Heart failure & cardiomyopathies

Prognostic Significance of Somatic Mutations in Myeloid Cells of Men with Chronic Heart Failure – Interaction Between Loss of Y Chromosome and Clonal Haematopoiesis

Eur J Heart FailPublished Prospective cohort study

Authors' conclusion

Somatic mutations in blood cells-particularly LOY-are associated with increased mortality in male CHF patients, with LOY emerging as an independent prognostic marker.

Study context

Population
Men with chronic HF across the full spectrum of LVEF
Participants
781 men
Exposure
LOY and/or DNMT3A/TET2 clonal haematopoiesis of indeterminate potential (CHIP) mutations vs none
Outcome
All-cause mortality
Methodological detailsvalidation cohort, single-cell RNA sequencing
  • Validation cohort
  • Single-cell RNA sequencing

Main finding

As reported in the abstract

  • LOY independently predicted all-cause mortality in heart failure with reduced ejection fraction (HFrEF)
  • Co-occurrence of LOY and DNMT3A/TET2 mutations further increased mortality among CHIP carriers
  • Detrimental prognostic effect of LOY confirmed in a validation cohort of HFrEF patients

Observational data: associations, not effects.

Further findings

Co-occurrence of LOY and CHIP mutations, men >70 years

LOY and CHIP mutations increased with age and co-occurred
27.1%

Single-cell RNA sequencing of PBMCs (HFrEF, ischaemic HF)

LOY monocytes: elevated pro-fibrotic signalling (↑ S100A8, TLR2, CLEC4D; ↓ SMAD7, TGIF2)
LOY + DNMT3A: enhanced pro-inflammatory gene expression (S100A8, HMGB2, IFNGR1, TRIM56, CD84)

Original publication

Prognostic Significance of Somatic Mutations in Myeloid Cells of Men with Chronic Heart Failure – Interaction Between Loss of Y Chromosome and Clonal Haematopoiesis. Eur J Heart Fail. Published 24 July 2025. doi:10.1002/ejhf.3778

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