Growth-differentiation factor-15: a novel biomarker in patients with diastolic dysfunction?

Abstract

BACKGROUND:

Growth differentiation factor-15 (GDF-15), a stress-responsive transforming growth factor-ß-related cytokine, is elevated and independently related to an adverse prognosis in systolic heart failure.

OBJECTIVE:

This study aimed to investigate plasma levels of GDF-15 in patients with preclinical diastolic dysfunction or heart failure with normal ejection fraction (HFnEF).

METHODS:

We evaluated 119 patients with normal ejection fraction referred for an elective coronary angiography, 75 (63%) of whom had coronary artery disease. Subjects were classified as having either mild left ventricular diastolic dysfunction (LVDD grade I, n = 61), HFnEF (LVDD grade II or III, n = 38) or normal diastolic function (controls, n = 20). In a subgroup of 20 subjects, changes in cardiac output (CO) were measured by inert gas rebreathing (InnocorTM) in response to an orthostatic hemodynamic test.

RESULTS:

Growth differentiation factor-15 levels in HFnEF [median 1.08, interquartile range (0.88-1.30) ng/ml] were significantly higher than in controls [0.60 (0.50-0.71) ng/ml, p = 0.003] and in patients with LVDD grade I [0.78 (0.62-1.04) ng/ml, p < 0.001]. In addition, GDF-15 was significantly elevated in patients with LVDD grade I compared to controls (p = 0.003). Furthermore, GDF-15 was correlated with echocardiographic markers of diastolic dysfunction and was correlated with the magnitude of CO response to the change in body position from standing to supine (r = -0.67, p = 0.005).

CONCLUSION:

Growth differentiation factor-15 levels are elevated in subjects with HFnEF and can differentiate normal diastolic function from asymptomatic LVDD. In addition, GDF-15 is associated with a reduced cardiac output response in the orthostatic hemodynamic test.

• Authors: Wilfried Dinh, Reiner Füth, Mark Lankisch, Georg Hess, Dietmar Zdunek, Thomas Scheffold, Frank Kramer, Rolf Michael Klein, Michael Coll Barroso, Werner Nickl
• Journal: Arquivos brasileiros de cardiologia (Arq Bras Cardiol) Vol. 97 Issue 1 Pg. 65-75 (Jul 2011) ISSN: 1678-4170 [Electronic] Brazil
• PMID: 21584478 (Publication Type: Evaluation Study, Journal Article)

Chemical References

• Biomarkers
• Growth Differentiation Factor 15

Topics

• Aged
• Biomarkers (blood)
• Echocardiography
• Female
• Glucose Tolerance Test
• Growth Differentiation Factor 15 (blood)
• Heart Failure, Systolic (diagnosis, physiopathology)
• Hemodynamics (physiology)
• Humans
• Male
• Middle Aged
• Reference Values
• Statistics, Nonparametric
• Stroke Volume (physiology)