Authors:	Göbel, Sebastian Braun, A. S. Hahad, Omar Henning, Urs von Brandt, Moritz Keller, Karsten Gaida, M. M. Gori, Tommaso Schultheiss, Heinz-Peter Escher, Felicitas Münzel, Thomas Wenzel, Philip
Title:	Etiologies and predictors of mortality in an all-comer population of patients with non-ischemic heart failure
Online publication date:	24-Jan-2024
Year of first publication:	2024
Language:	english
Abstract:	Background Despite progress in diagnosis and therapy of heart failure (HF), etiology and risk stratification remain elusive in many patients. Methods The My Biopsy HF Study (German clinical trials register number: DRKS22178) is a retrospective monocentric study investigating an all-comer population of patients with unexplained HF based on a thorough workup including endomyocardial biopsy (EMB). Results 655 patients (70.9% men, median age 55 [45/66] years) with non-ischemic, non-valvular HF were included in the analyses. 489 patients were diagnosed with HF with reduced ejection fraction (HFrEF), 52 patients with HF with mildly reduced ejection fraction (HFmrEF) and 114 patients with HF with preserved ejection fraction (HFpEF). After a median follow-up of 4.6 (2.5/6.6) years, 94 deaths were enumerated (HFrEF: 68; HFmrEF: 8; HFpEF: 18), equating to mortality rates of 3.3% and 11.6% for patients with HFrEF, 7.7% and 15.4% for patients with HFmrEF and 5.3% and 11.4% for patients with HFpEF after 1 and 5 years, respectively. In EMB, we detected a variety of putative etiologies of HF, including incidental cardiac amyloidosis (CA, 5.8%). In multivariate logistic regression analysis adjusting for age, sex and comorbidities only CA, age and NYHA functional class III + IV remained independently associated with all-cause mortality (CA: HRperui 3.13, 95% CI 1.5–6.51; p = 0.002). Conclusions In an all-comer population of patients presenting with HF of unknown etiology, incidental finding of CA stands out to be independently associated with all-cause mortality. Our findings suggest that prospective trials would be helpful to test the added value of a systematic and holistic work-up of HF of unknown etiology.
DDC:	610 Medizin 610 Medical sciences
Institution:	Johannes Gutenberg-Universität Mainz
Department:	FB 04 Medizin
Place:	Mainz
ROR:	https://ror.org/023b0x485
DOI:	http://doi.org/10.25358/openscience-9959
Version:	Published version
Publication type:	Zeitschriftenaufsatz
License:	CC BY
Information on rights of use:	https://creativecommons.org/licenses/by/4.0/
Journal:	Clinical research in cardiology Version of Record (VoR)
Publisher:	Springer
Publisher place:	Berlin
Issue date:	2024
ISSN:	1861-0692
Publisher DOI:	10.1007/s00392-023-02354-6
Appears in collections:	DFG-491381577-H