科研之友
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摘要
Background: Growth differentiation factor-15 (GDF-15) is a promising biomarker of cardiac remodeling. The purpose of this study was to explore the diagnostic value of plasma GDF-15 levels in different stages of heart failure (HF) and to assess the relationship with ventricular remodeling. Material/Methods: We enrolled 219 HF patients from the Department of Cardiology in Tianjin Union Medical Center as the HF group and 32 healthy subjects as the control group. Circulating GDF-15, NT-proBNP, procollagen I C-terminal propeptide (PICP), and N-terminal procollagen III propeptide (PIIINP) levels were measured using ELISA. Associations between GDF-15 and clinical indicators in cardiac remodeling were assessed using receiver operating characteristic (ROC) curves and Spearman correlation. All the patients were followed up for 1 year. Results: The level of plasma GDF-15 in HF patients was higher than in the control group (P< 0.05) and increased with higher ACCF/AHA and NYHA classification (P< 0.05). Patients with HFrEF had higher GDF-15 levels compared to patients with HFmrEF (P< 0.05). GDF-15 and left ventricular mass index (LVMI) were significantly increased as early as the pre-clinical HF stage. Also, GDF-15 levels were positively correlated to LVMI (r=0.433, P< 0.05), PICP (r=0.378, P< 0.001) and PIIINP (r=0.382, P< 0.001). ROC curves were constructed and GDF-15 plus NT-proBNP (AUC=0.905, 95% CI: 0.868-0.942, P< 0.001) was superior to NT-proBNP (AUC=0.869, 95% CI: 0.825-0.913, P< 0.001) in identifying HF. GDF-15 levels did not predict prognosis after a 1-year follow-up period. Conclusions: GDF-15 combined with NT-proBNP significantly improves the accuracy of diagnosing HF. Plasma GDF-15 levels can indirectly reflect the degree of cardiac remodeling and fibrosis.
