Clonal Hematopoiesis of Indeterminate Potential in Heart Failure.

Clonal Hematopoiesis of Indeterminate Potential in Heart Failure - RICO-HF.

This study is part of the Rico Macro-Project, a multidisciplinary research program promoted by FROM in collaboration with the ASST-PG23 and ATS Bergamo, aiming to investigate the role of clonal hematopoiesis on inflammation, studying in depth the mechanisms underlying the inflammatory process to determine their correlation with some important pathologies in different clinical fields (Hematology, Cardiology, Neurology, Pneumology, Gastroenterology, and Diabetology, etc.). In this context, the prospective observational study RICO-HF is developed.

The RICO HF is the first project focused on CHIP and inflammation in the area of Cardiology, specifically in HF.

CHIP is associated with a pro-inflammatory state and its mechanistic link to HF has been demonstrated in animal and cellular models, and in patient cohorts (14-24).

Although HF in humans has various causes, different pathophysiological mechanisms and heterogeneous clinical manifestations, the experimental and clinical data reported so far support the relevance of inflammatory cytokine production and signaling by immune cells in the pathogenesis of cardiac dysfunction and HF.

Inclusion Criteria:

• consecutive patients admitted to the Cardiology Unit of the ASST Papa Giovanni XXIII Hospital, Bergamo for acute HF and patients attending the outpatient HF clinic of the same hospital for chronic HF
• age >18 years
• written informed consent

Exclusion Criteria:

• chronic therapy with anti-inflammatories, steroids, immunomodulators, immunosuppressants, chemotherapeuthic agents
• previous heart transplant
• cardiogenic shock or cardiac arrest
• recent acute coronary syndrome (<3 months)
• current acute infection requiring specific treatment
• overt MPNs
• primary myelodysplastic syndromes
• malignant cancers
• non-cardiovascular co-morbidity reducing life expectancy to < 1 year
• any factor precluding 1-year follow-up