# Association of clonal hematopoiesis of indeterminate potential with myocardial characteristic differences in non-ischemic heart failure

## TL;DR

This study finds that clonal hematopoiesis of indeterminate potential (CHIP) is linked to specific heart tissue changes in non-ischemic heart failure patients.

## Contribution

The study is one of the first to link CHIP mutations with cardiac MRI characteristics in non-ischemic heart failure.

## Key findings

- Patients with CHIP mutations had higher native T1 and extracellular volume fraction on cardiac MRI.
- Late gadolinium enhancement was more pronounced in patients with CHIP mutations.
- CHIP mutations did not affect short-term left ventricular reverse remodeling.

## Abstract

Clonal hematopoiesis of indeterminate potential (CHIP) is an aging process associated with the prognosis in heart failure (HF), regardless of etiology. This study investigated the association between CHIP and myocardial tissue characteristics in patients with non-ischemic HF. We enrolled 95 patients diagnosed with non-ischemic HF with a left ventricular ejection fraction (LVEF) of ≤40 % who underwent cardiac magnetic resonance imaging (MRI) within 3 months of diagnosis. Next-generation sequencing was performed to determine the presence of CHIP-related mutations. Transthoracic echocardiography was performed to evaluate left ventricular reverse remodeling. CHIP was identified in 15 patients. Patients with CHIP-mutation had higher native T1, extracellular volume fraction, and late gadolinium enhancement quantification (LGE). After adjusting for age and sex, CHIP mutations remained as contributing factors to the differences in cardiac MRI mapping values. However, no difference was observed in left ventricular reverse remodeling by CHIP within 1 year. This study demonstrated CHIP’s association with higher mapping values and LGE on cardiac MRI. However, its impact on short-term LV reverse remodeling in non-ischemic HF patients was attenuated, indicating the need for further research on its long-term effect.

In non-ischemic HFrEF, patients with CHIP mutations, such as native T1, ECV, and T2, have higher mapping values on cardiac MRI performed during diagnosis than those without CHIP mutations.CHIP, clonal hematopoiesis of indeterminate potential; ECV, extracellular volume; HFrEF, heart failure with reduced ejection fraction.Image 1