNMT3A- and TET2-driver gene mutations
  • Beteiligte: Assmus, Birgit; Cremer, Sebastian; Kirschbaum, Klara; Culmann, David; Kiefer, Katharina; Dorsheimer, Lena; Rasper, Tina; Abou-El-Ardat, Khalil; Herrmann, Eva; Berkowitsch, Alexander; Hoffmann, Jedrzej; Seeger, Florian; Mas-Peiro, Silvia; Rieger, Michael A; Dimmeler, Stefanie; Zeiher, Andreas M
  • Erschienen: Oxford University Press (OUP), 2021
  • Erschienen in: European Heart Journal
  • Sprache: Englisch
  • DOI: 10.1093/eurheartj/ehaa845
  • ISSN: 0195-668X; 1522-9645
  • Entstehung:
  • Anmerkungen:
  • Beschreibung: <jats:title>Abstract</jats:title> <jats:sec> <jats:title>Aims</jats:title> <jats:p>Somatic mutations of the epigenetic regulators DNMT3A and TET2 causing clonal expansion of haematopoietic cells (clonal haematopoiesis; CH) were shown to be associated with poor prognosis in chronic ischaemic heart failure (CHF). The aim of our analysis was to define a threshold of variant allele frequency (VAF) for the prognostic significance of CH in CHF.</jats:p> </jats:sec> <jats:sec> <jats:title>Methods and results</jats:title> <jats:p>We analysed bone marrow and peripheral blood-derived cells from 419 patients with CHF by error-corrected amplicon sequencing. Cut-off VAFs were optimized by maximizing sensitivity plus specificity from a time-dependent receiver operating characteristic (ROC) curve analysis from censored data. 56.2% of patients were carriers of a DNMT3A- (N = 173) or a TET2- (N = 113) mutation with a VAF &amp;gt;0.5%, with 59 patients harbouring mutations in both genes. Survival ROC analyses revealed an optimized cut-off value of 0.73% for TET2- and 1.15% for DNMT3A-CH-driver mutations. Five-year-mortality was 18% in patients without any detected DNMT3A- or TET2 mutation (VAF &amp;lt; 0.5%), 29% with only one DNMT3A- or TET2-CH-driver mutations above the respective cut-off level and 42% in patients harbouring both DNMT3A- and TET2-CH-driver mutations above the respective cut-off levels. In carriers of a DNMT3A mutation with VAF ≥ 1.15%, 5-year mortality was 31%, compared with 18% mortality in those with VAF &amp;lt; 1.15% (P = 0.048). Likewise, in patients with TET2 mutations, 5-year mortality was 32% with VAF ≥ 0.73%, compared with 19% mortality with VAF &amp;lt; 0.73% (P = 0.029).</jats:p> </jats:sec> <jats:sec> <jats:title>Conclusion</jats:title> <jats:p>The present study defines novel threshold levels for clone size caused by acquired somatic mutations in the CH-driver genes DNMT3A and TET2 that are associated with worse outcome in patients with CHF.</jats:p> </jats:sec>
  • Zugangsstatus: Freier Zugang