Adaptive Anti-Myocardial Immune Response Following Hospitalization for Acute Heart Failure

Figure 1. Study flow. N = 47 patients hospitalized for acute heart failure were analysed for the presence of anti‐myocardial antibodies (AMyA). The red drop symbol indicates the time points of venous blood sampling. Twenty patients provided pairs of venous samples at index hospitalization (i.e. baseline). Out of those, n = 12 were AMyA negative at Day 3; none of these patients exhibited altered AMyA titres during the index hospitalization. However, 15 patients who had been AMyA negative at baseline had generated new AMyA titres 6 months later (F6). All patients were followed for 18 months (F18) to collect endpoint information. The lower part of the figure illustrates the qualitative course of AMyA (positive +; negative −) from baseline to F6 in the total study population.

Figure 2. Status of expression of anti‐myocardial antibodies at baseline (BL) and at the 6 month follow‐up visit (F6) in patients with acute heart failure and reduced (HFrEF, n = 23) vs. preserved (HFpEF, n = 24) left ventricular ejection fraction. +/+, anti‐myocardial antibodies (AMyA) titre positive at BL and F6; −/−, AMyA titre negative at BL and F6; −/+, AMyA titre newly developed between BL and F6.

Figure 3. Event‐free survival (hospitalization for heart failure or death) observing the 12 month period between 6 (F6) and 18 months (F18) after discharge from the index hospitalization. Groups composed by the presence of anti‐myocardial autoantibodies (AMyA) at baseline (BL) and F6 in n = 47 patients, who had been hospitalized for acute heart failure (AHF) at baseline (index hospitalization). HR, hazard ratio.