Abstract 12837: Growth Differentiation Factor-15 is a Useful Prognostic Marker in Patients With Heart Failure With Preserved Ejection Fraction
Introduction: Circulating growth differentiation factor 15 (GDF-15) levels correlate with diastolic dysfunction. To date, little is known about the prognostic impact of GDF-15 in patients with heart failure with preserved ejection fraction (HFpEF).
Hypothesis: In patients with HFpEF, GDF-15 could be a useful biomarker to predict future risk of cardiovascular events.
Methods and results: We measured serum GDF-15 levels in 150 patients with LV diastolic dysfunction (LVDD) with normal LVEF (>50%). LVDD was defined according to the ESC guideline. Serum GDF-15 concentrations were measured by ELISA. The endpoint of this study was major adverse cardiovascular events (MACE). These patients were divided into three tertiles based on GDF-15 levels. Serum GDF-15 levels were positively correlated with NYHA functional class (p≤0.0001), plasma BNP levels (p≤0.0001), and serum high sensitive troponin T levels (p=0.001) in all study participants. Then, we divided patients into HFpEF or LVDD groups according to the presence or absence of HF. Serum GDF-15 levels in HFpEF group were significantly higher than those in LVDD group (median 4215.1, interquartile range [3382.4-5287.1] vs. 3091.5, [2487.9-4217.8] pg/ml, p≤0.0001). Kaplan-Meier curve revealed that the risk of MACE was significantly increased with higher tertiles of GDF-15 when we analyzed all study population (log-rank test p=0.0002) or only in HFpEF group (p=0.021). Multivariate Cox hazard analysis identified age (hazard ratio [HR]: 0.90; 95% confidence interval [CI]: 0.85-0.96, p≤0.001), atrial fibrillation (HR: 10.26; 95% CI: 2.93-35.96, p≤0.001), BNP (ln[BNP]) (HR: 2.90; 95% CI: 1.55-5.43, p=0.001), E/e’ (HR: 1.18; 95% CI: 1.07-1.31, p=0.001), and GDF-15 (ln[GDF-15]) (HR: 5.43; 95% CI: 1.43-20.62, p=0.01) as independent predictors of primary endpoints.
Conclusions: GDF-15 could be a useful prognostic biomarker in patients with HFpEF.
- © 2013 by American Heart Association, Inc.